1
|
Berberi AN. Immediate Placement and Loading of Maxillary Single-Tooth with Scalloped Shape Implants and Digitalized Customized Restoration: A 5-Year Prospective Study of Marginal Bone Level. Int J Oral Maxillofac Implants 2024; 0:1-25. [PMID: 38728146 DOI: 10.11607/jomi.10965] [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: 05/12/2024] Open
Abstract
PURPOSE To evaluate, within a period of 5 years, the bone level in mesial, distal, palatal, and buccal areas around scalloped shape implants immediately placed and loaded with temporary crowns fixed on final prefabricated abutments, and also to evaluate the thickness of buccal bone. MATERIALS AND METHODS 18 implants were inserted and loaded immediately using computer-assisted design/computer-assisted manufacturing technology on 18 patients to replace single tooth in the esthetic part of the maxilla. The marginal bone level across the scalloped implant neck was measured mesially and distally using intraoral standardized radiographs after crown fixations and 1, 3, and 5 years later. Cone beam computed tomography para-axial cuts images were used to measure bone level buccally and palatally from the implant neck to the implant-to bone contact after 5 years of loading and to evaluate the thickness of the buccal bone at the implant neck and 4 mm apically, immediately after implant placement and 5 years later. RESULTS All implants were assessed clinically and radiologically after 5 years. No implant failure was recorded, and the average marginal bone variation on mesial and distal sites was 0.114 ± 0.135 mm at crown cementation, 0.239 ± 0.158 mm 1 year later, 0.233 ± 0.182 mm 3 years later, and 0.180 ± 0.182 mm 5 years later. Our findings indicate that at T0, the average thickness of the buccal bone was 2.27 mm at implant neck M0 (ranging from 1.9 to 2.4) and 2.33 mm at 4 mm apically to the implant neck M1 (ranging from 1.9 mm to 2.9 mm). By T4, the mean had decreased to 1.94 mm at M0 (with a range of 1.7 mm to 2.3 mm) and 2.14 mm at M1 (with a range of 1.8 mm to 2.4 mm). After 5 years the mean changes at buccal and palatal bone for all implants were +0.187 ± 0.52 mm and +0.06 ± 0.38 mm respectively. Minor prosthetic problems were observed over the five years: incisal ceramic chipping occurred in two crowns, and two crowns were replaced for esthetic reasons after one year. No loosening of crowns or abutments was reported. CONCLUSIONS Scalloped neck implants demonstrated a comparable behavior to regular neck implants with similar designs in an immediate implantation and temporization protocol over a five-year period.
Collapse
|
2
|
Marković A, Todorović A, Glišić M, Marković J, Ilić B, Janjić B, Mišić T, Trifković B, Vučić U, Šćepanović M, Dard MM. Immediate versus early loading of immediately placed bone-level tapered dental implants with hydrophilic surface in full arch maxillary rehabilitation: A pilot randomized clinical trial with 2-year follow-up. Clin Implant Dent Relat Res 2024. [PMID: 38693759 DOI: 10.1111/cid.13334] [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: 12/13/2023] [Revised: 02/21/2024] [Accepted: 04/12/2024] [Indexed: 05/03/2024]
Abstract
This study aimed to compare implant stabilities between the immediate and early loaded, immediately placed bone-level tapered dental implants in the maxilla and to evaluate marginal bone loss (MBL), oral health-related quality of life (OHRQoL), and patient satisfaction at a 2-year follow-up. A pilot, prospective, randomized, controlled clinical trial was conducted on 24 maxillary failing dentition patients. The bone-level tapered implants of 12 patients were immediately loaded with temporary restorations, while the other 12 patients did not receive any kind of temporization. Implant-supported screw-retained complete porcelain-fused-to-metal prostheses were delivered to all patients in the seventh postoperative week. The insertion torque values of implants assigned to the immediate and early loading groups were 33.0 ± 4.87 and 29.26 ± 8.31 Ncm, respectively. The dynamics of implant stability changes from implant placement up to a 2-year follow-up were similar for both groups (Penguin®, p = 0.268; Ostell®, p = 0.552), while the MBL was at submillimeter level. The cumulative implant survival rate was 91.80% for immediately loaded implants and 97.22% for early loaded implants, without significant difference (p = 0.162). The total score on the Oral Health Impact Profile questionnaire significantly decreased over time in both groups, indicating improvement in OHRQoL (p < 0.001), and the high level of patient satisfaction remained after 2 years of function regardless of a loading protocol. Both loading protocols, immediate and early, of six immediately placed bone-level tapered dental implants are an adequate treatment choice for fixed rehabilitation of the maxillary failing dentition.
Collapse
Affiliation(s)
- Aleksa Marković
- Implant Center, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Ana Todorović
- Implant Center, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Mirko Glišić
- Clinic of Prosthodontics, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Jovana Marković
- Implant Center, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Branislav Ilić
- Clinic of Oral surgery, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Bojan Janjić
- Clinic of Oral surgery, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Tijana Mišić
- Clinic of Oral surgery, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Branka Trifković
- Implant Center, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Uroš Vučić
- Clinic of Oral surgery, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Miodrag Šćepanović
- Implant Center, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Michel M Dard
- Columbia University, College of Dental Medicine, New York, New York, USA
- Institut Straumann, Basel, Switzerland
| |
Collapse
|
3
|
Park JY, Strauss FJ, Schiavon L, Patrizi A, Cha JK, Lee JS, Jung R, Jung UW, Thoma D. Immediate loading on two adjacent single dental implants with definitive nonsplinted restorations: A proof of concept in the posterior zone. J ESTHET RESTOR DENT 2024. [PMID: 38591169 DOI: 10.1111/jerd.13235] [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: 01/12/2024] [Revised: 03/14/2024] [Accepted: 03/28/2024] [Indexed: 04/10/2024]
Abstract
OBJECTIVES To evaluate clinical, clinician- and patient-reported outcomes (PROs) of two adjacent single posterior implants immediately loaded with definitive single crowns up to 1 year. Ten patients in need of two adjacent posterior single implants were included. All implants were placed applying a fully digital workflow. Definitive screw-retained single zirconia crowns were delivered within 72 h after implant placement. Clinical parameters, patient- and clinician-reported outcomes were assessed up to 1 year of follow-up. CLINICAL CONSIDERATIONS Clinical outcomes remained stable, with no implant failures or technical and biological complications throughout the observation period. Patient satisfaction was very high at baseline (crown delivery) and remained consistently high at 6 and 12 months of follow-up. Crown insertion 3 days after implant placement was rated as an easy procedure by clinicians. CONCLUSIONS Two adjacent single implants with immediate definitive restorations (<72 h) in the posterior region appear to be a viable and easy treatment option to shorten the overall treatment time and potentially enhancing patient satisfaction. However, randomized controlled trials are needed to confirm the advantages of this treatment protocol over a delayed loading approach. CLINICAL SIGNIFICANCE In selected cases, immediate implant loading with definitive restorations in the posterior region appears a valuable and straightforward option to shorten the overall treatment time.
Collapse
Affiliation(s)
- Jin-Young Park
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
| | - Franz-Josef Strauss
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Faculty of Dentistry, Universidad Finis Terrae, Santiago, Chile
| | - Lucia Schiavon
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Department of Neurosciences, Dentistry Section, University of Padova, Padova, Italy
| | - Andrea Patrizi
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Jae-Kook Cha
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
| | - Jung-Seok Lee
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
| | - Ronald Jung
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Ui-Won Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
| | - Daniel Thoma
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| |
Collapse
|
4
|
Fernandes G, Mysore A, Shetye O, Aras M, Chitre V. Customizing the Emergence Profile Around an Immediately Loaded Single Implant in the Esthetic Zone: A Case Report. Cureus 2024; 16:e58279. [PMID: 38752070 PMCID: PMC11094412 DOI: 10.7759/cureus.58279] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2024] [Indexed: 05/18/2024] Open
Abstract
An optimal esthetic result is essential for an implant-supported restoration in the anterior zone. In the esthetic zone, providing immediate interim restorations following implant surgery has been proposed as a reliable and desirable treatment approach. A well-contoured interim restoration following implant placement minimizes hard and soft tissue changes in the peri-implant zone. This in turn has the potential to enhance the esthetic outcome and, therefore, patient satisfaction. Multiple prosthetic and surgical aspects need to be carefully planned and executed to achieve the intended final result. This is a report describing the steps involved in recontouring the gingiva to achieve an optimal emergence profile following the immediate loading of a single implant in the esthetic zone.
Collapse
Affiliation(s)
- Grazina Fernandes
- Department of Prosthodontics and Crown and Bridge, Goa Dental College and Hospital, Bambolim, IND
| | - Ashwin Mysore
- Department of Prosthodontics and Crown and Bridge, Goa Dental College and Hospital, Bambolim, IND
| | - Omkar Shetye
- Department of Oral and Maxillofacial Surgery, Goa Dental College and Hospital, Bambolim, IND
| | - Meena Aras
- Department of Prosthodontics and Crown and Bridge, Goa Dental College and Hospital, Bambolim, IND
| | - Vidya Chitre
- Department of Prosthodontics and Crown and Bridge, Goa Dental College and Hospital, Bambolim, IND
| |
Collapse
|
5
|
Amato F, Spedicato GA. Immediate loading of implants inserted through impacted teeth in the aesthetic area: A retrospective study with a mean follow-up period of 7 years. Int J Oral Implantol (Berl) 2024; 17:75-86. [PMID: 38501400] [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: 03/20/2024]
Abstract
PURPOSE To evaluate the survival and success rate of and the incidence of complications affecting implants inserted and immediately loaded in sites where an impacted tooth was present in the maxilla. MATERIALS AND METHODS A total of 10 patients were treated and 14 implants were inserted, 4 in healed sites and 10 in extraction sites. The implant site preparation started in the crestal bone and continued in the enamel and dentine of the impacted tooth. The radiographic depth of implant penetration into the impacted tooth, peri-implant soft tissue and hard tissue condition at the 1-year follow-up and the last follow-up appointment, marginal bone loss at the 1-year follow-up and the last follow-up appointment, and the final aesthetic result were evaluated. RESULTS The implants healed uneventfully with an adequate hard and soft tissue response and no adverse clinical or radiographic signs or symptoms. They were in function for a minimum of 3 and a maximum of 11 years (mean 7.2 years). CONCLUSION Although further studies with a larger sample size are required to validate this unconventional approach, it can be considered a valuable clinical option to replace teeth in an area of impaction.
Collapse
|
6
|
Liu Y, He F, Zhao Y, Sun Q, Xia H, Xia D, Bai Y. Immediate versus Non- immediate Loading Protocols for Reduced-diameter Implants Supporting Overdentures: A Systematic Review and Meta-analysis. Int J Oral Maxillofac Implants 2024; 0:5100637. [PMID: 38498788 DOI: 10.11607/jomi.10625] [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: 03/20/2024] Open
Abstract
OBJECTIVE This systematic review aimed to compare the influence of immediate and non-immediate loading protocols on overdentures retained by reduced-diameter implants(≦3.5mm). METHODS Electronic databases, including MEDLINE (via PubMed), Embase and the Cochrane Central Register of Controlled Trials were searched for randomized controlled trials (RCTs) comparing clinical outcomes of immediately and nonimmediately loaded reduced-diameter implants supported overdentures. The risk of bias within and across the studies and the certainty of evidence were assessed by RoB 2.0 and GRADE, respectively. Sensitivity analysis was performed by eliminating studies at high risk of bias, and repeating the data synthesis employing the randomeffect model. Subgroup analyses were conducted based on the implant diameter and the length of follow-up. RESULTS Six RCTs with 255 patients were included in this systematic review. The meta-analyses found similar implant survival rates between immediate and nonimmediate loaded implants in mini implant (RR=0.98; 95% CI=0.95, 1.01; p=0.12) and narrow implant subgroups (RR=0.99, 95% CI=0.94, 1.03, p =0.56), as well as in short-term (RR=0.98, 95% CI=0.97, 1.00, p =0.11) and long-term (RR=0.97, 95% CI=0.93, 1.01, p =0.09) follow-up subgroups. Additionally, marginal bone loss (MBL) showed no statistically significant difference between the loading protocols in the subgroup of long-term follow-up (MD=0.03; 95%CI=-0.16, 0.23; p=0.74). Three RCTs investigating peri-implant parameters found relatively higher modified plaque index and probing depth in reduced-diameter implant under immediate loading. CONCLUSION Compared with non-immediate loading, the immediately loading protocol can achieve comparable survival rates and MBL in reduced-diameter implant retained overdentures.
Collapse
|
7
|
Ahn JH, Lim YJ, Lee J, Baek YW, Kim MJ, Kwon HB. A One-Year Randomized Controlled Clinical Trial of Three Types of Narrow-Diameter Implants for Fixed Partial Implant-Supported Prosthesis in the Mandibular Incisor Area. Bioengineering (Basel) 2024; 11:272. [PMID: 38534546 DOI: 10.3390/bioengineering11030272] [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: 02/18/2024] [Revised: 03/05/2024] [Accepted: 03/07/2024] [Indexed: 03/28/2024] Open
Abstract
Narrow-diameter implants (NDI) serve as a solution for treating limited bone volume in the anterior mandible. This study aimed to evaluate the one-year clinical outcomes of various NDIs in the mandibular incisor area after immediate loading in partially edentulous patients. This single-center, prospective, single-blinded, randomized controlled trial study included 21 patients, with 7 patients in each of the following groups: control (BLT NC SLActive®; Straumann), experimental group 1 (CMI IS-III Active® S-Narrow; Neobiotech), and experimental group 2 (CMI IS-III Active® Narrow; Neobiotech). Using full digital flow, two fixtures were placed in each patient and immediately provisionalized on the day of surgery. Evaluations encompassed periapical radiographs, implant stability quotient (ISQ), implant stability test (IST) readings, per-implant soft tissue health, patient satisfaction surveys, and esthetic score assessments. Definitive prostheses were delivered twelve weeks post-surgery (CRiS, number: KCT0007300). Following exclusions due to low stability values (n = 2), fixture failure (n = 5), and voluntary withdrawal (n = 1), the implant success rate for patients completing all clinical protocols stood at 100%. The resulting patient failure rates in the control, experimental group 1, and experimental group 2 were 50.0%, 42.9%, and 14.3%, respectively. There were no significant differences between the groups in terms of marginal bone loss, soft tissue health, patient satisfaction, and esthetic scores. Narrow implants showed superior clinical outcomes, followed by S-Narrow and Straumann implants. Calculated one-year survival rates at the implant level were 66.7% for the control group, 85.7% for experimental group 1, and 100% for experimental group 2. All three types of NDIs showed acceptable clinical and radiographic results during the year-long observation period.
Collapse
Affiliation(s)
- Ji-Ho Ahn
- Department of Prosthodontics and Dental Research Institute, School of Dentistry, Seoul National University, Seoul 03080, Republic of Korea
| | - Young-Jun Lim
- Department of Prosthodontics and Dental Research Institute, School of Dentistry, Seoul National University, Seoul 03080, Republic of Korea
| | - Jungwon Lee
- Department of Periodontology, One-Stop Specialty Center, Seoul National University Dental Hospital, Seoul 03080, Republic of Korea
| | - Yeon-Wha Baek
- Department of Prosthodontics, Gwanak Center, Seoul National University Dental Hospital, Seoul 08826, Republic of Korea
| | - Myung-Joo Kim
- Department of Prosthodontics and Dental Research Institute, School of Dentistry, Seoul National University, Seoul 03080, Republic of Korea
| | - Ho-Beom Kwon
- Department of Prosthodontics and Dental Research Institute, School of Dentistry, Seoul National University, Seoul 03080, Republic of Korea
| |
Collapse
|
8
|
Uesugi T, Shimoo Y, Munakata M, Kataoka Y, Sato D, Yamaguchi K, Sanda M, Fujimaki M, Nakayama K, Watanabe T, Malo P. A Study of the Associated Risk Factors for Early Failure and the Effect of Photofunctionalisation in Full-Arch Immediate Loading Treatment Based on the All-on-Four Concept. Bioengineering (Basel) 2024; 11:223. [PMID: 38534497 DOI: 10.3390/bioengineering11030223] [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: 01/05/2024] [Revised: 02/18/2024] [Accepted: 02/21/2024] [Indexed: 03/28/2024] Open
Abstract
Early implant failure occurring within 1 year after implantation has been attributed to various factors. Particularly, early failure can lead to challenges in maintaining a full-arch prosthetic device, necessitating prompt intervention, including reoperation. This study aimed to retrospectively examine implant- and patient-related factors and the effects of photofunctionalisation associated with early failure in patients who underwent treatment using the all-on-four concept in both the maxilla and mandible. We conducted this retrospective study comprising 561 patients with 2364 implants who underwent implant-supported immediate loading with fixed full-arch rehabilitation using the all-on-four concept. We aimed to assess the survival rate within 1 year after implantation and determine the risk factors influencing early failure. The 1-year survival rates after implantation were 97.1% (patient level) and 98.9% (implant level) for the maxilla and 98.5% (patient level) and 99.6% (implant level) for the mandible. There was a significant difference in the implant-level survival rates between the maxilla and mandible, with a lower rate in the maxilla (p = 0.043). The risk factors associated with early implant failure according to the all-on-four concept included the maxilla (implant level) and smoking (patient level). We could not find a significant effect of photofunctionalisation on early failure (p = 0.25) following this treatment protocol.
Collapse
Affiliation(s)
- Takashi Uesugi
- Malo Dental & Medical Tokyo, Tokyo 104-0061, Japan
- Department of Implant Dentistry, Showa University School of Dentistry, Tokyo 145-8515, Japan
| | - Yoshiaki Shimoo
- Malo Dental & Medical Tokyo, Tokyo 104-0061, Japan
- Department of Implant Dentistry, Showa University School of Dentistry, Tokyo 145-8515, Japan
| | - Motohiro Munakata
- Department of Implant Dentistry, Showa University School of Dentistry, Tokyo 145-8515, Japan
| | - Yu Kataoka
- Department of Oral Biomaterials and Technology, Showa University School of Dentistry, Tokyo 142-8555, Japan
| | - Daisuke Sato
- Department of Implant Dentistry, Showa University School of Dentistry, Tokyo 145-8515, Japan
| | - Kikue Yamaguchi
- Department of Implant Dentistry, Showa University School of Dentistry, Tokyo 145-8515, Japan
| | - Minoru Sanda
- Department of Prosthodontics, Showa University School of Dentistry, Tokyo 145-8515, Japan
| | | | | | - Tae Watanabe
- Malo Dental & Medical Tokyo, Tokyo 104-0061, Japan
| | - Paulo Malo
- Malo Dental & Medical Tokyo, Tokyo 104-0061, Japan
| |
Collapse
|
9
|
Diez-Fraile A, Barbier L, Abeloos J. Maxillary bone augmentation with calvarial bone graft for immediate full-arch rehabilitation: Insights from a 10-year proof-of-concept retrospective analysis. Clin Oral Implants Res 2024; 35:201-219. [PMID: 38050349 DOI: 10.1111/clr.14215] [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: 06/28/2023] [Revised: 11/13/2023] [Accepted: 11/14/2023] [Indexed: 12/06/2023]
Abstract
OBJECTIVE Evaluate the long-term outcomes of full-arch rehabilitation using immediate dental implant placement and continuous functional loading with full-fixed dental prostheses (FFDPs). MATERIALS AND METHODS Fifty-six patients received temporary implants (n = 327) at maxillary augmentation with calvarial bone. A provisional acrylic FFDP was immediately loaded onto these implants. After 6 months, the temporary implants were replaced with definitive implants (n = 326) and immediately loaded with a second provisional FFDP (N = 55). Subsequently, a baseline radiograph was taken following a 6-month healing period. The second bridge was then substituted with a definitive FFDP. Primary outcomes included peri-implant marginal bone level (MBL) and definitive implant survival. Secondary outcomes evaluated provisional implant and prostheses survival, complications, and patient satisfaction. RESULTS The provisional implants had a survival rate of 97.9%. One patient was excluded from further analysis due to loss of temporary implants and first FFDP. The definitive implant survival rate after 10 years was 92.2%, with a moderate but significant decrease in MBL between baseline radiography and 10 years later (-0.08 ± 0.18 vs. -0.24 ± 0.44). However, large individual variations were observed, with 65.8% of implants showing no bone loss and 9.2% showing loss ≥0.5 mm. Sinusitis was experienced by 14.3% of patients upon surgery. Patient satisfaction was high or reported no issues after protocol completion (80%). One patient lost all six definitive implants and definitive FFDP 8.2 years after implant placement. CONCLUSIONS The described protocol can be regarded as a long-term, highly successful method for full-arch rehabilitation of atrophied maxillae while enabling continuous masticatory and speaking functionality.
Collapse
Affiliation(s)
- Araceli Diez-Fraile
- Division of Maxillo-Facial Surgery, Department of Surgery, General Hospital of Sint-Jan, Bruges, Belgium
| | - Lieven Barbier
- Training Center for Dental Students of KU Leuven, General Hospital of Sint-Jan, Bruges, Belgium
| | - Johan Abeloos
- Division of Maxillo-Facial Surgery, Department of Surgery, General Hospital of Sint-Jan, Bruges, Belgium
| |
Collapse
|
10
|
Kumar M, Sah RP, Kumari R, Rupam RK, Priya P, Jha M. Aesthetic Outcome and Patient Perception of Immediate vs. Delayed Loading of Implant-Supported Single Crowns: A Randomized Controlled Trial. J Pharm Bioallied Sci 2024; 16:S446-S448. [PMID: 38595602 PMCID: PMC11001033 DOI: 10.4103/jpbs.jpbs_704_23] [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: 08/19/2023] [Revised: 08/25/2023] [Accepted: 08/29/2023] [Indexed: 04/11/2024] Open
Abstract
Background This randomized controlled trial aimed to compare the aesthetic outcome and patient perception of immediate versus DL of implant-supported single crowns. Methods A total of 60 patients with a single missing tooth were enrolled and randomly assigned to two groups: immediate loading (IL) and delayed loading (DL). Each group consisted of 30 patients with a total of 30 implants. In the IL group, crowns were loaded onto implants immediately after placement, while in the DL group, a healing period of 3 months was observed before crown placement. Aesthetic outcome was assessed using the Pink Esthetic Score (PES) for soft tissue and the White Esthetic Score (WES) for the crown. Patient perception was evaluated through a visual analog scale (VAS) for satisfaction, comfort, and overall experience. Results The IL group demonstrated comparable aesthetic outcomes to the DL group, with mean PES and WES scores of 10.2 ± 1.5 and 8.7 ± 1.2, respectively, in the IL group, and 10.5 ± 1.3 and 8.5 ± 1.4 in the DL group. Patient perception in terms of satisfaction, comfort, and overall experience was similarly high in both groups, with VAS scores above 8 for each parameter. Conclusion This randomized controlled trial suggests that both IL and DL of implant-supported single crowns result in favorable aesthetic outcomes and high levels of patient satisfaction.
Collapse
Affiliation(s)
- Mukesh Kumar
- Assistant Professor, Department of Dentistry, Sri Krishna Medical College and Hospital, Uma Nagar, Muzaffarpur, Bihar, India
| | - Ram Prasad Sah
- Department of Oral and Maxillofacial Surgery, Menhi Hospital, Line Bazar Chowk, Purnea, Bihar, India
| | - Rakhi Kumari
- Senior Resident, Department of Dentistry, Government Medical College and Hospital, Purnea, Bihar, India
| | - Rupam Kumari Rupam
- Department of Periodontology and Implantology, Mithila Minority Dental College and Hospital, Darbhanga, Bihar, India
| | - Priya Priya
- Department of Prosthodontics Crown and Bridge, Mithila Minority Dental College and Hospital, Darbhanga, Bihar, India
| | - Monalisha Jha
- Department of Conservative Dentistry and Endodontics, Mithila Minority Dental College and Hospital, Darbhanga, Bihar, India
| |
Collapse
|
11
|
Albiero AM, Bevilacqua L, Pegoraro F, Turco G, Momic S, Di Lenarda R, Maglione M. Mechanical and fatigue resistance of restorations supported by welded-framework and realized using computer-aided designed prosthetic shells: In vitro pilot study. Proc Inst Mech Eng H 2024; 238:250-256. [PMID: 38189276 DOI: 10.1177/09544119231221189] [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] [Indexed: 01/09/2024]
Abstract
Resin coating in implants rehabilitation cannot always be aesthetic, durable and comfortable for the patient mainly due to the limited dimensions of the final structure. Intraoral welding technique and computer-aided designed prosthetic shells may be a solution. This in vitro study evaluates the capacity of load and the weakest point of implant-supported provisional prosthesis using welded titanium framework. Twelve samples were produced to simulate an implant supported fixed prosthetic bridge. Two implants (Ankylos; Dentsply Sirona Implants; Germany) were inserted inside blocks of nanoceramic material produced with a stereolithographic 3D printer. A polymethylmethacrylate (PMMA) resin shell was performed with CAD/CAM and relined on welded framework. Six samples were produced with the same procedure reducing resin thickness. The samples were subjected to fatigue test (6,500,000 cycles) using ElectroForce 3310 fatigue machine (t1); subsequently a mechanical compression test using a universal Shimadzu AGS-X 10 machine (t2). The samples were analyzed with a photographic and radiographic documentation at t0, t1 and t2. The samples survived mechanical fatigue test without evidence of failure. The radiographic and photographic evaluation revealed the fracture of resin coating after the mechanical compression test. The samples with minimal resin thickness fractured first. Adequate assessment of the resin thickness is mandatory to improve the longevity of these rehabilitations. CAD-CAM digital prosthetic design allows us to optimize the thicknesses and the prosthetic shapes, allowing us to obtain good degrees of resistance even in the presence of reduced prosthetic spaces.
Collapse
Affiliation(s)
| | | | - Federica Pegoraro
- Department of Medical Sciences, University of Trieste, Trieste, Italy
| | - Gianluca Turco
- Department of Medical Sciences, University of Trieste, Trieste, Italy
| | | | | | - Michele Maglione
- Department of Medical Sciences, University of Trieste, Trieste, Italy
| |
Collapse
|
12
|
Todaro C, Cerri M, Rodriguez y Baena R, Lupi SM. Lower Jaw Full-Arch Restoration: A Completely Digital Approach to Immediate Load. Healthcare (Basel) 2024; 12:332. [PMID: 38338217 PMCID: PMC10855469 DOI: 10.3390/healthcare12030332] [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: 11/28/2023] [Revised: 01/08/2024] [Accepted: 01/24/2024] [Indexed: 02/12/2024] Open
Abstract
The digital transformation has revolutionized various sectors, including dentistry. Dentistry has emerged as a pioneer in embracing digital technologies, leading to advancements in surgical and prosthetic oral healthcare. Immediate loading for full-arch edentulous dental implants, once debated, is now widely accepted. This case report describes a 74-year-old patient with dental mobility and significant bone loss who was rehabilitated using a Toronto Bridge protocol on four dental implants with immediate loading. Digital planning, surgical guides, 3D printing, and precision techniques were employed. The surgery involved implant placement and prosthetic procedures. The patient reported minimal post-operative discomfort, and after four months, the definitive prosthesis was successfully placed. This case demonstrates the efficacy of immediate loading in complex dental scenarios with digital innovation, resulting in improved patient outcomes. The full digital workflow, including 3D printing and the use of modern materials, enhances the efficiency and predictability of oral rehabilitation, marking a transformative era in dental care. The integration of digital technology in all phases of treatment, from diagnosis to finalization, makes this approach safer, reliable, and efficient, thereby benefiting both patients and clinicians.
Collapse
Affiliation(s)
- Claudia Todaro
- School of Dentistry, Department of Clinical Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy; (R.R.y.B.); (S.M.L.)
| | - Michael Cerri
- Private Practice, 29011 Borgonovo Val Tidone, Italy;
| | - Ruggero Rodriguez y Baena
- School of Dentistry, Department of Clinical Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy; (R.R.y.B.); (S.M.L.)
| | - Saturnino Marco Lupi
- School of Dentistry, Department of Clinical Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy; (R.R.y.B.); (S.M.L.)
| |
Collapse
|
13
|
Ayna M, Jepsen S. A Retrospective Evaluation of 5 Years of Clinical Results of Metal-Ceramic vs. Monolithic Zirconia Superstructures in Maxillary All-on-4 TM Concept. J Clin Med 2024; 13:557. [PMID: 38256690 PMCID: PMC10816938 DOI: 10.3390/jcm13020557] [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: 12/06/2023] [Revised: 01/01/2024] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
The aim of the current study was to present the clinical and radiological outcomes of monolithic zirconia superstructures compared to the metal-ceramic ones in the All-on-4 concept for the prosthetic rehabilitation of the maxillae. A total of 30 patients were subdivided into groups according to their superstructure type (metal-ceramic (n = 15) or monolithic zirconia (n = 15)). All implants were functionally loaded within 24 h after insertion with provisional acrylic superstructures. Prosthetic complications, marginal bone loss, plaque accumulation, probing pocket depth, bleeding on probing, and bite force were documented over a period of 5 years. Marginal bone loss around the implants of the ceramic group remained well over the five years (1.21 ± 0.23 mm). However, marginal bone loss was significantly lower around the implants in the monolithic zirconia group (0.22 ± 0.14 mm) (p < 0.001). Bleeding on probing, plaque accumulation, and probing pocket depth values were correlated with marginal bone loss. Among all evaluated parameters, no differences could be detected in terms of the angulation of the implants. Detachment or chipping was observed in seven cases in the metal-ceramic superstructure group. In all cases, dentures were removed and repaired in the laboratory. In the monolithic zirconia group, chipping was detected after one year in two cases, after two years in four cases, and after five years in one case and could be managed by polishing in situ. Monolithic zirconia superstructures presented superior results regarding the parameters evaluated.
Collapse
Affiliation(s)
- Mustafa Ayna
- Department of Periodontology, University Hospital Bonn, University Bonn, 53127 Bonn, Germany;
| | | |
Collapse
|
14
|
Pelekanos S, Ntovas P, Rizou V, Pozzi A. Translucent monolithic zirconia titanium-supported FP1 full-arch prosthesis: A novel proof of concept to address esthetic, functional, and biologic challenges. J ESTHET RESTOR DENT 2024; 36:197-206. [PMID: 37975525 DOI: 10.1111/jerd.13167] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 09/14/2023] [Revised: 10/31/2023] [Accepted: 11/02/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVE Despite the wide clinical use of translucent zirconia for full-arch implant prostheses, reduced flexural strength and fracture toughness compared with high-strength opaque zirconia needs to be addressed. A novel proof of concept for FP1 full-arch prosthesis featured by translucent monolithic zirconia and titanium framework was presented. CLINICAL CONSIDERATIONS Computer-guided implant planning and surgery were executed and digitally designed FP1 temporary prosthesis prefabricated. Implant and prosthetic placement were achieved with a set of three-dimensional (3D)-printed templates. Implants were immediately loaded. After 4 months intraoral optical scan was taken to record implant coordinates, soft tissue anatomy, and temporary FP1 prosthesis. A novel digital workflow was used to design and mill overlaying translucent zirconia and anatomically shaped titanium framework with a scalloped soft-tissue interface. Final FP1 prosthesis was assembled cementing zirconia jacket on titanium counterpart. CONCLUSIONS Translucent zirconia supported by titanium framework can address esthetic and mechanical requirements of FP1 full-arch prosthesis, minimizing risk of fracture and providing a rigid and passive joint with supporting implants. The smooth and highly polished titanium surface with an anatomic design, tightly matching scalloped soft tissue interface, can limit food impaction, air and saliva leakage and contribute to overall biologic integration of FP1 full-arch prosthesis. CLINICAL SIGNIFICANCE Translucent monolithic zirconia featured with anatomically shaped titanium framework with scalloped transmucosal part, combining a pleasant esthetic outcome with increased flexural strength and fracture toughness, may be indicated to increase the clinical performance of FP1 full-arch prosthesis.
Collapse
Affiliation(s)
| | - Panagiotis Ntovas
- Department of Prosthodontics, Tufts University, School of Dental Medicine, Boston, Massachusetts, USA
| | | | - Alessandro Pozzi
- Department of Clinical Science and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
- Department of Restorative, Sciences Augusta University, Augusta, Georgia, USA
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| |
Collapse
|
15
|
Passos L, de Vasconcellos AB, Kanashiro L, Kina S. The natural CAD/CAM anterior implant single tooth restoration: A novel digital workflow. J ESTHET RESTOR DENT 2023; 35:1194-1204. [PMID: 37449557 DOI: 10.1111/jerd.13073] [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: 01/31/2023] [Revised: 05/14/2023] [Accepted: 06/05/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVE To report a novel digital workflow to replace an anterior maxillary tooth lost due to trauma with an implant multilayer restoration by using the patient's extracted tooth as a final crown restoration using computer-aided design/computer-aided manufacturing (CAD/CAM) technology. CLINICAL CONSIDERATIONS Instead of using the patient's natural tooth as an immediate provisional restoration to achieve predictable results in terms of esthetics and soft tissue structure, a novel digital strategy was performed to obtain a natural final crown restoration by using the patient's tooth associated with a lithium disilicate customized implant abutment. CONCLUSIONS The perspective of using this strategic approach for implant restorative dental treatments in patients with traumatic root fractures in the anterior region has great potential as it helps to maintain the emergence profile of the natural dentition and esthetics. CLINICAL SIGNIFICANCE Optimal esthetic outcomes are challenging in implant dentistry regarding soft tissue structure and morphology factors. Using natural teeth from surgery to deliver the final restoration might be beneficial when an anterior tooth is lost due to trauma.
Collapse
Affiliation(s)
- Leandro Passos
- Operative Dentistry & Biomaterials, Division of Comprehensive Oral Health, Adams School of Dentistry, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Adalberto Bastos de Vasconcellos
- Operative Dentistry & Biomaterials, Division of Comprehensive Oral Health, Adams School of Dentistry, University of North Carolina, Chapel Hill, North Carolina, USA
| | | | | |
Collapse
|
16
|
García-Gil I, Cortés-Bretón Brinkmann J, Martínez Ferrero M, Sánchez-Monescillo A, Peláez Rico J, Suárez-García MJ. Implant-supported full-arch rehabilitation with immediate loading using two different digital impression techniques: a case report with 2-year follow-up. Quintessence Int 2023; 54:844-851. [PMID: 37162311 DOI: 10.3290/j.qi.b4083477] [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: 05/11/2023]
Abstract
Immediate full-arch loading is a highly complex and technique-sensitive procedure. Digital impression techniques aim to replace conventional analog systems to carry out dental treatments in a more predictive, safer, and less time-consuming way. This case report describes a patient with a guarded periodontal prognosis, who was rehabilitated with implant-supported fixed prostheses after full-mouth extractions. Immediate full-arch loading was performed by means of two digital impression systems: photogrammetric technology with PIC dental in the maxillary arch, and MedicalFit in the mandible. Immediate provisional prostheses in acrylic resin (polymethyl methacrylate) were milled and placed within 12 hours after implant placement surgeries. Both provisional structures fitted properly providing adequate esthetics and function. After the implant osseointegration period, final digital impressions were registered, and definitive zirconia full-arch implant-supported prostheses were delivered. The 24-month follow-up did not show biologic or mechanical complications.
Collapse
|
17
|
Mazzoni A, Pellegrino G, Breccia C, Di Bene P, Mattoli R, Bonifazi L, Barausse C, Felice P. A new impression reference technique to simplify the digital workflow for immediate loading zygomatic implant-supported rehabilitation. Int J Oral Implantol (Berl) 2023; 16:305-313. [PMID: 37994818] [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: 11/24/2023]
Abstract
Zygomatic implant-supported rehabilitation has grown in popularity for use in clinical practice. Although many studies have been carried out into the surgical procedure, the prosthetic workflow is not clearly defined and standard techniques are not readily applied; thus, a digital approach may ultimately streamline the procedure. In the present study, the authors examined a digital workflow for immediately loaded prostheses supported by zygomatic implants. The novel technique proposed by the present authors, involving use of an impression reference, achieved promising results in terms of accuracy and procedural simplification.
Collapse
|
18
|
Singh R, Desai SR, Manjunath RGS. Influence of implant design and length on stress distribution in immediately loaded implants in posterior maxilla - A two-dimensional finite element analysis. J Indian Soc Periodontol 2023; 27:600-606. [PMID: 38434497 PMCID: PMC10906790 DOI: 10.4103/jisp.jisp_531_22] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 11/16/2023] [Accepted: 11/17/2023] [Indexed: 03/05/2024] Open
Abstract
Aim The aim of this two dimensional (2D) finite element analysis study was to evaluate the influence of implant design (step and tapered) and length on stress distribution at bone implant interface, when placed in maxillary posterior bone under immediate loading protocol. Materials and Methods 2D finite element models were developed to simulate the two types of implant designs, i.e., Tapered and step implants of 3.75-mm - Diameter and 6 and 10 mm lengths, respectively. Maxillary posterior bone quality (D4 bone) was simulated with a very thin cortical bone (0.5 mm) for the placement of implants. The respective material properties were assigned. The implant designs incorporated microthreads at the crestal part and rest of the implant body incorporated Acme threads. Forces of 100 Newtons were applied vertically and in oblique direction (at an angle of 45°) to long axis of the implants. Total deformation (micromovements), stresses and strains were evaluated at the bone implant interface. Results The results of micromovements, stresses and strains were found to be lower for long implants as compared to short implants. Also, all the values were found to be higher for oblique loads as compared to vertical loads. The von mises stress values were highest for 6 mm step implants and lowest for 10 mm step implants. Conclusion In the presence of low bone density with optimal bone height, standard diameter long step implants can be used. Incorporation of microthreads at the crestal portion and acme threads for body portion of the implant presents a good option to be used under immediate loading protocol.
Collapse
Affiliation(s)
- Rika Singh
- Department of Periodontology and Implantology, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | - Shrikar R. Desai
- Department of Periodontology and Implantology, H. K. E. Society’s, S. Nijalingappa Institute of Dental Sciences and Research, Kalaburagi, Karnataka, India
| | | |
Collapse
|
19
|
Ates G, Bilhan H, Sulun T, Dayan SC, Geckili O, Tuncer N. Comparative Evaluation of Survival Rates and Marginal Bone Levels of Nonsplinted Immediately Loaded Interforaminal Mandibular Implant-Retained Overdentures: A Randomized Controlled Clinical Trial with 5-Year Results. Int J Oral Maxillofac Implants 2023; 38:954-962. [PMID: 37847837 DOI: 10.11607/jomi.10129] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2023] Open
Abstract
PURPOSE Τo evaluate and compare the marginal bone loss (MBL), survival rates, and periodontal parameters of immediately loaded implants with either Dolder bar or Locator attachments placed in the interforaminal region of edentulous mandibles. MATERIALS AND METHODS A total of included 19 patients with edentulous mandibles each received two implants in the interforaminal area of the symphysis. Randomly allocated Dolder bar or Locator attachments were then attached immediately, and both clips and a framework were fastened to the denture by the dental laboratory within 24 hours. RESULTS A total of 28 subjects with 56 implants were treated in accordance with the immediate-loading study protocol. Of these, 9 patients were lost to follow-up; 1 patient reported a serious illness and 8 patients moved and couldn't be reached. The 19 subjects not lost to follow-up (11 women and 8 men; average age: 68 years) were included. Every patient received either two Locator abutments and were assigned to group A (7 patients; 36.8%) or two multiunit abutments and were assigned to group B (12 patients; 63.2%). No implant failure was detected for either group, and therefore the survival rate for both groups was 100% after 5 years. After 5 years without any symptoms, 2 implants from group A and 7 implants from group B showed > 2 mm of MBL, which makes the group A success rate 85.7% and the group B success rate 70.8%. Modified sulcular bleeding index (mSBI) did not differ significantly at any of the measurement intervals. However, the modified plaque index (mPI) of group B was significantly higher than group A at the 60-month follow-up. CONCLUSION It can be concluded that either splinting or not splinting the immediately loaded interforaminal implants to retain mandibular overdentures (OVDs) does not affect marginal bone levels after 5 years and immediate loading of nonsplinted implants with Locator attachments can be safely preferred to retain mandibular OVDs.
Collapse
|
20
|
Velasco-Ortega E, Carretero-Barrado L, Moreno-Muñoz J, Ortiz-García I, Núñez-Márquez E, Rondón-Romero JL, López-López J, Jiménez-Guerra Á, Monsalve-Guil L. Immediate Loading of Implants with Fixed Rehabilitations in Geriatric Edentulous Patients; Biological Complications. J Clin Med 2023; 12:6548. [PMID: 37892686 PMCID: PMC10607342 DOI: 10.3390/jcm12206548] [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: 09/09/2023] [Revised: 10/10/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND This study aimed to report the outcomes of the immediate loading of implants with fixed rehabilitations in edentulous geriatric patients. METHODS Edentulous geriatric patients were diagnosed with an oral examination, radiographic evaluation, and intermaxillary relations and treated with fixed rehabilitation over several implants. After immediate surgery, the implants were immediately loaded with a fully fixed prosthesis. RESULTS Twenty-four patients (20 females and 4 males) were treated using a total 210 implants. All patients (100%) had a previous history of periodontitis. Eleven patients (45.8%) were smokers. Eleven patients (45.8%) suffered from chronic medical diseases (i.e., diabetes, cardiovascular diseases). The study's clinical follow-up period extended for three years, during which thirty-three fixed prostheses were installed over the implants in 24 patients. The average marginal bone loss measured was 1.33 ± 0.17 mm. The success rate of the implants and prosthodontics being placed in this study yielded 98.5% and 97%, respectively. One patient (4.2%) showed some kind of technical complications. Eleven patients (45.8%) showed mucositis, and 25 implants (11.9%) in 10 patients (41.7%) were associated with peri-implantitis. CONCLUSIONS This study shows that the treatment of edentulous geriatric patients by immediate loading of implants with fixed rehabilitations is a clinically successful protocol but with a high prevalence of peri-implant diseases.
Collapse
Affiliation(s)
- Eugenio Velasco-Ortega
- Faculty of Dentistry, University of Seville, 41004 Sevilla, Spain; (E.V.-O.); (L.C.-B.); (J.M.-M.); (I.O.-G.); (E.N.-M.); (J.L.R.-R.); (L.M.-G.)
| | - Laura Carretero-Barrado
- Faculty of Dentistry, University of Seville, 41004 Sevilla, Spain; (E.V.-O.); (L.C.-B.); (J.M.-M.); (I.O.-G.); (E.N.-M.); (J.L.R.-R.); (L.M.-G.)
| | - Jesús Moreno-Muñoz
- Faculty of Dentistry, University of Seville, 41004 Sevilla, Spain; (E.V.-O.); (L.C.-B.); (J.M.-M.); (I.O.-G.); (E.N.-M.); (J.L.R.-R.); (L.M.-G.)
| | - Ivan Ortiz-García
- Faculty of Dentistry, University of Seville, 41004 Sevilla, Spain; (E.V.-O.); (L.C.-B.); (J.M.-M.); (I.O.-G.); (E.N.-M.); (J.L.R.-R.); (L.M.-G.)
| | - Enrique Núñez-Márquez
- Faculty of Dentistry, University of Seville, 41004 Sevilla, Spain; (E.V.-O.); (L.C.-B.); (J.M.-M.); (I.O.-G.); (E.N.-M.); (J.L.R.-R.); (L.M.-G.)
| | - José Luis Rondón-Romero
- Faculty of Dentistry, University of Seville, 41004 Sevilla, Spain; (E.V.-O.); (L.C.-B.); (J.M.-M.); (I.O.-G.); (E.N.-M.); (J.L.R.-R.); (L.M.-G.)
| | - José López-López
- Faculty of Medicine and Health Sciences (Dentistry) & Dentistry Hospital, University of Barcelona, 08907 L’Hospitalet de Llobregat, Spain
| | - Álvaro Jiménez-Guerra
- Faculty of Dentistry, University of Seville, 41004 Sevilla, Spain; (E.V.-O.); (L.C.-B.); (J.M.-M.); (I.O.-G.); (E.N.-M.); (J.L.R.-R.); (L.M.-G.)
| | - Loreto Monsalve-Guil
- Faculty of Dentistry, University of Seville, 41004 Sevilla, Spain; (E.V.-O.); (L.C.-B.); (J.M.-M.); (I.O.-G.); (E.N.-M.); (J.L.R.-R.); (L.M.-G.)
| |
Collapse
|
21
|
Stoilov M, Shafaghi R, Stark H, Marder M, Kraus D, Enkling N. Influence of Implant Macro-Design, -Length, and -Diameter on Primary Implant Stability Depending on Different Bone Qualities Using Standard Drilling Protocols-An In Vitro Analysis. J Funct Biomater 2023; 14:469. [PMID: 37754883 PMCID: PMC10531925 DOI: 10.3390/jfb14090469] [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: 08/15/2023] [Revised: 09/08/2023] [Accepted: 09/10/2023] [Indexed: 09/28/2023] Open
Abstract
(1) Background: Primary implant stability is vital for successful implant therapy. This study explores the influence of implant shape, length, and diameter on primary stability in different bone qualities. (2) Methods: Three implant systems (two parallel-walled and one tapered) with various lengths and diameters were inserted into polyurethane foam blocks of different densities (35, 25, 15, and 10 PCF) using standard drilling protocols. Primary stability was assessed through insertion torque (IT) and resonance frequency analysis (RFA). Optimal ranges were defined for IT (25 to 50 Ncm) and RFA (ISQ 60 to 80). A comparison of implant groups was conducted to determine adherence to the optimal ranges. (3) Results: Implant macro-design, -length, and -diameter and bone block density significantly influenced IT and RFA. Optimal IT was observed in 8/40 and 9/40 groups for the parallel-walled implants, while the tapered implant achieved optimal IT in 13/40 groups (within a 25-50 Ncm range). Implant diameter strongly impacted primary stability, with sufficient stability achieved in only one-third of cases despite the tapered implant's superiority. (4) Conclusions: The findings highlight the need to adapt the drilling protocol based on diverse bone qualities in clinical practice. Further investigations should explore the impact of these adapted protocols on implant outcomes.
Collapse
Affiliation(s)
- Milan Stoilov
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, Bonn University, 53111 Bonn, Germany; (M.S.); (H.S.); (M.M.)
| | - Ramin Shafaghi
- Department of Reconstructive Dentistry and Gerodontology, Bern University, 3012 Bern, Switzerland;
| | - Helmut Stark
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, Bonn University, 53111 Bonn, Germany; (M.S.); (H.S.); (M.M.)
| | - Michael Marder
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, Bonn University, 53111 Bonn, Germany; (M.S.); (H.S.); (M.M.)
| | - Dominik Kraus
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, Bonn University, 53111 Bonn, Germany; (M.S.); (H.S.); (M.M.)
| | - Norbert Enkling
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, Bonn University, 53111 Bonn, Germany; (M.S.); (H.S.); (M.M.)
- Department of Reconstructive Dentistry and Gerodontology, Bern University, 3012 Bern, Switzerland;
| |
Collapse
|
22
|
Capparè P, Tetè G, D'Orto B, Nagni M, Gherlone EF. Immediate Loaded Full-Arch Mandibular Rehabilitations in Younger vs. Elderly Patients: A Comparative Retrospective Study with 7-Year Follow-Up. J Clin Med 2023; 12:4524. [PMID: 37445559 DOI: 10.3390/jcm12134524] [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: 05/30/2023] [Revised: 06/14/2023] [Accepted: 07/02/2023] [Indexed: 07/15/2023] Open
Abstract
The aim of this comparative retrospective clinical study was to assess the effect of age on immediate loaded full-arch mandibular rehabilitation in younger vs. elderly patients. Patients with an age between 45 and 60 years (younger group, YG) or with an age more or equal to 75 years (older group, OG), requiring a mandibular full-arch rehabilitation were scheduled for the present study. Implant and prosthetic failure, biological and prosthetic complications, and peri-implant marginal bone level changes were recorded until a 7-year follow-up. Sixty-six patients were included in the study; a total of 264 implants were placed and, in total, 66 "all-on-four" rehabilitations were delivered. In total, 33 patients were scheduled in the YG and 33 patients in the OG. At the 7-year follow-up, an overall implant failure rate of 1.14% was reported. Moreover, at the 7-year radiographic evaluation, peri-implant crestal bone loss averaged 1.12 ± 0.91 mm for the YG and 1.04 ± 1.01 mm for the OG. No statistically significant differences were found between the YG and OG except for the rate of peri-implantitis, which was statistically higher in the YG. The present study reported that immediate fixed mandibular full-arch rehabilitation is a viable procedure in elderly people of equal or more than 75 years of age.
Collapse
Affiliation(s)
- Paolo Capparè
- Dental School, Vita-Salute San Raffaele University, 20132 Milan, Italy
- Department of Dentistry, IRCCS San Raffaele Hospital, 00163 Milan, Italy
| | - Giulia Tetè
- Dental School, Vita-Salute San Raffaele University, 20132 Milan, Italy
- Department of Dentistry, IRCCS San Raffaele Hospital, 00163 Milan, Italy
| | - Bianca D'Orto
- Dental School, Vita-Salute San Raffaele University, 20132 Milan, Italy
- Department of Dentistry, IRCCS San Raffaele Hospital, 00163 Milan, Italy
| | - Matteo Nagni
- Dental School, Vita-Salute San Raffaele University, 20132 Milan, Italy
- Department of Dentistry, IRCCS San Raffaele Hospital, 00163 Milan, Italy
| | - Enrico Felice Gherlone
- Dental School, Vita-Salute San Raffaele University, 20132 Milan, Italy
- Department of Dentistry, IRCCS San Raffaele Hospital, 00163 Milan, Italy
| |
Collapse
|
23
|
Kavitha G, Sonkesriya S, Kumar KA, Almutairi FJ, Parmar PM, Parihar AS, Sonkar TP. Outcome of Implant Diameter and Length on the Distribution of Stress with Immediate Loaded Implants: A 3D Finite Element Analysis. J Pharm Bioallied Sci 2023; 15:S1329-S1331. [PMID: 37693959 PMCID: PMC10485545 DOI: 10.4103/jpbs.jpbs_100_23] [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: 02/02/2023] [Revised: 02/07/2023] [Accepted: 02/08/2023] [Indexed: 09/12/2023] Open
Abstract
Objectives To assess the outcome of implant diameter and length on THE distribution of stress using a three-dimensional (3D) finite elements (FE) analysis, with immediate loading implants. Materials and Methods This study made use of a 3D FE model of an implant encased in a chunk of bone. The LEADER/ITALIA-Fix type implant was created specifically for immediate loading. To create a solid model of the implant and bone and to carry out the FE analysis, the ANSYS V.12 programme was used. Results The findings indicated that the neck of dental implants is the area of highest stress for all implant diameters and lengths, with an increase in implant length from 10 mm to 12 mm resulting in a slight raise in stress at the interface of implant-bone, and an increase in diameter from 3.75 mm to 4.25 mm having no appreciable impact on the value of stresses around dental implants. Conclusion It was concluded that an increase in length has a negative effect on stress, while a diameter increase has no discernible impact on stress values.
Collapse
Affiliation(s)
- G Kavitha
- Department of Conservative Dentistry, Sharavathi Dental College and Hospital, Shivamogga, Karnataka, India
| | - Subhash Sonkesriya
- Department of Prosthodontics and crown and Bridge, Government College of Dentistry, Indore, Madhya Pradesh, India
| | - K Anil Kumar
- Department of Prosthodontics, Saraswti Dhanwantari Dental College and Hospital, Parbani, Maharastra, India
| | - Faris Jaser Almutairi
- Assistant Professor, Separtment of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Qassim University, Kingdom of Saudi Arabia
| | - Pravin M Parmar
- Department of Prosthodontics Crown and Bridge, Dental Surgeon Class-1, General Hospital, Dist-Botad, India
| | - Anuj Singh Parihar
- Department of Periodontology, People’s Dental Academy, Bhopal, Madhya Pradesh, India
| | - Tanu Priya Sonkar
- Deportment of Prosthodontics Crown and Bridge, Rural Dental College, Loni, Maharastra, India
| |
Collapse
|
24
|
Grecchi F, D'Ambrogio RG, Stefanelli LV, Grivetto F, Goker F, Del Fabbro M, Schreiber A, Piazza C, Salgarello S, Dosio C, Grecchi E. Guided Zygomatic Implantology for Oral Cancer Rehabilitation: A Case Report. J Clin Med 2023; 12:jcm12113653. [PMID: 37297847 DOI: 10.3390/jcm12113653] [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: 04/26/2023] [Revised: 05/15/2023] [Accepted: 05/23/2023] [Indexed: 06/12/2023] Open
Abstract
Oral rehabilitation after maxillary oncological resection is challenging. This case report presents the rehabilitation of a 65-year-old Caucasian male adenoid cystic carcinoma patient using a myo-cutaneous thigh flap, zygomatic implant placement, and an immediate fixed provisional prosthesis made with computer-aided technologies. The patient presented complaints of asymptomatic enlarged swelling of 5-mm on the right hard hemi-palate. There was an oro-antral communication deriving from a previous local excision. Preoperative radiographs showed the involvement of the right maxilla, maxillary sinus, and nose with a suspect involvement of the maxillary division of the trigeminal nerve. Treatment was planned through a fully digital workflow. A partial maxillectomy was performed endoscopically, and maxilla was reconstructed using an anterolateral thigh free flap. Two zygomatic implants were inserted simultaneously. A provisional fix full-arch prosthesis was manufactured preoperatively through a fully digital workflow and was placed in the operating room. Following post-operative radiotherapy, the patient received a final hybrid prosthesis. During the follow-up period of two years, the patient reported good function, aesthetics, and significant enhancement in quality of life. According to the results of this case, the protocol represented can be a promising alternative for oral cancer patients with large defects, and can lead to an improved quality of life.
Collapse
Affiliation(s)
| | - Roberto Giuseppe D'Ambrogio
- Department of Surgical Specialties, Dental Clinic, School of Dentistry, University of Brescia, Piazza Spedali Civili 1, 25123 Brescia, Italy
| | | | - Fabrizio Grivetto
- Azienda Ospedaliero Universitaria Maggiore Della Carità Largo Bellini, 28100 Novara, Italy
| | - Funda Goker
- Department of Biomedical, Surgical and Dental Sciences, University of Milano, 20122 Milan, Italy
- Dental and Maxillo-Facial Surgery Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, University of Milano, 20122 Milan, Italy
- Dental and Maxillo-Facial Surgery Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Alberto Schreiber
- Department of Surgical Specialties, Ear, Nose and Throat Clinic, School of Dentistry, University of Brescia, Piazza Spedali Civili 1, 25123 Brescia, Italy
| | - Cesare Piazza
- Department of Surgical Specialties, Ear, Nose and Throat Clinic, School of Dentistry, University of Brescia, Piazza Spedali Civili 1, 25123 Brescia, Italy
| | - Stefano Salgarello
- Department of Surgical Specialties, Dental Clinic, School of Dentistry, University of Brescia, Piazza Spedali Civili 1, 25123 Brescia, Italy
| | - Camilla Dosio
- Azienda Ospedaliero Universitaria Maggiore Della Carità Largo Bellini, 28100 Novara, Italy
| | - Emma Grecchi
- Private Practice, Via Boccaccio 34, 20123 Milan, Italy
| |
Collapse
|
25
|
De Angelis N, Pesce P, De Lorenzi M, Menini M. Evaluation of Prosthetic Marginal Fit and Implant Survival Rates for Conventional and Digital Workflows in Full-Arch Immediate Loading Rehabilitations: A Retrospective Clinical Study. J Clin Med 2023; 12:jcm12103452. [PMID: 37240558 DOI: 10.3390/jcm12103452] [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: 04/06/2023] [Revised: 05/01/2023] [Accepted: 05/11/2023] [Indexed: 05/28/2023] Open
Abstract
Digital impression provides several advantages in implant prosthodontics; however, its use in full-arch rehabilitations, especially immediately after surgery, has yet to be validated. The aim of this study was to retrospectively analyse the fit of immediate full-arch prostheses, fabricated using conventional or digital impressions. Patients requiring a full-arch immediate loading rehabilitation were divided into three groups: T1 (digital impression taken immediately after surgery), T2 (Preoperative digital impression, guided surgery-prefabricated temporary bridge) and C (conventional impression taken immediately after surgery). Immediate temporary prostheses were delivered within 24 h after surgery. X-rays were obtained at the time of prosthesis delivery and at the 2-year follow-up. Primary outcomes were cumulative survival rate (CSR) and prosthesis fit. Secondary outcomes were marginal bone level (MBL) and patient satisfaction. One hundred and fifty patients were treated from 2018 to 2020, with 50 in each group. Seven implants failed during the observation period. The CSR was 99% for T1, 98% for T2 and 99.5% for C. A statistically significant difference in prosthesis fit was found among T1 and T2 vs. C. A statistically significant difference was found in the MBL between T1 and C. The outcomes of the present study suggest that digital impression is a viable alternative to conventional protocols for the realisation of full-arch immediate loading prostheses.
Collapse
Affiliation(s)
- Nicola De Angelis
- Department of Surgical Sciences (DISC), Unit of Endo and Restorative Dentistry, University of Genova, Largo R. Benzi 10, 16132 Genova, Italy
- Dental Department, University Technology MARA, Sungai Buloh 40450, Malaysia
- Dental Department, University Trisakti, Jakarta 11440, Indonesia
| | - Paolo Pesce
- Department of Surgical Sciences (DISC), Unit of Prosthodontics and Implant Prosthodontics, University of Genova, Largo R. Benzi 10, 16132 Genova, Italy
| | | | - Maria Menini
- Department of Surgical Sciences (DISC), Unit of Prosthodontics and Implant Prosthodontics, University of Genova, Largo R. Benzi 10, 16132 Genova, Italy
| |
Collapse
|
26
|
Susin D, Aquino DR, Cortelli JR, Costa FO, Duarte PM, Rovai ES, Cortelli SC. Periodontal bacterial species in hopeless dentitions with severe periodontitis: comparison of levels before extraction and 90 days after immediate implant placement. Gen Dent 2023; 71:40-45. [PMID: 37083612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
The aim of this study was to evaluate changes in periodontal bacterial species during the transition from hopeless teeth to denture-supporting immediate implants. Biofilm and saliva samples were collected from 13 women and 7 men before the extraction of hopeless teeth with severe periodontitis (baseline) and 90 days after the placement of immediate implants that supported immediately loaded complete dentures (day 90). The levels of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, and Streptococcus oralis were analyzed by real-time polymerase chain reaction. Differences in the levels of bacterial species in the subgingival biofilm and saliva and between baseline and day 90 were evaluated by a 2-way analysis of variance followed by the Tukey test. There was a significant reduction in the levels of T forsythia from baseline to day 90 in saliva and subgingival biofilms (P < 0.05) and a tendency toward a reduction of the other bacterial species. The total bacterial load was higher in saliva than in subgingival biofilm at baseline and day 90 (P < 0.05), while the individual levels of all species were higher in the biofilm than in saliva at both times (P < 0.05). The results showed an overall reduction in the levels of pathogenic bacterial species, particularly T forsythia, during the transition from hopeless dentition to implant-supported dentures. The subgingival biofilm harbored considerable levels of pathogenic species, suggesting that implant placement immediately after extraction of teeth with severe periodontitis may induce changes that favor colonization by pathogenic microorganisms.
Collapse
|
27
|
Ramakrishnan H, Sundar P, Halder S, Baskaran S, Baig MR. Graftless Immediate Dual Implant Anatomic Placement With Immediate Provisional Passive Loading and Definitive Hybrid Crown for the Restoration of Mandibular Molar: A Clinical Report. Cureus 2023; 15:e38654. [PMID: 37288238 PMCID: PMC10242359 DOI: 10.7759/cureus.38654] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2023] [Indexed: 06/09/2023] Open
Abstract
Immediate implant placement is well-known science and treatment in implant dentistry. It is a multitasking treatment consisting of surgical, prosthodontic, and periodontal aspects, implemented to obtain long-term clinically esthetic and functioning prosthesis. Immediate placement enables clinicians to reduce the number of surgical steps and shorter treatment duration. It has become a standard surgical protocol in modern implant practice. According to existing literature, dual implant placement can be done to avoid any cantilever effect in a single implant and to distribute masticatory forces. This clinical report describes the extraction of an infected mandibular right first molar, (46, Federation Dentaire Internationale) followed by immediate dual placement of dental implants in the rinsed and cleansed sockets. The tooth was atraumatically extracted from the socket, and the latter was prepared to the required depth, and endosseous implants were placed in both the mesial and distal sockets. This atraumatic graft-free operating technique and immediate placement resulted in the preservation of hard and soft tissues. It also increased the patient's comfort, acceptance, and satisfaction due to immediate loading with a provisional removable prosthesis. This was later replaced with a dual screw-retained hybrid implant crown.
Collapse
Affiliation(s)
- Hariharan Ramakrishnan
- Department of Prosthodontics and Implantology, Ragas Dental College and Hospital, Chennai, IND
| | - Praveen Sundar
- Department of Prosthodontics and Implantology, Ragas Dental College and Hospital, Chennai, IND
| | - Surabhi Halder
- Department of Prosthodontics and Implantology, Priyadarshini Dental College and Hospital, Chennai, IND
| | | | - Mirza Rustum Baig
- Department of Restorative Sciences, Faculty of Dentistry, Kuwait University, Jabriya, KWT
| |
Collapse
|
28
|
Agliardi EL, Pozzi A, Romeo D, Del Fabbro M. Clinical outcomes of full-arch immediate fixed prostheses supported by two axial and two tilted implants: A retrospective cohort study with 12-15 years of follow-up. Clin Oral Implants Res 2023; 34:351-366. [PMID: 36760035 DOI: 10.1111/clr.14047] [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: 06/30/2022] [Revised: 01/16/2023] [Accepted: 01/30/2023] [Indexed: 02/11/2023]
Abstract
PURPOSE To retrospectively assess clinical and radiographic outcomes of immediately loaded full-arch fixed prostheses supported by axial and tilted implants up to 15 years of function. MATERIALS AND METHODS Patients with one completely edentulous arch received an immediate full-arch fixed prosthesis supported by two anterior axial and two posterior tilted implants. Definitive prosthesis consisting of a CAD-CAM titanium framework and acrylic teeth was delivered 6 months later. Patients were regularly followed to assess clinical parameters and marginal bone level (MBL) change. Multilevel regression analysis was performed to investigate factors affecting implant failure and MBL. RESULTS Six hundred ninety-two implants were placed in 72 maxillae and 101 mandibles. Seven maxillary implants (5 axial and 2 tilted) in 6 patients and 12 mandibular implants (6 axial and 6 tilted) in 5 patients failed. 15-year cumulative implant survival was 97.51% and 96.91% in maxilla and mandible, respectively (p = .64). After 10 years, the difference in MBL between axial and tilted implants was not significant in the maxilla (p = .47, 65 patients), while it was in the mandible (p < .001, 80 patients). Significant higher bone loss was reported in the mandible at both 5- and 10-year follow-up (p < .001 and p = .004, respectively). Mixed-effect multilevel linear regression evidenced a correlation between arch and bone loss at 5- and 10-year follow-up, while no correlation was found with age, gender, smoking, diabetes, and history of periodontal disease. CONCLUSION This long-term study suggests that the present technique can be considered a viable treatment modality for the immediate rehabilitation of both maxilla and mandible.
Collapse
Affiliation(s)
- Enrico Luigi Agliardi
- Advanced Oral Surgery Unit, Department of Dentistry, Vita Salute University, San Raffaele Hospital, Milan, Italy
| | - Alessandro Pozzi
- Dental College of Georgia, Augusta, USA.,Private Practice in Rome, Rome, Italy
| | - Davide Romeo
- Advanced Oral Surgery Unit, Department of Dentistry, Vita Salute University, San Raffaele Hospital, Milan, Italy
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy.,UOC Maxillofacial Surgery and Dentistry, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| |
Collapse
|
29
|
Darriba I, Seidel A, Moreno F, Botelho J, Machado V, Mendes JJ, Leira Y, Blanco J. Influence of low insertion torque values on survival rate of immediately loaded dental implants: A systematic review and meta-analysis. J Clin Periodontol 2023; 50:158-169. [PMID: 36217696 PMCID: PMC10092009 DOI: 10.1111/jcpe.13733] [Citation(s) in RCA: 2] [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: 06/06/2022] [Revised: 09/26/2022] [Accepted: 10/04/2022] [Indexed: 01/18/2023]
Abstract
AIM The aim was to systematically evaluate the effect of low insertion torque values on the survival rate of immediately loaded dental implants. MATERIALS AND METHODS The protocol was registered with PROSPERO (ID CRD42020189499). An electronic search was performed in PubMed, Embase, Web of Science, and Cochrane Central Register of Controlled Trials until June 2022 in English and Spanish. Studies analysing the failure or survival rate of immediately loaded dental implants according to different insertion torque values were included. RESULTS Five-hundred seventy-three articles were assessed for eligibility, of which seven articles, four randomized clinical trials (RCTs), one controlled clinical trial, and two prospective case series studies were included in the qualitative analysis. The RCTs were classified as having low risk of bias and the non-RCTs as having moderate and serious risk of bias. The mean survival rate for implants with low insertion toque (≤35 Ncm) was 96% (p > .001, 95% confidence interval [CI]: 0.91-0.98) and that for implants with medium or high insertion torque (>35 Ncm) was 92% (p > .001, 95% CI: 0.86-0.96) (incidence rate ratio [IRR] = 1.05, 95% CI: 0.79-1.39, p = .175, I2 = 0.0%). Splinted implants with insertion torque >20 Ncm and single implants with insertion torque >35 Ncm had a higher survival rate than implants with lower insertion torque values (IRR = 1.05, 95% CI: 0.78-1.43, p = .956, I2 = 0.0%, and RR = 0.92, 95% CI: 0.48-1.75, p = .799, I2 = 0.0%, respectively). Different insertion torque values achieved equivalent outcomes. The mean follow-up was 24 months. CONCLUSIONS Low insertion torque values have no significant effect on survival rates of immediate loading implants at a mean follow-up of 24 months.
Collapse
Affiliation(s)
- Iria Darriba
- Periodontology Unit, Faculty of Odontology and Medicine, University of Santiago de Compostela and Medical-Surgical Dentistry Research Group, Health Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
| | - Anna Seidel
- Department of Prosthodontics, University Hospital Erlangen of Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Federico Moreno
- Periodontology Unit, UCL Eastman Dental Institute and NIHR UCLH Biomedical Research Centre, University College London, London, UK
| | - João Botelho
- Periodontology Department, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), Caparica, Portugal.,Evidence-Based Hub, CRU, CiiEM, Egas Moniz - Cooperativa de Ensino Superior, Caparica, Portugal
| | - Vanessa Machado
- Periodontology Department, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), Caparica, Portugal.,Evidence-Based Hub, CRU, CiiEM, Egas Moniz - Cooperativa de Ensino Superior, Caparica, Portugal
| | - José João Mendes
- Periodontology Department, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), Caparica, Portugal.,Evidence-Based Hub, CRU, CiiEM, Egas Moniz - Cooperativa de Ensino Superior, Caparica, Portugal
| | - Yago Leira
- Periodontology Unit, Faculty of Odontology and Medicine, University of Santiago de Compostela and Medical-Surgical Dentistry Research Group, Health Research Institute of Santiago de Compostela, Santiago de Compostela, Spain.,Periodontology Unit, UCL Eastman Dental Institute and NIHR UCLH Biomedical Research Centre, University College London, London, UK.,Clinical Neurosciences Research Laboratory, Health Research Institute of Santiago de Compostela, University Clinical Hospital, Santiago de Compostela, Spain
| | - Juan Blanco
- Periodontology Unit, Faculty of Odontology and Medicine, University of Santiago de Compostela and Medical-Surgical Dentistry Research Group, Health Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
| |
Collapse
|
30
|
Carosi P, Lorenzi C, Di Gianfilippo R, Papi P, Laureti A, Wang HL, Arcuri C. Immediate vs. Delayed Placement of Immediately Provisionalized Self-Tapping Implants: A Non-Randomized Controlled Clinical Trial with 1 Year of Follow-Up. J Clin Med 2023; 12:jcm12020489. [PMID: 36675417 PMCID: PMC9861545 DOI: 10.3390/jcm12020489] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 12/27/2022] [Accepted: 01/04/2023] [Indexed: 01/11/2023] Open
Abstract
This study aimed to examine the clinical and esthetic outcomes of immediately provisionalized self-tapping implants placed in extraction sockets or healed edentulous ridges one year after treatment. Sixty patients in need of a single implant-supported restoration were treated with self-tapping implants (Straumann BLX) and immediate provisionalization. The implant stability quotient (ISQ) and insertion torque were recorded intraoperatively. After one year in function, the implant and prosthesis survival rate, pink esthetic score (PES), white esthetic score (WES), and marginal bone levels (MBL) were assessed. Sixty patients received 60 self-tapping implants. A total of 37 implants were placed in extraction sockets and 23 in edentulous ridges, and then all implants were immediately provisionalized. All implants achieved a high implant stability with a mean insertion torque and ISQ value of 58.1 ± 14.1 Ncm and 73.6 ± 8.1 Ncm, respectively. No significant differences were found between healed vs. post-extractive sockets (p = 0.716 and p = 0.875), or between flap vs. flapless approaches (p = 0.862 and p = 0.228) with regards to the insertion torque and ISQ value. Nonetheless, higher insertion torque values and ISQs were recorded for mandibular implants (maxilla vs. mandible, insertion torque: 55.30 + 11.25 Ncm vs. 62.41 + 17.01 Ncm, p = 0.057; ISQ: 72.05 + 8.27 vs. 76.08 + 7.37, p = 0.058). One implant did not osseointegrate, resulting in an implant survival rate of 98.3%. All implants achieved PES and WES scores higher than 12 at the 1-year follow-up. The clinical use of newly designed self-tapping implants with immediate temporization was safe and predictable. The implants achieved a good primary stability, high implant survival rate, and favorable radiographic and esthetic outcomes, regardless of the immediate or delayed placement protocols.
Collapse
Affiliation(s)
- Paolo Carosi
- Department of Chemical Science and Technologies, PhD in Materials for Health, Environment and Energy–Dentistry, University of Rome Tor Vergata, 00133 Rome, Italy
- Correspondence:
| | - Claudia Lorenzi
- Department of Chemical Science and Technologies, PhD in Materials for Health, Environment and Energy–Dentistry, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Riccardo Di Gianfilippo
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI 48109, USA
| | - Piero Papi
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Andrea Laureti
- Department of Chemical Science and Technologies, PhD in Materials for Health, Environment and Energy–Dentistry, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI 48109, USA
| | - Claudio Arcuri
- Department of Clinical Sciences and Translational Medicine, School of Dentistry, University of Tor Vergata, 00133 Rome, Italy
| |
Collapse
|
31
|
Rozov RA, Trezubov VN, Gerasimov AB, Azarin GS. [A prospective single-cohort study of implant-supported full-arch metal-ceramic prosthesis with gold-platinum alloy framework for treatment edentulous mandible in elderly patients: 15-year report]. Stomatologiia (Mosk) 2023; 102:22-27. [PMID: 37997309 DOI: 10.17116/stomat202310206122] [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] [Subscribe] [Scholar Register] [Indexed: 11/25/2023]
Abstract
OBJECTIVE To study the effectiveness of implant-supported full-arch metal-ceramic prosthesis with gold-platinum alloy framework in elderly patients. MATERIALS AND METHODS The study included patients with complete and/or partial loss of teeth and terminal dentition. In 2007-2008, 354 implants were inserted in 27 patients. The age of the patients was 61.31±5.08 years. Mombelli index criteria (mBI [modified Sulcus Bleeding Index]) were used. The plaque index was determined using a modified Löe & Silness method. The state of the peri-implant bone (ΔMBL) was determined by a series of OPG. The Geriatric Oral Health Index (GOHAI) was used to assess oral health in the elderly. RESULTS Metal-ceramic full-arch implant prostheses with a gold-platinum alloy framework, based on a sufficient and optimal number of implants (6-8), showed high survival rate (100%) after 15 years. Marginal bone loss (ΔMBL) after 15 years was -1.44±1.27 mm. The survival rate of implants was 99.4%. Scores on the GOHAI scale were higher in patients after orthopedic rehabilitation (from 52.7±7.1 to 54.1±8.4, p<0.001). CONCLUSION After 15 years, all prostheses had mechanical defects, which at the same time allowed them to be used without restrictions. Screw fixation of full-arch implant prostheses, although it was associated with mechanical complications, nevertheless made it possible to perform surgical interventions in a timely manner and stop the development of inflammatory complications. Thus, we do not see any grounds for removing metal-ceramic prostheses and replacing them with new implant prostheses even after a 15-year period of operation. At the same time, it is necessary to take into account the reduction in the possibility of individual oral hygiene in elderly patients, as well as possible restrictions on self-visiting a dentist or dental hygienist.
Collapse
Affiliation(s)
- R A Rozov
- Academician I.P. Pavlov First St. Petersburg State Medical University of the Ministry of Healthcare of Russian Federation, St. Petersburg, Russia
- «City Dental Clinic No. 33», St. Petersburg, Russia
| | - V N Trezubov
- Academician I.P. Pavlov First St. Petersburg State Medical University of the Ministry of Healthcare of Russian Federation, St. Petersburg, Russia
| | | | - G S Azarin
- «City Dental Clinic No. 33», St. Petersburg, Russia
| |
Collapse
|
32
|
de Araújo Nobre M, Salvado F, Correia JA, Teixeira MCF, Coutinho FA. Long-Term Outcome of Dental Implants in Immediate Function Inserted on Autogenous Grafted Bone. J Clin Med 2022; 12. [PMID: 36615061 DOI: 10.3390/jcm12010261] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 12/23/2022] [Accepted: 12/26/2022] [Indexed: 12/31/2022] Open
Abstract
Background: There is a need for long-term evidence of immediate function dental implants inserted in grafted bone. The aim of this retrospective study was to investigate the outcome of full-arch rehabilitations supported by implants in grafted bone. Methods: Thirty-six patients (women: 24; men: 12; average age: 53.5 years) were included (225 implants). Primary outcome measure: to assess implant cumulative success rates evaluated through life tables. Secondary outcome measures: to evaluate implant and prosthetic survival, marginal bone loss, and the incidence of both biological and mechanical complications. Results: Twenty-five implants were unsuccessful giving a dental implant CS rate of 88.1% at 14 years and a 76.8% survival estimation (Kaplan−Meier) using the patient as the unit of analysis. No prosthesis was lost. Average MBL at 10 years was 2.01 mm. The incidence of biological complications was 36%, with smoking affecting it significantly (p < 0.001). The incidence of mechanical complications was 86.1% (45.2% and 54.8% in provisional and definitive prosthesis, respectively. Conclusions: The rehabilitation of atrophic maxillae through dental implants in immediate function inserted in grafted bone is a valid treatment alternative, despite the relevant rate of implant failures and incidence of complications.
Collapse
|
33
|
La Monaca G, Pranno N, Annibali S, Di Carlo S, Pompa G, Cristalli MP. Immediate flapless full-arch rehabilitation of edentulous jaws on 4 or 6 implants according to the prosthetic-driven planning and guided implant surgery: A retrospective study on clinical and radiographic outcomes up to 10 years of follow-up. Clin Implant Dent Relat Res 2022; 24:831-844. [PMID: 36197040 PMCID: PMC10092257 DOI: 10.1111/cid.13134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 04/26/2022] [Revised: 09/12/2022] [Accepted: 09/13/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVES to retrospectively evaluate clinical and radiographic outcomes of immediate, flapless full-arch prostheses, supported by 4/6 implants according to prosthetic-driven planning and guided surgery. MATERIALS AND METHODS The study involved 28 edentulous patients (20 female/8 males; average age 67.75 ± 8.627 years), 32 prostheses (17 all-on-4/15 all-on-6) and 164 implants. The Implants survival, prostheses success/survival, peri-implant marginal bone loss, incidence of biological and prosthetic complications were evaluated. Multiple linear regression analysis was performed to analyze the influence of implant and patient characteristics on marginal bone loss. RESULTS Cumulative implant survival rate was 89.7% for all-on-four (seven failures) and 99.0% for all-on-six (one failure) after a mean follow-up of 6.46 ± 2.236 years (range 1-10 years). Cumulative prosthesis success rate was 51.5% (58.8% for all-on-four/ 43.8% for all-on-six). Prosthesis survival rate was 88.2% for all-on-four. No failure was registered in all-on-six. Mean value of marginal bone loss was 1.38 ± 0.1.28 mm at 5-year and 2.09 ± 0.56 mm at 10-year follow-up. No difference was found in the mean value of marginal bone resorption between all-on-four (1.56 ± 1.61 mm) and all-on-six (1.20 ± 0.85 mm) (p = 0.104) and between tilted (1.22 ± 1.29 mm) and axial implants (1.44 ± 1.27 mm) (p = 0.385) after 5-year follow-up. The incidence of biological complications was 1.0% in all-on-six (one mucositis) and 10.3% in all-on-four (two peri-implantitis). Prosthetic complications affected teeth of final rehabilitations with 3 detachments, 10 chippings or fractures, and 3 severe occlusal wears. CONCLUSIONS Based on the results and within the limitations of the present study, the implant-supported hybrid prosthesis according to prosthetic-driven planning and guided surgery showed to be an efficient, safe, and effective approach to rehabilitate edentulous jaws.
Collapse
Affiliation(s)
- Gerardo La Monaca
- Department of Oral and Maxillofacial Sciences, Sapienza, University of Rome, Rome, Italy
| | - Nicola Pranno
- Department of Oral and Maxillofacial Sciences, Sapienza, University of Rome, Rome, Italy
| | - Susanna Annibali
- Department of Oral and Maxillofacial Sciences, Sapienza, University of Rome, Rome, Italy
| | - Stefano Di Carlo
- Department of Oral and Maxillofacial Sciences, Sapienza, University of Rome, Rome, Italy
| | - Giorgio Pompa
- Department of Oral and Maxillofacial Sciences, Sapienza, University of Rome, Rome, Italy
| | - Maria Paola Cristalli
- Department of Biotechnologies and Medical Surgical Sciences, Sapienza, University of Rome, Rome, Italy
| |
Collapse
|
34
|
Velasco-Ortega E, Cracel-Lopes JL, Matos-Garrido N, Jiménez-Guerra A, Ortiz-Garcia I, Moreno-Muñoz J, Núñez-Márquez E, Rondón-Romero JL, López-López J, Monsalve-Guil L. Immediate Functional Loading with Full-Arch Fixed Implant-Retained Rehabilitation in Periodontal Patients: Clinical Study. Int J Environ Res Public Health 2022; 19:13162. [PMID: 36293738 PMCID: PMC9602498 DOI: 10.3390/ijerph192013162] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 10/09/2022] [Accepted: 10/11/2022] [Indexed: 06/16/2023]
Abstract
(1) Background. The immediate functional loading of implants is a clinical procedure used for treating periodontal edentulous patients. This clinical study aimed to evaluate the clinical outcomes of the immediate functional loading of implants with fully fixed rehabilitations in compromised periodontal patients. (2) Methods. Three hundred and five implants IPX screw implants were placed in 27 periodontal patients using an immediate functional loading protocol with fixed rehabilitations. All patients had a previous history of periodontitis, four patients (14.8%) were smokers and seven patients (25.9%) suffered from chronic medical conditions. (3) Results. Implant and prosthetic clinical findings were evaluated during a mean period of 41.3 ± 19.6 months. No implants were lost during the clinical follow-up. The cumulative survival rate for all implants was 100%. Regarding the prostheses designed, a total of 54 fixed prostheses were placed in the 27 patients immediately after the surgery. Forty-four hybrid fixed prostheses (81.5%) and 10 fixed rehabilitations (18.5%) were placed in the patients. The mean marginal bone loss was 1.51 ± 1.16 mm, ranging from 0 to 3.5 mm during the follow-up evaluation. Thirty-one implants (10.2%) in 10 patients (37%) were associated with peri-implantitis. Five patients (18.5%) showed some kind of technical complications (loss/fracture of the prosthetic screw, acrylic resin fracture, ceramic chipping). (4) Conclusions. The clinical outcomes of this study demonstrate that fixed rehabilitation by immediate functional loading of implants is considered a predictable procedure.
Collapse
Affiliation(s)
- Eugenio Velasco-Ortega
- Department of Comprehensive Dentistry for Adults and Gerodontology, Faculty of Dentistry, University of Seville, 41018 Seville, Spain
| | - Joao Luis Cracel-Lopes
- Department of Comprehensive Dentistry for Adults and Gerodontology, Faculty of Dentistry, University of Seville, 41018 Seville, Spain
| | - Nuno Matos-Garrido
- Department of Comprehensive Dentistry for Adults and Gerodontology, Faculty of Dentistry, University of Seville, 41018 Seville, Spain
| | - Alvaro Jiménez-Guerra
- Department of Comprehensive Dentistry for Adults and Gerodontology, Faculty of Dentistry, University of Seville, 41018 Seville, Spain
| | - Ivan Ortiz-Garcia
- Department of Comprehensive Dentistry for Adults and Gerodontology, Faculty of Dentistry, University of Seville, 41018 Seville, Spain
| | - Jesús Moreno-Muñoz
- Department of Comprehensive Dentistry for Adults and Gerodontology, Faculty of Dentistry, University of Seville, 41018 Seville, Spain
| | - Enrique Núñez-Márquez
- Department of Comprehensive Dentistry for Adults and Gerodontology, Faculty of Dentistry, University of Seville, 41018 Seville, Spain
| | - José Luis Rondón-Romero
- Department of Comprehensive Dentistry for Adults and Gerodontology, Faculty of Dentistry, University of Seville, 41018 Seville, Spain
| | - José López-López
- Department of Odontoestomatology (Dentistry), Service of the Medical-Surgical Area of Dentistry Hospital, University of Barcelona, 08907 L’Hospitalet de Llobregat, Spain
| | - Loreto Monsalve-Guil
- Department of Comprehensive Dentistry for Adults and Gerodontology, Faculty of Dentistry, University of Seville, 41018 Seville, Spain
| |
Collapse
|
35
|
Norré D, Att W. STAR concept: A technique to improve the predictability of immediate implant placement and loading in edentulous arches. Int J Comput Dent 2022; 25:303-323. [PMID: 36125804 DOI: 10.3290/j.ijcd.b3380919] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The digital workflow in implant dentistry aims to provide safer and predictable implant placement. This is facilitated through visualization of the anatomical structures as well as the integration of the prosthetic information to dictate implant placement. Guided surgery is useful in edentulous arches planned for fixed rehabilitations, where the unfavorable position of the implants may limit the possibility to realize such a treatment option. In full-arch immediate implant placement and immediate loading, computer-guided implant surgery gains a significant importance. Here, clinicians rely on either soft tissue or bone to provide support for the surgical guide during implant placement. Due to tooth extraction and the loss of anatomical structures that improve the support of the surgical guide, the correct positioning of the guide can be challenging. Further, the procedure that follows to deliver the immediate temporary rehabilitation can also be challenging due to the lack of workflow integrity between the surgical and restorative phases. The present case report describes a novel digital workflow for immediate implant placement and immediate loading of a full-arch rehabilitation, which aims to improve the accuracy of implant placement surgery and simplify the procedure of delivering immediate provisional restorations. (Int J Comput Dent 2022;25(3):303-323; doi: 10.3290/j.ijcd.b3380919).
Collapse
|
36
|
Tang YM, Yu HJ, Qiu LX, Wang J. A Single-Visit Technique for Fabricating Interim, Immediately Loaded Implant-supported Full-arch Prostheses with Prefabricated Rigid Connecting Bars: a Case Report. Chin J Dent Res 2022; 25:233-239. [PMID: 36102893 DOI: 10.3290/j.cjdr.b3317973] [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: 06/15/2023]
Abstract
Traditional techniques for fabricating interim, immediately loaded implant-supported full-arch prostheses are complex and time-consuming. The present study presents an efficient technique for fabricating interim prostheses with prefabricated multipurpose rigid connecting bars. This technique can minimise the misfit attributed to the polymerisation shrinkage of resin and expansion of the working cast, and simultaneously facilitate impression taking and occlusal records in one visit, thus reducing laboratory and chair time. Due to its ease of use and clinical efficiency, the present technique is considered particularly beneficial for immediate loading rehabilitation.
Collapse
|
37
|
Zuffellato N, Massariol M, Gandini A, Dovigo S. Intraorally welded wing abutments supporting full-arch prostheses: A retrospective clinical study. Dent Med Probl 2022; 59:333-341. [PMID: 36098486 DOI: 10.17219/dmp/149470] [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] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Delayed loading in the rehabilitation of edentulous patients with an implant-supported prosthesis implies a longer treatment time. It requires additional surgery to uncover the submerged implants, and this may increase patients' discomfort and morbidity. OBJECTIVES The immediate loading-based technique described in this article involves creating a metal framework by intraorally welding the implants pair by pair, using specific wing abutments. The aim of the study was to investigate the implant-prosthetic success and complication rates of this technique when used to rehabilitate totally edentulous patients. MATERIAL AND METHODS The clinical records of totally edentulous patients were retrospectively evaluated. The prosthetic success rate as well as technical and biological complications were analyzed. Furthermore, the implant survival and success rates were assessed by measuring marginal bone loss (MBL) at the implant, prosthesis and patient levels. RESULTS The records of 37 patients (284 implants and 43 prostheses) were included in the study. At the last follow-up (45.5 ±33.6 months), the prosthetic success rate was 100%. Mucositis affected 4 implants (1.4%), while peri-implantitis affected 4 implants (1.4%). Meanwhile, 7 implants (2.5%) showed a lack of early osseointegration. According to the criteria of Albrektsson et al., 271 implants (95.4%) were successful. The average MBL at the implant, prosthesis and patient levels was 0.26 ±0.42 mm, 0.26 ±0.19 mm and 0.26 ±0.18 mm, respectively. CONCLUSIONS The technique described in this article seems to be a viable approach to the rehabilitation of totally edentulous patients through immediate loading. However, these results should be confirmed by appropriately designed prospective and comparative clinical studies.
Collapse
|
38
|
Abdullah AH, Abdel Gaber HK, Adel-Khattab D. Evaluation of soft tissue and labial plate of bone stability with immediate implant in direct contact versus gap with socket shield: A randomized clinical trial with 1 year follow-up. Clin Implant Dent Relat Res 2022; 24:548-558. [PMID: 35763398 DOI: 10.1111/cid.13117] [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: 01/04/2022] [Revised: 05/31/2022] [Accepted: 06/09/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE In the anterior region, the resorption of the buccal plate of bone after tooth extraction leads to contraction of the overlying soft tissues, resulting in an esthetic problem. In the socket shield technique, the buccal root section of the tooth is maintained, to preserve the buccal bone for immediate implant placement. The aim of this randomized clinical trial was to investigate the effect of leaving a gap or not between implant and retained root fragment on bone dimensions and soft tissue esthetics. METHODS This was a two armed parallel group randomized clinical trial with allocation ratio 1:1. Patients were eligible in case they needed immediate implant replacing teeth in esthetic zone with sufficient buccal bone support. CBCT was performed immediately after the intervention and 12 months later. RESULTS Forty six patients (26 females and 20 males) were enrolled in the study with 23 of them placed in contact with shield and 23 were placed palatal leaving a gap to graft with a xenograft. After 12 months, excellent soft tissue stability was reported (mean pink esthetic score at placement group A: 12.00 ± 1.60 after 12 months 12.90 ± 1.69, group B 12.62 ± 2.07 and after 12 months 12.38 ± 2.20) Using both surgical techniques. Radiographic crestal bone level changes mean for group A was -0.26 ± 0.52 and for group B -0.34 ± 0.31. There was a strong positive correlation between clinical and radiographic bone width values which was statistically significant (r = 0.782, p < 0.001). Width and thickness of keratinized gingiva showed no significant difference between values measured in both groups. Nonsignificant difference between studied groups according to the labial plate of bone clinical and radiographic changes after immediate implantation. CONCLUSION Within the limitations of this study, the present data seem to support that the clinical outcome of the socket shield technique with immediate implant placement placed in contact or leaving a gap gave excellent esthetic results.
Collapse
Affiliation(s)
- Amr Hany Abdullah
- Master Periodontology, Faculty of Dentistry, Ain Shams University, Cairo, Abbassia, Egypt
| | - Hala Kamal Abdel Gaber
- Professor of Oral Medicine, Periodontology and Diagnosis, Faculty of Dentistry Ain shams university, Cairo, Egypt
| | - Doaa Adel-Khattab
- Lecturer of Oral Medicine, Periodontology and Diagnosis Department, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| |
Collapse
|
39
|
Wanis RW, Hosny MM, ElNahass H. Clinical evaluation of the buccal aspect around immediate implant using dual zone therapeutic concept versus buccal gap fill to bone level: A randomized controlled clinical trial. Clin Implant Dent Relat Res 2022; 24:307-319. [PMID: 35507735 DOI: 10.1111/cid.13091] [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: 10/19/2021] [Revised: 04/01/2022] [Accepted: 04/04/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Soft tissue esthetics for immediate implant is considered challenging when restoring a tooth in an esthetic zone. This study aimed to evaluate the buccal aspect after immediate implant using the dual-zone therapeutic concept compared to grafting the buccal gap to the bone crest. MATERIALS AND METHODS Twenty-four patients were randomly assigned into either immediate implant with the dual-zone therapeutic concept (DZ, test group) or with bone grafting till buccal bone crest with immediate temporization (BCG, control group). Pink esthetic score (PES), buccal bone loss (BBL), mid-facial recession (MFR), soft tissue thickness (STT), keratinized tissue width (KTW), post-operative swelling (POS), and patient satisfaction (PS) were evaluated for 1 year. RESULTS At 12 months the PES in the test group was 11.36 ± 1.69, and 10.80 ± 1.55 in the control group, with no statistically significant difference (p = 0.45). MFR in the DZ and BCG groups was 0.27 ± 0.34 and 0.45 ± 0.44 after 12 months with no statistical significance difference (p = 0.195). The STT assessment showed a statistically significant increase in both groups, however the intergroup comparison was statistically not significant (p = 0.23). The mean KTW in the DZ and BCG groups was 4.55 ± 1.08 and 4.20 ± 0.82 mm, respectively with no statistical significance (p = 0.42). There was no statistical significant difference in patient satisfaction between the two groups except in question number 10 concerning the post-operative swelling which was higher in the DZ group (p = 0.009). CONCLUSIONS Both treatment modalities are considered reliable methods to achieve good soft tissue esthetics. However, both treatment modalities were not effective in preventing facial bone resorption despite the use of bone graft.
Collapse
Affiliation(s)
- Remon Wahid Wanis
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, Old Cairo, Egypt
| | - Manal Mohamed Hosny
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, Old Cairo, Egypt
| | - Hani ElNahass
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, Old Cairo, Egypt
| |
Collapse
|
40
|
de Araújo Nobre M, Lopes A, Antunes E. The 10 Year Outcomes of Implants Inserted with Dehiscence or Fenestrations in the Rehabilitation of Completely Edentulous Jaws with the All-on-4 Concept. J Clin Med 2022; 11:jcm11071939. [PMID: 35407547 PMCID: PMC8999632 DOI: 10.3390/jcm11071939] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 02/10/2022] [Revised: 03/25/2022] [Accepted: 03/27/2022] [Indexed: 12/10/2022] Open
Abstract
Background: There is a need for a long-term evidence of implants placed in challenging conditions. The aim of this study was to investigate the outcome of full-arch rehabilitations with the All-on-4 concept for implants inserted with dehiscence or fenestrations. Methods: This retrospective cohort study included 123 patients (dehiscence, n = 87 patients; fenestrations, n = 28 patients; both conditions, n = 8 patients), with a total of 192 implants in immediate function presenting dehiscence (n = 150), fenestrations (n = 40), or both conditions (n = 2). Primary outcome measures were cumulative implant survival (CSurR) and success (CSucR) rates. Secondary outcome measures were prosthetic survival, marginal bone loss, and incidence of biological complications. Results: CSurRs were 94.1% (overall), 95.6% (dehiscence), and 88.1% (fenestrations) at 10 years using the patient as the unit of analysis. Smoking affected implant failure significantly (p = 0.019). Implant-level CSurRs and CSucRs at 10 years were 96.2% and 93.5% (overall), 97.2% and 94.6% (dehiscence), and 90.0% and 87.6% (fenestrations), respectively. Average bone resorption at 5 and 10 years was 1.22 mm and 1.53 mm, respectively. Biological complications occurred in 18 patients (n = 18 implants). Conclusions: Implants inserted with dehiscence or fenestrations demonstrate good long-term outcomes with overall high success and survival rates and low average marginal bone resorption, despite an inferior outcome in implants with fenestrations and smoking’s negative effect.
Collapse
Affiliation(s)
- Miguel de Araújo Nobre
- Research, Development and Education Department, Maló Clinic, 1600-042 Lisboa, Portugal
- Correspondence: ; Tel.: +351-21-7228-100
| | - Armando Lopes
- Oral Surgery Department, Maló Clinic, 1600-042 Lisboa, Portugal;
| | - Elsa Antunes
- Dental Hygiene Department, Maló Clinic, 1600-042 Lisboa, Portugal;
| |
Collapse
|
41
|
Sobczak B, Majewski P. An Integrated Fully Digital Prosthetic Workflow for the Immediate Full-Arch Restoration of Edentulous Patients-A Case Report. Int J Environ Res Public Health 2022; 19:ijerph19074126. [PMID: 35409808 PMCID: PMC8998896 DOI: 10.3390/ijerph19074126] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 03/23/2022] [Accepted: 03/28/2022] [Indexed: 11/16/2022]
Abstract
Digital prosthetic workflows may significantly increase the efficiency and predictability of the immediate rehabilitation of implant-supported fixed complete dentures. Advanced digital prosthetic workflows require exact and detailed virtual planning models. The direct generation of these models via direct digital impressions remains technique sensitive and demanding. This report illustrates an advanced digital workflow for accurate and efficient immediate full-arch restoration, with an aesthetically and anatomically adapted natural tooth-like prosthesis. The workflow application to fully edentulous arches, and arches with residual failing dentition, is presented. A key characteristic was efficiently integrating and interlinking the prosthetic and surgical workflows via denture replica surgical guides as landmarks for scan registration. This approach allowed for accurate implant placement and efficient and detailed anatomy-based chairside prosthetic planning, and for the manufacturing of the provisional and final restorations under detailed consideration of implant restoration, and the patient's macro-aesthetic and soft tissue anatomy.
Collapse
Affiliation(s)
- Barbara Sobczak
- Dr Sobczak Dental Clinic, 04-881 Warsaw, Poland
- Correspondence:
| | - Piotr Majewski
- Implant Dentistry Department, Dental Institute Collegium Medicum, Jagiellonian University, 31-155 Cracow, Poland;
| |
Collapse
|
42
|
Ferro AS, de Araújo Nobre MA, Simões R. Ten-year follow-up of full-arch rehabilitations supported by implants in immediate function with nasal and full-length palatine bicortical anchorage on the anterior maxilla. J Oral Sci 2022; 64:129-134. [PMID: 35321963 DOI: 10.2334/josnusd.21-0378] [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] [Indexed: 11/01/2022]
Abstract
PURPOSE To evaluate the immediate function of anterior maxillary implants. METHODS One hundred nine patients (42 males and 67 females; average age 55.2 years; range 38-81 years) were followed for 10 years. One hundred eighty-eight implants using nasal and full-length palatine cortical anchorage were inserted in the anterior section of the maxilla together with 188 tilted implants placed posteriorly. Outcome measures were implant success and survival, prosthesis survival, bone loss, and the incidence of biological and mechanical complications. Cumulative success and survival were computed through Kaplan-Meyer product limit estimator (at patient level) and life tables (implant level). RESULTS Four patients lost one implant each, giving a 10-year cumulative survival rate of 95.8% and 97.7% using the patient and the implant as the unit of analysis, respectively. The prosthesis survival rate was 98.2%, and the average marginal bone loss was 1.79 mm (1.06 mm). The cumulative success rate was 89.1% and 92.5% using the patient and the implant as the unit of analysis, respectively. CONCLUSION Full-arch fixed prosthetic rehabilitations supported by immediately functional implants inserted in the anterior maxilla with bicortical anchorage together with posterior-tilted implants are viable in the long term.
Collapse
Affiliation(s)
| | - Miguel A de Araújo Nobre
- Research, Development and Education Department, Maló Clinic.,Oral Hygiene Department, Maló Clinic
| | | |
Collapse
|
43
|
Naishlos S, Reiser V, Zelikman H, Nissan J, Masri D, Nassra H, Chaushu G, Blumer S, Chaushu L. Esthetic Assessment following Ridge Augmentation, Late Implant Placement and Immediate Esthetic Reconstruction of the Atrophic Anterior Maxilla. Int J Environ Res Public Health 2022; 19. [PMID: 35329376 DOI: 10.3390/ijerph19063689] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 03/17/2022] [Accepted: 03/19/2022] [Indexed: 11/17/2022]
Abstract
Purpose: Evaluate the esthetic outcome of ridge augmentation using cancellous bone-block allografts, late implant placement, and immediate loading in the atrophic anterior maxilla, by PES (pink esthetic score) and WES (white esthetic score) indexes. Materials and Methods: Retrospective cohort study. Inclusion criteria were bone loss of at least 3 mm horizontally and 3 mm vertically according to preliminary CBCT; ridge augmentation using cancellous bone-block allografts; six months later the implant insertion and immediately loaded. PES-WES index was used for esthetic assessment of soft tissues surrounding the final implant-supported prosthesis (ISP). Results: All twenty-five successive individuals were included. The mean follow-up was 12.1 ± 56 months (range, 42−90 months). The mean PES index and WES index were 7 ± 1.74 (range: 5−10) and 8.4 ± 2.12 (range: 5−10), respectively. The mean total combination of PES index and WES index (PES/WES) was 15.3 ± 2.85 (range: 12−20). All ISPs had an overall score >12 (the defined threshold of clinical acceptability). Conclusions: Ridge augmentation in the atrophic anterior maxilla using cancellous bone-block allografts and immediate loading allows a stable esthetic result of the soft and hard tissues over the years (follow-up of 42−90 months).
Collapse
|
44
|
Seijas Naya F, García García A, Galindo-Moreno P, Gude Sampedro F, Reboiras López D, Rodríguez Zorrilla S, Gándara Vila P, Chamorro Petronacci CM, Otero Rey E, Somoza Martin JM, Blanco Carrión A, Pérez Sayáns M. Influence of loading and drilling on marginal bone loss around implants with a Dynamic Bone Management design: A single-blind, randomised, 12-month clinical trial. Int J Oral Implantol (Berl) 2022; 15:71-86. [PMID: 35266670] [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: 06/14/2023]
Abstract
PURPOSE To evaluate marginal bone loss 6 and 12 months after prosthetic loading of implants with Dynamic Bone Management (Straumann, Basel, Switzerland) through the implementation of different drilling protocols. MATERIALS AND METHODS A balanced, randomised, single-blind clinical trial was conducted with four parallel experimental arms: immediate loading and under-drilling, immediate loading and complete drilling, early loading and under-drilling, and early loading and complete drilling. Forty-four implants with a Dynamic Bone Management design and with a diameter of 3.75 mm and a length of 10.00 mm were placed in healed mature bone (more than 6 months post-extraction). RESULTS The mean primary stability achieved was 60.6 ± 12.2 implant stability quotient, with a range from 21 to 75, and no differences were observed when considering the drilling protocol used, bone type or location. Early loading resulted in a loss of 0.728 mm (standard error 0.212; 95% confidence interval 1.134 to -0.325; t value -3.440), whereas immediate loading did not result in any bone loss. When the interaction between the loading and drilling protocols was studied, performing the complete drilling protocol in conjunction with early implant loading was found to result in lower marginal bone loss, with a marginal bone gain effect of 0.814 mm (standard error 0.283; 95% confidence interval -0.274 to 1.353; t value 2.880). CONCLUSIONS Use of the complete drilling protocol in conjunction with early implant loading resulted in the lowest marginal bone loss at 12 months.
Collapse
|
45
|
Carosi P, Lorenzi C, Lio F, Cardelli P, Pinto A, Laureti A, Pozzi A. Accuracy of Computer-Assisted Flapless Implant Placement by Means of Mucosa-Supported Templates in Complete-Arch Restorations: A Systematic Review. Materials (Basel) 2022; 15:1462. [PMID: 35208002 DOI: 10.3390/ma15041462] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 02/10/2022] [Accepted: 02/14/2022] [Indexed: 01/10/2023]
Abstract
The aim of this study was to systematically review the current scientific literature regarding the accuracy of fully guided flapless implant positioning for complete-arch rehabilitations in edentulous patients and to assess if there was any statistically significant correlation between linear deviation at shoulder point, at apex point and angular deviation. The electronic and manual literature search of clinical studies was carried out using specified indexing terms. A total of 13 studies were eligible for qualitative analysis and 277 edentulous patients were rehabilitated with 1556 implants patients by means of fully guided mucosa-supported template-assisted flapless surgery. Angular deviation was 3.42° (95% CI 2.82–4.03), linear deviation at shoulder point 1.23 mm (95% CI 0.97–1.49) and linear deviation at apex point 1.46 mm (95% CI 1.17–1.74). No statistically significant correlations were found between the linear and angular deviations. A statistically significant correlation was found between the two linear deviations (correlation coefficient 0.91) that can be summarized by the regression equation y = 0.03080 + 0.8254x. Computer-assisted flapless implant placement by means of mucosa-supported templates in complete arch restorations can be considered a reliable and predictable treatment choice despite the potential effects that flapless approach could bring to the overall treatment.
Collapse
|
46
|
Keshari R, Chand P, Singh BP, Jurel SK, Singh R, Singh PK. Comparison of Crestal Bone Loss and Osteocalcin Release Kinetics in Immediately and Delayed Loaded Implants: A Randomised Controlled Trial. J Prosthodont 2022; 31:579-584. [PMID: 35150170 DOI: 10.1111/jopr.13495] [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: 05/16/2021] [Accepted: 02/08/2022] [Indexed: 11/30/2022] Open
Abstract
PURPOSE To compare concentration and release kinetics of osteocalcin and crestal bone loss under immediate and delayed loading conditions during osseointegration. MATERIALS AND METHODS Forty-one patients who were indicated for rehabilitation with dental implants randomly received either implant with placement of permanent prosthesis after 3 months (delayed loading) or implant with placement of permanent prosthesis within 7 days (immediate loading). Radiographic assessment of crestal bone loss at the mesial and distal surface was done at 3, 6 and 12 months after implant placement. Peri-implant sulcular fluid was collected immediately from the buccal surface at two sites after implant insertion and also, at 7, 15, 30 and 90 days after surgery. The level of osteocalcin was evaluated using ELISA and data were compared using two sample t-test. Differences between two groups were analyzed by unpaired Student's t test. Intragroup comparison was done by repeated measures ANOVA. RESULTS Mean crestal bone loss was lower in the immediate loading group compared to the delayed loading group at 3, 6 and 12 months (P < 0.001). Intragroup comparison revealed a statistically significant increase in osteocalcin levels in both group I (F = 26712.2) and group II (F = 10497.2) at the predetermined time intervals CONCLUSIONS: Lesser crestal bone loss and early release of osteocalcin was found in the immediately loaded condition than in the delayed loaded condition. The study substantiates that immediately loaded implants shows less crestal bone as well as early release of osteocalcin facilitating upregulation of bone metabolism, improving long term health of bone and prognosis of implants. Immediately loaded implants can be a better treatment protocol provided there is adequate bone and primary stability. This article is protected by copyright. All rights reserved.
Collapse
Affiliation(s)
- Rishabh Keshari
- Department of Prosthodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, India
| | - Pooran Chand
- Department of Prosthodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, India
| | - Balendra P Singh
- Department of Prosthodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, India
| | - Sunit K Jurel
- Department of Prosthodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, India
| | - Ranjana Singh
- Department of Prosthodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, India
| | - Punit Kumar Singh
- Department of Prosthodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, India
| |
Collapse
|
47
|
Pozzi A, Arcuri L, Kan J, Londono J. Navigation guided socket-shield technique for implant and pontic sites in the esthetic zone: A proof-of-concept 1-year prospective study with immediate implant placement and loading. J ESTHET RESTOR DENT 2022; 34:203-214. [PMID: 34994995 DOI: 10.1111/jerd.12867] [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: 12/11/2021] [Revised: 12/29/2021] [Accepted: 12/30/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To assess clinical, radiological performance of novel navigation guided socket-shield technique (NSS) with immediate implant placement and loading. MATERIALS AND METHODS Eighteen patients (12 females; age 52.54 ± 4.92; 33-72) treated between January 2018 and June 2019, were investigated, and followed for at least 1 year after definitive prosthesis placement (mean 20.1 months, 18-23). Primary outcomes: implant and prosthetic success rates, surgical, biologic, prosthetic complications. SECONDARY OUTCOMES marginal bone loss (MBL), implant stability quotient (ISQ), pink esthetic score (PES), plaque and bleeding indexes. RESULTS Sixty-nine navigation guided socket-shield procedures were performed (27 implant-sites and 42 pontic-sites) and 27 implants (NobelParallel, NobelBiocare AG) positioned and immediately loaded. Mean insertion torque and ISQ at implant positioning were 49 ± 5.34 Ncm (36-74), 73 ± 5.72 (68-81). No implant failure was experienced. Two root-shield exposures with mucositis, ulceration and bleeding were reported at two pontic-sites (2.9%) and successfully treated. No complications were experienced at implant-site leading to an overall NSS success-rate of 100%. No prosthetic complications occurred. Mean MBL was -0.72 ± 0.26 mm (-0.42 to -1.06 mm). PES final at the last follow-up 12.84 ± 0.92. The plaque and bleeding scores were 18.5 ± 6.12 and 3.15 ± 2.21. CONCLUSIONS Within study limitations, dynamic navigation was effective to streamline execution of socket-shield technique at implant and pontic sites, shortening treatment time and reducing complications. Navigation guided socket-shield technique was reliable to achieve digitally planned shield-to-implant distance, facilitate immediate implant placement and loading and establish the mucosal dimension needed for underlying bone-to-implant protection and esthetic integration. CLINICAL SIGNIFICANCE The investigated NSS technique overcomes the difficulties related to root preparation at implant and pontic-sites, facilitating immediate implant placement and loading. Dynamic guided surgery contributed to make socket-shield technique less technical-sensitive, shortening time for execution, reducing complication rate.
Collapse
Affiliation(s)
- Alessandro Pozzi
- Department of Restorative Sciences, Augusta University, Goldstein Center for Esthetic and Implant Dentistry, Augusta, Ga, USA
| | - Lorenzo Arcuri
- PhD Materials for Health, Environment and Energy, University of Tor Vergata, Rome, Italy
| | - Joseph Kan
- Advanced Dental Education Program in Implant Dentistry, School of Dentistry, Loma Linda University, Loma Linda, California, USA
| | - Jimmy Londono
- Goldstein Center for Esthetic and Implant Dentistry, Department of Restorative Sciences, The Dental College of Georgia at Augusta University, Augusta, Ga, USA
| |
Collapse
|
48
|
Husain F, Gupta S, Sood S, Bhaskar N, Jain A. To evaluate the effect of anodized dental implant surface on cumulative implant survival and success. A systematic review and meta-analysis. J Indian Soc Periodontol 2022; 26:525-532. [PMID: 36582952 PMCID: PMC9793921 DOI: 10.4103/jisp.jisp_797_20] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 06/20/2021] [Accepted: 01/09/2022] [Indexed: 12/12/2022] Open
Abstract
Background There have been certain apprehensions regarding the use of surface-modified dental implants due to peri-implant infection and crestal bone loss over the years. Thus, this review aims to evaluate the long-term effect of anodized implant surface on cumulative implant survival (CSR) and success rates in relation to marginal bone loss (MBL). Materials and Methods Systematic electronic search was done using two databases, PubMed and Embase to assess the potentially relevant records from January 2008 to October 2019. Publications reporting cumulative survival and success rates with anodized dental implants were identified. Screening for duplicate articles and extraction of data was carried out to formulate evidence tables. Meta-analysis was conducted following PRISMA guidelines. Results Out of 217 observational clinical studies, 8 studies were selected based on predefined selection criteria. The summary estimate for the included studies for CSR was reported as 0.98 (95% confidence interval [CI]: 0.96; 0.99). The heterogeneity (I2 = 37.3%) among these studies was found to be statistically nonsignificant (P = 0.1314). The mean values of MBL after the implant insertion were 0.84 mm at 0-1 year and 1.05mm by the end of follow-up period. This data were provided by five studies only. The mean difference of the analyzed studies came out to be 0.49 mm with a 95% CI (-0.22; 1.19). The heterogeneity (I 2 = 97%) for these studies was statistically significant with P < 0.01. Conclusion The anodized dental implants have demonstrated long-term survival and success rates in terms of clinical outcomes.
Collapse
Affiliation(s)
- Firasat Husain
- Department of Periodontics, Dr. Harvansh Singh Judge Institute of Dental Sciences and Hospital, Panjab University, Chandigarh, India
| | - Shipra Gupta
- Oral Health Sciences Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Shaveta Sood
- Department of Periodontics, Dr. Harvansh Singh Judge Institute of Dental Sciences and Hospital, Panjab University, Chandigarh, India
| | - Nandini Bhaskar
- Department of Periodontics, Dr. Harvansh Singh Judge Institute of Dental Sciences and Hospital, Panjab University, Chandigarh, India
| | - Ashish Jain
- Deparment of Dental, Dental Institute, RIMS, Bariatu, Ranchi, India,Address for correspondence: Dr. Ashish Jain, Department of Periodontics, Dr. Harvansh Singh Judge Institute of Dental Sciences and Hospital, Panjab University, Chandigarh, India. E-mail:
| |
Collapse
|
49
|
Singh K, Chand P, Chaurasia A, Solanki N, Pathak A. A randomized controlled trial for evaluation of bone density changes around immediate functionally and nonfunctionally loaded implants using three-dimensional cone-beam computed tomography. J Indian Prosthodont Soc 2022; 22:74-81. [PMID: 36510950 PMCID: PMC8884349 DOI: 10.4103/jips.jips_327_21] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Aim The aim of this study was to compare and assess bone density changes around immediate functionally and nonfunctionally loaded implants. Settings and design In vivo comparative study. Materials and Methods Sixty participants selected based on the predetermined inclusion and exclusion criteria received single tooth implants in mandible under two implant loading protocols: Immediate functionally loaded (IFL) and immediate nonfunctionally loaded (INFL). Randomization was done by computer-aided simple randomization procedure. Self-tapering, aggressive SLA implants were placed in the single tooth edentulous sites of mandible in both the groups. Three-dimensional cone-beam computed tomography (3D CBCT) was taken at baseline, 3 and 6 months postimplant placement. Quantitative analysis of the bone density was performed using 3D CBCT in three areas around the implants at crestal, middle, and apical regions of implants. Statistical Analysis Used Quantitative data were summarized as mean ± standard deviation. Statistical analyses were performed using the SPSS software version 21.0 (SPSS Inc., Chicago, IL, USA) by unpaired t-test. Results Bone density changes after implant placement in IFL group from baseline to 3 months were; crestal region (314.18 ± 71.69), middle (278.23 ± 70.17), apical (274.70 ± 59.79) and changes from 3 to 6 months were; crestal (-105.55 ± 39.60), middle (-114.80 ± 41.46), apical (-141.88 ± 69.58). Bone density changes after implant placement in INFL group from baseline to 3 months were crestal region (199.42 ± 47.97), middle (56.91 ± 10.39), apical (200.98 ± 67.43) and changes from 3 to 6 months were; crestal (-194.38 ± 75.30), middle (-204.40 ± 63.75), apical (-191.28 ± 62.33). Conclusions It was concluded that INFL implant group showed better bone density when compared to IFL implant group.
Collapse
Affiliation(s)
- Kamleshwar Singh
- Department of Prosthodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India,Address for correspondence: Dr. Kamleshwar Singh, Department of Prosthodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India. E-mail:
| | - Pooran Chand
- Department of Prosthodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Akhilanand Chaurasia
- Oral Medicine, Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Neeti Solanki
- Department of Prosthodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Anupama Pathak
- Department of Prosthodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India
| |
Collapse
|
50
|
Liu XQ, Liu JZ, Feng HL, Heng MD, Wang B, Pan SX. Time Efficiency of Immediate Loading of Full-arch Implant Reconstructions Using Prefabricated Prostheses Located by an Anchor Pin: a Pilot Study. Chin J Dent Res 2021; 24:257-265. [PMID: 35029097 DOI: 10.3290/j.cjdr.b2440831] [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: 06/14/2023]
Abstract
OBJECTIVE To investigate the time efficiency of prefabricated prostheses located by an anchor pin stereolithographic attachment system for immediate loading implant reconstruction of completely edentulous jaws and compare it with the conventional protocol. METHODS Edentulous patients were recruited and randomly assigned into two groups: the full digital workflow group (digital group) and the conventional workflow group (conventional group). In the digital group, a provisional prosthesis was fabricated before surgery using a fully digital workflow and delivered immediately after implant placement. The positioning of the provisional prosthesis was guided precisely by the anchor pin attachment system. In the conventional group, the provisional prosthesis was fabricated after implant placement using a conventional procedure. Clinical and laboratory time efficiency were recorded, and clinician and patient satisfaction were evaluated. RESULTS Six patients were enrolled in this pilot study and 57 implants were placed following the guided surgery protocol. Of these, 54 were immediately loaded. The total clinical chair time in the digital workflow group was significantly less than that in the conventional workflow group (digital 60.0 ± 13.2 minutes; conventional 106.7 ± 24.7 minutes) (P = 0.045). The total post-surgery procedure took significantly less time in the digital group than the conventional group (digital 202.5 ± 22.5 minutes; conventional 403.7 ± 55.4 minutes) (P = 0.004). The patients' and clinicians' satisfaction with the provisional prostheses was similar in both groups. CONCLUSION Time efficiency in immediate loading of implant-supported full-arch fixed restorations was improved with prefabricated prostheses located by the anchor-pin-attachment system. Less postoperative chair time was required in the digital group than in the conventional group.
Collapse
|