Material and methods : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results [2]
Simulation of the expansion process. At the end of the expansion process, a minimal snap back is realised. (MP4 9407 kb)
Planning of the implantological treatment followed usual clinical and radiological examination and, concerning the position and number of implants, the recommended categories from the German consensus conference [35]. The drilling sequence, condensing preparation (where necessary) and manual implant insertion as well as expansion are described in detail in Table 2. Participants were instructed not to wear their denture 1 week after surgery. Afterwards, the conventional dentures were relined with soft material (Visco-gel, Dentsply, Salzburg, Austria). In this study, conventional periods of submerged healing were chosen: 3 months in the mandible and 6 months in the maxilla. During the re-entry surgery, a minimum of 2-mm keratinised periimplant soft tissue mucosa was considered.
All prosthetic treatments were provided at the University School of Dental Medicine, Department of Prosthetic Dentistry. At the earliest, 2 weeks after surgical re-entry, prosthetic treatment was started. All treatment steps were performed as described in detail in Table 3. The abutment screws were fixed with a torque of 15 N cm. Wherever possible, adjacent implants were primarily splinted (crowns, bar) and extra-axial loading during dynamic occlusion was avoided. In other cases, eccentric group guidance was achieved. To reduce overloading in the periimplant bone and implant-abutment connection, the occlusal surface was designed smaller [20, 21, 30, 36]. Patients were instructed about optimal oral hygiene, and the use of a dental water jet was recommended.
All treatments were provided by two experienced maxillofacial surgeons (WR, CH) and two experienced prosthodontists (RS, JH) to minimise bias.
The first clinical follow-up was arranged at the latest 4 weeks after prosthetic treatment was completed. Further follow-ups were scheduled quarterly in the first year and later every 6 months. Patients were screened clinically and radiologically (yearly) for biological and technical complications. The authors applied the abovementioned success criteria according to Buser et al. [32]. Crestal bone changes were evaluated on digital radiograms (SIDEXIS imaging software, Sirona, Bensheim, Germany). The distance between the implant shoulder and first bone-implant contact at the mesial and distal aspect of each implant was measured (implant length as reference) by the first author (WR), and the mean values per implant were calculated [37] 1 and 2 years after loading.
Serial posts:
- Abstract : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results
- Introduction : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results [1]
- Introduction : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results [2]
- Material and methods : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results [1]
- Material and methods : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results [2]
- Material and methods : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results [3]
- Results : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results [1]
- Results : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results [2]
- Discussion : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results [1]
- Discussion : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results [2]
- Discussion : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results [3]
- Discussion : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results [4]
- Discussion : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results [5]
- Conclusion : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results
- Abbreviations : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results
- References : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results [1]
- References : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results [2]
- References : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results [3]
- References : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results [4]
- References : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results [5]
- References : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results [6]
- References : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results [7]
- Acknowledgements : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results
- Author information : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results [1]
- Author information : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results [2]
- Ethics declarations : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results
- Additional files : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results
- Rights and permissions : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results
- About this article : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results
- Table 1 Patient recruitment : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results
- Table 2 Surgical treatment protocol : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results
- Table 3 Prosthetic treatment protocol : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results
- Table 4 Clinical characteristics of the study cohort : Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results
- Fig. 1. a Closed short expandable dental implant (4.1 × 7 mm). The implant-abutment connection is characterised by an internal hexagon for rotation stability, combining the advantages of conical and parallel surfaces to reduce microgaps and micromovement [68]. The microthread concept and platform switching concept are implemented in the implant shoulder to reduce periimplant bone strain [53]. b Manual fixation of the expansion tool. Take note of the distance between both yellow rings. c Completion of the expansion process using the ratchet. Take note of the contact between both yellow rings. d Opened short expandable dental implant (4.1 × 7 mm). The expanded implant provides an increased bone-to-implant interface (pyramid shape) in the apical portion [54]. e Cross-section view of the implant apex. The apical expansion process is characterised by the unfolding of four wings, which are connected by four foils. D1: diameter of the closed implant. D2: diameter of the opened implant. fTop v
- Fig. 2. Cumulative implant survival over the follow-up period. The Kaplan-Meyer diagram visualises the analysis of implant survival in the maxilla and in the mandible (log rank test, p = 0.173) over the follow-up period up to 37 months (Table 4) : Novel expandable short dental implant
- Fig. 3. a Primary implant stability. The histogram visualises the distribution of the implant stability quotients (ISQ) for both jaws measured by resonance frequency analysis (Osstell AB, Göteborg, Sweden). b Secondary implant stability. The histogram shows the distribution of the implant stability quotients (ISQ) of osseointegrated implants. According to the measurement implant stability was classified as low with ISQ values < 60, medium with ISQ values 60–70, and high with values ISQ > 70 [34] : Novel expandable short dental implant
- Fig. 4. a–h Prosthetic restauration—follow-up examination. Intraoral and perioral views of a rehabilitated female patient. (She asked explicitly only for implantological treatment in the mandible.) : Novel expandable short dental implant
- Fig. 5. a Postoperative orthopantomogram. b Follow-up orthopantomogram. c Follow-up standard periapical radiogram (implants i42 and i44). d Follow-up standard periapical radiogram (implants i32 and i34) : Novel expandable short dental implant