Fig. 6. Position of the right mental foramen
Fig. 5. Position of the left mental foramen
Fig. 4. Left (l) and right (r) mandibular bone thickness (bt) in the four age groups (group 1, 0–20 years old; group 2, 21–40 years old; group 3, 41–60 years old; group 4, 61 and older) in men (0) and women [1]
Fig. 3. Left (l) and right (r) mandibular bone thickness in all patients
Fig. 2. Definition of the position of the mental foramen
Fig. 1. Measurement of mandibular bone thickness, defined as the distance between the lateral wall of the mandibular canal and the lateral mandibular compact bone (solid turquoise line)
Age groupTotal1234SexMale41363930146Female44513538168Total 85877468314Table 1 Number of men and women in each age group (group 1, 0–20 years old; group 2, 21–40 years old; group 3, 41–60 years old; group 4, 61 and older)
Valdec, S., Borm, J.M., Casparis, S. et al. Vestibular bone thickness of the mandible in relation to the mandibular canal—a retrospective CBCT-based study.
Int J Implant Dent 5, 37 (2019). https://doi.org/10.1186/s40729-019-0189-z
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Published: 15 November 2019
DOI: https://doi.org/10.1186/s40729-019-0189...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
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Silvio Valdec and Jan Borm are equally contributing first authors.
The study was approved by the cantonal ethics committee of the canton of Zurich (KEK 2018-01691).
Not applicable.
Silvio Valdec, Jan Borm, Stephanie Casparis, Georg Damerau, Michael Locher and Bernd Stadlinger declare that they have no competing interests.
Silvio Valdec and Jan M. Borm contributed equally to this work.
Clinic of Cranio-Maxillofacial and Oral Surgery, Centre for Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
Silvio Valdec, Jan M. Borm, Stephanie Casparis, Georg Damerau, Michael Locher & Bernd Stadlinger
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This study was conducted without external funding.
The authors thank Jacquie Klesing, Board-Certified Editor in the Life Sciences (ELS), for editing assistance with the manuscript. Further, we thank Malgorzata Roos for supporting the statistical analysis.
Namano S, Behrend DA, Harcourt JK, Wilson PR. Angular asymmetries of the human face. Int J Prosthodont. 2000;13(1):41–6.
Phillips JL, Weller RN, Kulild JC. The mental foramen: 2. Radiographic position in relation to the mandibular second premolar. J Endod. 1992;18(6):271–4.
Pyun JH, Lim YJ, Kim MJ, Ahn SJ, Kim J. Position of the mental foramen on panoramic radiographs and its relation to the...
Nucera R, Lo Giudice A, Bellocchio AM, Spinuzza P, Caprioglio A, Perillo L, et al. Bone and cortical bone thickness of mandibular buccal shelf for mini-screw insertion in adults. Angle Orthod. 2017;87(5):745–51.
Scomparin L, Soares MQ, Rubira CM, Yaedu RY, Imada TS, Centurion BS, et al. CBCT location of the fusion between the buccal and lingual cortical in the mandibular ramus: importance to sa...
Benninger B, Miller D, Maharathi A, Carter W. Dental implant placement investigation: is the anterior loop of the mental nerve clinically relevant? J Craniomaxillofac Surg. 2011;69(1):182–5.
Greenstein G, Tarnow D. The mental foramen and nerve: clinical and anatomical factors related to dental implant placement: a literature review. J Periodontol. 2006;77(12):1933–43.
Kuribayashi A, Watanabe...
Ozturk A, Potluri A, Vieira AR. Position and course of the mandibular canal in skulls. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;113(4):453–8.
Agbaje JO, de Casteele EV, Salem AS, Anumendem D, Lambrichts I, Politis C. Tracking of the inferior alveolar nerve: its implication in surgical planning. Clin Oral Investig. 2017;21(7):2213–20.
Zahedi S, Mostafavi M, Lotfirikan N. Anatomic stud...
Bone thickness
Cone-beam computed tomography
Digital Imaging and Communications in Medicine
Inferior alveolar nerve
The original datasets supporting the findings are available.
The results of this study support the relevance of a preoperative CBCT to allow detailed planning of a surgical intervention that may potentially touch the area of the mandibular canal. This applies to surgical procedures like wisdom tooth removal, root resection, implant placement and bone block harvesting. A CBCT allows the exact determination of the horizontal bone thickness vestibular to the I...
In a study comparing measurements between cadavers and CT images, the distance between the upper edge of the mandibular canal and the alveolar ridge showed possible over- and underestimations. The quantification showed a possible overestimation of up to 1.05 mm and a possible underestimation of up to 1.36 mm [34]. This discrepancy is of relevance in preoperative planning. Intraoperatively, a r...
The IAN is an important anatomical structure whose course affects the preoperative planning of a bone graft or implant insertion in the mandible. Knowledge on the bone thickness between the lateral wall of the mandibular canal and the lateral mandibular compact bone as well as of the position of the mental foramen facilitates decision-making [24]. Furthermore, for many other surgical procedures, t...
The median age of the patients was 40.2 years (range 12.6–84.4 years). Patients were distributed almost evenly across the age groups (see Table 1).
Figure 3 clearly shows the median vestibular bone thicknesses (bt) at 2-mm intervals throughout the anterior to posterior course of the canal on both the right (bt2 r to bt66 r) and left (bt2 l to bt66 l) side of the mandible. The maximum di...
In addition, the position of the mental foramen was determined relative to the roots of the neighbouring teeth. This was assessed by defining regions of interest in the area of the first premolar, second premolar and first molar by extending the respective mesial and distal points of the cement-enamel junction caudally along the tooth axis. The position of the midpoint of the mental foramen was th...
Three hundred fourteen cone-beam computed tomograms (CBCTs) from 168 (53.5%) females and 146 (46.5%) males from the database of the Department of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Switzerland, from the years 2008 to 2013 were analysed. Patients were divided into 4 age groups: group 1 = 0–20 years, group 2 = 21–40 years, group 3...
The mandibular canal is a bilateral, intraosseous opening through which the IAN runs from the mandibular foramen to the mental foramen. The nerve innervates the teeth, the mucous membranes in the area of the mental foramen and the skin around the chin [14, 15]. Anatomical variations of the mandibular canal, such as bifid canals and an anterior loop of the mental nerve, are common [16, 17] and have...
When performing any kind of surgical procedure, a surgeon needs to be familiar with the possible variations in the anatomical configurations of both the mandibular canal and inferior alveolar nerve (IAN) [1,2,3]. This is particularly the case when performing root resections, removing wisdom teeth or harvesting autologous bone grafts.
Different techniques are described for reconstruction of missin...
Fig. 8. Mean values of crestal bone loss (CBL) between the two groups during the follow-up period. ANOVA test
Fig. 8. Mean values of crestal bone loss (CBL) between the two groups during the follow-up period. ANOVA test
Fig. 7. Changes of CBL (mm) between the two groups in sites with KKT > 2 and ≤ 2 mm. ANOVA test
Fig. 7. Changes of CBL (mm) between the two groups in sites with KKT > 2 and ≤ 2 mm. ANOVA test
Fig. 6. Mean values of gingival recession (REC) between the two groups at the end of follow-up period (3-year). ANOVA test
Fig. 6. Mean values of gingival recession (REC) between the two groups at the end of follow-up period (3-year). ANOVA test
Fig. 5. Mean values of probing depth (PD) between the two groups during the follow-up period. ANOVA test P > 0.05
Fig. 5. Mean values of probing depth (PD) between the two groups during the follow-up period. ANOVA test P > 0.05
Fig. 4. Schematic view of radiographic measurement references
Fig. 4. Schematic view of radiographic measurement references
Fig. 3. Implants used in the present study and laser-microtextured intramucosal surface (original magnification × 800)
Fig. 3. Implants used in the present study and laser-microtextured intramucosal surface (original magnification × 800)
Fig. 2. Example of the location of a submerged implant, bone, and adjacent tooth
Fig. 2. Example of the location of a submerged implant, bone, and adjacent tooth
Fig. 1. Example of the location of a non-submerged implant, bone, and adjacent tooth
Fig. 1. Example of the location of a non-submerged implant, bone, and adjacent tooth
FMPPD (mm)FMPS (%)FMBS (%)Mean (SD)Mean (SD)Mean (SD)Baseline1.6 (0.3)13.7 (2.1)11.4 (1.7)3-year follow-up (T3)1.8 (0.2)15.1 (1.4)12.3 (1.4)Significance0.770.810.39Table 4 Patients’ full-mouth periodontal probing depth (FMPPD), full-mouth plaque score (FMPS), and full-mouth bleeding score (FMBS) recorded during the follow-up period
T01-year2-year3-yearNumber of sites with plaque Submerged77912 Nonsubmerged1210811 Significance0.230.310.220.82Number of sites with BOP Submerged210914 Nonsubmerged610411 Significance0.080.750.510.41Table 3 Differences in number of sites with plaque and bleeding on probing (BOP) between the two groups during the follow-up period (Wilcoxon signed-rank tests, P > 0.05)
PositionTotal implantsSubmergedNon-submerged142111552316312171-1244222543126321270--341-1351-13653237211442-2451-1464314722-Table 2 Distribution of each implant in each group
No. of patients/age (years)/sexPositionSubmergedNonsubmergedLength/diameter (mm)1/44y/M14X 10.5 × 3.826 X9 × 3.82/51y/M36X 9 × 4.644 X9 × 3.83/59y/F35 X10.5 × 3.846X 10.5 × 4.64/38y/F47X 9 × 4.636 X9 × 4.65/57y/M24 X12 × 3.815X 12 × 3.86/44y/F16 X9 × 4.624X 12 × 3.87/60y/M36X 10.5 × 4.646 X10.5 × 4.68/49y/F15 X12 × 3.824X 10.5 × 3.89/46y/M37X 9 × 4.645 X9 × 3.81...
Guarnieri, R., Di Nardo, D., Di Giorgio, G. et al. Clinical and radiographics results at 3 years of RCT with split-mouth design of submerged vs. nonsubmerged single laser-microgrooved implants in posterior areas. Int J Implant Dent 5, 44 (2019). https://doi.org/10.1186/s40729-019-0196-0
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Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
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The study was approved by the Institutional Ethic committee of La Sapienza University, Rome, Italy, (#4597). All patients were informed that two different implants were used and gave their informed consent to the treatment
Not applicable.
Renzo Guarnieri, Dario Di Nardo, Gianni Di Giorgio, Gabriele Miccoli, and Luca Testarelli state that they have no competing interests.
Department of Dental and Maxillofacial Sciences, School of Dentistry, University La Sapienza, Rome, Italy
Renzo Guarnieri, Dario Di Nardo, Gianni Di Giorgio, Gabriele Miccoli & Luca Testarelli
Treviso, Italy
Renzo Guarnieri
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The study was supported by BioHorizons, Birmingham, AL, USA, who provided the materials.
Authors report no conflict of interests. BioHorizons, Birmingham, AL, USA, provided the materials of the study.
Derks J, Håkansson J, Wennström JL, Tomasi C, Larsson M, Berglundh T. Effectiveness of implant therapy analyzed in a Swedish population: early and late implant loss. J Dent Res. 2015;94(3 Suppl):44S–51S.
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Al Amri MD. Crestal bone loss around submerged and nonsubmerged dental implants: a systematic review. J Prosthet Dent. 2016;115(5):564–570.e1.
Sanz M, Ivanoff CJ, Weingart D, Wiltfang J, Gahlert M, Cordaro L, Ganeles J, Bragger U, Jackowski J, Martin WC, Jung RE, Chen S, Hammerle C. Clinical and radiologic outcomes after submerged and transmucosal implant placement with two-piece implants in th...
Esposito M, Grusovin MG, Chew YS, Coulthard P, Worthington HV. One-stage versus two-stage implant placement. A Cochrane systematic review of randomised controlled clinical trials. Eur J Oral Implantol. 2009; Summer;2(2):91–9.
Berglundh T, Lindhe J. Dimension of the periimplant mucosa. Biological width revisited. J Clin Periodontol. 1996;23:971–3.
Flores-Guillen J, Álvarez-Novoa C, Barbieri ...
Esposito M, Coulthard P, Thomsen P, Worthington HV. Interventions for replacing missing teeth: different types of dental implants. Cochrane Database Syst Rev. 2005;1:CD003815.
Brånemark PI, Breine U, Adell R, Hansson BO, Lindstrom J, Ohlsson A. Intraosseous anchorage of dental prostheses. I. Experimental studies. Scand J Plast Reconstr Surg. 1969;3(2):81–100.
Brånemark PI, Hansson BO, Adell ...
The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.
After 3 years of loading, no differences were founded in CBL and soft tissue conditions between single submerged two-stage and non-submerged one-stage laser-microgrooved implants.
Few studies evaluated the influence of vertical KTT on CBL at the time of implant placement [28,29,30]. Linkevicius et al. [30] investigated the influence of vertical KTT on CBL around implants placed 2 mm supracrestally (non-submerged/test) and implants placed at bone level (submerged connected with healing abutments/control), after 1 year of loading. In sites with vertical KTT ≤ 2 mm, al...
Data from available literature indicate that if submerged/nonsubmerged techniques do affect CBL, this effect could be associated with the post-operative healing period [9, 23, 24]. In the present study, at the end of the follow-up period (3 years), no significant difference was detected in CBL around submerged and nonsubmerged implants. A possible explanation for this observation could be that s...
CBL mean values recorded around submerged and nonsubmerged implants at different timepoints are the most interesting results of the present randomized clinical trial. Before functional loading, radiographic CBL was significantly greater in submerged implants than that in nonsubmerged implants (0.23 mm ± 0.05 mm vs. 0.09 mm ± 0.07 mm). During the follow-up period, both implants showed sim...
At the end of the follow-up period, no patient dropped off the study, and the survival rate was 100% for both groups of implants.
At the 3-year follow-up, no statistically significant difference was found between the study groups regarding PI and BOP (P > 0.05). The number of sites with plaque was 12 (15%) for submerged implants and 11 (13.7%) for the nonsubmerged implants, whereas the mean numbe...
A public domain online software (Raosoft, http://www.raosoft.com/samplesize.html) was used to calculate the minimum number necessary for statistical evaluation. Data were analyzed using SPSS software version 13.0 (Chicago, IL, USA). For clinical parameters (PD and REC) and radiographic CBL, data were calculated for each implant and reported as the mean ± SD, at baseline (T0), at 1-year (T1), 2-ye...
The following radiographic measurements were performed:
radiographic implant length (IL): distance (in mm) between the implant coronal margin and the implant apex as assessed at the mid portion of the implant
residual bone height at the mesial (MI) and distal (DI) aspects of the implant: distance (in mm) between the line linking the coronal implant margin and the first contact of the crestal b...
In the submerged group, second-stage surgeries for the placement of healing abutments were carried out after 4 months in the mandible and 6 months in the maxilla. This procedure was performed by a midcrestal minimal incision, slightly larger than the coronal diameter of the implant. No secondary surgical manipulation of the soft tissue was performed. Once the healing screw was inserted, suturi...
The cases were randomly divided into two groups as two-stage/submerged and one-stage/nonsubmerged. Thus, in each patient, the two implants (submerged and nonsubmerged) were placed randomly in the left and right posterior area of the mandible, or in the left and right posterior area of the maxilla (Tables 1 and 2).
For a complete pre-surgical evaluation, an intra-oral rx and a CBCT scan examinat...
This randomized clinical trial included 20 patients, 12 males and 8 females, between the age of 36 and 64 (mean age of 49.7 ± 12.3 years), who were partially edentulous and needed implants for rehabilitation with a single tooth/implant of two non-adjacent sites. Patients were consecutively enrolled between January and July 2014. The study was approved by the Institutional Ethics committee of La...
In the last decades, the replacement of missing teeth with implant-supported restorations has become a predictable treatment with excellent long-term results [1]. It is based on the concept of intimate interfacial contact between the bone and functionally loaded dental implants, defined as “osseointegration” by Brånemark et al. [2, 3] and “functional ankylosis or direct bone apposition to t...
To evaluate and compare radiographic crestal bone loss (CBL) and soft tissue parameters around submerged/two-stage and nonsubmerged/one-stage single implants with the same endosseous portion (body design and surface, thread design and distance) and identical intramucosal laser-microgrooved surface, after 3 years of loading.
Twenty submerged/two-stage implants and 20 nonsubmerged/one-stage impla...
Figure 6. Control group. Some implant thread areas were not covered by bone layer (magnification × 25—toluidine blue)
Figure 6. Control group. Some implant thread areas were not covered by bone layer (magnification × 25—toluidine blue)
Figure 5. Control group. Implants belonging to the control group showed some small surface areas not contacted with bone (magnification × 25—toluidine blue)
Figure 5. Control group. Implants belonging to the control group showed some small surface areas not contacted with bone (magnification × 25—toluidine blue)
Figure 4. Control group. No bone condensation was possible with traditional burs and standard implant (magnification × 25—toluidine blue)
Figure 4. Control group. No bone condensation was possible with traditional burs and standard implant (magnification × 25—toluidine blue)
Figure 3. Test group. The present histological photo showed a continuous thin layer of newly formed bone along the neck area of the implant (magnification × 25—toluidine blue)
Figure 3. Test group. The present histological photo showed a continuous thin layer of newly formed bone along the neck area of the implant (magnification × 25—toluidine blue)
Figure 2. Test group. Implants in the test group showed an extremely high percentage of bone directly contacted to implant surface (magnification × 25—toluidine blue)
Figure 2. Test group. Implants in the test group showed an extremely high percentage of bone directly contacted to implant surface (magnification × 25—toluidine blue)
Figure 1. Test group. The implant achieved a high osseointegration degree. The newly formed bone appeared well interconnected with the pre-existing trabeculae. The “corticalization” phenomenon is evident: the bone appears densified around a titanium implant (magnification × 8—toluidine blue)
Figure 1. Test group. The implant achieved a high osseointegration degree. The newly formed b...
BIC%P < 0.05BV%P < 0.05VamP < 0.05Reverse torqueP > 0.05 NsISQP < 0.05Table 3 Statistical comparison (T test) of examined parameters between the test and control groups. The histomorphometric analysis demonstrated significant differences in BIC% and %BV values between the two implant groups
Implant typeBIC%BV%Vam (μm) ± SDReverse torque (N/cm) ± SDISQ value ± SDTest group70.91 ± 7.9541.83 ± 6.3082.6 ± 23.2798.2 ± 16.8163.5 ± 1.30Control group49.33 ± 10.7329.61 ± 5.0560.5 ± 16.5898.8 ± 24.4059.4 ± 1.39Table 2 Mean values of histomorphometric parameters (%BIC and %BV) and biomechanical values (VAM, reverse torque, and ISQ) of each implant group
Basal %BV 26.17 ± 2.35Test groupControl group 41.83 ± 6.30*29.61 ± 5.05Table 1 Basal bone volume percentage (basal %BV) was compared to %BV around implants after 2 months of healing in both groups. %BV in the test group was significantly higher than basal %BV (P < 0.05)
Trisi, P., Falco, A. & Berardini, M. Single-drill implant induces bone corticalization during submerged healing: an in vivo pilot study. Int J Implant Dent 6, 2 (2020). https://doi.org/10.1186/s40729-019-0198-y
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Received: 30 August 2019
Accepted: 04 December 2019
Published: 15 January 2020
DOI: https://doi.org/10.1186/s40729-019-0198-y
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
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The Ethics Committee for Animal Research of the Veterinary School of the University of Teramo (Teramo, Italy) approved the study protocol with the protocol number 8110.
The Ethics Committee for Animal Research of the Veterinary School of the University of Teramo (Teramo, Italy) approved the study protocol with the protocol number 8110.
The authors declare that they have no competing interests.
Biomaterial Clinical and Histological Research Association, Private Practice, Via Galilei 8, 65122, Pescara, Italy
Paolo Trisi, Antonello Falco & Marco Berardini
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PT contributed to the study design, animal s...
No grants were received for the present study.
The authors wish to thank Cortex® Dental Implants (Shlomi, Israel) and NoDrill® (Milano, Italy) for providing the implants used in the present study.
Gehrke SA, Bettach R, Aramburú Júnior JS, Prados-Frutos JC, Del Fabbro M, Shibli JA. Peri-Implant Bone Behavior after Single Drill versus Multiple Sequence for Osteotomy Drill. Biomed Res Int. 2018;11:2018.
Möhlhenrich SC, Abouridouane M, Heussen N, Hölzle F, Klocke F, Modabber A. Thermal evaluation by infrared measurement of implant site preparation between single and gradual drilling in art...
Summers RB. A new concept in maxillary implant surgery: the osteotome technique. Compendium. 1994;15:152–6.
Büchter A, Kleinheinz J, Wiesmann HP, et al. Biological and biomechanical evaluation of bone remodelling and implant stability after using an osteotome technique. Clin Oral Implants Res. 2005;16:1–8.
Stavropoulos A, Nyengaard JR, Lang NP, et al. Immediate loading of single SLA implant...
Albrektsson T, Brånemark PI, Hansson HA, et al. Osseointegrated titanium implants. Requirements for ensuring a long-lasting, direct bone-to-implant anchorage in man. Acta Orthop Scand. 1981;52(2):155–70.
Molly L. Bone density and primary stability in implant therapy. Clin Oral Implants Res. 2006;2:124–35.
Chong L, Khocht A, Suzuki JB, et al. Effect of implant design on initial stability of ...
All data and materials are available from the corresponding author in Pescara, Italy.
The hypothesis was accepted. Compressing implants with single-drill bone preparation demonstrated many clinical and histological advantages with respect with to standard implant drilling procedures and classical implant shape and design in low-density bone type. It is possible to summarize the advantages of this technique as follows: higher bone to implant contact percentage than the control group...
The comparison between the basal %BV and %BV in the test group revealed that these innovative implants were able to increase in a significant way the peri-implant bone density with respect to starting host bone density. This increased peri-implant bone density extended from about 0.5–0.7 mm beyond the implant perimeter causing an osseocorticalization around the fixture profile.
A recent study [...
Results from the present study clearly show that it is possible to insert an implant using a one-step concept for the surgical preparation of the bone bed in cancellous bone.
Guazzi et al. [24], comparing the clinical outcome of implants inserted in sites prepared with a simplified protocol consisting of one large single drill versus multiple conventional drilling steps, demonstrated less surgica...
No implant failure was observed after 2 months of healing. The clinical examination, done immediately after the bone block retrieval, showed no crestal bone resorption. No bone defects around implants, such as fenestration or dehiscence, were detected. The host bone density expressed in bone volume percentage (basal %BV) was 26.17 ± 2.35. This low value of BV% is common in soft bone, according to...
Specimens were immediately fixed in 10% neutral buffered formalin and processed for histologic analysis. After dehydration, samples were infiltrated with a methyl-methacrylate resin from a starting solution 50% ethanol/resin and subsequently 100% resin, with each step lasting 24 h. After polymerization, the blocks were sectioned and then ground down to about 40 μm. Toluidine blue staining was use...
After implant insertion, cover screws were secured and the surgical wounds were closed by a resorbable periosteal-muscular inner suture, followed by an external cutaneous 2-0 silk suture.
Each animal underwent systemic antibiotic therapy for 5 days with 8 ml long-acting Clamoxil (Pfizer Limited, Sandwich, USA). After surgery, animals received appropriate veterinary care and were allowed free acce...
The Ethics Committee for Animal Research of the Veterinary School of the University of Teramo (Teramo, Italy) approved the study protocol, which followed the guidelines established by the European Union Council Directive of February 2013 (R.D.53/2013).
Two female sheep, 4–5 years old, were included in the study. Clinical examination determined that all animals were in good general health. Exclu...
The aim of the present paper is to evaluate a reduced implant site preparation technique to preserve bone bulk and enhance primary stability using a new conical self-tapping implant in cancellous type IV bone. A histologic, histomorphometric, and biomechanical comparative analysis was conducted in low-density bone of the sheep’s iliac crest. The hypothesis to test is if undersized preparation an...
It is well documented that implant initial bone fixation, known as primary implant stability, represents the pre-requisite to achieve a successful long-term osseointegration [1].
Many studies demonstrated that the implant primary stability is strictly influenced by host bone density [2], fixture geometry [3, 4], and surgical technique used for preparing bone implant bed [5]. Other studies [6, 7] ...
The aim of the present paper is to evaluate a simplified implant site preparation technique to preserve bone bulk and enhance osseointegration using a new conical self-tapping implant in cancellous bone.
Ten Expander® 3.8 × 10 mm implants (NoDrill®, Milano, Italy) were inserted in the right side (test group) of sheep’s iliac crest using only the pilot drill 1.8 mm in diameter. Ten 3.8 × 10 ...
OHIP domainMinimumMaximumMeanSDFunctional limitation072.341.70Physical pain071.161.51Psychological discomfort081.642.27Physical disability080.751.77Psychological disability081.182.11Social disability080.611.40Handicap080.701.71Total0648.49.7Table 5 Summary of OHIP-14 (N = 44 and response range 0–8)
Outcome variablesCorrelationsSpearman’s rhoP valueOHRQoLOral health compared0.596
QuestionResponseFrequencyOral healthVery good/good81.8%Quality of LifeVery good/good90.9%General healthVery good/good81.8%Pain after hip operationExcessive35.0%Satisfaction hip operationVery85.7%Post op infection in hip siteNo95.3%Visible scar on hipYes48.8%Acceptable scarYes20 of 21aReduced sensibility on hip siteNo86.0%Problem walkingNo92.9%Augmented bone block still presentNo6.8%New augmentatio...
VariableFrequencyN or Mean ± SD%Patients Female2454.5 Male2045.5Age (years)61.16 ± 13.10 Age at operation53.73 ± 13.07 Time from augmentation to completing questionnaire (months)93.55 ± 31.75 Civil status Married3068.2 Single1125.0 Widow(er)36.8Housing Alone1227.3 With another person2352.3 > two persons920.5Education Up to primary711.3 Up to secondary23...
CategoryResponseQuestion (1) Perceived health-status General health“Very good” to “bad” Oral health“Very good” to “bad” Overall quality of life“Excellent” to “bad” (2) Lifestyle-related Smoking“Yes,” “no,” or “sometimes” Appetite“Good” to “bad” (3) Donor site-related Pain“Yes” and “no” Infection“Yes” a...
Gjerde, C.G., Shanbhag, S., Neppelberg, E. et al. Patient experience following iliac crest-derived alveolar bone grafting and implant placement. Int J Implant Dent 6, 4 (2020). https://doi.org/10.1186/s40729-019-0200-8
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Received: 10 October 2019
Accepted: 11 December 2019
Published: 05 February 2020
DOI: https://doi.org/10.1186/s40729-019-0200-8
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
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The Ethics Committee was contacted in 2015, and no ethical approval was needed since this was then considered a quality control study. Written consent was obtained from all participants.
Not applicable.
Cecilie G Gjerde, Siddharth Shanbhag, Evelyn Neppelberg, Kamal Mustafa, and Harald Gjengedal declare that they have no competing interests.
Correspondence to Cecilie G. Gjerde.
Department of Oral and Maxillofacial Surgery, Institute of Clinical Dentistry, University of Bergen, Årstadveien 19, 5009, Bergen, Norway
Cecilie G. Gjerde & Evelyn Neppelberg
Centre for Clinical Dental Research, Institute of Clinical Dentistry, University of Bergen, Bergen, Norway
Cecilie G. Gjerde, Siddharth Shanbhag & Kamal Mustafa
Department of Oral and Maxillofacial Surgery, Head an...
This work was partially funded by the Research Council of Norway through the BEHANDLING project (grant no. 273551) and TROND MOHN Foundation, Norway (BFS2018TMT10).
The staff and surgeons at the Department of Oral and Maxillofacial Surgery, Head and Neck Clinic, Haukeland University Hospital, Bergen. Randi Aursland, master student, who helped collecting data. The patients included in this study.
Landes CA, Bundgen L, Laudemann K, Ghanaati S, Sader R. Patient satisfaction after prosthetic rehabilitation of bone-grafted alveolar clefts with nonsubmerged ITI Straumann dental implants loaded at three months. Cleft Palate Craniofac J. 2012;49(5):601–8.
Reisine S, Freilich M, Ortiz D, Pendrys D, Shafer D, Taxel P. Quality of life improves among post-menopausal women who received bone augment...
Locker D, Allen F. What do measures of ‘oral health-related quality of life’ measure? Community Dent Oral Epidemiol. 2007;35(6):401–11.
Sischo L, Broder HL. Oral health-related quality of life: what, why, how, and future implications. J Dent Res. 2011;90(11):1264–70.
Slade GD. Assessing change in quality of life using the Oral Health Impact Profile. Community Dent Oral Epidemiol. 1998;26...
Hill NM, Horne JG, Devane PA. Donor site morbidity in the iliac crest bone graft. Aust N Z J Surg. 1999;69(10):726–8.
Finkemeier CG. Bone-grafting and bone-graft substitutes. J Bone Joint Surg Am. 2002;84-A(3):454–64.
Hernigou P, Desroches A, Queinnec S, Flouzat Lachaniette CH, Poignard A, Allain J, et al. Morbidity of graft harvesting versus bone marrow aspiration in cell regenerative thera...
Schaaf H, Lendeckel S, Howaldt HP, Streckbein P. Donor site morbidity after bone harvesting from the anterior iliac crest. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;109(1):52–8.
Sakkas A, Wilde F, Heufelder M, Winter K, Schramm A. Autogenous bone grafts in oral implantology-is it still a “gold standard”? A consecutive review of 279 patients with 456 clinical procedures. Int J I...
Health-related quality of life
Oral Health Impact Profile-14
Oral health-related quality of life
Patient-reported outcome measures
Quality of life
The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
Favorable OHRQoL and satisfaction were reported after advanced reconstruction with iliac crest-derived grafts and implant treatment in orally compromised patients. However, this treatment requires substantial resources including hospitalization and sick leave.
Patients in our study reported satisfaction with the augmentation and implant installation, and as these patients were orally compromised before the operation, their satisfaction with getting fixed teeth most likely improved their perceived oral health condition. This might also, in part, explain why they reported good OHRQoL. Thus, our findings indicate that a majority of patients tolerate the au...
An important finding in this study is that a majority of patients were very satisfied after iliac crest-derived alveolar bone grafting and implant therapy. Although 90% of the patients in our study had successful bone grafting, only 70.1% reported implant survival together with prosthetic rehabilitation after 1 year. These figures are lower than those reported in previous studies [2, 3, 9]. A rev...
The correlation analyses performed did not show a significant correlation between the complications at the donor site and implant loss (Table 4).
The mean OHIP-14 score (Table 5) was 8.4 ± 9.7 (range 0–56) in 44 patients of whom 35 patients scored 14 or less. Nine patients scored a total sum of 1 [1], i.e. “hardly ever” impact on any single item and “at no time” on the remaining ...
The final sample consisted of 44 patients that responded and completed the questionnaire, giving a response rate of 74.6%: 24 women and 20 men, mean age of 61.2 years ± 13.1 (range 27–82 years). The mean time from augmentation surgery until completing the questionnaire was 7.8 years ± 2.65 (range 1.9–12 years).
Summary of demographic and lifestyle-related data is presented (Tabl...
Implants were placed 4–6 months after the grafting procedure. The implant installations were performed by different oral surgeons (not in the hospital) and different implant systems were used. The implants installed into the augmented bone were allowed to heal for an additional 4–6 months before loading.
The records of the original 69 patients were examined with regard to (1) grafting sit...
This cross-sectional retrospective cohort study was based on records from all patients (n = 69) who underwent advanced alveolar augmentation with autologous iliac bone grafts at the Department of Oral and Maxillofacial Surgery, Haukeland University Hospital, Bergen, Norway, over 10 years (2002–2012). These patients were orally compromised with severe chewing problems as well as speech diff...
Health-related QoL (HRQoL) is a dynamic concept referring to an individual’s subjective assessment and perspective of current general health condition as well as functional, social, and emotional well-being [23, 24]. Most people regard oral health as important for QoL, and this is mediated through the concept of oral health-related QoL (OHRQoL) [25]. In this regard, OHRQoL is an important PROM i...
Insufficient alveolar bone volume, as a result of periodontal disease, trauma, congenital anomalies and/or resorption atrophy, often presents a clinical challenge for optimal placement of dental implants for prosthetic rehabilitation. In such cases, augmentation of alveolar bone, with either autologous bone, allogeneic, xenogeneic, or alloplastic biomaterials, is a prerequisite for placing implant...
The objective of this study was to assess patient-reported outcomes such as satisfaction and quality of life after advanced alveolar bone augmentation with anterior iliac crest grafting and implant treatment in orally compromised patients.
This cross-sectional retrospective cohort study included 59 patients (29 women and 30 men) with major functional problems, who underwent advanced alveolar augm...
Fig. 6. Optic microscope photo (× 9 magnification) after 30 days of implantation. Left side: machined implant (group C). Central photo: sandblasted and acid-etched implant (group A). Right side: laser-treated implant
Fig. 6. Optic microscope photo (× 9 magnification) after 30 days of implantation. Left side: machined implant (group C). Central photo: sandblasted and acid-etched implant ...
Fig. 5. Optic microscope photo (× 9 magnification) after 15 days of implantation. Left side: machined implant (group C). Central photo: sandblasted and acid-etched implant (group A). Right side: laser-treated implant
Fig. 5. Optic microscope photo (× 9 magnification) after 15 days of implantation. Left side: machined implant (group C). Central photo: sandblasted and acid-etched implant ...
Fig. 4. Exemplificative photo of implant placement in sheep iliac crest (left side). All implant groups were inserted in the same bone host
Fig. 4. Exemplificative photo of implant placement in sheep iliac crest (left side). All implant groups were inserted in the same bone host
Fig. 3. Scanning electron microscopy picture of group C implant surface
Fig. 3. Scanning electron microscopy picture of group C implant surface
Fig. 2. Scanning electron microscopy picture of group B implant surface
Fig. 2. Scanning electron microscopy picture of group B implant surface
Fig. 1. Scanning electron microscopy picture of group A implant surface
Fig. 1. Scanning electron microscopy picture of group A implant surface
Group
BIC% (mean ± SD)
A
50.31 ± 13.44
B
56.53 ± 13.62
C
20.54 ± 11.06
Table 3 Mean BIC% value of each group after 30 days of healing
Group
BIC% (mean ± SD)
A
39.08 ± 15.85
B
37.35 ± 15.76
C
25.28 ± 8.97
Table 2 Mean BIC% value of each group after 15 days of healing
Group A implantsGroup B implantsGroup C implantsScrew pitch1.25 mm0.6 mm0.6 mmSmooth neck2.8 mm0.25 mm0.25 mmSurface treatmentLarge grit-blasted and acid-etched SLA surface, processed to a high degree of hydrophilicity (SLActive®)Laser surface characterized by a series of 20 μm diameter holes (7–10 μm deep) every 10 μm (Syntegra®)Machined surfaceSurface roughness (Ra)1.5...
De Tullio, I., Berardini, M., Di Iorio, D. et al. Comparative evaluation among laser-treated, machined, and sandblasted/acid-etched implant surfaces: an in vivo histologic analysis on sheep. Int J Implant Dent 6, 7 (2020). https://doi.org/10.1186/s40729-019-0204-4
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Received: 30 August 2019
Accepted: 24 December 2019
Published: 19 February 2020
DOI: https://doi.org/10.1186/s40...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
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The Ethics Committee for Animal Research of the Veterinary School of the University of Teramo (Teramo, Italy) approved the study protocol, according to the guidelines established by the European Union Council Directive of February 2013 (R.D.53/2013) (protocol number 3809).
The Ethics Committee for Animal Research of the Veterinary School of the University of Teramo (Teramo, Italy) approved the st...
Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy
I. De Tullio, F. Perfetti & G. Perfetti
Pescara, Italy
M. Berardini
Foggia, Italy
D. Di Iorio
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No grants were received for the present study.
The authors wish to thank the company Geass s.r.l. for providing implants used in the present study.
Piattelli A, Manzon L, Scarano A, Paolantonio M, Piattelli M. Histologic and histomorphometric analysis of the bone response to machined and sandblasted titanium implants: an experimental study in rabbits. Int J Oral Maxillofac Implants. 1998;13:805–10.
Lee JT, Cho SA. Biomechanical evaluation of laser-etched Ti implant surfaces vs. chemically modified SLA Ti implant surfaces: Removal torque an...
Gaggl A, Schultes G, Muller WD, Karcher H. Scanning electron microscopical analysis of laser-treated titanium implant surfaces. A comparative study. Biomaterials. 2000;21(10):1067–73.
Bonsignore LA, Colbrunn RW, Tatro JM, Messerschmitt PJ, Hernandez CJ, Goldberg VM, Stewart MC, Greenfield EM. Surface contaminants inhibit osseointegration in a novel murine model. Bone. 2011;49(5):923–30.
Peng...
Albrektsson T, Brånemark PI, Hansson HA, Lindström J. Osseointegrated titanium implants. Requirements for ensuring a long-lasting, direct bone-to-implant anchorage in man. Acta Orthop Scand. 1981;52(2):155–70.
Puleo DA, Nanci A. Understanding and controlling the bone-implant interface. Biomaterials. 1999;20(23-24):2311–21.
Huang MS, Chen LK, Ou KL, et al. Rapid osseointegration of titanium...
All data and materials are available at University Chieti-Pescara, Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy.
Results from the present in vivo analysis revealed that both sandblasted and acid-etched titanium implants and laser-treated titanium implants, compared to the machined ones, have higher values of osseointegration in less healing time.
Indeed, both groups A and B at 15 days had higher values of the BIC% if compared to group C and were able to significantly increase their BIC% in the passage fro...
Data showed by the present study suggest that laser and sandblasted and acid-etched surface treatments could enhance the osteogenic bone formation by “contact,” already observed by other authors [20, 21].
Another interesting emerging datum is the observation of BIC% changes between 15 and 30 days: it is possible to assume that between the fifteenth and the thirtieth day, most part of the pe...
In the present study, the iliac crest of the sheep was chosen as a model because the site is characterized by a cancellous bone rich in marrow spaces, similar for quality to D4 density. This bone model appears superimposable to postero-lateral sectors of the human upper jaw that often represents a hard challenge for implant osseointegration due to low bone density.
Bone quality, in fact, is a key...
All implants resulted clinically integrated and stable into the bone tissue. No signs of tissue inflammation or infection were detected.
At low magnification, all the samples appeared surrounded by new tissue. The distinction between native tissue and newly formed bone was not clear, likely due to the fact that the latter is still in an initial forming phase. In the machined samples (group C) bon...
Measurement of the total length of the left half of the fixture;
Measurement of the contact area between bone and implant in the left half of the fixture;
Measurement of the total length of the right half of the fixture; and
Measurement of the contact area between bone and implant in the right half of the fixture.
Afterwards, the sum of parameters A and C represented the total length of the wh...
Implant drilling procedures were carried out using the drill sequence recommended by the manufacturer. The drill speed was set at 700 rpm under continuous sterile saline solution irrigation (stored at + 4 °C).
Implants were inserted with an insertion torque peak between 28 and 34 Ncm. Each animal received three implants of each group.
The suture of deep muscle planes was performed with poly...
The Ethics Committee for Animal Research of the Veterinary School of the University of Teramo (Teramo, Italy) approved the study protocol, which followed guidelines established by the European Union Council Directive of February 2013 (R.D.53/2013).
A total of 36 implants were used in the present study. Implants had different macro-geometries and surfaces and they were divided into three groups of...
In addition, some animal studies [15, 16] found an increased removal torque in laser processed implants compared to machined surface implants inserted.
The aim of the present paper was to evaluate the osseointegration process, in terms of bone to implant contact percentage (BIC%), of three different implants surface (machined, sandblasted and acid-etched, and laser-treated) both after 15 and 30...
Dental implant surfaces represent one of the key factors that could influence the osseointegration processes [1]. Puleo et al. [2] confirmed that the surface topography, as well as the chemical nature and the implant macro and micro geometry, is involved in creating a clinical and histological efficient bone-implant interface. It was demonstrated that different superficial treatments could affect ...
The aim of the present in vivo analysis was to evaluate the osseointegration process of titanium implants with three different surfaces (machined, sandblasted and acid-etched, and laser-treated) after 15 and 30 days of healing period.
Thirty-six implants with different surfaces were placed in the iliac crest of four Bergamasca sheep. The implant surfaces tested were sandblasted and acid-etched ...
Fig. 8. Photomicrographs of decalcified sections. a Untreated site. Woven bone formed from the sinus walls after 1 week of healing. b Treated site. After 8 weeks, woven bone was still found forming ridges towards residues of provisional matrix, showing that the healing was not completed yet. Scarlet-acid fuchsine and toluidine blue stain. a × 100 magnification. b × 20 magnification
...
Fig. 7. Box-plot representing the new bone percentage and standard deviations (whiskers) found in the various regions evaluated after 8 weeks of healing. (*), a statistical significant difference
Fig. 7. Box-plot representing the new bone percentage and standard deviations (whiskers) found in the various regions evaluated after 8 weeks of healing. (*), a statistical significant difference
Fig. 6. Photomicrographs of decalcified sections illustrating the healing after 8 weeks. a Treated site. Most of the antrostomies presented remaining defects in the outer contour. b, c Untreated sites. Two antrostomies of the treated sites and four of the untreated sites appeared not closed with corticalized bone and presented connective tissue interposed between the edges of the antrostomy. S...
Fig. 5. Photomicrographs of decalcified sections illustrating the healing after 8 weeks. Both at the treated (a) and untreated (b) sites, the antrostomy was closed in most cases, presenting residual defects of various dimensions in the outer side. New bone was connecting the lateral and medial sinus walls. The middle and sub-mucosa regions were not healed completely yet. Scarlet-acid fuchsine ...
Fig. 4. Photomicrographs of ground sections. a) Treated site. Bone residues (examples in yellow asterisks) included in soft tissue containing fibroblast-like cells and inflammatory cells. b) Untreated site. Xenograft residues (examples in red asterisks) surrounded by soft tissue rich in fibroblast-like cells. Scarlet-acid fuchsine and toluidine blue stain. a) 200 x magnification.; b) 100 x magni...
Fig. 3. Photomicrographs of decalcified sections illustrating the healing after 1 week. a Treated site. Bone strips occupying the antrostomy and the subjacent area (close-to-window region). b Untreated site. Note the new bone-forming from the sinus bone walls. Scarlet-acid fuchsine and toluidine blue stain. Images grabbed at × 20 magnification
Fig. 3. Photomicrographs of decalcified sect...
Fig. 2. The various regions evaluated at the histomorphometric analyses. Bone walls (red arrow); middle (white arrow); sub-mucosa (yellow arrow); close-to-window (orange arrow). The antrostomy region was also evaluated at the medial and lateral edges (dark green arrows) and in the middle aspect (light green arrow)
Fig. 2. The various regions evaluated at the histomorphometric analyses. Bone w...
Fig. 1. Clinical view of the surgical procedures. a Tibial bone exposed for autogenous bone harvesting using a bone scraper. b Antrostomies prepared. c Autogenous bone particles placed in the antrostomy. d Xenograft and bone particles (red arrow) at the antrostomies. e Collagen membranes placed on the antrostomies. f Wounds closed with sutures
Fig. 1. Clinical view of the surgical procedures....
AntrostomySinus regions EdgesCenterTotalClose-to-windowMiddleSub-mucosaBone wallsTotalNew boneTreated sites40.3 ± 21.337.8 (27.0;56.0)24.3 ± 23.222.0 (3.4;42.2)35.5 ± 20.927.7 (23.3;52.0)25.8* ± 16.122.9 (15.2;39.7)19.5 ± 16.711.7 (10.1;22.3)22.5 ± 11.620.4 (12.6;31.3)38.0 ± 15.044.8 (31.8;47.5)27.9 ± 12.930.1 (19.6;34.5)Untreated sites32.2 ± 22....
AntrostomySinus regions EdgesCenterTotalClose-to-windowMiddleSub-mucosaBone wallsTotalNew boneTreated sites9.2 ± 10.6 4.6 (3.2;12.5)5.2 ± 13.90.0 (0.0;0.5)7.7 ± 11.22.7 (1.9;7.9)0.6 ± 1.00.0 (0.0;0.7)0.0 ± 0.00.0 (0.0;0.0)1.4 ± 1.80.8 (0.0;2.2)7.7 ± 6.38.2 (1.3;11.1)2.8 ± 2.62.2 (0.7;4.0)Untreated sites8.9 ± 8.5 6.2 (4.0;10.8)1.0 ± 2.70.0 (0....
Favero, G., Viña-Almunia, J., Carda, C. et al. Influence of the use of autogenous bone particles to close the access window after maxillary sinus floor augmentation: an experimental study in rabbits.
Int J Implant Dent 6, 9 (2020). https://doi.org/10.1186/s40729-020-0206-2
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Received: 20 October 2019
Accepted: 21 January 2020
Published: 04 March 2020
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Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
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The present research was approved by the Ethics Committee of Valencia University, Spain. Reference number: A1434714637496.
Not applicable.
Daniele Botticelli declares to be the co-owner of Ariminum Odontologica. Giacomo Favero, Jose Viña-Almunia, Carmen Carda, José Javier Martín de Llano, Berta García-Mira, David Soto-Peñaloza, Daniele Botticelli, and Miguel Peñarrocha-Diago declare that t...
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GF participated in the concept/design, data analysis/interpretation, drafting of the article and surgical procedures. JV-A performed the surgical procedures, made the follow up of the animals, participated in the manuscript revision and ethical committee redaction and approval. BG-M and DS-P performed the surgi...
Private practice, London, UK
Giacomo Favero
Oral Surgery Unit. Department of Stomatology, Faculty of Medicine and Dentistry, Clinica Odontológica, University of Valencia, Valencia, Spain
Jose Viña-Almunia, Berta García-Mira, David Soto-Peñaloza & Miguel Peñarrocha-Diago
Department of Pathology and Health Research Institute of the Hospital Clínico (INCLIVA), Faculty of Medicine and De...
Funds from the present have been provided by ARDEC Academy, by Ariminum Odontologica s.r.l., Rimini, Italy and Tecnoss srl, Giaveno, Italy. The biomaterials use were provided free of charge by Tecnoss srl, Giaveno, Italy.
Favero V, Lang NP, Canullo L, Urbizo Velez J, Bengazi F, Botticelli D. Sinus floor elevation outcomes following perforation of the Schneiderian membrane. An experimental study in sheep. Clin Oral Implants Res. 2016;27(2):233–40.
Scala A, Lang NP, Velez JU, Favero R, Bengazi F, Botticelli D. Effects of a collagen membrane positioned between augmentation material and the sinus mucosa in the eleva...
Kawakami S, Lang NP, Ferri M, Apaza Alccayhuaman KA, Botticelli D. Influence of the height of the antrostomy in sinus floor elevation assessed by cone beam computed tomography- a randomized clinical trial. Int J Oral Maxillofac Implants. 2019;34(1):223–32.
Kawakami S, Lang NP, Iida T, Ferri M, Apaza Alccayhuaman KA, Botticelli D. Influence of the position of the antrostomy in sinus floor elevat...
Tatum, H., Jr. Maxillary sinus grafting for endosseous implants. Lecture presented at the Annual Meeting of the Alabama Implant Study Group (1977); cited in Smiler, D.G., Johnson, P.W., Lozada, J.L., Misch, C., Rosenlicht, J.L., Tatum, O.H. Jr. & Wagner J.R. Sinus lift grafts and endosseous implants. Treatment of the atrophic posterior maxilla. Dental clinics of North America. 1992;36:151–186.
...
Animal Research Reporting In Vivo Experiments
Cone beam computed tomography
Deproteinized bovine bone mineral
Tricalcium phosphate
The datasets used or analyzed during the current study are available from the corresponding author on reasonable request.
The lower phylogenetic level of the animals compared to humans was the main limitation of the present study. An increased number of animals might allow reaching a statistical difference in favor of the treated sites also in the antrostomy region. Nevertheless, the outcomes obtained, allow to performing studies in humans that might demonstrate the advantages of applying autologous bone on the antro...
In both studies presented above on sinus floor elevation in sheep, all the lateral windows were prepared using a piezoelectric device. In an experiment in rabbits [21], the antrostomies were done with either a sonic instrument or drills to evaluate differences in bone formation in the antrostomy. Elevated space is filled with a collagenated porcine bone similar that used in the present experiment,...
The present experiment aimed to study the influence on the healing after the placement of autogenous bone on the antrostomy and in the subjacent region after maxillary sinus elevation. After 8 weeks of healing, in the antrostomy region, a trend of higher bone formation in the treated compared to the untreated sites was observed. No statistically significant difference was found. In the subjacent ...
After 1 week of healing (Table 1), in the close-to-window region, the proportions of xenograft were 21.3 ± 14.7% and 55.9 ± 19.0 (p = 0.012) in the treated and untreated sites, respectively. After 8 weeks of healing (Table 2), these values decreased to a similar percentage (15.5 ± 14.4% and to 15.5 ± 14.2%; p = 0.917, respectively).
After 1 week of healing (Table...
Biopsies could be harvested from all animals. However, histological sections could not be obtained from one rabbit of the 8 weeks group; therefore, eight and seven were achieved for the 1-week and 8-week periods, respectively.
After 1 week of healing, at the treated sites, the antrostomy and close-to-windows regions were occupied by a high proportion of residues of autogenous bone (Fig. 3a),...
Overlapping calibrated digital images of the tissues were recorded with Leica Applications Suite version 4.4.0 software from a bright field Leica DM4000 B microscope (Leica Microsystems GmbH, Wëtzlar, Germany) equipped with a 5× lens and DFC420 digital camera. Single images were pasted and merged to compose each elevated sinus using the program Photoshop (Adobe Photoshop CC 2015.0.0).
The histo...
Afterward, a trichotomy was performed in the nasal dorsum and, after disinfection of the experimental region using Betadine (MEDA Pharma®, Madrid, Spain), a sagittal incision was carried out. The skin and the periosteum were dissected and shifted laterally to expose the nasal bone. Antrostomies, 4 × 4 mm in dimensions, located about 3–4 mm laterally to the midline and about 10 mm in f...
Prior to the experiment, the protocol was approved by the Ethics Committee of Valencia University, Spain (A1434714637496). The guidelines indicated by the Council Directive of the European Union (53/2013; February 1, 2013) for animal experimentation and the ethical rules proposed by Royal Decree 223, March 14 and October 13, 1988, were fulfilled. The study was reported following the ARRIVE guideli...
Hence, the present experiment aimed to study the influence on healing, of the autogenous bone particle placement in the antrostomy and in the subjacent region after maxillary sinus elevation.
Maxillary sinus floor elevation through lateral access was first proposed in 1977 [1], while the technique was published in 1984 [2]. Several modifications in the surgical approach and the biomaterials used have been introduced over time [3,4,5]. In a systematic review with meta-analysis, it was concluded that the best survival rate was observed when implants with rough surface and membrane to cov...
To study the influence on the healing of the placement of particulate autogenous bone in the antrostomy and in the subjacent region after maxillary sinus elevation.
Sixteen New Zealand rabbits were undergone to bilateral maxillary sinus floor augmentation with 4 × 4 mm antrostomy dimension. The sinus mucosa was elevated, and the space obtained was filled with xenograft. In the test site (tr...
Fig. 6. Graph representing new bone and composite bone percentages within the elevated area
Fig. 6. Graph representing new bone and composite bone percentages within the elevated area
Fig. 5. Graph representing the tissue percentages within the elevated area. No statistically significant differences were found
Fig. 5. Graph representing the tissue percentages within the elevated area. No statistically significant differences were found
Fig. 4. Photomicrographs of ground sections after 4 months of healing. a Bone formed from the base of the sinus. b Bone plate connected by bridges of the new bone to the close-to-window region. c Particle of the graft surrounded by new bone. d Overexposed image to show the new bone ingrowth within the granules of biomaterial
Fig. 4. Photomicrographs of ground sections after 4 months of he...
Fig. 3. a The elevated area was divided into four regions for morphometric analysis. RED: submucosa; GREEN: middle; YELLOW: base; PURPLE: close-to-window. INC: top of the infraorbital nerve canal
Fig. 3. a The elevated area was divided into four regions for morphometric analysis. RED: submucosa; GREEN: middle; YELLOW: base; PURPLE: close-to-window. INC: top of the infraorbital nerve canal
Fig. 2. Clinical view at a bone plate site. a The bone window was removed. b The sinus mucosa was carefully elevated, and a twisted wire was placed. c The elevated sinus was grafted. d The access bony window was repositioned and secured with cyanoacrylate
Fig. 2. Clinical view at a bone plate site. a The bone window was removed. b The sinus mucosa was carefully elevated, and a twisted wire wa...
Fig. 1. Clinical view at a membrane site. a Skin and periosteum were separately elevated, and the facial sinus wall exposed. b A 12 × 8-mm window was cut and removed. c The Schneiderian membrane was carefully elevated. d A twisted wire was inserted in the middle of the long side of the window and the elevated sinus was grafted. e At the control site, a resorbable membrane was placed and secured...
BoneSoft tissuePure graftInterpenetrated graftComposite boneReplaced windowCenter61.5 ± 46.982.5 (22.2; 96.9)21.7 ± 22.6*17.5 (3.1; 34.4)2.3 ± 4.3*0.0 (0.0; 2.3)7.9 ± 19.30.0 (0.0; 0.0)69.3 ± 38.582.5 (57.6; 96.9)Edge37.2 ± 37.021.6 (16.8; 55.8)41.0 ± 39.833.6 (9.2; 64.9)5.3 ± 7.31.6 (0.0; 9.1)13.8 ± 19.0*6.7 (0.0; 19.7)54.8 ± 34.162.9 (37.5; 69.7)MembraneCenter5.8 ± 2.1 (P = 0.116)5....
New boneSoft tissuePure graftInterpenetrated graftComposite boneReplaced windowTotal16.4 ± 5.618.8 (13.8; 20.3)32.9 ± 8.031.2 (27.7; 37.0)13.6 ± 4.212.0 (10.8; 16.2)37.1 ± 7.534.4 (31.7; 43.4)53.5 ± 7.652.4 (50.8; 57.8)Base15.0 ± 7.216.4 (10.1; 20.1)38.6 ± 14.334.5 (28.9; 47.1)13.4 ± 6.415.3 (13.1; 17.0)33.1 ± 11.133.1 (26.8; 40.0)48.0 ± 18.149.9 (36.9; 59.7)Middle16.9 ± 7.318.1 (11.2...
Perini, A., Ferrante, G., Sivolella, S. et al. Bone plate repositioned over the antrostomy after sinus floor elevation: an experimental study in sheep. Int J Implant Dent 6, 11 (2020). https://doi.org/10.1186/s40729-020-0207-1
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Received: 01 October 2019
Accepted: 04 February 2020
Published: 18 March 2020
DOI: https://doi.org/10.1186/s40729-020-0207-1
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
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The research protocol was submitted to and approved by the Ethical Committee of the University of Medical Sciences, School of Dentistry, Havana, Cuba (prot. 013/2013).
All the authors consent to publication.
Alessandro Perini, Giada Ferrante, Stefano Sivolella, Joaquín Urbizo Velez, Franco Bengazi, and Daniele Botticelli declare that they have no competing interests.
Correspondence to Alessandro Perini.
Department of Neuroscience, Division of Dentistry, University of Padua, Via Giustiniani 2, 35128, Padua, Italy
Alessandro Perini, Giada Ferrante & Stefano Sivolella
Faculty of Dentistry, University of Medical Science, Havana, Cuba
Joaquín Urbizo Velez & Franco Bengazi
ARDEC Academy, Ariminum Odontologica, Rimini, Italy
Daniele Botticelli
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This study was funded by ARDEC Academy, Ariminum Odontologica s.r.l., Rimini, Italy.
Degradable Solutions AG, a Sunstar Group Company, CH-8952 Schlieren ZH, Switzerland, provided free of charge the biomaterials used.
Iida T. Carneiro Martins Neto E, Botticelli D, Apaza Alccayhuaman KA, Lang NP, Xavier SP. Influence of a collagen membrane positioned subjacent the sinus mucosa following the elevation of the maxillary sinus: a histomorphometric study in rabbits. Clin Oral Implants Res. 2017 Dec;28(12):1567–76.
Inal S, Yilmaz N, Nisbet C, Güvenç T. Biochemical and histopathological findings of N-butyl-2-cyano...
Russell WMS, Burch RL. The principles of human experimental technique. London: Methuen; 1959.
Schroeder HE, Münzel-Pedrazzoli S. Correlated morphometric and biochemical analysis of gingival tissue: morphometric model, tissue sampling and test of stereologic procedures. J Microsc. 1973 Dec;99(3):301–29.
Sohn DS, Kim WS, An KM, Song KJ, Lee JM, Mun YS. Comparative histomorphometric analysis of ...
Nosaka Y, Nosaka H, Arai Y. Complications of postoperative swelling of the maxillary sinus membrane after sinus floor augmentation. J Oral Sci Rehab. 2015;1:26–33.
Tawil G, Tawil P, Khairallah A. Sinus floor elevation using the lateral approach and bone window repositioning I: clinical and radiographic results in 102 consecutively treated patients followed from 1 to 5 years. Int J Oral Maxillof...
Tatum H Jr. Maxillary sinus grafting for endosseous implants. Lecture presented at the Annual Meeting of the Alabama Implant Study Group (1977); cited in Smiler DG, Johnson PW, Lozada JL, Misch C, Rosenlicht JL, Tatum OH Jr., Wagner JR. Sinus lift grafts and endosseous implants. Treatment of the atrophic posterior maxilla. Dent Clin North Am. 1992;36:151–86.
Boyne PJ, James RA. Grafting of the ...
Biphasic calcium phosphate
Deproteinized Bovine Bone Mineral
Hydroxyapatite
Infraorbital nerve canal
Standard deviation
Beta-tricalcium phosphate
All data and materials are available for control and consultation contacting the first author (alexperini@studioschweiger.it).
In conclusion, the repositioning of the bone window after sinus floor elevation in sheep, compared with the use of a resorbable membrane, improved the closure of the antrostomy and led to a greater amount of the newly formed bone in the close-to-window zone of the grafted area. The bone window appeared partially bonded to the newly formed bone. Bridges of new bone from the edges of the antrostomy ...
In the present study, a lesser amount of bone was registered subjacent to the sinus mucosa compared with the other regions. This is in agreement with another experiment, in which a similar material was used for sinus augmentation in sheep [24]. A similar outcome was also reported in another study [27] that used DBBM xenograft for sinus augmentation in sheep. In that study, a collagen membrane was ...
In another similar experiment in sheep, the sinuses were augmented using a similar biphasic calcium phosphate (60% HA, 40% β-TCP) [24], the biomaterial used in the present study. The perforation of the sinus mucosa was performed at the test sites and a collagen membrane was placed to protect the perforation, while at control sites the elevated mucosa was left unprotected. After 12 weeks of heal...
The aim of the present study was to compare the healing of the augmented sinus in large animals, where the antrostomy was covered by a polylactic membrane or a repositioned bone plate, both secured with cyanoacrylate.
No statistically significant differences were found between test and control sites in the bone formation within the augmented space. This outcome is in agreement with a similar stud...
In the centre of the window area, at the test sites, in the analysed histological sections, the bone plate was still visible in five out of six sheep. It appeared partly remodelled and connected by the new bone formed in the sub-window area. Out of the five bone plates still present, three were bridged to the edges of the antrostomy, while in the two cases no contact was achieved in the observed s...
During surgery, one sheep showed acute sinusitis at the test site. The sinus mucosa was perforated to allow sinus drainage and surgery was completed. During the healing period, no evident clinical complications were observed.
At the histomorphometric analysis, one sinus of the control group and one of the test group (corresponding to the sinusitis case) appeared to have lost almost all biomateria...
The percentages of the new mineralised bone, soft or connective tissue, pure graft, graft interpenetrated by bone, and remnants of cyanoacrylate were evaluated. The total tissue percentages in the elevated space that included submucosa, middle, base, and sub-window regions were also calculated.
Mean values and standard deviations (SDs) as well as the 25th, 50th (median), and 75th percentiles were...
After 4 months, the animals were anaesthetised and then euthanised with an overdose of pentobarbital sodium and subsequently perfused with 10% formalin. The maxilla was retrieved en bloc, trimmed, and immersed in formalin solution.
All histological procedures were performed in the Laboratorio de Histologıa de la Facultad de Odontologıa de la Universidad de Ciencia Medica in Havana, Cuba. Bila...
Through an extra-oral approach, an oblique incision was made bilaterally along the sagittal axis between the facial tuberosity and the inferior orbital rim. The skin and periosteum were elevated separately, and the bony facial sinus wall was exposed on both sides of the maxilla (Fig. 1a).
A 12-mm large and 8-mm high antrostomy was prepared using a burr (H254E Komet Dental, Trophagener Weg 25, L...
The research protocol was submitted to and approved by the Ethical Committee of the University of Medical Sciences, School of Dentistry, Havana, Cuba (prot. 013/2013).
Eight female Pelibuey sheep, with a mean body weight of approximately 35 kg and a mean age of approximately 3 years, were provided by the Centro Nacional para la Producción de Animales de Laboratorio (CENPALAB) in Havana, Cuba...
To prevent the movement of the bony plate and to gain adequate stability, cyanoacrylate has been suggested to glue the plate to the bony edges of the antrostomy [17]. Cyanoacrylates (as methyl 2-cyanoacrylate or ethyl 2-cyanoacrylate) are widely used in surgery and have shown good compatibility [18] and biomechanical strength for fixation of grafts [19]. In an experiment in rabbits [17], the antro...
Sinus floor elevation is a commonly used technique to increase bone volume in the posterior maxilla prior to implant placement. This procedure was first developed by Tatum in 1977 [1], modified by Boyne and James in 1980 [2], and further modified over time. In this well-described technique, a bony window is created on the lateral wall of the sinus with a round burr, and the membrane elevated. Diff...
The objective of this study was to compare the healing of the augmented sinus at which the antrostomy was covered with a membrane or the repositioned bone plate.
Eight sheep underwent bilateral maxillary sinus floor augmentation. The control site was covered with a resorbable membrane, while at the experimental site the bone plate was repositioned, and both were secured with cyanoacrylate. Animal...
Fig. 7. The box plot shows the distribution of age between the sex groups
Fig. 7. The box plot shows the distribution of age between the sex groups
Fig. 6. Pie chart shows the distribution of loaded implants prosthetic restorations
Fig. 6. Pie chart shows the distribution of loaded implants prosthetic restorations
Fig. 5. Pie charts shows the distribution of the demographic datas of the patients
Fig. 5. Pie charts shows the distribution of the demographic datas of the patients
Fig. 4. The crown-implant ratio measurement showing a the length of the crown (red line) and b the length of the implant (red line)
Fig. 4. The crown-implant ratio measurement showing a the length of the crown (red line) and b the length of the implant (red line)
Fig. 3. Fractal analysis stages. a Selected region of interest (ROI). b Cropped and duplicated version of ROI. c Addition of Gaussian filter. d Subtraction. e Addition of 128 pixels. f Binarized version. g Eroded version. h Dilated version. i Inverted version j Skeletonization
Fig. 3. Fractal analysis stages. a Selected region of interest (ROI). b Cropped and duplicated version of ROI. c Addi...
Fig. 2. Region of interests (ROIs) were selected arbitrarily in a preoperative radiographic image and b a follow-up radiographic image
Fig. 2. Region of interests (ROIs) were selected arbitrarily in a preoperative radiographic image and b a follow-up radiographic image
Fig. 1. Fractal dimension values measured from the same area of interest on each panoramic radiograph over five different time intervals are shown in the figure. FD0, fractal dimension 0 (preoperative); FD1, fractal dimension 1 (0–1 months of follow-up); FD2, fractal dimension 2 (1–3 months of follow-up); FD3, fractal dimension 3 (6–12 months of follow-up); FD4, fractal dimension 4 ...
nMeanStandard deviationMinimumMaximumFD01301.2430.1520.7501.560FD11301.1130.2240.4051.510FD21301.1160.1960.4101.510FD3671.0920.2160.4301.500FD4671.0810.2470.4301.500Table 2 Mean fractal dimension (FD) values before and after implant insertion
Failure (n)Success (n)P valuePowerEffect sizeSexWomen3870.0240.680.21Men634FD190.82 ± 0.28 (mean)0.45 (min)–1.26 (max)1211.13 ± 0.25 (mean)0.41 (min)–1.51 (max)< 0.0010.991.45FD290.97 ± 0.24 (mean)0.61 (min)–1.36 (max)1211.13 ± 0.19 (mean)0.41 (min)–1.51 (max)0.0230.990.79Crown-implant Ratio26.51 ± 3.89 (mean)3.77 (min)–9.27 (max)654.61 ± 1.58 (mean)2.57 min)–10.67 (max)0.101...
Kış, H.C., Güleryüz Gürbulak, A. Evaluation of the peri-implant bone trabecular microstructure changes in short implants with fractal analysis. Int J Implant Dent 6, 13 (2020). https://doi.org/10.1186/s40729-020-00209-7
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Received: 12 September 2019
Accepted: 12 March 2020
Published: 01 April 2020
DOI: https://doi.org/10.1186/s40729-020-00209-7
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material...
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
Hatice Cansu Kış and Ayşegül Güleryüz Gür...
Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Nuh Naci Yazgan University, Kayseri, Turkey
Hatice Cansu Kış
Department of Prosthetic Dentistry, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
Ayşegül Güleryüz Gürbulak
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The work was supported by the Department of Oral & Maxillofacial Radiology, Nuh Naci Yazgan University in Kayseri, Turkey.
We would like to thank Editage (www.editage.com) for English language editing.
Mu T-J, Lee D-W, Park K-H, Moon I-S. Changes in the fractal dimension of peri-implant trabecular bone after loading: a retrospective study. Journal of periodontal & implant science. 2013;43(5):209–14.
Zeytinoğlu M, İlhan B, Dündar N, Boyacioğlu H. Fractal analysis for the assessment of trabecular peri-implant alveolar bone using panoramic radiographs. Clinical oral investigations. 2015;19(2...
Mandelbrot BB. The fractal geometry of nature: WH freeman New York; 1983.
Sánchez I, Uzcátegui G. Fractals in dentistry. Journal of dentistry. 2011;39(4):273–92.
Boutroy S, Bouxsein ML, Munoz F, Delmas PD. In vivo assessment of trabecular bone microarchitecture by high-resolution peripheral quantitative computed tomography. The Journal of Clinical Endocrinology & Metabolism. 2005;90(12):6508...
Dental panoramic radiographs
Fractal dimension 0 (preoperative)
Fractal dimension 1 (0–1 months of follow-up)
Fractal dimension 2 (1–3 months of follow-up)
Fractal dimension 3 (6–12 months of follow-up)
Fractal dimension 4 (12 + months of follow-up)
Cone beam computed tomography
Region of interest
Fractal analysis is a useful method to measure the trabecular microstructure of bone in nonstandardized dental radiographs. The present study has a low power to reject the null hypothesis because of the low number of cases of failed implants. Therefore, further studies with a large sample size are warranted. Assessing a series of studies can provide certain cut-off values; this can enable to routi...
Fractal analysis of bone microstructure on dental radiographs may be useful for diagnostic applications; however, the histological microstructures of the bone cannot be visualized by any clinical imaging modality. Corpas et al. [12] stated that minor changes in bone occurring over a short-term period can be followed up with digital intraoral radiography; however, the results of radiographic fracta...
This study aimed to evaluate the microstructural changes in the peri-implant bone in patients with short implants in terms of the implant survival status by using fractal analysis measurements.
In this study, a significant difference was found in the FD1 and FD2 values between the implant survival groups, and the mean FD1 and FD2 values of the success group were significantly higher than those of...
Descriptive statistics were performed. The data were not normally distributed (p < 0.05). The intra-observer correlation coefficients of repeated measurements were 0.927, 0.889, 0.913, 0.988, 0.961, and 0.936 for FD0 (fractal dimension), FD1, FD2, FD3, FD4, and crown-implant ratio, respectively. Descriptive data are shown in Figs. 5, 6, and 7. A significant difference was found for sex between the...
The crown-implant ratio was measured using the ImageJ version 1.38 software measuring tool in conjunction with a magnification tool. Each implant was measured from its bottom to the crown base and then from the crown base to its highest point (Fig. 4).
All measurements were performed by a dento-maxillofacial radiologist who was blinded to patient information. To evaluate the intra-observer correl...
This retrospective study was conducted in the dental clinic of Oral and Maxillofacial Radiology department and was approved by the local ethics committee (2013/203). The participants had approached the Prosthodontics Clinic between 2012 and 2019 for partial or complete tooth complaints. Among the data of 116 patients reviewed, panoramic radiographs of 67 patients were examined and included in this...
The quality of bone tissue at the site of implantation can be determined preoperatively with high accuracy, and changes in the trabecular structure, which is vital for the primary and secondary stability of the implant, can be observed during the follow-up after implantation.
Previous studies have evaluated fractal analysis of peri-implant bone before and after loading. However, no study has exam...
Mandelbrot introduced fractals to describe his observation of shapes in nature, such as curves, surfaces, disconnected “dust,” and odd shapes. The word fractal originates from the Latin word “fractus,” which means broken. By using fractal mathematics, several studies have analyzed various fractal patterns in the human body. Fractal analysis is a mathematical method of describing complex sh...
This study aimed to evaluate the microstructural changes in the peri-implant bone in patients with short implants in terms of implant survival status by using fractal analysis measurements.
Dental panoramic radiographs (DPRs) of 67 patients were examined and included in this study. Fractal analysis and measurement of the crown-implant ratio were performed with ImageJ. The fractal analysis measure...
Fig. 5. PROMs over 5 years: improvement of satisfaction from loading to study end
Fig. 5. PROMs over 5 years: improvement of satisfaction from loading to study end
Fig. 4. Soft tissue parameters at 5-year post-loading. a Plaque index: score 0, no plaque detected; score 1, plaque only recognized by running a probe across the smooth marginal surface of the implant; score 2, plaque seen by the naked eye; score 3, abundance of soft matter. b Sulcus bleeding index: score 0, no bleeding when a periodontal probe was passed along the gingival margin adjacent to th...
Fig. 3. Standardized peri-apical radiographs representing the bone level changes at the implant level: immediately post insertion (a), at loading (abutment/crown placement) (b), and at 5-year post-loading (c)
Fig. 3. Standardized peri-apical radiographs representing the bone level changes at the implant level: immediately post insertion (a), at loading (abutment/crown placement) (b), and at 5...
Fig. 2. Kaplan-Meier cumulative survival rate
Fig. 2. Kaplan-Meier cumulative survival rate
Fig. 1. Study flow-chart: assessments and reason for dropouts. Study visits were done according to standard procedures in the respective study centers. Blue, mandatory visits; gray, optional visits
Fig. 1. Study flow-chart: assessments and reason for dropouts. Study visits were done according to standard procedures in the respective study centers. Blue, mandatory visits; gray, optional visits
Bone level changenMeanSDInsertion-loading103− 0.520.55Loading-1-year follow-up93− 0.040.37Loading-3-year follow-up90− 0.040.40Loading-5-year follow-up86− 0.090.43Table 3 Mean crestal bone level changes in mm
CharacteristicsCategoryTotalTotal patients/implantsn94/130Center 19/17Center 218/26Center 320/26Center 414/16Center 518/26Center 615/19Gender, n (%)Male30 (31.9)Female64 (68.1)Age at surgery, yearsMean ± SD50.4 ± 13.7Range (min/max)19.1-75.6Age range distribution, n (%)< 30 years8 (8.5)30-45 years22 (23.4)45-60 years38 (40.4)60-75 years25 (26.6)> 75 years1 (1.1)Tobacco use, n (%)Non-sm...
Time periodPatientsImplantsBefore loading58Loading-1 year681-3 years673-5 years13Total1826Table 1 Dropouts over observation time
Ackermann, KL., Barth, T., Cacaci, C. et al. Clinical and patient-reported outcome of implant restorations with internal conical connection in daily dental practices: prospective observational multicenter trial with up to 7-year follow-up.
Int J Implant Dent 6, 14 (2020). https://doi.org/10.1186/s40729-020-00211-z
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Received: 16 December 2019
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Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material...
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A written consent was given by all patients after being informed of the study. The study was performed following the declaration of Helsinki. Ethics committee approval was obtained from the international ethical committee of Freiburg (Germany, Ref. 010/1833).
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All authors declare that they have no conflicts of interest regarding this study. All authors have been lecturing for Caml...
Filderstadt, Germany
Karl-Ludwig Ackermann
Leipzig, Germany
Thomas Barth
Munich, Germany
Claudio Cacaci
Landsberg a. L., Germany
Steffen Kistler
Forchheim, Germany
Markus Schlee
Department of Maxillofacial Surgery, Goethe University Frankfurt, Frankfurt, Germany
Markus Schlee
Berlin, Germany
Michael Stiller
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This study was funded by an unrestricted grant (NISCAM01/10) of the Oral Reconstruction Foundation (previously CAMLOG Foundation).
The authors thank Lucius Keller of Touchpoint Communication AG (Luzern, Switzerland) for the medical writing support.
Chang M, Odman PA, Wennstrom JL, Andersson B. Esthetic outcome of implant-supported single-tooth replacements assessed by the patient and by prosthodontists. Int J Prosthodont. 1999;12(4):335–41.
Kiltz U, Winter J, Schirmer M, Weber U, Hammel L, Baraliakos X, et al. German translation and cross-cultural adaptation of the ASAS health index: an ICF-based instrument for documentation of functional...
Ravald N, Dahlgren S, Teiwik A, Grondahl K. Long-term evaluation of Astra Tech and Branemark implants in patients treated with full-arch bridges. Results after 12-15 years. Clin Oral Implants Res. 2013;24(10):1144–51.
Schwarz F, Alcoforado G, Nelson K, Schaer A, Taylor T, Beuer F, et al. Impact of implant-abutment connection, positioning of the machined collar/microgap, and platform switching...
Gupta S, Sabharwal R, Nazeer J, Taneja L, Choudhury BK, Sahu S. Platform switching technique and crestal bone loss around the dental implants: a systematic review. Ann Afr Med. 2019;18(1):1–6.
Hsu YT, Lin GH, Wang HL. Effects of platform-switching on peri-implant soft and hard tissue outcomes: a systematic review and meta-analysis. Int J Oral Maxillofac Implants. 2017;32(1):e9–e24.
Nelson K,...
Cacaci C, Ackermann KL, Barth T, Kistler S, Stiller M, Schlee M. A non-interventional multicenter study to document the implants success and survival rates in daily dental practices of the CONELOG screw-line implant. Clin Oral Investig. 2019;23(6):2609–16.
Cochran D, Oates T, Morton D, Jones A, Buser D, Peters F. Clinical field trial examining an implant with a sand-blasted, acid-etched surface...
Krennmair G, Seemann R, Weinlander M, Piehslinger E. Comparison of ball and telescopic crown attachments in implant-retained mandibular overdentures: a 5-year prospective study. Int J Oral Maxillofac Implants. 2011;26(3):598–606.
Slot W, Raghoebar GM, Cune MS, Vissink A, Meijer HJA. Four or six implants in the maxillary posterior region to support an overdenture: 5-year results from a randomize...
Adverse event
Bone level change
Distance implant shoulder to first visible bone contact
Orthopantomogram
Plaque index
Patient reported outcome measures
Platform switching
Sulcus bleeding index
The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
This prospective observational multicenter study demonstrated successful functional and esthetic outcomes of the study implant restorations (single tooth restoration, fixed partial dentures) with reliable peri-implant hard and soft tissue stability and high patients’ satisfaction. The results are comparable with the outcome of already published controlled randomized clinical studies and retrospe...
In recent years, patients’ needs have increased in terms of the esthetic and functional outcome of the dental restoration. PROMs have been reported in several studies and represent a well-described non-invasive method to measure patient’s satisfaction with these needs; however, they might present a lack of standardization [39, 40] due to the very subjective view on esthetics or functionality o...
Changes in crestal bone level are well-documented in the literature. Bone remodeling is reported to take place between surgery and loading. The reported changes are generally around 0.5 mm [17, 27, 30] but can reach more than 1 mm [31] in randomized or observational trials. The present study is well in accordance with these findings with its bone remodeling of − 0.52 ± 0.55 mm. Nearly 45%...
Endosseous dental implants are a commonly accepted treatment procedure and showed high survival and success rates as well as good functional performance in numerous clinical trials and retrospective analyses, also for Conelog implants as for their specific implant surface [17, 23, 26]. However, in general, one could argue that results of controlled clinical studies do not reflect the real situatio...
Table 3 shows the mean bone level changes of the implants with available radiographs from insertion to 5-year post-loading. Bone remodeling around the implant was noticeable from surgery to loading, presenting a mean value of − 0.52 ± 0.55 mm. From loading to the 5-year follow-up, the mean change in crestal bone remained clinically stable (−0.09 ± 0.43 mm) (Fig. 3).
Split into three g...
The study was started with 94 patients with 130 implants. At the end of the study (5-year post-loading), 76 patients with 104 implants were considered for analysis. Dropouts were distributed over the time of the study as described in Table 1. The majority of dropouts occurred early in the study phase. The reasons for the dropouts were variable as described in Fig. 1.
The demographic and clinica...
The study data, soft and hard tissue parameters as well as the PROMs were descriptively analyzed using IBM SPSS V25.0 (IBM Corp., Armonk, NY, USA): Categorical variables were shown with frequencies and mean values were used for continuous variables. Survival analysis was performed using Kaplan–Meier method. Time of loading was the study baseline as per protocol, and the statistical unit was the ...
Patients were scheduled to follow-ups at 6 months, 1-, 2-, 3-, 4-, and 5-year post-loading for the assessment of the study parameter (Fig. 1). Depending on the investigators’ standard post-operative protocol, follow-up appointments were scheduled slightly differently: One center skipped the control visits at 6 months. Additionally, due to the observational character of the study and the pati...
This is an observational multicenter clinical study, approved by the ethics committee of the Freiburg ethics commission international (feci 010/1833). The study was planned and conducted according to the German medical devices law, the Declaration of Helsinki, good clinical practice, and the reporting is aligned with the STROBE statement. A minimum of 90 to 100 patients were planned to be included...
Features of the chosen implant system for a study may also influence the outcome of the treatment: The degree of the manufacturer’s tolerances of implants with a conical implant-abutment connection heightens the risk of a mispositioning of the abutment, which cannot be corrected by repeated torqueing. Platform switching (PS) implants tend to have a protective effect on hard implant tissue outcom...
Many randomized controlled clinical trials have been published about dental implants. They have demonstrated long-term success in the rehabilitation of edentulous patients [1, 2] as well as patients with single or multiple teeth replacements [3, 4].
While this type of trials have an indispensable place in establishing a new product or a new operation technique regarding safety and efficacy, the r...
The interpretation of the results of randomized clinical trials is often questioned in relation with daily circumstances in practices. This prospective observational multicenter study was instigated to reflect the need for information in real-life situations with dental implants with internal conical implant-abutment connection (Conelog implant system). The implants were followed up at least 5-yea...
Fig. 5. Anti-RANKL and anti-RANKL+miR-146a treatments decreased gingival mRNA expression of TNF-α and RANKL with different patterns in experimental peri-implantitis of WT and TLR2/4 KO mice. Gingival tissues around ligatured implants and non-ligation implants were excised and processed for RT-qPCR analysis to determine mRNA level of TNF-α of WT mice (a) and TLR2/4 KO mice (b) (mean ± SD, n = ...
Fig. 4. Anti-RANKL and anti-RANKL+miR-146a treatments decreased the inflammatory cell infiltration of the implant gingival tissues with different patterns in experimental peri-implantitis of WT and TLR2/4 KO mice. HE staining of the gingival tissue around implants were performed in the control group, ligation group, ligation with anti-RANKL antibody treatment group, and ligation with anti-RANKL ...
Fig. 3. Anti-RANKL and anti-RANKL+miR-146a treatments decreased TRAP-positive cell quantities with different patterns in experimental peri-implantitis of WT and TLR2/4 KO mice. TRAP-positive cells (red color) with 3 or more nuclei were considered osteoclasts and were shown in the control group, ligation group, ligation with anti-RANKL antibody treatment group, and ligation with anti-RANKL antibo...
Fig. 2. Anti-RANKL and anti-RANKL+miR-146a treatments decreased ligature-induced bone resorption with different patterns in experimental peri-implantitis of WT and TLR2/4 KO mice. Buccal side images of the defleshed skulls were taken of the control (non-ligation) group, ligation (non-treatment) group, ligation with anti-RANKL antibody (ligation+AR) treatment group, and ligation with anti-RANKL a...
Fig. 1. Mouse model of ligature-induced experimental peri-implantitis. (a) Tooth extraction: left maxillary first and second molars extracted at 4 weeks old and the tooth extraction socket healed well with smooth gingiva surface after 6 weeks post-extraction. Implant placement: implant was put in alveolar bone without flap elevation. Ligature placement: at 4 weeks post-implant, 7-0 ligatur...
Total implantsLostLooseOsseointegratedSuccess rate (%)SR P valueWild type group60654981.670.595TLR2/4 KO group60445286.67Table 1 Success rate (SR) of osseointegrated implants 4 weeks after implant placement
Pan, K., Hu, Y., Wang, Y. et al. RANKL blockade alleviates peri-implant bone loss and is enhanced by anti-inflammatory microRNA-146a through TLR2/4 signaling. Int J Implant Dent 6, 15 (2020). https://doi.org/10.1186/s40729-020-00210-0
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Published: 15 April 2020
DOI: https://doi.org/10.1186/s40729-020-00210-0
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Keqing Pan, Yang Hu, Yufeng Wang, Hao Li, Michele Patel, Danyang Wang, Zuomin Wang, and Xiaozhe Han certify that they do not have any commercial or associate interest that represents a conflict of interest in connection with the manuscript. The submitted work was not carried out in the presence of any personal, professional, or financial relationships that could pot...
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KP contributed to the conception and design; contributed to the acquisition, analysis, and interpretation of data; and drafted the manuscript. YH contributed to the conception and design, contributed to the acquisition, anal...
Department of Stomatology, The Affiliated Hospital of Qingdao University, College of Stomatology, Qingdao University, Qingdao, 266003, Shandong, China
Keqing Pan
Department of Immunology and Infectious Diseases, The Forsyth Institute, 245 First Street, Cambridge, MA, 02142, USA
Keqing Pan, Yang Hu, Yufeng Wang, Hao Li, Michele Patel & Xiaozhe Han
Department of Oral Medicine, Ninth People...
This study was supported by NIH NIDCR R01DE025255 and the Forsyth Institute FPILOT36 to X Han and the Forsyth Institute FPILOT52 to Y Hu.
Tu S, Zhong D, Xie W, Huang W, Jiang Y, Li Y. Role of toll-like receptor signaling in the pathogenesis of graft-versus-host diseases. Int J Mol Sci. 2016;17(8).
Gaddis DE, Michalek SM, Katz J. TLR4 signaling via MyD88 and TRIF differentially shape the CD4+ T cell response to Porphyromonas gingivalis hemagglutinin B. J Immunol. 2011;186(10):5772–83.
Zhang P, Liu J, Xu Q, et al. TLR2-dependent m...
Kawai T, Akira S. Toll-like receptors and their crosstalk with other innate receptors in infection and immunity. Immunity. 2011;34(5):637–50.
Song GG, Kim JH, Lee YH. Toll-like receptor (TLR) and matrix metalloproteinase (MMP) polymorphisms and periodontitis susceptibility: a meta-analysis. Mol Biol Rep. 2013;40(8):5129–41.
Lin J, Bi L, Yu X, et al. Porphyromonas gingivalis exacerbates ligat...
Shuto T, Wachi T, Shinohara Y, Nikawa H, Makihira S. Increase in receptor activator of nuclear factor kappaB ligand/osteoprotegerin ratio in peri-implant gingiva exposed to Porphyromonas gingivalis lipopolysaccharide. J Dent Sci. 2016;11(1):8–16.
O'Connell MB. Prescription drug therapies for prevention and treatment of postmenopausal osteoporosis. J Manag Care Pharm. 2006;12(6 Suppl A):S10-19; ...
Bertin TJC, Thivichon-Prince B, LeBlanc ARH, Caldwell MW, Viriot L. Current perspectives on tooth implantation, attachment, and replacement in amniota. Front Physiol. 2018;9:1630.
Schminke B, Vom Orde F, Gruber R, Schliephake H, Burgers R, Miosge N. The pathology of bone tissue during peri-implantitis. J Dent Res. 2015;94(2):354–61.
Mombelli A, Muller N, Cionca N. The epidemiology of peri-impl...
Receptor activator of nuclear factor-kappa Β ligand
Toll-like receptor
Wild type
MicroRNA 146a
Micro-computed tomography
Real-time quantitative PCR
Tumor necrosis factor alpha
Osteoprotegerin
Lipopolysaccharides
Hematoxylin and eosin
Tartrate-resistant acid phosphatase
Presented in the main paper
In summary, the present study suggests that anti-inflammatory miR-146a enhance anti-RANKL-induced inhibition of peri-implant bone resorption through the regulation of TLR2/4 signaling and inhibition of TNF-α expression. Combination of regimens antagonizing both osteoclastogenesis and inflammation may become a more effective strategy to ameliorate peri-implantitis bone loss.
According to the previous studies, miR-146a was regulated by NF-κB and blockade of miR-146a could decrease TLR4 and NF-κB in human cells [41, 42], suggesting that miR-146a is involved in TLR/NF-κB signaling pathway. Our recent study showed that miR-146a inhibited inflammatory cytokine secretion in B cells after challenged with P. gingivalis LPS and decreased bone resorption in experimental peri...
Our present study showed that anti-RANKL antibody can significantly inhibit the bone loss in peri-implantitis and additional miR-146a treatment will enhance this inhibition through its anti-inflammation effects via TLR2/4 signaling. This is the first report in a murine model of peri-implantitis to demonstrate that anti-RANKL antibody and miR-146a together can significantly reduce bone resorption a...
In both WT mice and TLR2/4 KO mice, a significantly higher number of inflammatory cells were found infiltrating around the peri-implant tissues in the ligation group compared with the non-ligation group (Fig. 4a–c). However, the number of inflammatory cells in tissues of the ligation group was not significantly changed when treated with anti-RANKL antibody alone in both WT and TLR2/4 KO mice com...
In our ligature-induced experimental peri-implantitis mouse model, teeth extraction, implant placement, ligation placement, and gingival injection will be performed in a 12-week process (Fig. 1). 86.67% (52 out of 60) of implants in TLR2/4 KO mice achieved osteointegration (no mobility when touched by needles, no obvious bleeding upon probing) after being placed for 4 weeks, which has no signifi...
Palatal gingival tissues were isolated from around ligatured implants and were homogenized in lysis buffer using a tissue homogenizer. Total RNA was extracted using PureLink® RNA Mini Kit (Ambion). cDNA was synthesized using the SuperScript III Reversed Transcriptase kit (Invitrogen) according to the manufacturer’s protocol. The mRNA expression of TNF-α and RANKL in gingival was determined by ...
The ligations were maintained for 2 weeks, and after which the mice were euthanized by CO2 inhalation and the maxilla were harvested. The gingival tissues of half group of mice were isolated and collected for mRNA expression study. The skulls left were defleshed by beetles for 1 week. Briefly, in beetle’s chamber, freshly dissected skull was put in a paper cup with 0.5 cm diameter holes at...
Wild-type (WT) C57BL/6 and TLR2 KO and TLR4 KO mice in C57/BL6 background were purchased from the Jackson Laboratory (Bar Harbor, ME). TLR2 and TLR4 double KO mice (TLR2/4 KO) were crossbreed from TLR2 KO and TLR4 KO mice and confirmed by genotyping. All the animal-associated protocols were reviewed and approved (#17-022) by the Institutional Animal Care and Use Committee of the Forsyth Institute....
Toll-like receptors (TLR) are a family of well-characterized pattern recognition receptors (PRRs) and play an important role in the induction of pro-inflammatory cytokines by recognizing the signature molecules of the host innate immunity [25,26,27]. Our previous studies showed that TLR2 are associated with implant bone loss in a mouse model of peri-implantitis [5] and TLR4 is essential for period...
Dental implant has become a preferable choice to restore the missing tooth in the past few decades for functional and esthetic purposes [1]. However, peri-implantitis has become prevalent accompanying the exponential growth of dental implant procedures [2, 3]. Peri-implantitis is indicated by infection of implant surrounding soft tissues and bone loss, resulting in implant failure eventually [4,5,...
This study suggests that anti-inflammatory miR-146a enhance anti-RANKL-induced inhibition of peri-implant bone resorption through the regulation of TLR2/4 signaling and inhibition of TNF-α expression.
The present study was to determine the effect of local anti-RANKL antibody administration in the presence or absence of microRNA-146a on ligature-induced peri-implant bone resorption, and the potential role of TLR2/4 signaling in such effect.
Titanium implants were placed in the left maxilla alveolar bone 6 weeks after extraction of first and second molars in C57/BL6 wild-type (WT) and TLR2−/...
OHIP domainMinimumMaximumMeanSDFunctional limitation072.341.70Physical pain071.161.51Psychological discomfort081.642.27Physical disability080.751.77Psychological disability081.182.11Social disability080.611.40Handicap080.701.71Total0648.49.7Table 5 Summary of OHIP-14 (N = 44 and response range 0–8)
Outcome variablesCorrelationsSpearman’s rhoP valueOHRQoLOral health compared0.596
QuestionResponseFrequencyOral healthVery good/good81.8%Quality of LifeVery good/good90.9%General healthVery good/good81.8%Pain after hip operationExcessive35.0%Satisfaction hip operationVery85.7%Post op infection in hip siteNo95.3%Visible scar on hipYes48.8%Acceptable scarYes20 of 21aReduced sensibility on hip siteNo86.0%Problem walkingNo92.9%Augmented bone block still presentNo6.8%New augmentatio...
VariableFrequencyN or Mean ± SD%Patients Female2454.5 Male2045.5Age (years)61.16 ± 13.10 Age at operation53.73 ± 13.07 Time from augmentation to completing questionnaire (months)93.55 ± 31.75 Civil status Married3068.2 Single1125.0 Widow(er)36.8Housing Alone1227.3 With another person2352.3 > two persons920.5Education Up to primary711.3 Up to secondary23...
CategoryResponseQuestion (1) Perceived health-status General health“Very good” to “bad” Oral health“Very good” to “bad” Overall quality of life“Excellent” to “bad” (2) Lifestyle-related Smoking“Yes,” “no,” or “sometimes” Appetite“Good” to “bad” (3) Donor site-related Pain“Yes” and “no” Infection“Yes” a...
Gjerde, C.G., Shanbhag, S., Neppelberg, E. et al. Patient experience following iliac crest-derived alveolar bone grafting and implant placement.
Int J Implant Dent 6, 4 (2020). https://doi.org/10.1186/s40729-019-0200-8
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Received: 10 October 2019
Accepted: 11 December 2019
Published: 05 February 2020
DOI: https://doi.org/10.1186/s40729-019-0200-8
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were ...
A self-administered questionnaire.
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The Ethics Committee was contacted in 2015, and no ethical approval was needed since this was then considered a quality control study. Written consent was obtained from all participants.
Not applicable.
Cecilie G Gjerde, Siddharth Shanbhag, Evelyn Neppelberg, Kamal Mustafa, and Harald Gjengedal declare that they have no competing interests.
Correspondence to
Cecilie G. Gjerde.
Department of Oral and Maxillofacial Surgery, Institute of Clinical Dentistry, University of Bergen, Årstadveien 19, 5009, Bergen, Norway
Cecilie G. Gjerde & Evelyn Neppelberg
Centre for Clinical Dental Research, Institute of Clinical Dentistry, University of Bergen, Bergen, Norway
Cecilie G. Gjerde, Siddharth Shanbhag & Kamal Mustafa
Department of Oral and Maxillofacial Surgery, Head an...
This work was partially funded by the Research Council of Norway through the BEHANDLING project (grant no. 273551) and TROND MOHN Foundation, Norway (BFS2018TMT10).
The staff and surgeons at the Department of Oral and Maxillofacial Surgery, Head and Neck Clinic, Haukeland University Hospital, Bergen. Randi Aursland, master student, who helped collecting data. The patients included in this study.
Landes CA, Bundgen L, Laudemann K, Ghanaati S, Sader R. Patient satisfaction after prosthetic rehabilitation of bone-grafted alveolar clefts with nonsubmerged ITI Straumann dental implants loaded at three months. Cleft Palate Craniofac J. 2012;49(5):601–8.
Reisine S, Freilich M, Ortiz D, Pendrys D, Shafer D, Taxel P. Quality of life improves among post-menopausal women who received bone augment...
Locker D, Allen F. What do measures of ‘oral health-related quality of life’ measure? Community Dent Oral Epidemiol. 2007;35(6):401–11.
Sischo L, Broder HL. Oral health-related quality of life: what, why, how, and future implications. J Dent Res. 2011;90(11):1264–70.
Slade GD. Assessing change in quality of life using the Oral Health Impact Profile. Community Dent Oral Epidemiol. 1998;26...
Hill NM, Horne JG, Devane PA. Donor site morbidity in the iliac crest bone graft. Aust N Z J Surg. 1999;69(10):726–8.
Finkemeier CG. Bone-grafting and bone-graft substitutes. J Bone Joint Surg Am. 2002;84-A(3):454–64.
Hernigou P, Desroches A, Queinnec S, Flouzat Lachaniette CH, Poignard A, Allain J, et al. Morbidity of graft harvesting versus bone marrow aspiration in cell regenerative thera...
Schaaf H, Lendeckel S, Howaldt HP, Streckbein P. Donor site morbidity after bone harvesting from the anterior iliac crest. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;109(1):52–8.
Sakkas A, Wilde F, Heufelder M, Winter K, Schramm A. Autogenous bone grafts in oral implantology-is it still a “gold standard”? A consecutive review of 279 patients with 456 clinical procedures. Int J I...
Health-related quality of life
Oral Health Impact Profile-14
Oral health-related quality of life
Patient-reported outcome measures
Quality of life
The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
Favorable OHRQoL and satisfaction were reported after advanced reconstruction with iliac crest-derived grafts and implant treatment in orally compromised patients. However, this treatment requires substantial resources including hospitalization and sick leave.
Patients in our study reported satisfaction with the augmentation and implant installation, and as these patients were orally compromised before the operation, their satisfaction with getting fixed teeth most likely improved their perceived oral health condition. This might also, in part, explain why they reported good OHRQoL. Thus, our findings indicate that a majority of patients tolerate the au...
An important finding in this study is that a majority of patients were very satisfied after iliac crest-derived alveolar bone grafting and implant therapy. Although 90% of the patients in our study had successful bone grafting, only 70.1% reported implant survival together with prosthetic rehabilitation after 1 year. These figures are lower than those reported in previous studies [2, 3, 9]. A rev...
The correlation analyses performed did not show a significant correlation between the complications at the donor site and implant loss (Table 4).
The mean OHIP-14 score (Table 5) was 8.4 ± 9.7 (range 0–56) in 44 patients of whom 35 patients scored 14 or less. Nine patients scored a total sum of 1 [1], i.e. “hardly ever” impact on any single item and “at no time” on the remaining ...
The final sample consisted of 44 patients that responded and completed the questionnaire, giving a response rate of 74.6%: 24 women and 20 men, mean age of 61.2 years ± 13.1 (range 27–82 years). The mean time from augmentation surgery until completing the questionnaire was 7.8 years ± 2.65 (range 1.9–12 years).
Summary of demographic and lifestyle-related data is presented (Tabl...
Implants were placed 4–6 months after the grafting procedure. The implant installations were performed by different oral surgeons (not in the hospital) and different implant systems were used. The implants installed into the augmented bone were allowed to heal for an additional 4–6 months before loading.
The records of the original 69 patients were examined with regard to (1) grafting sit...
This cross-sectional retrospective cohort study was based on records from all patients (n = 69) who underwent advanced alveolar augmentation with autologous iliac bone grafts at the Department of Oral and Maxillofacial Surgery, Haukeland University Hospital, Bergen, Norway, over 10 years (2002–2012). These patients were orally compromised with severe chewing problems as well as speech diff...
Health-related QoL (HRQoL) is a dynamic concept referring to an individual’s subjective assessment and perspective of current general health condition as well as functional, social, and emotional well-being [23, 24]. Most people regard oral health as important for QoL, and this is mediated through the concept of oral health-related QoL (OHRQoL) [25]. In this regard, OHRQoL is an important PROM i...
Insufficient alveolar bone volume, as a result of periodontal disease, trauma, congenital anomalies and/or resorption atrophy, often presents a clinical challenge for optimal placement of dental implants for prosthetic rehabilitation. In such cases, augmentation of alveolar bone, with either autologous bone, allogeneic, xenogeneic, or alloplastic biomaterials, is a prerequisite for placing implant...
The objective of this study was to assess patient-reported outcomes such as satisfaction and quality of life after advanced alveolar bone augmentation with anterior iliac crest grafting and implant treatment in orally compromised patients.
This cross-sectional retrospective cohort study included 59 patients (29 women and 30 men) with major functional problems, who underwent advanced alveolar augm...
Fig. 6. Optic microscope photo (× 9 magnification) after 30 days of implantation. Left side: machined implant (group C). Central photo: sandblasted and acid-etched implant (group A). Right side: laser-treated implant
Fig. 6. Optic microscope photo (× 9 magnification) after 30 days of implantation. Left side: machined implant (group C). Central photo: sandblasted and acid-etched implant ...
Fig. 5. Optic microscope photo (× 9 magnification) after 15 days of implantation. Left side: machined implant (group C). Central photo: sandblasted and acid-etched implant (group A). Right side: laser-treated implant
Fig. 5. Optic microscope photo (× 9 magnification) after 15 days of implantation. Left side: machined implant (group C). Central photo: sandblasted and acid-etched implant ...
Fig. 4. Exemplificative photo of implant placement in sheep iliac crest (left side). All implant groups were inserted in the same bone host
Fig. 4. Exemplificative photo of implant placement in sheep iliac crest (left side). All implant groups were inserted in the same bone host
Fig. 3. Scanning electron microscopy picture of group C implant surface
Fig. 3. Scanning electron microscopy picture of group C implant surface
Fig. 2. Scanning electron microscopy picture of group B implant surface
Fig. 2. Scanning electron microscopy picture of group B implant surface
Fig. 1. Scanning electron microscopy picture of group A implant surface
Fig. 1. Scanning electron microscopy picture of group A implant surface
GroupBIC% (mean ± SD)A50.31 ± 13.44B56.53 ± 13.62C20.54 ± 11.06Table 3 Mean BIC% value of each group after 30 days of healing
Group
BIC% (mean ± SD)
A
39.08 ± 15.85
B
37.35 ± 15.76
C
25.28 ± 8.97
Table 2 Mean BIC% value of each group after 15 days of healing
Group A implantsGroup B implantsGroup C implantsScrew pitch1.25 mm0.6 mm0.6 mmSmooth neck2.8 mm0.25 mm0.25 mmSurface treatmentLarge grit-blasted and acid-etched SLA surface, processed to a high degree of hydrophilicity (SLActive®)Laser surface characterized by a series of 20 μm diameter holes (7–10 μm deep) every 10 μm (Syntegra®)Machined surfaceSurface roughness (Ra)1.5...
De Tullio, I., Berardini, M., Di Iorio, D. et al. Comparative evaluation among laser-treated, machined, and sandblasted/acid-etched implant surfaces: an in vivo histologic analysis on sheep.
Int J Implant Dent 6, 7 (2020). https://doi.org/10.1186/s40729-019-0204-4
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Received: 30 August 2019
Accepted: 24 December 2019
Published: 19 February 2020
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Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
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The Ethics Committee for Animal Research of the Veterinary School of the University of Teramo (Teramo, Italy) approved the study protocol, according to the guidelines established by the European Union Council Directive of February 2013 (R.D.53/2013) (protocol number 3809).
The Ethics Committee for Animal Research of the Veterinary School of the University of Teramo (Teramo, Italy) approved the st...
Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy
I. De Tullio, F. Perfetti & G. Perfetti
Pescara, Italy
M. Berardini
Foggia, Italy
D. Di Iorio
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No grants were received for the present study.
The authors wish to thank the company Geass s.r.l. for providing implants used in the present study.
Piattelli A, Manzon L, Scarano A, Paolantonio M, Piattelli M. Histologic and histomorphometric analysis of the bone response to machined and sandblasted titanium implants: an experimental study in rabbits. Int J Oral Maxillofac Implants. 1998;13:805–10.
Lee JT, Cho SA. Biomechanical evaluation of laser-etched Ti implant surfaces vs. chemically modified SLA Ti implant surfaces: Removal torque an...
Gaggl A, Schultes G, Muller WD, Karcher H. Scanning electron microscopical analysis of laser-treated titanium implant surfaces. A comparative study. Biomaterials. 2000;21(10):1067–73.
Bonsignore LA, Colbrunn RW, Tatro JM, Messerschmitt PJ, Hernandez CJ, Goldberg VM, Stewart MC, Greenfield EM. Surface contaminants inhibit osseointegration in a novel murine model. Bone. 2011;49(5):923–30.
Peng...
Albrektsson T, Brånemark PI, Hansson HA, Lindström J. Osseointegrated titanium implants. Requirements for ensuring a long-lasting, direct bone-to-implant anchorage in man. Acta Orthop Scand. 1981;52(2):155–70.
Puleo DA, Nanci A. Understanding and controlling the bone-implant interface. Biomaterials. 1999;20(23-24):2311–21.
Huang MS, Chen LK, Ou KL, et al. Rapid osseointegration of titanium...
All data and materials are available at University Chieti-Pescara, Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy.
Results from the present in vivo analysis revealed that both sandblasted and acid-etched titanium implants and laser-treated titanium implants, compared to the machined ones, have higher values of osseointegration in less healing time.
Indeed, both groups A and B at 15 days had higher values of the BIC% if compared to group C and were able to significantly increase their BIC% in the passage fro...
Data showed by the present study suggest that laser and sandblasted and acid-etched surface treatments could enhance the osteogenic bone formation by “contact,” already observed by other authors [20, 21].
Another interesting emerging datum is the observation of BIC% changes between 15 and 30 days: it is possible to assume that between the fifteenth and the thirtieth day, most part of the pe...
In the present study, the iliac crest of the sheep was chosen as a model because the site is characterized by a cancellous bone rich in marrow spaces, similar for quality to D4 density. This bone model appears superimposable to postero-lateral sectors of the human upper jaw that often represents a hard challenge for implant osseointegration due to low bone density.
Bone quality, in fact, is a key...
All implants resulted clinically integrated and stable into the bone tissue. No signs of tissue inflammation or infection were detected.
At low magnification, all the samples appeared surrounded by new tissue. The distinction between native tissue and newly formed bone was not clear, likely due to the fact that the latter is still in an initial forming phase. In the machined samples (group C) bon...
Measurement of the total length of the left half of the fixture;
Measurement of the contact area between bone and implant in the left half of the fixture;
Measurement of the total length of the right half of the fixture; and
Measurement of the contact area between bone and implant in the right half of the fixture.
Afterwards, the sum of parameters A and C represented the total length of the wh...
Implant drilling procedures were carried out using the drill sequence recommended by the manufacturer. The drill speed was set at 700 rpm under continuous sterile saline solution irrigation (stored at + 4 °C).
Implants were inserted with an insertion torque peak between 28 and 34 Ncm. Each animal received three implants of each group.
The suture of deep muscle planes was performed with poly...
The Ethics Committee for Animal Research of the Veterinary School of the University of Teramo (Teramo, Italy) approved the study protocol, which followed guidelines established by the European Union Council Directive of February 2013 (R.D.53/2013).
A total of 36 implants were used in the present study. Implants had different macro-geometries and surfaces and they were divided into three groups of...
In addition, some animal studies [15, 16] found an increased removal torque in laser processed implants compared to machined surface implants inserted.
The aim of the present paper was to evaluate the osseointegration process, in terms of bone to implant contact percentage (BIC%), of three different implants surface (machined, sandblasted and acid-etched, and laser-treated) both after 15 and 30...
Dental implant surfaces represent one of the key factors that could influence the osseointegration processes [1]. Puleo et al. [2] confirmed that the surface topography, as well as the chemical nature and the implant macro and micro geometry, is involved in creating a clinical and histological efficient bone-implant interface. It was demonstrated that different superficial treatments could affect ...
The aim of the present in vivo analysis was to evaluate the osseointegration process of titanium implants with three different surfaces (machined, sandblasted and acid-etched, and laser-treated) after 15 and 30 days of healing period.
Thirty-six implants with different surfaces were placed in the iliac crest of four Bergamasca sheep. The implant surfaces tested were sandblasted and acid-etched ...
Fig. 8. Photomicrographs of decalcified sections. a Untreated site. Woven bone formed from the sinus walls after 1 week of healing. b Treated site. After 8 weeks, woven bone was still found forming ridges towards residues of provisional matrix, showing that the healing was not completed yet. Scarlet-acid fuchsine and toluidine blue stain. a × 100 magnification. b × 20 magnification
...
Fig. 7. Box-plot representing the new bone percentage and standard deviations (whiskers) found in the various regions evaluated after 8 weeks of healing. (*), a statistical significant difference
Fig. 7. Box-plot representing the new bone percentage and standard deviations (whiskers) found in the various regions evaluated after 8 weeks of healing. (*), a statistical significant difference
Fig. 6. Photomicrographs of decalcified sections illustrating the healing after 8 weeks. a Treated site. Most of the antrostomies presented remaining defects in the outer contour. b, c Untreated sites. Two antrostomies of the treated sites and four of the untreated sites appeared not closed with corticalized bone and presented connective tissue interposed between the edges of the antrostomy. S...
Fig. 5. Photomicrographs of decalcified sections illustrating the healing after 8 weeks. Both at the treated (a) and untreated (b) sites, the antrostomy was closed in most cases, presenting residual defects of various dimensions in the outer side. New bone was connecting the lateral and medial sinus walls. The middle and sub-mucosa regions were not healed completely yet. Scarlet-acid fuchsine ...
Fig. 4. Photomicrographs of ground sections. a) Treated site. Bone residues (examples in yellow asterisks) included in soft tissue containing fibroblast-like cells and inflammatory cells. b) Untreated site. Xenograft residues (examples in red asterisks) surrounded by soft tissue rich in fibroblast-like cells. Scarlet-acid fuchsine and toluidine blue stain. a) 200 x magnification.; b) 100 x magni...
Fig. 3. Photomicrographs of decalcified sections illustrating the healing after 1 week. a Treated site. Bone strips occupying the antrostomy and the subjacent area (close-to-window region). b Untreated site. Note the new bone-forming from the sinus bone walls. Scarlet-acid fuchsine and toluidine blue stain. Images grabbed at × 20 magnification
Fig. 3. Photomicrographs of decalcified sect...
Fig. 2. The various regions evaluated at the histomorphometric analyses. Bone walls (red arrow); middle (white arrow); sub-mucosa (yellow arrow); close-to-window (orange arrow). The antrostomy region was also evaluated at the medial and lateral edges (dark green arrows) and in the middle aspect (light green arrow)
Fig. 2. The various regions evaluated at the histomorphometric analyses. Bone w...
Fig. 1. Clinical view of the surgical procedures. a Tibial bone exposed for autogenous bone harvesting using a bone scraper. b Antrostomies prepared. c Autogenous bone particles placed in the antrostomy. d Xenograft and bone particles (red arrow) at the antrostomies. e Collagen membranes placed on the antrostomies. f Wounds closed with sutures
Fig. 1. Clinical view of the surgical procedures....
AntrostomySinus regions EdgesCenterTotalClose-to-windowMiddleSub-mucosaBone wallsTotalNew boneTreated sites40.3 ± 21.337.8 (27.0;56.0)24.3 ± 23.222.0 (3.4;42.2)35.5 ± 20.927.7 (23.3;52.0)25.8* ± 16.122.9 (15.2;39.7)19.5 ± 16.711.7 (10.1;22.3)22.5 ± 11.620.4 (12.6;31.3)38.0 ± 15.044.8 (31.8;47.5)27.9 ± 12.930.1 (19.6;34.5)Untreated sites32.2 ± 22....
AntrostomySinus regions EdgesCenterTotalClose-to-windowMiddleSub-mucosaBone wallsTotalNew boneTreated sites9.2 ± 10.6 4.6 (3.2;12.5)5.2 ± 13.90.0 (0.0;0.5)7.7 ± 11.22.7 (1.9;7.9)0.6 ± 1.00.0 (0.0;0.7)0.0 ± 0.00.0 (0.0;0.0)1.4 ± 1.80.8 (0.0;2.2)7.7 ± 6.38.2 (1.3;11.1)2.8 ± 2.62.2 (0.7;4.0)Untreated sites8.9 ± 8.5 6.2 (4.0;10.8)1.0 ± 2.70.0 (0....
Favero, G., Viña-Almunia, J., Carda, C. et al. Influence of the use of autogenous bone particles to close the access window after maxillary sinus floor augmentation: an experimental study in rabbits.
Int J Implant Dent 6, 9 (2020). https://doi.org/10.1186/s40729-020-0206-2
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Received: 20 October 2019
Accepted: 21 January 2020
Published: 04 March 2020
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Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
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The present research was approved by the Ethics Committee of Valencia University, Spain. Reference number: A1434714637496.
Not applicable.
Daniele Botticelli declares to be the co-owner of Ariminum Odontologica. Giacomo Favero, Jose Viña-Almunia, Carmen Carda, José Javier Martín de Llano, Berta García-Mira, David Soto-Peñaloza, Daniele Botticelli, and Miguel Peñarrocha-Diago declare that t...
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GF participated in the concept/design, data analysis/interpretation, drafting of the article and surgical procedures. JV-A performed the surgical procedures, made the follow up of the animals, participated in the manuscript revision and ethical committee redaction and approval. BG-M and DS-P performed the surgi...
Private practice, London, UK
Giacomo Favero
Oral Surgery Unit. Department of Stomatology, Faculty of Medicine and Dentistry, Clinica Odontológica, University of Valencia, Valencia, Spain
Jose Viña-Almunia, Berta García-Mira, David Soto-Peñaloza & Miguel Peñarrocha-Diago
Department of Pathology and Health Research Institute of the Hospital Clínico (INCLIVA), Faculty of Medicine and De...
Funds from the present have been provided by ARDEC Academy, by Ariminum Odontologica s.r.l., Rimini, Italy and Tecnoss srl, Giaveno, Italy. The biomaterials use were provided free of charge by Tecnoss srl, Giaveno, Italy.
Favero V, Lang NP, Canullo L, Urbizo Velez J, Bengazi F, Botticelli D. Sinus floor elevation outcomes following perforation of the Schneiderian membrane. An experimental study in sheep. Clin Oral Implants Res. 2016;27(2):233–40.
Scala A, Lang NP, Velez JU, Favero R, Bengazi F, Botticelli D. Effects of a collagen membrane positioned between augmentation material and the sinus mucosa in the eleva...
Kawakami S, Lang NP, Ferri M, Apaza Alccayhuaman KA, Botticelli D. Influence of the height of the antrostomy in sinus floor elevation assessed by cone beam computed tomography- a randomized clinical trial. Int J Oral Maxillofac Implants. 2019;34(1):223–32.
Kawakami S, Lang NP, Iida T, Ferri M, Apaza Alccayhuaman KA, Botticelli D. Influence of the position of the antrostomy in sinus floor elevat...
Tatum, H., Jr. Maxillary sinus grafting for endosseous implants. Lecture presented at the Annual Meeting of the Alabama Implant Study Group (1977); cited in Smiler, D.G., Johnson, P.W., Lozada, J.L., Misch, C., Rosenlicht, J.L., Tatum, O.H. Jr. & Wagner J.R. Sinus lift grafts and endosseous implants. Treatment of the atrophic posterior maxilla. Dental clinics of North America. 1992;36:151–186.
...
Animal Research Reporting In Vivo Experiments
Cone beam computed tomography
Deproteinized bovine bone mineral
Tricalcium phosphate
The datasets used or analyzed during the current study are available from the corresponding author on reasonable request.
The lower phylogenetic level of the animals compared to humans was the main limitation of the present study. An increased number of animals might allow reaching a statistical difference in favor of the treated sites also in the antrostomy region. Nevertheless, the outcomes obtained, allow to performing studies in humans that might demonstrate the advantages of applying autologous bone on the antro...
In both studies presented above on sinus floor elevation in sheep, all the lateral windows were prepared using a piezoelectric device. In an experiment in rabbits [21], the antrostomies were done with either a sonic instrument or drills to evaluate differences in bone formation in the antrostomy. Elevated space is filled with a collagenated porcine bone similar that used in the present experiment,...
The present experiment aimed to study the influence on the healing after the placement of autogenous bone on the antrostomy and in the subjacent region after maxillary sinus elevation. After 8 weeks of healing, in the antrostomy region, a trend of higher bone formation in the treated compared to the untreated sites was observed. No statistically significant difference was found. In the subjacent ...
After 1 week of healing (Table 1), in the close-to-window region, the proportions of xenograft were 21.3 ± 14.7% and 55.9 ± 19.0 (p = 0.012) in the treated and untreated sites, respectively. After 8 weeks of healing (Table 2), these values decreased to a similar percentage (15.5 ± 14.4% and to 15.5 ± 14.2%; p = 0.917, respectively).
After 1 week of healing (Table...
Biopsies could be harvested from all animals. However, histological sections could not be obtained from one rabbit of the 8 weeks group; therefore, eight and seven were achieved for the 1-week and 8-week periods, respectively.
After 1 week of healing, at the treated sites, the antrostomy and close-to-windows regions were occupied by a high proportion of residues of autogenous bone (Fig. 3a),...
Overlapping calibrated digital images of the tissues were recorded with Leica Applications Suite version 4.4.0 software from a bright field Leica DM4000 B microscope (Leica Microsystems GmbH, Wëtzlar, Germany) equipped with a 5× lens and DFC420 digital camera. Single images were pasted and merged to compose each elevated sinus using the program Photoshop (Adobe Photoshop CC 2015.0.0).
The histo...
Afterward, a trichotomy was performed in the nasal dorsum and, after disinfection of the experimental region using Betadine (MEDA Pharma®, Madrid, Spain), a sagittal incision was carried out. The skin and the periosteum were dissected and shifted laterally to expose the nasal bone. Antrostomies, 4 × 4 mm in dimensions, located about 3–4 mm laterally to the midline and about 10 mm in f...
Prior to the experiment, the protocol was approved by the Ethics Committee of Valencia University, Spain (A1434714637496). The guidelines indicated by the Council Directive of the European Union (53/2013; February 1, 2013) for animal experimentation and the ethical rules proposed by Royal Decree 223, March 14 and October 13, 1988, were fulfilled. The study was reported following the ARRIVE guideli...
Hence, the present experiment aimed to study the influence on healing, of the autogenous bone particle placement in the antrostomy and in the subjacent region after maxillary sinus elevation.
Maxillary sinus floor elevation through lateral access was first proposed in 1977 [1], while the technique was published in 1984 [2]. Several modifications in the surgical approach and the biomaterials used have been introduced over time [3,4,5]. In a systematic review with meta-analysis, it was concluded that the best survival rate was observed when implants with rough surface and membrane to cov...
To study the influence on the healing of the placement of particulate autogenous bone in the antrostomy and in the subjacent region after maxillary sinus elevation.
Sixteen New Zealand rabbits were undergone to bilateral maxillary sinus floor augmentation with 4 × 4 mm antrostomy dimension. The sinus mucosa was elevated, and the space obtained was filled with xenograft. In the test site (tr...
Fig. 6. Graph representing new bone and composite bone percentages within the elevated area
Fig. 6. Graph representing new bone and composite bone percentages within the elevated area
Fig. 5. Graph representing the tissue percentages within the elevated area. No statistically significant differences were found
Fig. 5. Graph representing the tissue percentages within the elevated area. No statistically significant differences were found
Fig. 4. Photomicrographs of ground sections after 4 months of healing. a Bone formed from the base of the sinus. b Bone plate connected by bridges of the new bone to the close-to-window region. c Particle of the graft surrounded by new bone. d Overexposed image to show the new bone ingrowth within the granules of biomaterial
Fig. 4. Photomicrographs of ground sections after 4 months of he...
Fig. 3. a The elevated area was divided into four regions for morphometric analysis. RED: submucosa; GREEN: middle; YELLOW: base; PURPLE: close-to-window. INC: top of the infraorbital nerve canal
Fig. 3. a The elevated area was divided into four regions for morphometric analysis. RED: submucosa; GREEN: middle; YELLOW: base; PURPLE: close-to-window. INC: top of the infraorbital nerve canal
Fig. 2. Clinical view at a bone plate site. a The bone window was removed. b The sinus mucosa was carefully elevated, and a twisted wire was placed. c The elevated sinus was grafted. d The access bony window was repositioned and secured with cyanoacrylate
Fig. 2. Clinical view at a bone plate site. a The bone window was removed. b The sinus mucosa was carefully elevated, and a twisted wire wa...
Fig. 1. Clinical view at a membrane site. a Skin and periosteum were separately elevated, and the facial sinus wall exposed. b A 12 × 8-mm window was cut and removed. c The Schneiderian membrane was carefully elevated. d A twisted wire was inserted in the middle of the long side of the window and the elevated sinus was grafted. e At the control site, a resorbable membrane was placed and secured...
BoneSoft tissuePure graftInterpenetrated graftComposite boneReplaced windowCenter61.5 ± 46.982.5 (22.2; 96.9)21.7 ± 22.6*17.5 (3.1; 34.4)2.3 ± 4.3*0.0 (0.0; 2.3)7.9 ± 19.30.0 (0.0; 0.0)69.3 ± 38.582.5 (57.6; 96.9)Edge37.2 ± 37.021.6 (16.8; 55.8)41.0 ± 39.833.6 (9.2; 64.9)5.3 ± 7.31.6 (0.0; 9.1)13.8 ± 19.0*6.7 (0.0; 19.7)54.8 ± 34.162.9 (37.5; 69.7)MembraneCenter5.8 ± 2.1 (P = 0.116)5....
New boneSoft tissuePure graftInterpenetrated graftComposite boneReplaced windowTotal16.4 ± 5.618.8 (13.8; 20.3)32.9 ± 8.031.2 (27.7; 37.0)13.6 ± 4.212.0 (10.8; 16.2)37.1 ± 7.534.4 (31.7; 43.4)53.5 ± 7.652.4 (50.8; 57.8)Base15.0 ± 7.216.4 (10.1; 20.1)38.6 ± 14.334.5 (28.9; 47.1)13.4 ± 6.415.3 (13.1; 17.0)33.1 ± 11.133.1 (26.8; 40.0)48.0 ± 18.149.9 (36.9; 59.7)Middle16.9 ± 7.318.1 (11.2...
Perini, A., Ferrante, G., Sivolella, S. et al. Bone plate repositioned over the antrostomy after sinus floor elevation: an experimental study in sheep.
Int J Implant Dent 6, 11 (2020). https://doi.org/10.1186/s40729-020-0207-1
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Received: 01 October 2019
Accepted: 04 February 2020
Published: 18 March 2020
DOI: https://doi.org/10.1186/s40729-020-0207-1
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
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The research protocol was submitted to and approved by the Ethical Committee of the University of Medical Sciences, School of Dentistry, Havana, Cuba (prot. 013/2013).
All the authors consent to publication.
Alessandro Perini, Giada Ferrante, Stefano Sivolella, Joaquín Urbizo Velez, Franco Bengazi, and Daniele Botticelli declare that they have no competing interests.
Correspondence to
Alessandro Perini.
Department of Neuroscience, Division of Dentistry, University of Padua, Via Giustiniani 2, 35128, Padua, Italy
Alessandro Perini, Giada Ferrante & Stefano Sivolella
Faculty of Dentistry, University of Medical Science, Havana, Cuba
Joaquín Urbizo Velez & Franco Bengazi
ARDEC Academy, Ariminum Odontologica, Rimini, Italy
Daniele Botticelli
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...
This study was funded by ARDEC Academy, Ariminum Odontologica s.r.l., Rimini, Italy.
Degradable Solutions AG, a Sunstar Group Company, CH-8952 Schlieren ZH, Switzerland, provided free of charge the biomaterials used.
Iida T. Carneiro Martins Neto E, Botticelli D, Apaza Alccayhuaman KA, Lang NP, Xavier SP. Influence of a collagen membrane positioned subjacent the sinus mucosa following the elevation of the maxillary sinus: a histomorphometric study in rabbits. Clin Oral Implants Res. 2017 Dec;28(12):1567–76.
Inal S, Yilmaz N, Nisbet C, Güvenç T. Biochemical and histopathological findings of N-butyl-2-cyano...
Russell WMS, Burch RL. The principles of human experimental technique. London: Methuen; 1959.
Schroeder HE, Münzel-Pedrazzoli S. Correlated morphometric and biochemical analysis of gingival tissue: morphometric model, tissue sampling and test of stereologic procedures. J Microsc. 1973 Dec;99(3):301–29.
Sohn DS, Kim WS, An KM, Song KJ, Lee JM, Mun YS. Comparative histomorphometric analysis of ...
Nosaka Y, Nosaka H, Arai Y. Complications of postoperative swelling of the maxillary sinus membrane after sinus floor augmentation. J Oral Sci Rehab. 2015;1:26–33.
Tawil G, Tawil P, Khairallah A. Sinus floor elevation using the lateral approach and bone window repositioning I: clinical and radiographic results in 102 consecutively treated patients followed from 1 to 5 years. Int J Oral Maxillof...
Tatum H Jr. Maxillary sinus grafting for endosseous implants. Lecture presented at the Annual Meeting of the Alabama Implant Study Group (1977); cited in Smiler DG, Johnson PW, Lozada JL, Misch C, Rosenlicht JL, Tatum OH Jr., Wagner JR. Sinus lift grafts and endosseous implants. Treatment of the atrophic posterior maxilla. Dent Clin North Am. 1992;36:151–86.
Boyne PJ, James RA. Grafting of the ...
Biphasic calcium phosphate
Deproteinized Bovine Bone Mineral
Hydroxyapatite
Infraorbital nerve canal
Standard deviation
Beta-tricalcium phosphate
All data and materials are available for control and consultation contacting the first author (alexperini@studioschweiger.it).
In conclusion, the repositioning of the bone window after sinus floor elevation in sheep, compared with the use of a resorbable membrane, improved the closure of the antrostomy and led to a greater amount of the newly formed bone in the close-to-window zone of the grafted area. The bone window appeared partially bonded to the newly formed bone. Bridges of new bone from the edges of the antrostomy ...
In the present study, a lesser amount of bone was registered subjacent to the sinus mucosa compared with the other regions. This is in agreement with another experiment, in which a similar material was used for sinus augmentation in sheep [24]. A similar outcome was also reported in another study [27] that used DBBM xenograft for sinus augmentation in sheep. In that study, a collagen membrane was ...
In another similar experiment in sheep, the sinuses were augmented using a similar biphasic calcium phosphate (60% HA, 40% β-TCP) [24], the biomaterial used in the present study. The perforation of the sinus mucosa was performed at the test sites and a collagen membrane was placed to protect the perforation, while at control sites the elevated mucosa was left unprotected. After 12 weeks of heal...
The aim of the present study was to compare the healing of the augmented sinus in large animals, where the antrostomy was covered by a polylactic membrane or a repositioned bone plate, both secured with cyanoacrylate.
No statistically significant differences were found between test and control sites in the bone formation within the augmented space. This outcome is in agreement with a similar stud...
In the centre of the window area, at the test sites, in the analysed histological sections, the bone plate was still visible in five out of six sheep. It appeared partly remodelled and connected by the new bone formed in the sub-window area. Out of the five bone plates still present, three were bridged to the edges of the antrostomy, while in the two cases no contact was achieved in the observed s...
During surgery, one sheep showed acute sinusitis at the test site. The sinus mucosa was perforated to allow sinus drainage and surgery was completed. During the healing period, no evident clinical complications were observed.
At the histomorphometric analysis, one sinus of the control group and one of the test group (corresponding to the sinusitis case) appeared to have lost almost all biomateria...
The percentages of the new mineralised bone, soft or connective tissue, pure graft, graft interpenetrated by bone, and remnants of cyanoacrylate were evaluated. The total tissue percentages in the elevated space that included submucosa, middle, base, and sub-window regions were also calculated.
Mean values and standard deviations (SDs) as well as the 25th, 50th (median), and 75th percentiles were...
After 4 months, the animals were anaesthetised and then euthanised with an overdose of pentobarbital sodium and subsequently perfused with 10% formalin. The maxilla was retrieved en bloc, trimmed, and immersed in formalin solution.
All histological procedures were performed in the Laboratorio de Histologıa de la Facultad de Odontologıa de la Universidad de Ciencia Medica in Havana, Cuba. Bila...
Through an extra-oral approach, an oblique incision was made bilaterally along the sagittal axis between the facial tuberosity and the inferior orbital rim. The skin and periosteum were elevated separately, and the bony facial sinus wall was exposed on both sides of the maxilla (Fig. 1a).
A 12-mm large and 8-mm high antrostomy was prepared using a burr (H254E Komet Dental, Trophagener Weg 25, L...
The research protocol was submitted to and approved by the Ethical Committee of the University of Medical Sciences, School of Dentistry, Havana, Cuba (prot. 013/2013).
Eight female Pelibuey sheep, with a mean body weight of approximately 35 kg and a mean age of approximately 3 years, were provided by the Centro Nacional para la Producción de Animales de Laboratorio (CENPALAB) in Havana, Cuba...
To prevent the movement of the bony plate and to gain adequate stability, cyanoacrylate has been suggested to glue the plate to the bony edges of the antrostomy [17]. Cyanoacrylates (as methyl 2-cyanoacrylate or ethyl 2-cyanoacrylate) are widely used in surgery and have shown good compatibility [18] and biomechanical strength for fixation of grafts [19]. In an experiment in rabbits [17], the antro...
Sinus floor elevation is a commonly used technique to increase bone volume in the posterior maxilla prior to implant placement. This procedure was first developed by Tatum in 1977 [1], modified by Boyne and James in 1980 [2], and further modified over time. In this well-described technique, a bony window is created on the lateral wall of the sinus with a round burr, and the membrane elevated. Diff...
The objective of this study was to compare the healing of the augmented sinus at which the antrostomy was covered with a membrane or the repositioned bone plate.
Eight sheep underwent bilateral maxillary sinus floor augmentation. The control site was covered with a resorbable membrane, while at the experimental site the bone plate was repositioned, and both were secured with cyanoacrylate. Animal...
Fig. 7. The box plot shows the distribution of age between the sex groups
Fig. 7. The box plot shows the distribution of age between the sex groups
Fig. 6. Pie chart shows the distribution of loaded implants prosthetic restorations
Fig. 6. Pie chart shows the distribution of loaded implants prosthetic restorations
Fig. 5. Pie charts shows the distribution of the demographic datas of the patients
Fig. 5. Pie charts shows the distribution of the demographic datas of the patients
Fig. 4. The crown-implant ratio measurement showing a the length of the crown (red line) and b the length of the implant (red line)
Fig. 4. The crown-implant ratio measurement showing a the length of the crown (red line) and b the length of the implant (red line)
Fig. 3. Fractal analysis stages. a Selected region of interest (ROI). b Cropped and duplicated version of ROI. c Addition of Gaussian filter. d Subtraction. e Addition of 128 pixels. f Binarized version. g Eroded version. h Dilated version. i Inverted version j Skeletonization
Fig. 3. Fractal analysis stages. a Selected region of interest (ROI). b Cropped and duplicated version of ROI. c Addi...
Fig. 2. Region of interests (ROIs) were selected arbitrarily in a preoperative radiographic image and b a follow-up radiographic image
Fig. 2. Region of interests (ROIs) were selected arbitrarily in a preoperative radiographic image and b a follow-up radiographic image
Fig. 1. Fractal dimension values measured from the same area of interest on each panoramic radiograph over five different time intervals are shown in the figure. FD0, fractal dimension 0 (preoperative); FD1, fractal dimension 1 (0–1 months of follow-up); FD2, fractal dimension 2 (1–3 months of follow-up); FD3, fractal dimension 3 (6–12 months of follow-up); FD4, fractal dimension 4 ...
n
Mean
Standard deviation
Minimum
Maximum
FD0
130
1.243
0.152
0.750
1.560
FD1
130
1.113
0.224
0.405
1.510
FD2
130
1.116
0.196
0.410
1.510
FD3
67
1.092
0.216
0.430
1.500
FD4
67
1.081
0.247
0.430
1.500
Table 2 Mean fractal dimension (FD) values before and after implant insertion
Failure (n)Success (n)P valuePowerEffect sizeSexWomen3870.0240.680.21Men634FD190.82 ± 0.28 (mean)0.45 (min)–1.26 (max)1211.13 ± 0.25 (mean)0.41 (min)–1.51 (max)< 0.0010.991.45FD290.97 ± 0.24 (mean)0.61 (min)–1.36 (max)1211.13 ± 0.19 (mean)0.41 (min)–1.51 (max)0.0230.990.79Crown-implant Ratio26.51 ± 3.89 (mean)3.77 (min)–9.27 (max)654.61 ± 1.58 (mean)2.57 min)–10.67 (max)0.101...
Kış, H.C., Güleryüz Gürbulak, A. Evaluation of the peri-implant bone trabecular microstructure changes in short implants with fractal analysis. Int J Implant Dent 6, 13 (2020). https://doi.org/10.1186/s40729-020-00209-7
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Received: 12 September 2019
Accepted: 12 March 2020
Published: 01 April 2020
DOI: https://doi.org/10.1186/s40729-020-00209-7
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material...
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
Hatice Cansu Kış and Ayşegül Güleryüz Gür...
Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Nuh Naci Yazgan University, Kayseri, Turkey
Hatice Cansu Kış
Department of Prosthetic Dentistry, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
Ayşegül Güleryüz Gürbulak
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The work was supported by the Department of Oral & Maxillofacial Radiology, Nuh Naci Yazgan University in Kayseri, Turkey.
We would like to thank Editage (www.editage.com) for English language editing.
Mu T-J, Lee D-W, Park K-H, Moon I-S. Changes in the fractal dimension of peri-implant trabecular bone after loading: a retrospective study. Journal of periodontal & implant science. 2013;43(5):209–14.
Zeytinoğlu M, İlhan B, Dündar N, Boyacioğlu H. Fractal analysis for the assessment of trabecular peri-implant alveolar bone using panoramic radiographs. Clinical oral investigations. 2015;19(2...
Mandelbrot BB. The fractal geometry of nature: WH freeman New York; 1983.
Sánchez I, Uzcátegui G. Fractals in dentistry. Journal of dentistry. 2011;39(4):273–92.
Boutroy S, Bouxsein ML, Munoz F, Delmas PD. In vivo assessment of trabecular bone microarchitecture by high-resolution peripheral quantitative computed tomography. The Journal of Clinical Endocrinology & Metabolism. 2005;90(12):6508...
Dental panoramic radiographs
Fractal dimension 0 (preoperative)
Fractal dimension 1 (0–1 months of follow-up)
Fractal dimension 2 (1–3 months of follow-up)
Fractal dimension 3 (6–12 months of follow-up)
Fractal dimension 4 (12 + months of follow-up)
Cone beam computed tomography
Region of interest
Fractal analysis is a useful method to measure the trabecular microstructure of bone in nonstandardized dental radiographs. The present study has a low power to reject the null hypothesis because of the low number of cases of failed implants. Therefore, further studies with a large sample size are warranted. Assessing a series of studies can provide certain cut-off values; this can enable to routi...
Fractal analysis of bone microstructure on dental radiographs may be useful for diagnostic applications; however, the histological microstructures of the bone cannot be visualized by any clinical imaging modality. Corpas et al. [12] stated that minor changes in bone occurring over a short-term period can be followed up with digital intraoral radiography; however, the results of radiographic fracta...
This study aimed to evaluate the microstructural changes in the peri-implant bone in patients with short implants in terms of the implant survival status by using fractal analysis measurements.
In this study, a significant difference was found in the FD1 and FD2 values between the implant survival groups, and the mean FD1 and FD2 values of the success group were significantly higher than those of...
Descriptive statistics were performed. The data were not normally distributed (p < 0.05). The intra-observer correlation coefficients of repeated measurements were 0.927, 0.889, 0.913, 0.988, 0.961, and 0.936 for FD0 (fractal dimension), FD1, FD2, FD3, FD4, and crown-implant ratio, respectively. Descriptive data are shown in Figs. 5, 6, and 7. A significant difference was found for sex between the...
The crown-implant ratio was measured using the ImageJ version 1.38 software measuring tool in conjunction with a magnification tool. Each implant was measured from its bottom to the crown base and then from the crown base to its highest point (Fig. 4).
All measurements were performed by a dento-maxillofacial radiologist who was blinded to patient information. To evaluate the intra-observer correl...
This retrospective study was conducted in the dental clinic of Oral and Maxillofacial Radiology department and was approved by the local ethics committee (2013/203). The participants had approached the Prosthodontics Clinic between 2012 and 2019 for partial or complete tooth complaints. Among the data of 116 patients reviewed, panoramic radiographs of 67 patients were examined and included in this...
The quality of bone tissue at the site of implantation can be determined preoperatively with high accuracy, and changes in the trabecular structure, which is vital for the primary and secondary stability of the implant, can be observed during the follow-up after implantation.
Previous studies have evaluated fractal analysis of peri-implant bone before and after loading. However, no study has exam...
Mandelbrot introduced fractals to describe his observation of shapes in nature, such as curves, surfaces, disconnected “dust,” and odd shapes. The word fractal originates from the Latin word “fractus,” which means broken. By using fractal mathematics, several studies have analyzed various fractal patterns in the human body. Fractal analysis is a mathematical method of describing complex sh...
This study aimed to evaluate the microstructural changes in the peri-implant bone in patients with short implants in terms of implant survival status by using fractal analysis measurements.
Dental panoramic radiographs (DPRs) of 67 patients were examined and included in this study. Fractal analysis and measurement of the crown-implant ratio were performed with ImageJ. The fractal analysis measure...
Fig. 5. PROMs over 5 years: improvement of satisfaction from loading to study end
Fig. 5. PROMs over 5 years: improvement of satisfaction from loading to study end
Fig. 4. Soft tissue parameters at 5-year post-loading. a Plaque index: score 0, no plaque detected; score 1, plaque only recognized by running a probe across the smooth marginal surface of the implant; score 2, plaque seen by the naked eye; score 3, abundance of soft matter. b Sulcus bleeding index: score 0, no bleeding when a periodontal probe was passed along the gingival margin adjacent to th...
Fig. 3. Standardized peri-apical radiographs representing the bone level changes at the implant level: immediately post insertion (a), at loading (abutment/crown placement) (b), and at 5-year post-loading (c)
Fig. 3. Standardized peri-apical radiographs representing the bone level changes at the implant level: immediately post insertion (a), at loading (abutment/crown placement) (b), and at 5...
Fig. 2. Kaplan-Meier cumulative survival rate
Fig. 2. Kaplan-Meier cumulative survival rate
Fig. 1. Study flow-chart: assessments and reason for dropouts. Study visits were done according to standard procedures in the respective study centers. Blue, mandatory visits; gray, optional visits
Fig. 1. Study flow-chart: assessments and reason for dropouts. Study visits were done according to standard procedures in the respective study centers. Blue, mandatory visits; gray, optional visits
Bone level changenMeanSDInsertion-loading103− 0.520.55Loading-1-year follow-up93− 0.040.37Loading-3-year follow-up90− 0.040.40Loading-5-year follow-up86− 0.090.43Table 3 Mean crestal bone level changes in mm
CharacteristicsCategoryTotalTotal patients/implantsn94/130Center 19/17Center 218/26Center 320/26Center 414/16Center 518/26Center 615/19Gender, n (%)Male30 (31.9)Female64 (68.1)Age at surgery, yearsMean ± SD50.4 ± 13.7Range (min/max)19.1-75.6Age range distribution, n (%)< 30 years8 (8.5)30-45 years22 (23.4)45-60 years38 (40.4)60-75 years25 (26.6)> 75 years1 (1.1)Tobacco use, n (%)Non-sm...
Time periodPatientsImplantsBefore loading58Loading-1 year681-3 years673-5 years13Total1826Table 1 Dropouts over observation time
Ackermann, KL., Barth, T., Cacaci, C. et al. Clinical and patient-reported outcome of implant restorations with internal conical connection in daily dental practices: prospective observational multicenter trial with up to 7-year follow-up.
Int J Implant Dent 6, 14 (2020). https://doi.org/10.1186/s40729-020-00211-z
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Received: 16 December 2019
Accepted: 12 Ma...
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material...
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
A written consent was given by all patients after being informed of the study. The study was performed following the declaration of Helsinki. Ethics committee approval was obtained from the international ethical committee of Freiburg (Germany, Ref. 010/1833).
Not applicable.
All authors declare that they have no conflicts of interest regarding this study. All authors have been lecturing for Caml...
Filderstadt, Germany
Karl-Ludwig Ackermann
Leipzig, Germany
Thomas Barth
Munich, Germany
Claudio Cacaci
Landsberg a. L., Germany
Steffen Kistler
Forchheim, Germany
Markus Schlee
Department of Maxillofacial Surgery, Goethe University Frankfurt, Frankfurt, Germany
Markus Schlee
Berlin, Germany
Michael Stiller
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This study was funded by an unrestricted grant (NISCAM01/10) of the Oral Reconstruction Foundation (previously CAMLOG Foundation).
The authors thank Lucius Keller of Touchpoint Communication AG (Luzern, Switzerland) for the medical writing support.
Chang M, Odman PA, Wennstrom JL, Andersson B. Esthetic outcome of implant-supported single-tooth replacements assessed by the patient and by prosthodontists. Int J Prosthodont. 1999;12(4):335–41.
Kiltz U, Winter J, Schirmer M, Weber U, Hammel L, Baraliakos X, et al. German translation and cross-cultural adaptation of the ASAS health index: an ICF-based instrument for documentation of functional...
Ravald N, Dahlgren S, Teiwik A, Grondahl K. Long-term evaluation of Astra Tech and Branemark implants in patients treated with full-arch bridges. Results after 12-15 years. Clin Oral Implants Res. 2013;24(10):1144–51.
Schwarz F, Alcoforado G, Nelson K, Schaer A, Taylor T, Beuer F, et al. Impact of implant-abutment connection, positioning of the machined collar/microgap, and platform switching...
Gupta S, Sabharwal R, Nazeer J, Taneja L, Choudhury BK, Sahu S. Platform switching technique and crestal bone loss around the dental implants: a systematic review. Ann Afr Med. 2019;18(1):1–6.
Hsu YT, Lin GH, Wang HL. Effects of platform-switching on peri-implant soft and hard tissue outcomes: a systematic review and meta-analysis. Int J Oral Maxillofac Implants. 2017;32(1):e9–e24.
Nelson K,...
Cacaci C, Ackermann KL, Barth T, Kistler S, Stiller M, Schlee M. A non-interventional multicenter study to document the implants success and survival rates in daily dental practices of the CONELOG screw-line implant. Clin Oral Investig. 2019;23(6):2609–16.
Cochran D, Oates T, Morton D, Jones A, Buser D, Peters F. Clinical field trial examining an implant with a sand-blasted, acid-etched surface...
Krennmair G, Seemann R, Weinlander M, Piehslinger E. Comparison of ball and telescopic crown attachments in implant-retained mandibular overdentures: a 5-year prospective study. Int J Oral Maxillofac Implants. 2011;26(3):598–606.
Slot W, Raghoebar GM, Cune MS, Vissink A, Meijer HJA. Four or six implants in the maxillary posterior region to support an overdenture: 5-year results from a randomize...
Adverse event
Bone level change
Distance implant shoulder to first visible bone contact
Orthopantomogram
Plaque index
Patient reported outcome measures
Platform switching
Sulcus bleeding index
The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
This prospective observational multicenter study demonstrated successful functional and esthetic outcomes of the study implant restorations (single tooth restoration, fixed partial dentures) with reliable peri-implant hard and soft tissue stability and high patients’ satisfaction. The results are comparable with the outcome of already published controlled randomized clinical studies and retrospe...
In recent years, patients’ needs have increased in terms of the esthetic and functional outcome of the dental restoration. PROMs have been reported in several studies and represent a well-described non-invasive method to measure patient’s satisfaction with these needs; however, they might present a lack of standardization [39, 40] due to the very subjective view on esthetics or functionality o...
Changes in crestal bone level are well-documented in the literature. Bone remodeling is reported to take place between surgery and loading. The reported changes are generally around 0.5 mm [17, 27, 30] but can reach more than 1 mm [31] in randomized or observational trials. The present study is well in accordance with these findings with its bone remodeling of − 0.52 ± 0.55 mm. Nearly 45%...
Endosseous dental implants are a commonly accepted treatment procedure and showed high survival and success rates as well as good functional performance in numerous clinical trials and retrospective analyses, also for Conelog implants as for their specific implant surface [17, 23, 26]. However, in general, one could argue that results of controlled clinical studies do not reflect the real situatio...
Table 3 shows the mean bone level changes of the implants with available radiographs from insertion to 5-year post-loading. Bone remodeling around the implant was noticeable from surgery to loading, presenting a mean value of − 0.52 ± 0.55 mm. From loading to the 5-year follow-up, the mean change in crestal bone remained clinically stable (−0.09 ± 0.43 mm) (Fig. 3).
Split into three g...
The study was started with 94 patients with 130 implants. At the end of the study (5-year post-loading), 76 patients with 104 implants were considered for analysis. Dropouts were distributed over the time of the study as described in Table 1. The majority of dropouts occurred early in the study phase. The reasons for the dropouts were variable as described in Fig. 1.
The demographic and clinica...
The study data, soft and hard tissue parameters as well as the PROMs were descriptively analyzed using IBM SPSS V25.0 (IBM Corp., Armonk, NY, USA): Categorical variables were shown with frequencies and mean values were used for continuous variables. Survival analysis was performed using Kaplan–Meier method. Time of loading was the study baseline as per protocol, and the statistical unit was the ...
Patients were scheduled to follow-ups at 6 months, 1-, 2-, 3-, 4-, and 5-year post-loading for the assessment of the study parameter (Fig. 1). Depending on the investigators’ standard post-operative protocol, follow-up appointments were scheduled slightly differently: One center skipped the control visits at 6 months. Additionally, due to the observational character of the study and the pati...
This is an observational multicenter clinical study, approved by the ethics committee of the Freiburg ethics commission international (feci 010/1833). The study was planned and conducted according to the German medical devices law, the Declaration of Helsinki, good clinical practice, and the reporting is aligned with the STROBE statement. A minimum of 90 to 100 patients were planned to be included...
Features of the chosen implant system for a study may also influence the outcome of the treatment: The degree of the manufacturer’s tolerances of implants with a conical implant-abutment connection heightens the risk of a mispositioning of the abutment, which cannot be corrected by repeated torqueing. Platform switching (PS) implants tend to have a protective effect on hard implant tissue outcom...
Many randomized controlled clinical trials have been published about dental implants. They have demonstrated long-term success in the rehabilitation of edentulous patients [1, 2] as well as patients with single or multiple teeth replacements [3, 4].
While this type of trials have an indispensable place in establishing a new product or a new operation technique regarding safety and efficacy, the r...
The interpretation of the results of randomized clinical trials is often questioned in relation with daily circumstances in practices. This prospective observational multicenter study was instigated to reflect the need for information in real-life situations with dental implants with internal conical implant-abutment connection (Conelog implant system). The implants were followed up at least 5-yea...
Fig. 5. Anti-RANKL and anti-RANKL+miR-146a treatments decreased gingival mRNA expression of TNF-α and RANKL with different patterns in experimental peri-implantitis of WT and TLR2/4 KO mice. Gingival tissues around ligatured implants and non-ligation implants were excised and processed for RT-qPCR analysis to determine mRNA level of TNF-α of WT mice (a) and TLR2/4 KO mice (b) (mean ± SD, n = ...
Fig. 4. Anti-RANKL and anti-RANKL+miR-146a treatments decreased the inflammatory cell infiltration of the implant gingival tissues with different patterns in experimental peri-implantitis of WT and TLR2/4 KO mice. HE staining of the gingival tissue around implants were performed in the control group, ligation group, ligation with anti-RANKL antibody treatment group, and ligation with anti-RANKL ...
Fig. 3. Anti-RANKL and anti-RANKL+miR-146a treatments decreased TRAP-positive cell quantities with different patterns in experimental peri-implantitis of WT and TLR2/4 KO mice. TRAP-positive cells (red color) with 3 or more nuclei were considered osteoclasts and were shown in the control group, ligation group, ligation with anti-RANKL antibody treatment group, and ligation with anti-RANKL antibo...
Fig. 2. Anti-RANKL and anti-RANKL+miR-146a treatments decreased ligature-induced bone resorption with different patterns in experimental peri-implantitis of WT and TLR2/4 KO mice. Buccal side images of the defleshed skulls were taken of the control (non-ligation) group, ligation (non-treatment) group, ligation with anti-RANKL antibody (ligation+AR) treatment group, and ligation with anti-RANKL a...
Fig. 1. Mouse model of ligature-induced experimental peri-implantitis. (a) Tooth extraction: left maxillary first and second molars extracted at 4 weeks old and the tooth extraction socket healed well with smooth gingiva surface after 6 weeks post-extraction. Implant placement: implant was put in alveolar bone without flap elevation. Ligature placement: at 4 weeks post-implant, 7-0 ligatur...
Total implantsLostLooseOsseointegratedSuccess rate (%)SR P valueWild type group60654981.670.595TLR2/4 KO group60445286.67Table 1 Success rate (SR) of osseointegrated implants 4 weeks after implant placement
Pan, K., Hu, Y., Wang, Y. et al. RANKL blockade alleviates peri-implant bone loss and is enhanced by anti-inflammatory microRNA-146a through TLR2/4 signaling. Int J Implant Dent 6, 15 (2020). https://doi.org/10.1186/s40729-020-00210-0
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Received: 24 September 2019
Accepted: 12 March 2020
Published: 15 April 2020
DOI: https://doi.org/10.1186/s40729-020-00210-0
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material...
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Keqing Pan, Yang Hu, Yufeng Wang, Hao Li, Michele Patel, Danyang Wang, Zuomin Wang, and Xiaozhe Han certify that they do not have any commercial or associate interest that represents a conflict of interest in connection with the manuscript. The submitted work was not carried out in the presence of any personal, professional, or financial relationships that could pot...
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KP contributed to the conception and design; contributed to the acquisition, analysis, and interpretation of data; and drafted the manuscript. YH contributed to the conception and design, contributed to the acquisition, analysis, and interpretation of data; drafted the manu...
Department of Stomatology, The Affiliated Hospital of Qingdao University, College of Stomatology, Qingdao University, Qingdao, 266003, Shandong, China
Keqing Pan
Department of Immunology and Infectious Diseases, The Forsyth Institute, 245 First Street, Cambridge, MA, 02142, USA
Keqing Pan, Yang Hu, Yufeng Wang, Hao Li, Michele Patel & Xiaozhe Han
Department of Oral Medicine, Ninth People...
This study was supported by NIH NIDCR R01DE025255 and the Forsyth Institute FPILOT36 to X Han and the Forsyth Institute FPILOT52 to Y Hu.
Tu S, Zhong D, Xie W, Huang W, Jiang Y, Li Y. Role of toll-like receptor signaling in the pathogenesis of graft-versus-host diseases. Int J Mol Sci. 2016;17(8).
Gaddis DE, Michalek SM, Katz J. TLR4 signaling via MyD88 and TRIF differentially shape the CD4+ T cell response to Porphyromonas gingivalis hemagglutinin B. J Immunol. 2011;186(10):5772–83.
Zhang P, Liu J, Xu Q, et al. TLR2-dependent m...
Kawai T, Akira S. Toll-like receptors and their crosstalk with other innate receptors in infection and immunity. Immunity. 2011;34(5):637–50.
Song GG, Kim JH, Lee YH. Toll-like receptor (TLR) and matrix metalloproteinase (MMP) polymorphisms and periodontitis susceptibility: a meta-analysis. Mol Biol Rep. 2013;40(8):5129–41.
Lin J, Bi L, Yu X, et al. Porphyromonas gingivalis exacerbates ligat...
Shuto T, Wachi T, Shinohara Y, Nikawa H, Makihira S. Increase in receptor activator of nuclear factor kappaB ligand/osteoprotegerin ratio in peri-implant gingiva exposed to Porphyromonas gingivalis lipopolysaccharide. J Dent Sci. 2016;11(1):8–16.
O'Connell MB. Prescription drug therapies for prevention and treatment of postmenopausal osteoporosis. J Manag Care Pharm. 2006;12(6 Suppl A):S10-19; ...
Bertin TJC, Thivichon-Prince B, LeBlanc ARH, Caldwell MW, Viriot L. Current perspectives on tooth implantation, attachment, and replacement in amniota. Front Physiol. 2018;9:1630.
Schminke B, Vom Orde F, Gruber R, Schliephake H, Burgers R, Miosge N. The pathology of bone tissue during peri-implantitis. J Dent Res. 2015;94(2):354–61.
Mombelli A, Muller N, Cionca N. The epidemiology of peri-impl...
Receptor activator of nuclear factor-kappa Β ligand
Toll-like receptor
Wild type
MicroRNA 146a
Micro-computed tomography
Real-time quantitative PCR
Tumor necrosis factor alpha
Osteoprotegerin
Lipopolysaccharides
Hematoxylin and eosin
Tartrate-resistant acid phosphatase
Presented in the main paper
In summary, the present study suggests that anti-inflammatory miR-146a enhance anti-RANKL-induced inhibition of peri-implant bone resorption through the regulation of TLR2/4 signaling and inhibition of TNF-α expression. Combination of regimens antagonizing both osteoclastogenesis and inflammation may become a more effective strategy to ameliorate peri-implantitis bone loss.
According to the previous studies, miR-146a was regulated by NF-κB and blockade of miR-146a could decrease TLR4 and NF-κB in human cells [41, 42], suggesting that miR-146a is involved in TLR/NF-κB signaling pathway. Our recent study showed that miR-146a inhibited inflammatory cytokine secretion in B cells after challenged with P. gingivalis LPS and decreased bone resorption in experimental peri...
Our present study showed that anti-RANKL antibody can significantly inhibit the bone loss in peri-implantitis and additional miR-146a treatment will enhance this inhibition through its anti-inflammation effects via TLR2/4 signaling. This is the first report in a murine model of peri-implantitis to demonstrate that anti-RANKL antibody and miR-146a together can significantly reduce bone resorption a...
In both WT mice and TLR2/4 KO mice, a significantly higher number of inflammatory cells were found infiltrating around the peri-implant tissues in the ligation group compared with the non-ligation group (Fig. 4a–c). However, the number of inflammatory cells in tissues of the ligation group was not significantly changed when treated with anti-RANKL antibody alone in both WT and TLR2/4 KO mice com...
In our ligature-induced experimental peri-implantitis mouse model, teeth extraction, implant placement, ligation placement, and gingival injection will be performed in a 12-week process (Fig. 1). 86.67% (52 out of 60) of implants in TLR2/4 KO mice achieved osteointegration (no mobility when touched by needles, no obvious bleeding upon probing) after being placed for 4 weeks, which has no signifi...
Palatal gingival tissues were isolated from around ligatured implants and were homogenized in lysis buffer using a tissue homogenizer. Total RNA was extracted using PureLink® RNA Mini Kit (Ambion). cDNA was synthesized using the SuperScript III Reversed Transcriptase kit (Invitrogen) according to the manufacturer’s protocol. The mRNA expression of TNF-α and RANKL in gingival was determined by ...
The ligations were maintained for 2 weeks, and after which the mice were euthanized by CO2 inhalation and the maxilla were harvested. The gingival tissues of half group of mice were isolated and collected for mRNA expression study. The skulls left were defleshed by beetles for 1 week. Briefly, in beetle’s chamber, freshly dissected skull was put in a paper cup with 0.5 cm diameter holes at...
Wild-type (WT) C57BL/6 and TLR2 KO and TLR4 KO mice in C57/BL6 background were purchased from the Jackson Laboratory (Bar Harbor, ME). TLR2 and TLR4 double KO mice (TLR2/4 KO) were crossbreed from TLR2 KO and TLR4 KO mice and confirmed by genotyping. All the animal-associated protocols were reviewed and approved (#17-022) by the Institutional Animal Care and Use Committee of the Forsyth Institute....
Toll-like receptors (TLR) are a family of well-characterized pattern recognition receptors (PRRs) and play an important role in the induction of pro-inflammatory cytokines by recognizing the signature molecules of the host innate immunity [25,26,27]. Our previous studies showed that TLR2 are associated with implant bone loss in a mouse model of peri-implantitis [5] and TLR4 is essential for period...
Dental implant has become a preferable choice to restore the missing tooth in the past few decades for functional and esthetic purposes [1]. However, peri-implantitis has become prevalent accompanying the exponential growth of dental implant procedures [2, 3]. Peri-implantitis is indicated by infection of implant surrounding soft tissues and bone loss, resulting in implant failure eventually [4,5,...
This study suggests that anti-inflammatory miR-146a enhance anti-RANKL-induced inhibition of peri-implant bone resorption through the regulation of TLR2/4 signaling and inhibition of TNF-α expression.
The present study was to determine the effect of local anti-RANKL antibody administration in the presence or absence of microRNA-146a on ligature-induced peri-implant bone resorption, and the potential role of TLR2/4 signaling in such effect.
Titanium implants were placed in the left maxilla alveolar bone 6 weeks after extraction of first and second molars in C57/BL6 wild-type (WT) and TLR2−/...
Figure 5. Flow diagram of CBCT imaging and measurements to calculate bone thickness buccally of implants.
Figure 5. Flow diagram of CBCT imaging and measurements to calculate bone thickness buccally of implants.
Figure 4.
Figure 4. Implant measurements. Measurements were performed at each millimeter along the axis of the implant for 5 mm, beginning at the neck of the implant.
Figure 3. Implant position. Due to the alienation of the patients’ DICOM files by MIRIT, the exact position of the implant was defined. As such, the measurements could take place in the exact correct buccal direction.
Figure 3. Implant position. Due to the alienation of the patients’ DICOM files by MIRIT, the exact position of the implant was defined. As such, the measurements could take ...
Figure 2. Conventional intra-oral radiograph of same patient with implant-supported restoration at position 21.
Figure 2. Conventional intra-oral radiograph of same patient with implant-supported restoration at position 21.
Figure 1. Clinical photograph of implant-supported restoration at position 21.
Figure 1. Clinical photograph of implant-supported restoration at position 21.
Slagter, K.W., Raghoebar, G.M., Vissink, A. et al. Inter- and intraobserver reproducibility of buccal bone measurements at dental implants with cone beam computed tomography in the esthetic region. Int J Implant Dent 1, 8 (2015). https://doi.org/10.1186/s40729-015-0007-1
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Received: 24 December 2014
Accepted: 19 February 2015
Published: 18 April 2015
DOI: https://doi.org/10.11...
Kirsten W. Slagter, Gerry M. Raghoebar, Arjan Vissink, Henny JA. Meijer declare that they have no competing interests.
KWS, GMR, AV, and HJAM provided substantial contributions to the conception or design of the work, or the acquisition, analysis, or interpretation of data for the work; drafted the paper or revised it critically; gave final approval of the version to be published; and agreed to b...
Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700RB, Groningen, The Netherlands
Kirsten W Slagter, Gerry M Raghoebar, Arjan Vissink & Henny J A Meijer
Department of Fixed and Removable Prosthodontics, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700RB, Groningen, The Netherlands
He...
Miyamoto Y, Obama T. Dental cone beam computed tomography analyses of postoperative labial bone thickness in maxillary anterior implants: comparing immediate and delayed implant placement. Int J Periodontics Restorative Dent. 2011;31:215–25.
Kamburoglu K, Murat S, Kilic C, Yuksel S, Avsever H, Farman A, et al. Accuracy of CBCT images in the assessment of buccal marginal alveolar peri-implant de...
Den Hartog L, Slater JJ, Vissink A, Meijer HJ, Raghoebar GM. Treatment outcome of immediate, early and conventional single-tooth implants in the aesthetic zone: a systematic review to survival, bone level, soft-tissue, aesthetics and patient satisfaction. J Clin Periodontol. 2008;35:1073–86.
De Rouck T, Collys K, Cosyn J. Single-tooth replacement in the anterior maxilla by means of immediate im...
three-dimensional
cone beam computed tomography
computerized tomography
Digital Imaging and Communications in Medicine
field of view
Hounsfield unit
Multimodality Image Registration using Information Theory
When applying 3D image-based software programs according to the set-up used in this study, CBCTs are suitable for reliable and reproducible measurements of buccal bone thickness at implants.
Intraobserver and interobserver agreement was very high with measurements on CBCTs of bone buccally of dental implants. Apparently, the method is clear and measurements can be performed reproducibly. Moreover, measurements are not observer dependent, meaning that results of different observers in different studies can be compared with each other.
In previous studies, buccal bone thickness was als...
The mean buccal bone thickness measured by observers 1 and 2 was 2.42 mm (sd: 0.50) and 2.41 mm (sd: 0.47), respectively. Interobserver intraclass correlation coefficient was 0.96 (95% CI 0.93 to 0.98). The mean buccal bone thickness of the first measurement and the second measurement of observer 1 was 2.42 mm (sd: 0.50) and 2.53 mm (sd: 0.49), respectively, with an intraobserver intraclass co...
The implant and patient dataset were exactly aligned by the MIRIT method, so that the distance from the central axis of the implant to the outer contour of the buccal bone could be measured. Area of interest was the upper 5 mm section of the implant, beginning at the neck of the implant towards the apical direction. Exact dimensions along the implant axis of each implant configuration used in the...
Ten patients with a dental implant in the esthetic zone (regions 13 to 23) were included (Figures 1 and 2). Research was carried out in compliance with the Helsinki Declaration. Patients were part of a randomized controlled trial on esthetics; the study was approved by the Medical Ethic Board of the University Medical Center Groningen, University of Groningen (METC 2010.246) as well as that writt...
Single-tooth implant placement in the esthetic zone is a highly reliable treatment option for replacing a failing tooth [1-4]. Yet, research interest has shifted from implant survival towards optimal preservation of soft and hard tissues [5-7]. Especially in the esthetic region, buccal bone and its preservation is one of the key factors in esthetic outcome [8].
Computerized tomography (CT) scans ...
Sufficient buccal bone is important for optimal esthetic results of implant treatment in the anterior region. It can be measured with cone beam computed tomography (CBCT), but background scattering and problems with standardization of the measurements are encountered. The aim was to develop a method for reliable, reproducible measurements on CBCTs.
Using a new method, buccal bone thickness was me...
Fig. 4. PPS mean crestal bone level change plotted against time (mean, 95 % CI)
Fig. 4. PPS mean crestal bone level change plotted against time (mean, 95 % CI)
Fig. 3. Participant flow diagram
Fig. 3. Participant flow diagram
Fig. 2. Restorative flow diagram
Fig. 2. Restorative flow diagram
Fig. 1. Clinical pictures in each procedure. a Before implant placement. b After abutment connection. c Temporary prosthesis. d Final prosthesis
Fig. 1. Clinical pictures in each procedure. a Before implant placement. b After abutment connection. c Temporary prosthesis. d Final prosthesis
Indicator
Prosthetic comforta
Appearanceb
Ability to chewc
Ability to tasted
Fittinge
General satisfactionf
Treatment arm
...
Treatment arm
Summary statistics
Baseline
6 months
Change from baseline to 6 months
...
Characteristics
Early loading arm
Conventional loading arm
Total
(N = 38)
(N =...
Loading criteria 1
Loading criteria 2
• Sufficient oral hygiene
• At least 1 mm bone volume around the implanta
• No major dehiscence (
Inclusion criteria
Age over 20 Patient who have missing teeth in premolar or molar site Good oral hygiene Predicted implant site has 1–3 quality of bone densityand enough quantity of bone Extraction socket in predicted implant site is completely healed (16 weeks or more)
...
Dard, M., Shiota, M., Sanda, M. et al. A randomized, 12-month controlled trial to evaluate non-inferiority of early compared to conventional loading of modSLA implants in single tooth gaps.
Int J Implant Dent 2, 10 (2016). https://doi.org/10.1186/s40729-016-0040-8
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Received: 25 September 2015
Accepted: 23 March 2016
Published: 04 April 2016
DOI: https://d...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Michel Dard, Makoto Shiota, Minoru Sanda, Yasutomo Yajima, Hideshi Sekine, and Shohei Kasugai state that there are no conflicts of interest.
MD mainly prepared the manuscript and figures. MS arranged this study, participated in its design and coordination, and helped to draft the manuscript. YY, HS, and SK managed the data collection from each centers of Tokyo Dental College Chiba Hospital (TDCC)...
College of Dentistry, New York University, New York, NY, USA
Michel Dard
Tokyo Medical and Dental University, Tokyo, Japan
Makoto Shiota, Minoru Sanda & Shohei Kasugai
Suidobashi Hospital, Tokyo Dental College, Tokyo, Japan
Yasutomo Yajima
School of Dentistry, Ohu University, Fukushima, Japan
Hideshi Sekine
Department of Oral Implantology and Regenerative Dental Medicine, Tokyo Medical ...
This trial was sponsored by Straumann Japan KK. The authors would like to acknowledge the assistance of Eusaku Watanabe and Nariyuki Maezawa (both Straumann Japan KK) for their contributions to the study.
Krebs M, Schmenger K, Neumann K, Weigl P, Moser W, Nentwig GH. Long-term evaluation of ANKYLOS® dental implants, part I: 20-year life table analysis of a longitudinal study of more than 12,500 implants. Clin Implant Dent Relat Res. 2013. doi:10.1111/cid.12154.
Lops D, Bressan E, Pisoni G, Cea N, Corazza B, Romeo E. Short implants in partially edentulous maxillae and mandibles: a 10 to 20 years ...
Salvi GE, Gallini G, Lang NP. Early loading (2 or 6 weeks) of sandblasted and acid-etched (SLA) ITI implants in the posterior mandible. A 1-year randomised controlled clinical trial. Clin Oral Implants Res. 2004;15:142–9.
El-Sheikh AM, Shihabuddin OF, Ghoraba SM. A prospective study of early loaded single implant-retained mandibular overdentures: preliminary one-year results. Int J Dent. 2012. ...
Morton D, Bornstein MM, Wittneben JG, et al. Early loading after 21 days healing of nonsubmerged titanium implants with a chemically modified sandblasted and acid-etched surface: two-year results of a prospective two-center study. Clin Implant Dent Relat Res. 2010;12:9–17.
Cochran DL, Jackson JM, Bernard JP, et al. A 5-year prospective multicenter study of early loaded titanium implants with a ...
Bornstein MM, Wittneben JG, Brägger U, Buser D. Early loading at 21 days of non-submerged titanium implants with a chemically modified sandblasted and acid-etched surface: 3-year results of a prospective study in the posterior mandible. J Periodontol. 2010;81:809–18.
Ganeles J, Zöllner A, Jackowski J, ten Bruggenkate C, Beagle J, Guerra F. Immediate and early loading of Straumann implants wit...
Bornstein MM, Valderrama P, Jones AA, Wilson TG, Seibl R, Cochran DL. Bone apposition around two different sandblasted and acid-etched titanium implant surfaces: a histomorphometric study in canine mandibles. Clin Oral Implants Res. 2008;19:233–41.
Lai HC, Zhuang LF, Zhang ZY, Wieland M, Liu X. Bone apposition around two different sandblasted, large-grit and acid-etched implant surfaces at site...
Esposito M, Grusovin MG, Maghaireh H, Worthington HV. Interventions for replacing missing teeth: different times for loading dental implants. Cochrane Database of Syst Rev. 2013;3:CD003878.
Esposito M, Grusovin MG, Willings M, Coulthard P, Worthington HV. The effectiveness of immediate, early, and conventional loading of dental implants: a Cochrane systematic review of randomized controlled clini...
Blanes RJ, Bernard JP, Blanes ZM, Belser UC. A 10-year prospective study of ITI dental implants placed in the posterior region. I: clinical and radiographic results. Clin Oral Implants Res. 2007;18:699–706.
Covani U, Chiappe G, Bosco M, Orlando B, Quaranta A, Barone A. A 10-year evaluation of implants placed in fresh extraction sockets: a prospective cohort study. J Periodontol. 2012;83:1226–...
In conclusion, this study demonstrated that early implant loading was non-inferior to conventional implant loading in terms of crestal bone level change in a Japanese patient population in short follow-up period and single tooth gaps in molar regions. High implant survival and patient satisfaction rates, and a good safety profile, were also achieved.
Early loading of the implants showed a good safety profile, with a similar incidence in AEs between the early and conventional loading groups. The benefits to the patient for the early loading procedure were demonstrated by the patient satisfaction question “What does the patient think about the time taken until occlusal loading was started after implantation surgery?” All patients in the earl...
The implant survival rate of 100 % after 12 months is also in line with the results from previous studies with chemically modified SLA implants in various situations, including 100 % survival in early loading of mandibular overdentures [55], 100 % survival in single-tooth applications in the anterior maxilla [56], 96.8 % with maxillary sinus floor augmentation [57], and 98 and 97 % with imme...
This was a randomized, controlled, multicenter clinical trial to investigate whether the outcomes for chemically modified SLA implants in terms of change in crestal bone level from implant surgery to 6 months were non-inferior with early loading (25 ± 3 days) compared to conventional loading (13 ± 1 weeks). The difference in mean crestal bone level change between the early loading and...
In the PPS and FAS, the implant survival rate was 100 % after 12 months. In the PPS, the implant success rate was 100 % at all time points in both the conventional and early loading arms; however, in the FAS, the success rate in the conventional loading arm was 100 % at all time points, while in the early loading arm, success was 100 % at suture removal at 12-month follow-up and 95 % at the ...
The study enrolled 84 Japanese patients who had single missing tooth in the molar region. Since four patients were withdrawn due to the exclusion criteria (systemic disease, adjacent teeth with probing pocket depth deeper than 4 mm, mental disorder, and bone deficiency, respectively), 80 patients underwent implant placement. Two further patients were withdrawn before randomization because the ins...
In addition, periodontal examination, in the form of probing depth (PD) and bleeding on probing (BoP), was performed at pre-screening and at the 12-month follow-up.
Descriptive summary statistics were computed for all parameters, and quantitative parameters were described using mean, standard deviation, median, quartiles, minimum, and maximum. For qualitative variables, absolute and relative freq...
The primary endpoint was a change of crestal bone level between implant surgery (baseline) and final restoration (6 months), assessed by measuring the distance from the implant shoulder to the first bone-to-implant contact both mesially and distally to the implant.
Bone level was measured by a single reader on standardized periapical radiographs taken at baseline (day 0), suture removal (7–14...
When a patient fulfilled all inclusion criteria and had no exclusion criteria, then he/she got implant surgery and checked the condition met first criteria for loading (loading criteria 1 (LC1)) (Table 2).
All patients received Ti grade IV Straumann Standard Plus Regular Neck (SP RN) implants, 4.1 mm in diameter and 8, 10, or 12 mm in length, with SLActive® surface (Institut Straumann AG, Bas...
This study was designed as a randomized, controlled, multicenter clinical trial to evaluate non-inferiority of early loading compared to conventional loading of dental implants with a chemically modified SLA surface placed in single tooth gaps, involving three centers in Japan (Tokyo Medical and Dental University (TMDU), Tokyo Dental College Chiba Hospital (TDCC), and Tokyo Dental College Suidobas...
Early loading protocols have become relatively common procedures in many countries for implant restoration, but the procedure is much less common in Japan. The purpose of this study, therefore, was to investigate whether the chemically modified SLA implant with early loading was non-inferior to conventional loading, based on the amount of crestal bone change between baseline and 6 months after su...
The use of dental implants to replace missing or compromised teeth has been well documented clinically over many years. High implant survival rates have been demonstrated for over 10 [1–3], 15 [4], and 20 years [5, 6]. Long-term survival rates for single-tooth implants have been shown to be greater than those for tooth-supported restorations, e.g., fixed partial dentures (FPDs) [7, 8]. Good lon...
The aim of the study was to evaluate whether early loading of implants with a chemically modified sandblasted, large-grit, acid-etched (SLA) (SLActive®) surface was non-inferior to conventional loading in terms of change in crestal bone level.
This was a randomized, controlled, multicenter study. Patients requiring single-tooth rehabilitation in the posterior maxilla or mandible received implant...
Fig. 3. Peri-implant bone level at baseline, 3 months post-operative, and 6 months post-operative. a Mesial defect depth. b Mesial defect width. c Distal defect depth. d Distal defect width
Fig. 3. Peri-implant bone level at baseline, 3 months post-operative, and 6 months post-operative. a Mesial defect depth. b Mesial defect width. c Distal defect depth. d Distal defect width
Fig. 2. Test group (PRF augmentation)
Fig. 2. Test group (PRF augmentation)
Fig. 1. Control group (no PRF augmentation)
Fig. 1. Control group (no PRF augmentation)
Illustration 11. ive (a), 1 week post-operative (b), 1 month post-operative (c), and 3 months post-operative (d)
Illustration 11. a–d Post-operative healing process at 3 days post-operative (a), 1 week post-operative (b), 1 month post-operative (c), and 3 months post-operative (d)
Illustration 10. a–d Second measuring, reentry, and insertion of a screwed, full ceramic crown
Illustration 10. a–d Second measuring, reentry, and insertion of a screwed, full ceramic crown
Illustration 9. a–c Radiographic control a at time of implant placement (a), 3 months post-operative (b), and 6 months post-operative (c)
Illustration 8. Fixation of the flap with Seralene® 6.0
Illustration 8. Fixation of the flap with Seralene® 6.0
Illustration 7. Insertion of PRF membranes in a double-layered technique for tissue augmentation
Illustration 7. Insertion of PRF membranes in a double-layered technique for tissue augmentation
Illustration 6. PRF membrane made by centrifugating and pressing the patient’s blood
Illustration 6. PRF membrane made by centrifugating and pressing the patient’s blood
Illustration 5. Implant placed with a split-flap technique
Illustration 5. Implant placed with a split-flap technique
Illustration 4. NobelSpeedy Replace® (source: https://www.nobelbiocare.com/de/de/home/products-and-solutions/implant-systems/nobelspeedy.html)
Illustration 4. NobelSpeedy Replace® (source: https://www.nobelbiocare.com/de/de/home/products-and-solutions/implant-systems/nobelspeedy.html)
Illustration 3. Insertion of the implant
Illustration 3. Insertion of the implant
Illustration 2. Crestal incision and preparation of a split-flap
Illustration 2. Crestal incision and preparation of a split-flap
Illustration 1. Measurement of tissue thickness with an endodontic micro-opener
Illustration 1. Measurement of tissue thickness with an endodontic micro-opener
Hehn, J., Schwenk, T., Striegel, M. et al. The effect of PRF (platelet-rich fibrin) inserted with a split-flap technique on soft tissue thickening and initial marginal bone loss around implants: results of a randomized, controlled clinical trial.
Int J Implant Dent 2, 13 (2016). https://doi.org/10.1186/s40729-016-0044-4
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Received: 30 July 2015
Accepted: 23 ...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Julia Hehn, Thomas Schwenk, Marcus Striegel, and Markus Schlee declare that they have no competing interests. This study was self-supported.
JH was responsible for the study design and recruitment of the patients, carried out the implant surgery and follow-up examinations, and drafted the manuscript. TS participated in the surgical treatment and follow-up examinations. MS performed the digital me...
Periodontology, Edel & Weiß Clinic, Ludwigsplatz 1a, 90403, Nuremberg, Germany
Julia Hehn
Esthetic Dentistry, Edel & Weiß Clinic, Nuremberg, Germany
Thomas Schwenk & Markus Striegel
Private Clinic for Periodontology, Forchheim and Department of Maxillofacial Surgery, Goethe University, Frankfurt, Germany
Markus Schlee
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The authors thank Dr. Wolfgang Reimers of MedCommTools for performing the statistics.
Abrahamsson I, Berglundh T. Effects of different implant surfaces and designs on marginal bone-level alterations: a review. Clin Oral Implants Res. 2009;20 Suppl 4:207–15.
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Dohan DM et al. Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part II: platelet-related biologic features. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;101(3):e45–50.
Choukroun J, et al. Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part IV: clinical effects on tissue healing. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;101(3)...
Cardaropoli G et al. Tissue alterations at implant-supported single-tooth replacements: a 1-year prospective clinical study. Clin Oral Implants Res. 2006;17(2):165–71.
Fickl S et al. Dimensional changes of the alveolar ridge contour after different socket preservation techniques. J Clin Periodontol. 2008;35(10):906–13.
Vela-Nebot X et al. Benefits of an implant platform modification techniqu...
platelet-derived growth factor
platelet-rich fibrin
standard deviation
transforming growth factor-b
Soft tissue augmentation with PRF using a split-flap technique cannot be recommended to alter thin gingiva types. Future experimental and clinical studies will be necessary to evaluate whether augmentation with PRF is suitable for mucosa thickening.
With respect to marginal bone loss, it could be shown that there were no significant differences when comparing dimension of bone loss between test and control groups. The study of present research data shows, to the best knowledge of the authors, no other RCTs about tissue thickening with PRF and peri-implant bone loss. However, several studies focused on mucosa thickening with tissue grafts and ...
In this study over a period of 6 months, it could be demonstrated that mucosal tissue thickening above implants with PRF led to reduced tissue thickness when performed in a split-flap technique.
The initial post-operative dehiscence and the associated complete loss of mucosal and augmented tissue above the implant were observed in all test patients.
PRF is supposed to be a good healing aid in v...
The mean marginal bone level alterations are displayed in Fig. 3.
Six months after surgery, both groups showed a statistically significant peri-implant bone loss.
The mesial resp. distal defect depth was 0.70 mm ± 0.72 SD resp. 0.64 mm ± 0.66 SD at baseline. Six months later, the marginal bone defect increased to 1.47 mm ± 0.65 SD on the mesial side resp. 1.46 mm ± 0.54 ...
At time of surgery, the patients ranged in age from 33 to 79 years (mean age 53.8 years).
The first surgeries for implant placement in the test group were carried out as described above. Two layers of a PRF matrix were placed on top of the implant. Though surgical flaps were all sutured completely free of tension, a post-operative dehiscence above the implant could be observed in all test pati...
Comparison of bone level alterations between test and control groups.
Data were expressed as means ± standard deviation. Comparisons were made using the Wilcoxon test, the Mann–Whitney U test, and the multiple comparisons test by Schaich-Hamerle (p = 0.05).
After the implantation, standardized digital X-rays were taken with parallel technique (baseline) (illustration 9). For each patient, an individual customized digital film holder was fabricated to ensure a reproducible radiographic analysis. Patients were instructed to avoid chewing hard nutrition in the treated area and to use chlorhexidine mouthwash and a soft brush twice a day for the first 2 ...
Patients aged 18+ who required an implant in the posterior mandible were eligible for this study.
Exclusion criteria were the following:
general contraindications to implant surgery
insufficient oral hygiene and periodontitis
patients with a history of severe periodontitis
bone augmentation required
smokers
substance abuse
uncontrolled diabetes
severe cardiovascular problems
treated or u...
As a consequence, recent research focused on soft tissue augmentation of thin gingiva types prior to or simultaneous to implant insertion. Wiesner et al. published a significant gain of soft tissue by thickening the gingiva with a connective soft tissue graft harvested from the palate [12]. Soft tissues at augmented sites were 1.3 mm thicker than on control sites and had a better pink esthetic sc...
The initial bone modeling around implants within the first year after insertion presents a challenging topic in current research. Previous studies have shown that this process is characterized by a remodeling of the horizontal and vertical bone dimension with a range of 0.7 to 3 mm within the first year [1].
First attempts to reduce this loss of tissue focused on changes of implant shapes, impla...
Previous studies have shown that adequate thickness or initial augmentation of soft tissue has a positive effect on the stability of peri-implant bone. This randomized, controlled trial aimed to evaluate the influence of augmenting soft tissue with platelet-rich fibrin (PRF) on crestal bone and soft tissue around implants.
After randomization, 31 fully threaded titanium implants were inserted in ...
Fig. 9. Comparison of the CBD medians in the immediate implant and the control groups
Fig. 9. Comparison of the CBD medians in the immediate implant and the control groups
Fig. 8. Comparison of the CBD means in the immediate implant and the control groups
Fig. 8. Comparison of the CBD means in the immediate implant and the control groups
Fig. 7. CBD in millimeters plotted over 10 years for the control group
Fig. 7. CBD in millimeters plotted over 10 years for the control group
Fig. 6. CBD in millimeters plotted over 10 years for the immediate implant group
Fig. 6. CBD in millimeters plotted over 10 years for the immediate implant group
Fig. 5. Measurement specifications: clinical realization [6]
Fig. 5. Measurement specifications: clinical realization [6]
Fig. 4. Measurement specifications: outline [6]
Fig. 4. Measurement specifications: outline [6]
Fig. 3. Number of implants in the respective region (anterior region ranging from 13 to 23 and 33 to 43, and posterior region ranging from 18 to 14, 24 to 28, 38 to 34, and 44 to 48)
Fig. 3. Number of implants in the respective region (anterior region ranging from 13 to 23 and 33 to 43, and posterior region ranging from 18 to 14, 24 to 28, 38 to 34, and 44 to 48)
Fig. 2. Prosthodontic indications
Fig. 2. Prosthodontic indications
Fig. 1. On the left, the Tübingen ceramic implant; on the right, the Frialit stepped-screw implant. The transgingival part with the cervical groove of the Tübingen implant has been removed in the Frialit implant; this part is now replaced by a mirror-polished transgingival portion of the Frialit abutment; all the intraosseous portion of the implant has now a thread and is shaped like the origi...
IM vs. CG
Insertion
Prosthetic treatment
1st year after prosthetic treatment
2nd year after prosthetic treatment
...
Implant diameter and length
Formula for the calculation of the CBD
(CBD = coronal bone defect)
(DD = defect depth)
3.8 × 13 mm
CBD = DD + 5 mm
3.8 × 15 mm
CBD = DD + 7 mm
All other diameters
CBD = DD + 3.2 mm
Table 3 Formula for the CBD
Length (mm)
Diameter
10
13
15
3.8 mm
0
...
Age (year)
Gender
15–20
21–40
41–60
61–75
Fe...
Gomez-Roman, G., Launer, S. Peri-implant bone changes in immediate and non-immediate root-analog stepped implants—a matched comparative prospective study up to 10 years.
Int J Implant Dent 2, 15 (2016). https://doi.org/10.1186/s40729-016-0048-0
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Received: 03 November 2015
Accepted: 14 May 2016
Published: 23 May 2016
DOI: https://doi.org/10.1186/s40729-...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Department of Prosthodontics, Dental School, University of Tübingen, Osianderstr. 2-8, Tübingen, D-72076, Germanyᅟ
German Gomez-Roman & Steffen Launer
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Correspondence to
German Gomez-Roman.
The study was supported by the German Society of Research, Special research project 175, Implantology (DFG—Deutsche Forschungsgemeinschaft, Sonderforschungsbereich 175, Implantologie). The authors of this study express their appreciation to Dr. Detlef Axmann for the expert advice in statistics.
GG-R conceived of the study and participated in its design and coordination and helped to draft the m...
Perry J, Lenchewski E. Clinical performance and 5-year retrospective evaluation of Frialit-2 implants. Int J Oral Maxillofac Implants. 2003;19(6):887–91.
Quirynen M, Van Assche N, Botticelli D, Berglundh T. How does the timing of implant placement to extraction affect outcome? Int J Oral Maxillofac Implants. 2007;22:203–26.
Ortega-Martínez J, Pérez-Pascual T, Mareque-Bueno S, Hernández-Al...
Lsidor F. Clinical probing and radiographic assessment in relation to the histologic bone level at oral implants in monkeys. Clin Oral Implants Res. 1997;8(4):255–64. doi:10.1034/j.1600-0501.1997.080402.x.
Zechner W, Watzak G, Gahleitner A, Busenlechner D, Tepper G, Watzek G. Rotational panoramic versus intraoral rectangular radiographs for evaluation of peri-implant bone loss in the anterior a...
Brånemark P-I. Osseointegration and its experimental background. J Prosthet Dent. 1983;50(3):399–410.
Schulte W, Heimke G. Das Tübinger Sofortimplantat. Quintessenz. 1976;27(6):17–23.
Cooper LF, Raes F, Reside G, Garriga JS, Tarrida LG, Wiltfang J, et al. Immediate provisionalization of dental implants placed in healed alvelar ridges and extraction sockets: a 5-year prospective evaluation....
coronal bone defect (part of the implant that has no contact to the bone; a calculated value)
control group
defect depth visible in the radiographs
dots per inch
immediate implant group
interquartile range
The examination and comparison of the peri-implant bone situation in immediate implants and a control group of non-immediate implants that were matched following specific criteria over a long period of time (10 years) has shown statistically significant differences only at the time of insertion and for the Wilcoxon hypothesis in the second year after prosthetic treatment. In our study, immediate ...
When Quirynen et al. did their review on how the time difference between extraction or tooth loss and implantation affects the success of the implant, no significant difference could be found [27]. They as well as Ortega-Martínez et al. clearly demand more studies evaluating the bone situation for the future [28]. This question was the motivation for our study.
Studies that evaluate the peri-implant bone situation specifically in the Frialit 2 implant system were, among others, conducted by Krennmair et al. and Ricci et al. Krennmair et al. found a bone resorption of 1.4 ± 1.2 mm over their follow-up period [24], which compares to the results found in this study. Ricci et al. found a higher bone resorption of the crestal bone after a 5-year follow-...
The fact that the used measurement protocol is reliable has been proven in former studies [7, 8].
The use of intraoral radiographs as well as panoramic radiographs is an accepted method for the peri-implant bone evaluation [11–13]. The radiographic distortions present in panoramic imaging are well known; however, according to several studies, panoramic images are suitable to assess the crestal ...
The primary objective of this study was the assessment of the peri-implant bone situation in immediate implants over a long-term period up to 10 years and to compare it to the situation found in matched non-immediate implants because there are no similar studies published. The hypothesis was that both the immediate implantation and the implantation after a healing period using the Frialit 2 impla...
Comparing the medians (Fig. 9) of the IM and CG, a difference of 0.7 mm at the time of insertion is visible. The respective values were 0 mm for the CG and 0.7 mm for the IM group. While at the time the patients received their definite restorations, a difference of only 0.3 mm was recorded (0.9 mm for IM and 0.6 mm for CG).
Over the years after definite restorations were emplaced, the medi...
The corresponding group of non-immediate implants was named the control group (CG) and analyzed the same way, and the results are shown in Fig. 7.
Like the immediate implant group, the mean values for the CG mainly stayed stable. At the time of insertion, a value of 0.6 mm was found, which was a little smaller than the value found at the time of the prosthetic treatment (1.0 mm). The maximum v...
For the evaluation of the received data, immediate and non-immediate implants were first examined separately.
The immediate implant (IM) group and its CBD plotted against the time, starting at the time of insertion, is shown in Fig. 6. One can see that the data are quite homogeneous.
The arithmetic means of the CBD range from 1.0 to 1.9 mm, most of them lying between 1.1 and 1.5 mm. The lowes...
After this, the data set was imported into the Excel program (Microsoft Corporation, Redmond, WA 980526399, USA) for further breakdown. For the final examination of the observed values, the mesial and distal CBD was compared. Since there were no larger differences of the values, the mesial and distal CBD were averaged and this was used for further assessment. The gained results were visualized usi...
The protocol used for measuring the distances in every radiograph was described by the author [6] and is outlined in Figs. 4 and 5. Crucial is the determination of a reliable reference line for every implant type. Rather than measuring only the bone level, the “coronal bone defect,” described by the author in 1995 [6], is assessed, which is the extent to which the part of the implant that is ...
One hundred and thirty-three patients receiving 174 implants were selected: 87 immediate implants (IM) and as a matched group 87 implants that were inserted in healed bone (control group (CG)).
The mean age of the patients in this study was 42 years, the youngest patient being 15 years old and the oldest 75 years at the time they received their implant. A gender and age distribution of all ins...
All patients within this study were treated at the Dental School of the Eberhard Karls University in Tübingen between the 22nd of February in 1991 and the 24th of October in 2005. Every patient received at least one Frialit implant. The study protocol of the study was approved by the German Society of Research (Sonderforschungsbereich 175 Implantologie). Informed consent was obtained from all pat...
The present study was designed as a retrospective long-term study which compares the peri-implant bone situation of immediate implants and non-immediate implants as a control group (matched with specific criteria) using reliable measurement specifications [6–8]. The hypothesis was that both the immediate implantation and the implantation after a healing period using the Frialit 2 implant system ...
The success of dental implants has become more and more predictable since Brånemark first observed what he later called osseointegration, in 1960 [1], meaning the direct structural and functional interlocking of the natural bone and titanium implant surfaces. With implantation becoming a predictable treatment for dental restorations, patients also have become more critical towards the esthetic ou...
The purpose of this retrospective long-term study was to evaluate the peri-implant bone changes in immediate implants and matched non-immediate implants as a control group using a specific and proven measurement protocol over a 10-year period, because there are no similar studies published.
One hundred and thirty-three patients received 174 implants (immediate implants (IM) n = 87; control gr...
Fig. 8. Postoperative panoramic radiograph taken about 3 years after implant loading
Fig. 8. Postoperative panoramic radiograph taken about 3 years after implant loading
Fig. 7. Radiographic findings on panoramic computed tomography after nongrafted sinus lift with simultaneous implant placement. a Immediately. b At 6 months. c At 42 months
Fig. 7. Radiographic findings on panoramic computed tomography after nongrafted sinus lift with simultaneous implant placement. a Immediately. b At 6 months. c At 42 months
Fig. 6. Radiographic findings on cross-sectional computed tomography in the right second molar region after nongrafted sinus lift with simultaneous implant placement. a Immediately. b At 6 months. c At 42 months
Fig. 6. Radiographic findings on cross-sectional computed tomography in the right second molar region after nongrafted sinus lift with simultaneous implant placement. a Immediately....
Fig. 5. Clinical view of the repositioned bone window with the HA/PLLA mesh plate device
Fig. 5. Clinical view of the repositioned bone window with the HA/PLLA mesh plate device
Fig. 4. a Front view of the bone window with the HA/PLLA mesh plate device fixed by a screw. b Lower view of the bone window with the HA/PLLA mesh plate device fixed by a screw
Fig. 4. a Front view of the bone window with the HA/PLLA mesh plate device fixed by a screw. b Lower view of the bone window with the HA/PLLA mesh plate device fixed by a screw
Fig. 3. After the removal of the bone window, the membrane was lifted upward, and the dental implants were placed without grafting materials
Fig. 3. After the removal of the bone window, the membrane was lifted upward, and the dental implants were placed without grafting materials
Kaneko, T., Nakamura, S., Hino, S. et al. Continuous intra-sinus bone regeneration after nongrafted sinus lift with a PLLA mesh plate device and dental implant placement in an atrophic posterior maxilla: a case report. Int J Implant Dent 2, 16 (2016). https://doi.org/10.1186/s40729-016-0049-z
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Received: 18 March 2016
Accepted: 01 June 2016
Published: 06 June 2016
DOI: https:/...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
Takahiro Kaneko, Satoshi Nakamura, Shunsuke Hino, Norio Horie, and Tetsuo Shimoyama declare that they have no competing interests.
TK, SN, and SH were involved with the literature review and performance of the surgery. NH and TS suggested the treatment planning and were also involved with the surgeries. All authors read and approved the final manuscript.
Department of Oral and Maxillofacial Surgery, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan
Takahiro Kaneko, Satoshi Nakamura, Shunsuke Hino, Norio Horie & Tetsuo Shimoyama
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Atef M, Hakam MM, EIFaramawey MI, Abou EIFetouh A, Ekram M. Nongrafted sinus floor elevation with a space-maintaining titanium mesh: case-series study on four patients. Clin Oral Implants Res. 2011;23:100–5.
Kaneko T, Masuda I, Horie N, Shimoyama T. New bone formation in nongrafted sinus lifting with space-maintaining management: a novel technique using a titanium bone fixation device. J Oral M...
Pjetursson BE, Tan WC, Zwahlen M, Lang NP. A systematic review of the success of sinus floor elevation and survival of implants inserted in combination with sinus floor elevation. J Clin Periodontol. 2008;35:216–40.
Tan WC, Lang NP, Zwahlen M, Pjetursson BE. A systematic review of the success of sinus floor elevation and survival of implants inserted in combination with sinus floor elevation. P...
computed tomography
bioresorbable unsintered hydroxyapatite combined with poly l-lactide
Written informed consent was obtained from the patient for publication of this report and all accompanying images.
This nongrafted sinus-lifting procedure using an HA/PLLA mesh plate device helps to attain predictable bone formation. Stable membrane elevation by the HA/PLLA device for the long term could contribute to predictable bone formation in the sinus. The source of cell supply could possibly be the Schneiderian membrane, reflecting its osteogenic potential.
In nongrafted sinus-lifting procedure, several devices such as titanium [12–14], hollow hydroxyapatite [15], and bioresorbable materials [16] have been used for space retention to maintain the lifted sinus membrane and the results of predictable bone formation have been reported in addition to histological examination. In this case, a mesh plate device consisting of HA/PLLA materials was applied...
A 60-year-old healthy female, who desired dental implant therapy in the right molar region of the maxilla, was referred to the Department of Oral and Maxillofacial Surgery. Clinical examination revealed an edentulous maxilla from the right first premolar to the second molar region. Panoramic radiography showed atrophy of the maxillary alveolar ridge in the same site (Fig. 1), and the need for sin...
Maxillary sinus lift is a bone augmentation procedure in the sinus that improves the alveolar crest height in atrophic posterior maxilla by forming new bone in the space created under the elevated sinus membrane. To date, numerous grafting materials have been used as a scaffold for new bone regeneration, including autogenous bone, bone graft substitutes, or their combination [1, 2]. Autogenous bon...
Sinus lift is a bone augmentation procedure that improves the alveolar crest height in an atrophic posterior maxilla. However, the regenerated bone volume can vary and generally has a tendency to decrease after sinus operation. This article describes nongrafted maxillary sinus lift using a bioresorbable unsintered hydroxyapatite combined with poly l-lactide (HA/PLLA) mesh plate device and dental i...
Patients
Intervention
Follow-up
Outcome
Study
Reference
No.
Agea
No. of implants
Position
Supra-structure
Change
Declarations
(DAVIS et al. 1999) [17]
44
61.2
NG
Symphyseal
Fixed
6.6 Ya
VBH (−.8 to +3.3 mm)
–
R
(Powers et al. 1994) [32]
146
52
NG
TMI
Fixed
18–51 M
BF (+2 to 9 mm)
–
R
(Adell et al. 1981) [58]
410
53
276...
Focus question
In patient with implant restoration, what is the chance of residual alveolar ridge preserving and bone formation in the adaptive remodeling and what are the features of this preservation?
Search strategy
Population
#1—edentulous patient
Intervention
#2—implant OR overdenture OR fixed bridge OR transmandibular implant OR full rehabilitation
O...
Khalifa, A.K., Wada, M., Ikebe, K. et al. To what extent residual alveolar ridge can be preserved by implant? A systematic review. Int J Implant Dent 2, 22 (2016). https://doi.org/10.1186/s40729-016-0057-z
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Received: 21 May 2016
Accepted: 16 November 2016
Published: 23 November 2016
DOI: https://doi.org/10.1186/s40729-016-0057-z
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
Department of Prosthodontics, Faculty of Dentistry, Mansoura University, 68 ElGomhoria Street, ElMansoura, 35516, Egypt
Ahmed Khalifa Khalifa
Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
Ahmed Khalifa Khalifa, Masahiro Wada, Kazunori Ikebe & Yoshinobu Maeda
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Murphy WM, Williams KR, Gregory MC. Stress in bone adjacent to dental implants. J Oral Rehabil. 1995;22(12):897–903.
Chou HY, Jagodnik JJ, Müftü S. Predictions of bone remodeling around dental implant systems. J Biomech. 2008;41(6):1365–73.
Chang S-H, Huang S-R, Huang S-F, Lin C-L. Mechanical response comparison in an implant overdenture retained by ball attachments on conventional regular...
Kremer U, Schindler S, Enkling N, Worni A, Katsoulis J, Mericske-Stern R. Bone resorption in different parts of the mandible in patients restored with an implant overdenture. A retrospective radiographic analysis. Clin Oral Implants Res. 2016;27(3):267-72.
von Wowern N, Gotfredsen K. Implant-supported overdentures, a prevention of bone loss in edentulous mandibles? A 5-year follow-up study. Clin ...
de Jong MHM, Wright PS, Meijer HJA, Tymstra N. Posterior mandibular residual ridge resorption in patients with overdentures supported by two or four endosseous implants in a 10-year prospective comparative study. Int J Oral Maxillofac Implants. 2010;25(6):1168–74.
Jacobs R, Schotte A, van Steenberghe D, Quirynen M, Naert I. Posterior jaw bone resorption in osseointegrated implant-supported over...
Block MS, Kent JN, Finger IM. Use of the integral implant for overdenture stabilization. Int J Oral Maxillofac Implants. 1990;5(2):140–7.
Norton MR, Gamble C. Bone classification: an objective scale of bone density using the computerized tomography scan. Clin Oral Implants Res. 2001;12(1):79–84.
de Oliveira RCG, Leles CR, Normanha LM, Lindh C, Ribeiro-Rotta RF. Assessments of trabecular bone...
Cowin SC. Bone stress adaptation models. J Biomech Eng. 1993;115(4B):528.
Byrne G. Fundamentals of implant dentistry. New Jersey: Wiley; 2014. 264 p.
Traini T, Degidi M, Iezzi G, Artese L, Piattelli A. Comparative evaluation of the peri-implant bone tissue mineral density around unloaded titanium dental implants. J Dent. 2007;35(1):84–92.
Hoshaw SJ, Brunski JB, Cochran GVB. Mechanical loading...
Roberts WE, Helm FR, Marshall KJ, Gongloff RK. Rigid endosseous implants for orthodontic and orthopedic anchorage. Angle Orthod. 1989;59(4):247–56.
Roberts WE, Smith RK, Zilberman Y, Mozsary PG, Smith RS. Osseous adaptation to continuous loading of rigid endosseous implants. Am J Orthod. 1984;86(2):95–111.
Wyatt CCLL. The effect of prosthodontic treatment on alveolar bone loss: a review of t...
Klemetti E, Kolmakow S. Morphology of the mandibular cortex on panoramic radiographs as an indicator of bone quality. Dentomaxillofacial Radiol. 1997;26(1):22–5.
Ortman LF, McHenry K, Hausmann E. Relationship between alveolar bone measured by 125I absorptiometry with analysis of standardized radiographs: 2. Bjorn technique. J Periodontol. 1982;53(5):311–4.
Davis WH, Lam PS, Marshall MW, Dorc...
Petersen PE, Bourgeois D, Ogawa H, Estupinan-Day S, Ndiaye C. The global burden of oral diseases and risks to oral health. Bull World Health Organ. 2005;83(9):661–9.
Nowjack-Raymer RE, Sheiham A. Association of edentulism and diet and Nutrition in US adults. J Dent Res. 2003;82(2):123–6.
Araújo MG, Lindhe J. Dimensional ridge alterations following tooth extraction. An experimental study in ...
Within the limitation of this review and based on previous studies, implant restoration has a noticeable residual alveolar ridge preservation which varies from reducing rate of physiologic resorption to bone apposition. However, the extension of this preservation from the implant to surrounding bony area, horizontally and vertically, is unknown. So, further studies are needed to elaborate the exte...
As most of the previous studies declared the favorable bone preservation of the residual alveolar ridge anteriorly around implants, biomechanically, and according to finite element analysis, bone modifying shows variations depending on the cancellous or cortical nature. Bone density is enhanced gradually from the third month to the end of the first year of loading coming stable after 30 months. W...
Despite age-related [71], local and/or systemic factors causing prolonged ridge resorption [9], authors reported the probability of preservative effect and overhaul to maintain the residual alveolar ridge with different restoration [70, 71]. In the previous study, bone formation was noticed with the distal implant in severely resorbed atrophied mandibular ridge [20]. Sennerby et al. [72] concluded...
Many procedures are used to recover denture foundation, but the majority is considered sophisticated techniques [51–53]. Observations tried to notify bone modifications with different types of implant-assisted restoration [23, 40, 54]. The clinical and radiographic investigations, detection of the altered mineral levels, or bone density within the bone may give a valuable data for the bony state...
Bone changes were reported after implant placement in three phases: healing, remodeling, and equilibrium. The remodeling phase is launched confronting the altered pattern of force transmission to the bone tissue. To withstand the applied functional load, continuous remodeling is conducted to reach a “steady state.” Mechanical stimulus is the primary bone modifier influenced by other in situ va...
Apparently, there is an enduring adaptive process surrounding the implant which sustains the rigid interface between alveolar bone and implant after non-destructive surgical and loading procedures. Like other body bones, and according to Wolff’s law, bone has the ability to differentiate with different stresses applied [22]. This reform is started from the time of surgical conduction of implant ...
The required documents were collected from PubMed, Web of Science, and Ovid databases. For expanding the traces of researching, further readings for the bibliography of the relevant publications and hand searching for some denoted articles were done. The keywords, for intervention and outcome, used in research engines in databases as “implant overdenture,” “implant bone resorption,” “alv...
Edentulism is rated between 7 and 69% internationally [1]. Many biological and non-bilogical predisposing factors lead to the main result of edentulism [2]. Regardless the debate to understand the way of resorption [3], the loss of periodontal ligament by tooth extraction leaves alveolar bone without a chance of reformation which leads to bone resorption only. The resorption shows variation in rat...
It has been reported that the load for (or to) implant-supported restoration may lead to bone remodeling as bone resorption and/or formation. While many authors supported the process of bone resorption, others elaborated bone apposition and increasing bone density close and remote to implant body (or fixture). This may suggest the role of the implant to reserve alveolar ridge from physiologic/path...
Fig. 6. Immunohistochemical staining of osteocalcin (a) and collagen I (c) in sections from mini pigs mandible from 9M and IR osteocalcin (b) and collagen I (d). There were statistically significant differences to osteocalcin in 9M samples and no statistically significant differences to collagen I samples. Magnification: ×40 (a, b) and ×100 (c, d)
Fig. 6. Immunohistochemical staining of ost...
Fig. 5. Representative photomicrographs of each third of the peri-implant bone of IR experimental condition (H&E, ×40). a First third (cervical third). b Intermediate third. c Apical third. Note the edges of bone grooving present rounded contour, mainly in the last third
Fig. 5. Representative photomicrographs of each third of the peri-implant bone of IR experimental condition (H&E, ×40). a...
Fig. 4. Representative photomicrographs of each third of the peri-implant bone of 9M experimental condition (H&E, ×40). a First third (cervical third). b Intermediate third. c Apical third. Bone grooving with no altered contour
Fig. 4. Representative photomicrographs of each third of the peri-implant bone of 9M experimental condition (H&E, ×40). a First third (cervical third). b Intermediat...
Fig. 3. Prothesis fixed installed on the three implants
Fig. 3. Prothesis fixed installed on the three implants
9M
IR
Third
Mean
Standard deviation
Mean
...
9M
IR
Third
Mean
Standard deviation
Mean
...
Animal
Mean
Standard deviation
Minimum
Maximum
1
150.1
30.2
122.7
184.4
2
163.3
35.1
132.4
205.3
3
175.2
15.2
153.2
204.6
4
163.6
15.4
157.3
185.1
5
153.3
15.2
146.2
174.2
6
150.3
26.4
129.2
174.6
Table 2 Removal torque value (Ncm) of three implants removed after 9 months (9M) per animal
Animal
Mean
Standard deviation
Minimum
Maximum
1
98.3
5.5
92.2
103.3
2
91.6
9.1
82.1
102.5
3
105.3
8.3
100.4
115.0
4
71.6
10.5
61.2
82.2
5
78.6
5.8
72.7
83.1
6
88.6
6.6
81
93.6
Table 1 Removal torque value (Ncm) of three implants immediate removed (IR) per animal
Silva, R.d., Passador, F. & Caria, P.H.F. Twist removal of healed vs. nonhealed implants—a mechanical and histological study in mini pigs. Int J Implant Dent 2, 23 (2016). https://doi.org/10.1186/s40729-016-0059-x
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Received: 27 April 2016
Accepted: 18 November 2016
Published: 25 November 2016
DOI: https://doi.org/10.1186/s40729-016-0059-x
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
FOP/UNICAMP, Piracicaba, SP, Brasil
Ricardo de Oliveira Silva & Paulo Henrique Ferreira Caria
CPG São Leopoldo Mandic, Campinas, SP, Brasil
Fabrício Passador
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Correspondence to Ricardo de Oliveira Silva.
We would like to thank Mario Perussi for supplying us with the customized system, implants, and prosthetic components, Dentifix®, FESB, veterinary professors Rafael Rodrigues and Alexander Correa Borghesan, and CAPES for the scholarship and financial support.
ROS conceived the study, held surgical procedures, and drafted the manuscript. FP did the preparation and helped in reading the histologic...
Yun H-M, Ahn S-J, Park K-R, Kim M-J, Kim J-J, Jin G-Z, et al. Magnetic nanocomposite scaffolds combined with static magnetic field in the stimulation of osteoblastic differentiation and bone formation. Biomaterials [Internet]. 2016;85:88–98. [cited 2016 Feb 10] Available from: http://www.sciencedirect.com/science/article/pii/S0142961216000491.
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Aubin JE, Liu F, Malaval L, Gupta AK. Osteoblast and chondroblast differentiation. Bone [Internet]. 1995;17(2):S77–83. [cited 2015 Dec 30] Available from: http://www.sciencedirect.com/science/article/pii/875632829500183E.
Mariano M. Minisuíno (minipig) na pesquisa biomédica experimental. O Minipig br1. Acta Cirúrgica Bras. 2003;18(5):387–91.
Herring SW. How can animal models answer clinic...
Piattelli A, Scarano A, Piattelli M. Microscopical aspects of failure in osseointegrated dental implants: a report of five cases. Biomaterials [Internet]. 1996;17(12):1235–41. [cited 2015 Oct 5] Available from: http://www.sciencedirect.com/science/article/pii/0142961296849441.
Stajčić Z, Stojčev Stajčić LJ, Kalanović M, Đinić A, Divekar N, Rodić M, et al. Removal of dental implants: re...
Assenza B, Scarano A, Perrotti V, Vozza I, Quaranta A, Quaranta M, et al. Peri-implant bone reactions around immediately loaded conical implants with different prosthetic suprastructures: Histological and histomorphometrical study on minipigs. Clin Oral Investig. 2010;14(3):285–90.
Sasaki H, Koyama S, Yokoyama M, Yamaguchi K, Itoh M SK. Bone metabolic activity around dental implants under loadi...
Glauser R, Sailer I, Wohlwend A, Studer S, Schibli M, Schärer P. Experimental zirconia abutments for implant-supported single-tooth restorations in esthetically demanding regions: 4-year results of a prospective clinical study. Int J Prosthodont [Internet]. 2004;17(3):285–90. [cited 2015 Oct 6] Available from: http://www.mendeley.com/catalog/experimental-zirconia-abutments-implantsupported-sing...
Brånemark PI. Osseointegration and its experimental background. J Prosthet Dent. 1983;50(3):399–410.
Chiapasco M, Gatti C. Immediate loading of dental implants placed in revascularized fibula free flaps: a clinical report on 2 consecutive patients. Int J Oral Maxillofac Implants. 2015;19(6):906–12.
Shemtov-Yona K, Rittel D. On the mechanical integrity of retrieved dental implants. J Mech Be...
Implant removal torque should be higher to remove implants with long-time installation than implants removed immediately after installation. Although, removal torque causes microscopical fractures and smooth on the peri-implant bone grooves, it does not compromised the bone healing.
According to Christenson R.H. [24], the bone structure, metabolism, and regulation are reflected by markers of resorption, formation, and/or turnover. Among the markers of bone resorption is the type 1 collagen degradation and maker of bone formation: Osteocalcin. Bone formation markers derive from the osteoblastic activity, formed during the different stages of osteoblasts proliferation, differen...
In order to better use a model which reproduce the natural conditions of dental implant in action, minipigs (BR-1) have been used in this study [44], the nonprimate animal model that is most appropriate for the study of human mastication [45] and commonly used in research because suine and human share important anatomic and physiologic characteristics [46, 47].
The osseointegration process is qui...
Dental implant revolutionized oral rehabilitation, becoming the natural teeth replacement by a titanium implant, a successful alternative to treat total or partial edentulism [14, 26, 27]. Nowadays, dental implants are definitely a current procedure in many dental offices [3, 28, 29]. Despite the long-term success shown by different studies [14, 30], implant failure is inevitable [31–33]. Since,...
Duplicate sections of peri-impant bone were obtained from each implant sample to evaluate the percentage of stained areas in order to differentiate markers of collagen I and osteocalcin within both experimental conditions (Fig. 6). The highest collagen I expression values were observed at the IR experimental condition, and osteocalcin expression was higher at the 9M.
There was a statistically si...
No remarkable complications were found during the healing period. At sacrifice, all 18 implants fixed after 9 months were considered successfully integrated at the time of the removal and none showed any mobility or signal of infection at sacrifice. There was no difference in the healing between animals who had the implants immediately removed after installation, and animal whose implants were re...
Hematoxylin-eosin-stained section images were digitized and analyzed in order to recognize the presence of native bone tissue by the presence of osteocyte lacunae-containing cells and the newly formed bone tissue recognized by the absence of lacunae. Also, the characteristics of peri-implant bone, presence or absence of bone fractures, and the shape and contour of bone grooving resultant of the tr...
The mandibles were sectioned into left and right segments, and each peri-implant bone was sectioned again to individualize them. Each peri-implant bone block was fixed in buffered formalin solution, pH 7.0, for 6 days, demineralized in 10% formic acid, and dehydrated through progressing alcohol concentrations and paraffin-embedded. Paraffin blocks were sectioned at 7-μm thick mounted on poly-l-...
This study was approved by the University Animal Ethics Committee-CEUA/UNICAMP-(Campinas, SP) (no.2730-1/12). Six adult male mini pigs (BR-1 mini pigs, São Paulo, Brazil) with ~36 months old and weighed ~55 kg were used in the experiment. The mini pigs were kept in the Experimental Center of the Veterinary Faculty (FESB-Bragança Paulista, SP) and were allowed to adapt to the environment 1 wee...
Many authors investigated bone reactions around dental implants [17–21]. What happens in the peri-implant bone implants removed is not reported in scientific articles. This study evaluated the peri-implant bone after his immediate removal and after 9 months of osseointegration. The aim of the present study was to evaluate the peri-implant bone after dental implant removal.
Since the discovery of osseointegration by Branemark in Sweden in 1960, where found that when titanium screws left undisturbed in bone, the osteocytes grow in close apposition to the titanium surfaces and provide firm anchorage. This discovery was successfully applied in dental and craniofacial reconstructive surgery in 1965 [1, 2]. Dental implants became a common procedure in the modern dental tr...
The objective of this study was to evaluate the effect of removal torque (reverse torque) of titanium implants in peri-implant bone.
The P1-M1 teeth were extracted bilaterally of 6 mini pigs (BR-1). Each animal received 6 titanium implants, three for each side of mandible. On the right side of mandible, 3 implants reminded 9 months (9M) under masticatory activity and on the left side, other 3 im...
Patient
Implant region
(FDI)
Implant parameters
Dimensions of implant
Diameter [mm]/length [mm]
...
Fretwurst, T., Grunert, S., Woelber, J.P. et al. Vitamin D deficiency in early implant failure: two case reports. Int J Implant Dent 2, 24 (2016). https://doi.org/10.1186/s40729-016-0056-0
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Received: 04 August 2016
Accepted: 16 November 2016
Published: 25 November 2016
DOI: https://doi.org/10.1186/s40729-016-0056-0
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Department of Oral- and Craniomaxillofacial Surgery, Center for Dental Medicine, University Medical Center Freiburg, Hugstetter Straße 55, Freiburg, D-79106, Germany
Tobias Fretwurst, Sebastian Grunert, Katja Nelson & Wiebke Semper-Hogg
Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, USA
Tobias Fretwurst
Department of Operative Dentistr...
We would like to thank Dr. John Nelson for his resourceful and constructive ideas.
The authors Tobias Fretwurst, Sebastian Grunert, Johan Woelber, Katja Nelson, and Wiebke Semper-Hogg declare no conflicts of interest with respect to the research, authorship, and/or publication of this article.
The authors Tobias Fretwurst, Sebastian Grunert, Johan Woelber, Katja Nelson, and Wiebke Semper-Hogg do...
Di Rosa M, Malaguarnera M, Nicoletti F, Malaguarnera L. Vitamin D3: a helpful immuno-modulator. Immunology. 2011;134(2):123–39.
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Kikuta J, Kawamura S, Okiji F, Shirazaki M, Sakai S, Saito H, Ishii M. Sphingosine-1-phosphate-mediated osteoclast precursor monocyte migration is a critical point of control in antibone-resorptive action of active vitamin D. Proc Natl Acad Sci U S A. 2013;110(17):7009–13.
Hewison M, Freeman L, Hughes SV, Evans KN, Bland R, Eliopoulos AG, Kilby MD, Moss PA, Chakraverty R. Differential regulatio...
Hong HH, Chou TA, Yang JC, Chang CJ. The potential effects of cholecalciferol on bone regeneration in dogs. Clin Oral Implants Res. 2012;23(10):1187–92.
Hong HH, Yen TH, Hong A, Chou TA. Association of vitamin D3 with alveolar bone regeneration in dogs. J Cell Mol Med. 2015;19(6):1208–17.
Schulze-Späte U, Dietrich T, Wu C, Wang K, Hasturk H, Dibart S. Systemic vitamin D supplementation and ...
Gallagher JC, Sai AJ. Vitamin D insufficiency, deficiency, and bone health. J Clin Endocrinol Metab. 2010;95(6):2630–3.
Ning Z, Song S, Miao L, Zhang P, Wang X, Liu J, Hu Y, Xu Y, Zhao T, Liang Y, Wang Q, Liu L, Zhang J, Hu L, Huo M, Zhou Q. High prevalence of vitamin D deficiency in urban health checkup population. Clin Nutr. 2016;35(4):859–63.
Spiro A, Buttriss JL. Vitamin D: an overview o...
Maier GS, Horas K, Seeger JB, Roth KE, Kurth AA, Maus U. Is there an association between periprosthetic joint infection and low vitamin D levels? Int Orthop. 2014;38(7):1499–504.
Alvim-Pereira F, Montes CC, Thomé G, Olandoski M, Trevilatto PC. Analysis of association of clinical aspects and vitamin D receptor gene polymorphism with dental implant loss. Clin Oral Implants Res. 2008;19(8):786–...
Esposito M, Thomsen P, Ericson LE, Lekholm U. Histopathologic observations on early oral implant failures. Int J Oral Maxillofac Implants. 1999;14:798–810.
Olmedo-Gaya MV, Manzano-Moreno FJ, Cañaveral-Cavero E, de Dios Luna-Del Castillo J, Vallecillo-Capilla M. Risk factors associated with early implant failure: a 5-year retrospective clinical study. J Prosthet Dent. 2016;115(2):150–5.
Wenn...
To overcome the shortcomings of this case reports, prospective, multicenter, and controlled studies must follow to affirm a potential relationship between vitamin D deficiency, osteoimmunology, and the early failure of dental implants. Currently, a general recommendation for a standardized vitamin D screening in dental implantology cannot be stated due to lack of evidence.
Nevertheless, the vitamin D deficiency prevalence in the European population indicates that a vitamin D deficiency is probably not a sole causative factor for early implant failure; otherwise, the early implant failure rate would be significantly higher. However, a synergistic effect with other factors is conceivable. Some authors stated that implant osseointegration is not simply a wound healing ...
Local and systemic factors can affect the survival rate of dental implants [30–33]. The causes of early implant failure are not fully clarified and an association between vitamin D and dental implant osseointegration has not been investigated properly [8, 13–16]. Some recent animal studies in rodents demonstrated a relationship between vitamin D supplementation and an increased bone to implant...
In this 51-year-old male patient, no grafting procedure was performed as vertical and horizontal alveolar ridge dimension was adequate for implant placement. The implant placement in regions 36 and 37 was performed as guided surgery (Fig. 2a, Table 1). The implant placement was uneventful and the bone appeared clinically healthy. A cortical bone profiling was performed during implant placement. ...
The medical history of this 48-year-old male patient showed a high blood pressure; otherwise, the patient was healthy. A successfully completed periodontal therapy was done before implant therapy. The patient demonstrated stable marginal bone levels. Autologous retromolar bone grafting using local anesthesia was performed in the left mandible (see Fig. 1a). This patient received a postoperative o...
Patients treated consecutively in one center (Department of Oral- and Craniomaxillofacial Surgery, University Medical Center Freiburg). None of the patients showed systemic disease. Both patients did not take regular medication and were negative for alcohol, nicotine, and drug use. Bothe male patients (48 and 51 years of age) were not immunosuppressed, irradiated or received chemotherapy. Written...
Long-term stable osseointegrated implants are the primary goal in dental implantology. Although dental implants have proven clinical reliable in the long term, the failure of implants at a very early stage of osseointegration has been described [1, 2]. The pursuit to identify the mechanisms leading to early implant failure is ongoing to date and include the following: tobacco usage, diabetes, wear...
An association between vitamin D deficiency and early dental implant failure is not properly verified, but its role in osteoimmunology is discussed. This article illustrates two case reports with vitamin D deficiency and early implant failure. Prior to implant placement, the first patient received crestal bone grafting with autologous material. Both patients received dental implants from different...
Fig. 20. Colour-coded superimposition of intraoral scans before extraction and after definitive prosthetic restoration
Fig. 20. Colour-coded superimposition of intraoral scans before extraction and after definitive prosthetic restoration
Fig. 19. Colour-coded superimposition of intraoral scans before extraction and after definitive prosthetic restoration
Fig. 19. Colour-coded superimposition of intraoral scans before extraction and after definitive prosthetic restoration
Fig. 18. Finalized prosthetic restoration after 1 year
Fig. 18. Finalized prosthetic restoration after 1 year
Fig. 17. Histology of dentin augmentation. aactive process in the bone marrow lacunae with osteoblast rimming. No signs of necrosis or infection (H&E stain, ×100 magnification). b Larger magnification at ×200. c EvG (Elastica van Gieson) stain, ×200
Fig. 17. Histology of dentin augmentation. a Asterisk denotes incorporated dentin particle, surrounded by vital woven bone. Triangle shows rea...
Fig. 16. Single tooth X-ray, 1 year post-implantation, showing the finalized crown
Fig. 16. Single tooth X-ray, 1 year post-implantation, showing the finalized crown
Fig. 15. Single tooth X-ray, showing a constant bone level 7 months after implant placement
Fig. 15. Single tooth X-ray, showing a constant bone level 7 months after implant placement
Fig. 14. Single tooth X-ray immediately after the augmentation using autogenous dentin
Fig. 14. Single tooth X-ray immediately after the augmentation using autogenous dentin
Fig. 13.
Fig. 13. a, b Clinical situation prior to implant placement
Fig. 12. Axial view
Fig. 12. Axial view
Fig. 11. Sagittal view
Fig. 11. Sagittal view
Fig. 10. Soft tissue graft placed on the recipient site
Fig. 10. Soft tissue graft placed on the recipient site
Fig. 9. Soft tissue punch
Fig. 9. Soft tissue punch
Fig. 8. Autologous, particulated dentin in the alveolar socket
Fig. 8. Autologous, particulated dentin in the alveolar socket
Fig. 7. Autologous, particulated dentin mixed with blood from the operating site
Fig. 7. Autologous, particulated dentin mixed with blood from the operating site
Fig. 6. Autologous dentin with the desired particle size
Fig. 6. Autologous dentin with the desired particle size
Fig. 5. Autologous dentin in a bone mill
Fig. 5. Autologous dentin in a bone mill
Fig. 4. Removal of enamel and the cementum
Fig. 4. Removal of enamel and the cementum
Fig. 3. Removal of the pulp
Fig. 3. Removal of the pulp
Fig. 2. The remaining root of tooth 11
Fig. 2. The remaining root of tooth 11
Fig. 1. Extraction with the benex system
Fig. 1. Extraction with the benex system
Valdec, S., Pasic, P., Soltermann, A. et al. Alveolar ridge preservation with autologous particulated dentin—a case series. Int J Implant Dent 3, 12 (2017). https://doi.org/10.1186/s40729-017-0071-9
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Received: 07 December 2016
Accepted: 15 March 2017
Published: 30 March 2017
DOI: https://doi.org/10.1186/s40729-017-0071-9
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, University Hospital Zurich, Plattenstrasse 11, 8032, Zürich, Switzerland
Silvio Valdec, Pavla Pasic, Bernd Stadlinger & Martin Rücker
Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland
Alex Soltermann
Clinic of Fixed and Removable Prosthodontics and Dental Mater...
We would like to express our thanks to Dr. Gabriel Bosch for the superimposition, calculation and illustration of the intraoral scans.
SV, BS and MR created the conception and study design. MR performed the surgical and DT the prosthodontic treatment. SV, PP and DT performed the data collection and AS the histological examination. SV, BS and AS analysed and interpreted the data. SV drafted the ma...
Sculean A, Berakdar M, Chiantella GC, Donos N, Arweiler NB, Brecx M. Healing of intrabony defects following treatment with a bovine-derived xenograft and collagen membrane. A controlled clinical study. J Clin Periodontol. 2003;30(1):73–80.
Sutton DN, Lewis BR, Patel M, Cawood JI. Changes in facial form relative to progressive atrophy of the edentulous jaws. Int J Oral Maxillofac Surg. 2004;33(7...
Liu X, Li Q, Wang F, Wang Z. Maxillary sinus floor augmentation and dental implant placement using dentin matrix protein-1 gene-modified bone marrow stromal cells mixed with deproteinized boving bone: a comparative study in beagles. Arch Oral Biol. 2016;64:102–8. doi:10.1016/j.archoralbio.2016.01.004.
Pang KM, Um IW, Kim YK, Woo JM, Kim SM, Lee JH. Autogenous demineralized dentin matrix from ex...
Furhauser R, Florescu D, Benesch T, Haas R, Mailath G, Watzek G. Evaluation of soft tissue around single-tooth implant crowns: the pink esthetic score. Clin Oral Implants Res. 2005;16(6):639–44. doi:10.1111/j.1600-0501.2005.01193.x.
Guirado JL, Troiano M, Lopez-Lopez PJ, Ramirez-Fernandez MP, de Val JE, Marin JM, Gehrke SA. Different configuration of socket shield technique in peri-implant bone...
Al-Asfour A, Andersson L, Kamal M, Joseph B. New bone formation around xenogenic dentin grafts to rabbit tibia marrow. Dent Traumatol. 2013;29(6):455–60. doi:10.1111/edt.12045.
Albrektsson T, Zarb G, Worthington P, Eriksson AR. The long-term efficacy of currently used dental implants: a review and proposed criteria of success. Int J Oral Maxillofac Implants. 1986;1(1):11–25.
Andersson L. Den...
Within the limits of this case series, it has been shown that particulated dentin of autologous teeth may serve as an alternative to autologous bone for alveolar ridge preservation prior to implant therapy. However, randomized studies on this treatment option are necessary.
In humans, particulated tooth material has been used for sinus augmentation in order to enhance implant therapy. Preliminary results from five patients histologically showed an osteoconductive osteogenesis with partial resorption of tooth components [25].
In the present case series, all patients underwent socket preservation with AutoPD. In all cases, one or two upper frontal central incisors wer...
The aim of this case series is to demonstrate the efficacy and safety of this novel augmentative procedure for ridge preservation prior to implant therapy. This shall serve as a basis for a prospective study.
In all four cases, patients showed a stable volume of soft and hard tissues after the augmentation with AutoPD and good osseointegration of titanium implants, having been placed in this augm...
Four months post-extraction and augmentation with autologous, particulated dentin, all four patients received an implant placement in the augmented area. In all cases, a CBCT was taken in between the dentin augmentation and the implant placement.
During implant placement, a biopsy of the bone from the augmented area was taken for histological examination (Fig. 17).
The final prosthetic solution...
The 1-year follow-up examination of the presented case showed an implant success, according to the appropriate clinical criteria [2] (Figs. 14, 15 and 16).
The pink esthetic score (PES) was used for the evaluation of reproducible soft tissue around the final implant crown as a parameter for the aesthetic outcome [12]. Seven variables were evaluated comparing the soft tissue around the implant wi...
An autologous soft tissue graft was harvested from the patient’s palate using a soft tissue punch (Biopsy Punch, kai Europe GmbH, Solingen, Germany) (Fig. 9). The graft had a comparable dimension as the recipient site. The gingival graft was placed on top of the augmentation material, adapted and carefully sutured to the marginal gingiva after the sulcus epithelium was removed with a rotating d...
Four patients between 36 and 65 years of age are presented in this case series. There was no financial compensation. All four patients suffered from a trauma, causing damage to one or two teeth of the anterior maxilla. The frontal tooth/teeth has/had to be extracted. The pulp of the extracted teeth of three patients and the root canal filling of one patient had to be removed. All patients were in...
Subsequent to tooth extraction, a resorption of the host bone as defined by atrophy of the alveolar ridge can be observed. Sutton et al. classified the different degrees of alveolar ridge atrophy [32]. Bone resorption especially occurs in the frontal and premolar area of the jaw in the region of the thin buccal lamella. This may lead to a change in contour [11, 28]. Physiological reason for this a...
Ridge preservation can be performed with autologous bone, alloplastic bone substitute material or a combination of both. Dentin is similar to bone in its chemical composition. In its use as bone substitute material, it undergoes a remodelling process and transforms to bone. The presented case report introduces a technique in which the extraction socket is augmented with autologous, particulated de...
Fig. 6. Micro CT scan images of the MDIs and Ankylos® embedded in rabbit bone 6 weeks post implantation
Fig. 6. Micro CT scan images of the MDIs and Ankylos® embedded in rabbit bone 6 weeks post implantation
Fig. 5. Histological section of standard implant in rabbit tibia stained with methylene blue and basic fuchsin
Fig. 5. Histological section of standard implant in rabbit tibia stained with methylene blue and basic fuchsin
Fig. 4. Histological section of mini dental implant in rabbit tibia stained with methylene blue and basic fuchsin
Fig. 4. Histological section of mini dental implant in rabbit tibia stained with methylene blue and basic fuchsin
Fig. 3. Histological sections being obtained with Leica SP 1600 saw microtome
Fig. 3. Histological sections being obtained with Leica SP 1600 saw microtome
Fig. 2. Leica SP 1600 saw microtome
Fig. 2. Leica SP 1600 saw microtome
Fig. 1. Radiograph showing implants in the rabbit tibia
Fig. 1. Radiograph showing implants in the rabbit tibia
BIC
3M™ ESPE™ MDIs
Ankylos® Friadent (Dentsply)
Median
58.5
57
Mean
57
56.5
Interquartile range
8
5.5
First quartile
53.25
53.75
Third quartile
61.25
59.25
Table 2 Descriptive statistics of the experimental and control group
Sample
3M™ESPE™ MDIs
Ankylos®
1.
67
54
2.
59
67
3.
54
45
4.
51
58
5.
47
57
6.
64
49
7.
50
54
8.
60
56
9.
56
60
10.
61
53
11.
62
59
12.
61
55
13.
59
59
14.
45
51
15.
58
59
16.
54
62
17.
66
62
18.
56
57
Table 1 Comparison of % BIC in both groups
Dhaliwal, J.S., Albuquerque, R.F., Murshed, M. et al. Osseointegration of standard and mini dental implants: a histomorphometric comparison. Int J Implant Dent 3, 15 (2017). https://doi.org/10.1186/s40729-017-0079-1
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Received: 22 February 2017
Accepted: 26 April 2017
Published: 01 May 2017
DOI: https://doi.org/10.1186/s40729-017-0079-1
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
This article was ammended to correct discrpencies in the Abstract. An erratum has also been published for this manuscript.
An erratum to this article is available at http://dx.doi.org/10.1186/s40729-017-0088-0.
Faculty of Dentistry, McGill University, 2001 McGill College Avenue, Suite 500, Montreal, Quebec, H3A 1G1, Canada
Jagjit S. Dhaliwal, Monzur Murshed & Jocelyne S. Feine
Faculty of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
Rubens F. Albuquerque Jr
Department of Medicine, McGill University, Montreal, Quebec, Canada
Monzur Murshed
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Schwartz Z, Lohmann CH, Oefinger J, Bonewald LF, Dean DD, Boyan BD. Implant surface characteristics modulate differentiation behavior of cells in the osteoblastic lineage. Adv Dent Res. 1999;13:38–48.
Boyan BD, Lossdorfer S, Wang L, Zhao G, Lohmann CH, Cochran DL, et al. Osteoblasts generate an osteogenic microenvironment when grown on surfaces with rough microtopographies. Eur Cell Mater. 2003...
Hayakawa T, Yoshinari M, Kiba H, Yamamoto H, Nemoto K, Jansen JA. Trabecular bone response to surface roughened and calcium phosphate (Ca-P) coated titanium implants. Biomaterials. 2002;23(4):1025–31.
Sul YT, Byon ES, Jeong Y. Biomechanical measurements of calcium-incorporated oxidized implants in rabbit bone: effect of calcium surface chemistry of a novel implant. Clin Implant Dent Relat Res. ...
Park JW, Kim HK, Kim YJ, An CH, Hanawa T. Enhanced osteoconductivity of micro-structured titanium implants (XiVE S CELLplus) by addition of surface calcium chemistry: a histomorphometric study in the rabbit femur. Clin Oral Implants Res. 2009;20(7):684–90.
Yang GL, He FM, Yang XF, Wang XX, Zhao SF. Bone responses to titanium implants surface-roughened by sandblasted and double etched treatments...
Buser D, Schenk RK, Steinemann S, Fiorellini JP, Fox CH, Stich H. Influence of surface characteristics on bone integration of titanium implants. A histomorphometric study in miniature pigs. J Biomed Mater Res. 1991;25(7):889–902.
Gotfredsen K, Wennerberg A, Johansson C, Skovgaard LT, Hjorting-Hansen E. Anchorage of TiO2-blasted, HA-coated, and machined implants: an experimental study with rabbi...
Trisi P, Lazzara R, Rao W, Rebaudi A. Bone-implant contact and bone quality: evaluation of expected and actual bone contact on machined and osseotite implant surfaces. Int J Periodontics Restorative Dent. 2002;22(6):535–45.
Froum SJ, Simon H, Cho SC, Elian N, Rohrer MD, Tarnow DP. Histologic evaluation of bone-implant contact of immediately loaded transitional implants after 6 to 27 months. In...
Hong RK, Heo JM, Ha YK. Lever-arm and mini-implant system for anterior torque control during retraction in lingual orthodontic treatment. Angle Orthod. 2005;75(1):129–41.
Mazor Z, Steigmann M, Leshem R, Peleg M. Mini-implants to reconstruct missing teeth in severe ridge deficiency and small interdental space: a 5-year case series. Implant Dent. 2004;13(4):336–41.
Siddiqui AA, Sosovicka M, Go...
Branemark PI, Adell R, Breine U, Hansson BO, Lindstrom J, Ohlsson A. Intra-osseous anchorage of dental prostheses. I. Experimental studies. Scand J Plast Reconstr Surg. 1969;3(2):81–100.
Boerrigter EM, Stegenga B, Raghoebar GM, Boering G. Patient satisfaction and chewing ability with implant-retained mandibular overdentures: a comparison with new complete dentures with or without preprosthetic ...
The results of this study show that MDIs as well as regular implants osseointegrate in rabbits.
Our study is also in concordance with the results of a removal torque study by Simon et al. [63] in immediately loaded “transitional endosseous implants” in humans. The percentage BIC for MDIs was similar to standard implants.
The surface topography also affects the BIC, Wennerberg et al. [32] measured and compared removal torque values on screw-shaped titanium implants with three surface typ...
The osseointegration potential of 3M™ESPE™ MDIs has not been studied. The MDI is a one-piece implant that simplifies the restorative phase resulting in a reduced cost for the patient. Titanium-aluminum-vanadium alloy (Ti 6Al-4V-ELI) is used for increased strength. The success of these implants led to its use in long-term fixed and removable dental prostheses [51]. Conventional implant treatmen...
On the whole, postoperative wound healing in all the rabbits was good. None of them exhibited any signs of wound infection or exposure. A total of 36 specimens were retrieved for histological examination.
All of the implants in both groups showed osseointegration and displayed a good amount of bone contact length (Figs. 4 and 5). No discernible differences were noticed between both the groups. T...
The saw blade has a thickness of 280 μm and a feed of 310 μm was selected to obtain the final section thickness of 30 μm. The knurled screw was used for the setting of the section thickness. The prepared section was finally removed from the saw blade. The specimens were prepared for histology by the method as described by Donath and Breuner [49].
Subsequently, the sections were stained with...
The specimens were dehydrated in the ascending graded ethanol solution and kept in a pre-filtration solution for 3 h at room temperature and then in the filtration solution at 4 °C for 17 h. The specimens were then embedded in a light curing resin Technovit 9100 NEW (Kulzer & Co., Wehrheim, Germany) polymerization system based on methyl methacrylate, specially developed for embedding mineraliz...
Expected length of the procedure was approximately 1 h. Following placement of the implants, the wound was sutured in layers. The underlying muscle, fascia, and dermal layers were sutured with the help of Vicryl (Polyglactin 910) suture with 3/8 circle reverse cutting needle. The skin was sutured to a primary closer with the same suture material.
Plain X-ray images of all the rabbit tibia were t...
A small longitudinal skin incision just distal to the tibia-femur joint was made. The tibia/femur head was exposed subperiosteally and an osteotomy performed with the delicately placed pilot drill over the entry point and lightly pumped up and down under copius saline irrigation just to enter the cortical bone for the MDIs. This was used for initial bone drilling to depth of 0.5 mm. The 3M™ESPE...
Nine clinically healthy New Zealand white rabbits weighing 3.5 kg and more were used for the study, and the animals were housed in the central animal house facility. The head of tibia/femur of the animals were used for the implantation of samples. Rabbits’ tibiae and femur have been widely used as an animal model by various other authors to study osseointegration of dental implants [36–45].
...
Despite the advantages of the mini dental implants, evidence on their efficacy and long-term success is lacking. The success of these implants will depend on their union with the surrounding bone. New implant systems entering into the market have to be studied with the help of animal models first, to demonstrate the osseointegration potential for their probable success in humans. There is a limite...
The term “osseointegration” was first introduced to explain the phenomenon for stable fixation of titanium to bone by Brånemark et al. in the 1960s [1]. Osseointegrated implants were introduced, a new era in oral rehabilitation began, and many studies were conducted [2, 3]. A success rate of over 90% has been reported [4, 5]. Further, a success rate of 81% in the maxillary bone and 91% in the...
Mini dental implants (MDIs) are becoming increasingly popular for rehabilitation of edentulous patients because of their several advantages. However, there is a lack of evidence on the osseointegration potential of the MDIs. The objective of the study was to histomorphometrically evaluate and compare bone apposition on the surface of MDIs and standard implants in a rabbit model.
Nine New Zealand ...
Fig. 6. Histomorphometric evaluation results (considering six sections for each biopsy), for newly formed bone, soft tissues, and others
Fig. 6. Histomorphometric evaluation results (considering six sections for each biopsy), for newly formed bone, soft tissues, and others
Fig. 5. Histomicrograph of a biopsy from the BC + EMD group, showing an aspect of newly formed bone. Section stained with picrosirius-hematoxylin and digitalized with bright-field (d) and linearly polarized light (e and f). e, f Results of near 45° section rotation (between axes B–B’ and C–C’) to compensate some of the orientation-related effects associated with linearly polarized l...
Fig. 4. Histomicrograph of a biopsy from the BC group, showing an aspect of newly formed bone. Section stained with picrosirius-hematoxylin and digitalized with bright-field (a) and linearly polarized light (b and c). b, c Results of near 45° section rotation (between axes B–B’ and C–C’) to compensate some of the orientation-related effects associated with linearly polarized light. In a...
Fig. 3. Histomicrograph of a biopsy from the BC + EMD group. Overview—×25 magnification; b ×30 magnification; c ×60 magnification. Areas corresponding to BC + EMD removed during histological processing (square) surrounded by newly formed bone (asterisk), with large numbers of osteocytes and soft tissue (arrow) can be observed. There is direct contact between the BC reminiscent, soft...
Fig. 2. Histomicrograph of a biopsy from the BC group. a Overview—×25 magnification; b ×30 magnification; c ×60 magnification. Areas corresponding to BC removed during histological processing (square) in direct contact with newly formed bone (asterisk), containing a large number of osteocytes, and with soft tissue (arrow) can be observed (hematoxylin-eosin stain)
Fig. 2. Histomicrograph ...
Fig. 1. Histomicrograph illustrating the various tissue areas measured on the sections: newly formed bone (green mask), soft tissues (purple mask), and “others”, including residual bone substitute particles and empty spaces either due to removal of the bone substitute particles during to the decalcification processing or due to artifacts (white mask)
Fig. 1. Histomicrograph illustrating t...
Nery, J.C., Pereira, L.A.V.D., Guimarães, G.F. et al. β-TCP/HA with or without enamel matrix proteins for maxillary sinus floor augmentation: a histomorphometric analysis of human biopsies.
Int J Implant Dent 3, 18 (2017). https://doi.org/10.1186/s40729-017-0080-8
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Received: 08 December 2016
Accepted: 22 April 2017
Published: 04 May 2017
DOI: https://do...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
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Correspondence to
James Carlos Nery.
Department of Implantology, São Leopoldo Mandic Research Center, Brasília, DF, Brazil
James Carlos Nery, George Furtado Guimarães & Fabiana Mantovani Gomes França
Department of Biochemistry and Tissue Biology, UNICAMP – State University of Campinas, Institute of Biology, Campinas, São Paulo, Brazil
Luís Antônio Violin Dias Pereira
Department of Periodontology, UNESP – Univ. Estad...
Wikesjo UM, Sorensen RG, Kinoshita A, Wozney JM. RhBMP-2/alphaBSM induces significant vertical alveolar ridge augmentation and dental implant osseointegration. Clin Implant Dent Relat Res. 2002;4:174–82.
Carinci F, Brunelli G, Franco M, Viscioni A, Rigo L, Guidi R, et al. A retrospective study on 287 implants installed in resorbed maxillae grafted with fresh frozen allogenous bone. Clin Implant...
Miron RJ, Sculean A, Cochran DL, Froum S, Zucchelli G, Nemcovsky C, et al. Twenty years of enamel matrix derivative: the past, the present and the future. J Clin Periodontol. 2016;43:668–83.
Sculean A, Nikolidakis D, Nikou G, Ivanovic A, Chapple IL, Stavropoulos A. Biomaterials for promoting periodontal regeneration in human intrabony defects: a systematic review. Periodontol 2000. 2015;68:182...
Esposito M, Felice P, Worthington HV. Interventions for replacing missing teeth: augmentation procedures of the maxillary sinus. Cochrane Database Syst Rev. 2014;17:CD008397.
Jungner M, Cricchio G, Salata LA, Sennerby L, Lundqvist C, Hultcrantz M, et al. On the early mechanisms of bone formation after maxillary sinus membrane elevation: an experimental histological and immunohistochemical study. ...
The present study showed that maxillary sinus floor augmentation with BC resulted in adequate amounts of new bone formation allowing successful implant installation, while adding EMD did not have a significant effect.
Nevertheless, the amount of bone generated with BC or BC + EMD herein was adequate to support successful implant placement and osseointegration of implants. In fact, more or less similar amounts of bone formation have been reported in studies evaluating human sinus biopsies after grafting with a variety of biomaterials (bone formation ranging approximately from 30 to 50%) [19]. On the other ha...
The present study compared the histological and histomorphometrical outcome of healing after maxillary sinus floor augmentation with BC with or without EMD, based on human biopsies. The results showed that addition of EMD did not enhance the outcome of healing, neither in terms of quality nor quantity of new bone. Nevertheless, the amount of bone generated after maxillary sinus floor augmentation ...
All ten patients showed uneventful healing after the sinus floor augmentation procedure as well as after dental implant placement, with no overt postoperative inflammation or infection. Consistently, in all ten patients, no significant jiggling of the drill was noticed during biopsy harvesting, while subjective drilling resistance during implant placement was similar in both groups and all implant...
The data for each tissue component from the three histological sections were averaged to represent the biopsy. Commercially available software (GraphPad Prism 5.0 for Windows, GraphPad Software Inc., USA) was utilized for statistical comparisons between groups and for drawing the graphics. The assumption of normality was checked using D’Agostino & Pearson omnibus test. The data for each evaluate...
Six months after grafting, another CBCT examination was carried out for implant planning. In the sequence, following the previously described antiseptic and anesthetic procedures, two implants with a sand-blasted and acid etching surface were installed in each of the grafted sinuses, i.e., 40 implants in total (32—Neoporous, Neodent, Curitiba, Paraná, Brazil; 8—SLA, Straumann, Basel, Switzerl...
This research project was approved by the Ethics Committee of the School of Dentistry and Dental Research Center São Leopoldo Mandic, Brazil, under the protocol 2010/0360.
Ten consecutive patients (age range 35–75 years) with the need of bilateral maxillary sinus floor augmentation prior to the placement of four dental implants (two in each side of posterior maxilla) were selected for the stu...
The aim of the present study was to compare histomorphometrically the outcome of maxillary sinus floor augmentation with β-TCP/HA with or without enamel matrix proteins (BC + EMD and EMD, respectively) in humans.
Reconstruction of the edentulous and severely atrophied posterior maxilla is often performed by means of maxillary sinus floor augmentation in combination with dental implants [1, 2]. Various bone graft materials are typically used for enhancing bone formation within the sinus cavity; autogenous bone (AB) is considered as the gold standard due to its osteogenic, osteoinductive, and osteoconductive...
It is still unclear whether enamel matrix proteins (EMD) as adjunct to bone grafting enhance bone healing. This study compared histomorphometrically maxillary sinus floor augmentation (MSFA) with β-TCP/HA in combination with or without EMD in humans.
In ten systemically healthy patients needing bilateral MSFA, one side was randomly treated using β-TCP/HA mixed with EMD (BC + EMD) and the ot...
Fig. 7. Nine-year follow-up radiograph of the implants
Fig. 7. Nine-year follow-up radiograph of the implants
Fig. 6. Application of final fixed prosthesis
Fig. 6. Application of final fixed prosthesis
Fig. 5. Plate removal and insertion of two implants 6 months after grafting
Fig. 5. Plate removal and insertion of two implants 6 months after grafting
Fig. 4. Preoperative and postoperative radiograph
Fig. 4. Preoperative and postoperative radiograph
ed
Fig. 3. a A paracrestal incision was made on the buccal side, and horizontal and vertical osteotomies were made with a piezo-electric device. b Placement of the ramus bone block as an interpositional graft. c Ramus bone graft fixed
Fig. 2. Septa and thickened sinus membrane within maxillary sinus
Fig. 2. Septa and thickened sinus membrane within maxillary sinus
Fig. 1. Preoperative intraoral photograph and radiograph
Fig. 1. Preoperative intraoral photograph and radiograph
Tanaka, K., Sailer, I., Kataoka, Y. et al. Sandwich bone graft for vertical augmentation of the posterior maxillary region: a case report with 9-year follow-up. Int J Implant Dent 3, 20 (2017). https://doi.org/10.1186/s40729-017-0063-9
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Received: 15 October 2016
Accepted: 13 January 2017
Published: 19 May 2017
DOI: https://doi.org/10.1186/s40729-017-0063-9
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Division of Oral and Maxillofacial Surgery, Department of Oral Medicine and Surgery, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai, 980-8575, Miyagi, Japan
Kenko Tanaka, Yoshihiro Kataoka, Shinnosuke Nogami & Tetsu Takahashi
Division of Fixed Prosthodontics and Biomaterials Clinic of Dental Medicine, University of Geneva, 19 rue Barthélemy-Menn, CH-1205, ...
The authors thank Atumu Kouketu for his figure illustration support and Kouhei Shinmyouzu for the clinical support.
Authors Kenko Tanaka, Irena Sailer, Yoshihiro Kataoka, Shinnosuke Nogami, and Tetsu Takahashi declare that they have no competing interests.
Thoma DS, Zeltner M, Hüsler J, Hämmerle CH, Jung RE, EAO Supplement Working Group 4 - EAO CC. Short implants versus sinus lifting with longer implants to restore the posterior maxilla: a systematic review. Clin Oral Implants Res. 2015;26:154–169.
Lee SA, Lee CT, Fu MM, Elmisalati W, Chuang SK. Systematic review and meta-analysis of randomized controlled trials for the management of limited ve...
Adell R, Brånemark PI. A 15-year study of osseointegrated implant in the treatment of the edentulous jaw. Int J Oral Maxillofac Surg. 1981;10:387–416.
Albrektsson T, Zarb G, Worthington P, Eriksson AR. The long-term efficacy of currently used dental implants: a review and proposed criteria of success. Int J Oral Maxillofac Implants. 1986;1:11–25.
Cordo L, Terheyden H. ITI treatment guide vo...
We described in the present case a vertical lack of the bone from the alveolar ridge to the opposing teeth, the short distance from the reabsorbed ridge to the floor of the maxillary sinus, and the presence of septa and a thickened sinus membrane within the maxillary sinus. A sandwich bone graft was successfully applied and followed up in the long term. The resulting gains in ridge height and incr...
In this case, the alveolar ridge was Seibert class II, and septa and a thickened sinus membrane were evident within the maxillary sinus. Sinus floor elevation was limited because of the condition of the floor morphology, the presence of septa, and the thickness of sinus floor membrane [22, 23]. Considering these issues, we selected the interpositional bone graft technique using autologous bone in ...
This paper reports on a segmental osteotomy procedure with an interpositional graft in the posterior maxillary region with 9 years of follow-up.
The techniques used to overcome a lack of alveolar bone height rely on the placement supplemented by various vertical guided bone regeneration (GBR) procedures [4, 5] and the use of alveolar distraction osteogenesis [6], titanium mesh [7], or onlay bone...
Six months after surgery, radiological examinations were carried out and the patient underwent implant placement (Fig. 4). The postoperative bone height had increased to 10.1 mm at position 26 and 12.9 mm at position 27 compared with the preoperative heights of 6.1 and 7.5 mm, respectively. Postoperative clearance was reduced by 11 mm compared with the preoperative clearance. Careful separati...
A 67-year-old male patient sought implant rehabilitation for the purposes of restoration of occlusal support and assistance with chewing difficulties. Clinical and radiological examinations revealed that teeth were absent 26–27. The clearance from the alveolar ridge to the opposing teeth was 20 mm (Fig. 1). A CT scan showed that the distance from the reabsorbed ridge to the floor of the maxill...
In the literature, the technique of segmental osteotomy accompanied by interpositional grafting has been reported as a practical and predictable procedure with a low incidence of complications and a high probability of success [15,16,17,18,19]. This approach leaves the soft tissue on the oral side of the midcrestal incision attached to the crestal bone segment. Various studies have shown that alve...
Osseointegrated implants for the replacement of missing teeth have recently become a routine treatment option [1, 2]. However, any tooth loss may be followed by extensive resorption of the alveolar ridge, which usually makes implant placement difficult or impossible because of the lack of bone volume. There are a variety of defect situations with increasing complexity, ranging from fenestrations, ...
The loss of teeth followed by bone resorption often lead to defects in the alveolar ridge, making installation of dental implants difficult. Correction of such bone defects, especially lack of height of the ridge, is a difficult problem for all dental surgeons. This report describes the outcome of treatment after alveolar ridge augmentation in the atrophic posterior maxillary region via segmental ...
Fig. 6. Histomorphometric evaluation results (considering six sections for each biopsy), for newly formed bone, soft tissues, and others
Fig. 6. Histomorphometric evaluation results (considering six sections for each biopsy), for newly formed bone, soft tissues, and others
Fig. 5. Histomicrograph of a biopsy from the BC + EMD group, showing an aspect of newly formed bone. Section stained with picrosirius-hematoxylin and digitalized with bright-field (d) and linearly polarized light (e and f). e, f Results of near 45° section rotation (between axes B–B’ and C–C’) to compensate some of the orientation-related effects associated with linearly polarized l...
Fig. 4. Histomicrograph of a biopsy from the BC group, showing an aspect of newly formed bone. Section stained with picrosirius-hematoxylin and digitalized with bright-field (a) and linearly polarized light (b and c). b, c Results of near 45° section rotation (between axes B–B’ and C–C’) to compensate some of the orientation-related effects associated with linearly polarized light. In a...
Fig. 3. Histomicrograph of a biopsy from the BC + EMD group. Overview—×25 magnification; b ×30 magnification; c ×60 magnification. Areas corresponding to BC + EMD removed during histological processing (square) surrounded by newly formed bone (asterisk), with large numbers of osteocytes and soft tissue (arrow) can be observed. There is direct contact between the BC reminiscent, soft...
Fig. 2. Histomicrograph of a biopsy from the BC group. a Overview—×25 magnification; b ×30 magnification; c ×60 magnification. Areas corresponding to BC removed during histological processing (square) in direct contact with newly formed bone (asterisk), containing a large number of osteocytes, and with soft tissue (arrow) can be observed (hematoxylin-eosin stain)
Fig. 2. Histomicrograph ...
Fig. 1. Histomicrograph illustrating the various tissue areas measured on the sections: newly formed bone (green mask), soft tissues (purple mask), and “others”, including residual bone substitute particles and empty spaces either due to removal of the bone substitute particles during to the decalcification processing or due to artifacts (white mask)
Fig. 1. Histomicrograph illustrating t...
Nery, J.C., Pereira, L.A.V.D., Guimarães, G.F. et al. β-TCP/HA with or without enamel matrix proteins for maxillary sinus floor augmentation: a histomorphometric analysis of human biopsies.
Int J Implant Dent 3, 18 (2017). https://doi.org/10.1186/s40729-017-0080-8
Download citation
Received: 08 December 2016
Accepted: 22 April 2017
Published: 04 May 2017
DOI: https://do...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
You can also search for this author in
PubMed Google Scholar
Correspondence to
James Carlos Nery.
Department of Implantology, São Leopoldo Mandic Research Center, Brasília, DF, Brazil
James Carlos Nery, George Furtado Guimarães & Fabiana Mantovani Gomes França
Department of Biochemistry and Tissue Biology, UNICAMP – State University of Campinas, Institute of Biology, Campinas, São Paulo, Brazil
Luís Antônio Violin Dias Pereira
Department of Periodontology, UNESP – Univ. Estad...
Wikesjo UM, Sorensen RG, Kinoshita A, Wozney JM. RhBMP-2/alphaBSM induces significant vertical alveolar ridge augmentation and dental implant osseointegration. Clin Implant Dent Relat Res. 2002;4:174–82.
Carinci F, Brunelli G, Franco M, Viscioni A, Rigo L, Guidi R, et al. A retrospective study on 287 implants installed in resorbed maxillae grafted with fresh frozen allogenous bone. Clin Implant...
Miron RJ, Sculean A, Cochran DL, Froum S, Zucchelli G, Nemcovsky C, et al. Twenty years of enamel matrix derivative: the past, the present and the future. J Clin Periodontol. 2016;43:668–83.
Sculean A, Nikolidakis D, Nikou G, Ivanovic A, Chapple IL, Stavropoulos A. Biomaterials for promoting periodontal regeneration in human intrabony defects: a systematic review. Periodontol 2000. 2015;68:182...
Esposito M, Felice P, Worthington HV. Interventions for replacing missing teeth: augmentation procedures of the maxillary sinus. Cochrane Database Syst Rev. 2014;17:CD008397.
Jungner M, Cricchio G, Salata LA, Sennerby L, Lundqvist C, Hultcrantz M, et al. On the early mechanisms of bone formation after maxillary sinus membrane elevation: an experimental histological and immunohistochemical study. ...
The present study showed that maxillary sinus floor augmentation with BC resulted in adequate amounts of new bone formation allowing successful implant installation, while adding EMD did not have a significant effect.
Nevertheless, the amount of bone generated with BC or BC + EMD herein was adequate to support successful implant placement and osseointegration of implants. In fact, more or less similar amounts of bone formation have been reported in studies evaluating human sinus biopsies after grafting with a variety of biomaterials (bone formation ranging approximately from 30 to 50%) [19]. On the other ha...
The present study compared the histological and histomorphometrical outcome of healing after maxillary sinus floor augmentation with BC with or without EMD, based on human biopsies. The results showed that addition of EMD did not enhance the outcome of healing, neither in terms of quality nor quantity of new bone. Nevertheless, the amount of bone generated after maxillary sinus floor augmentation ...
All ten patients showed uneventful healing after the sinus floor augmentation procedure as well as after dental implant placement, with no overt postoperative inflammation or infection. Consistently, in all ten patients, no significant jiggling of the drill was noticed during biopsy harvesting, while subjective drilling resistance during implant placement was similar in both groups and all implant...
The data for each tissue component from the three histological sections were averaged to represent the biopsy. Commercially available software (GraphPad Prism 5.0 for Windows, GraphPad Software Inc., USA) was utilized for statistical comparisons between groups and for drawing the graphics. The assumption of normality was checked using D’Agostino & Pearson omnibus test. The data for each evaluate...
Six months after grafting, another CBCT examination was carried out for implant planning. In the sequence, following the previously described antiseptic and anesthetic procedures, two implants with a sand-blasted and acid etching surface were installed in each of the grafted sinuses, i.e., 40 implants in total (32—Neoporous, Neodent, Curitiba, Paraná, Brazil; 8—SLA, Straumann, Basel, Switzerl...
This research project was approved by the Ethics Committee of the School of Dentistry and Dental Research Center São Leopoldo Mandic, Brazil, under the protocol 2010/0360.
Ten consecutive patients (age range 35–75 years) with the need of bilateral maxillary sinus floor augmentation prior to the placement of four dental implants (two in each side of posterior maxilla) were selected for the stu...
The aim of the present study was to compare histomorphometrically the outcome of maxillary sinus floor augmentation with β-TCP/HA with or without enamel matrix proteins (BC + EMD and EMD, respectively) in humans.
Reconstruction of the edentulous and severely atrophied posterior maxilla is often performed by means of maxillary sinus floor augmentation in combination with dental implants [1, 2]. Various bone graft materials are typically used for enhancing bone formation within the sinus cavity; autogenous bone (AB) is considered as the gold standard due to its osteogenic, osteoinductive, and osteoconductive...
It is still unclear whether enamel matrix proteins (EMD) as adjunct to bone grafting enhance bone healing. This study compared histomorphometrically maxillary sinus floor augmentation (MSFA) with β-TCP/HA in combination with or without EMD in humans.
In ten systemically healthy patients needing bilateral MSFA, one side was randomly treated using β-TCP/HA mixed with EMD (BC + EMD) and the ot...
Tanaka, K., Sailer, I., Kataoka, Y. et al. Sandwich bone graft for vertical augmentation of the posterior maxillary region: a case report with 9-year follow-up.
Int J Implant Dent 3, 20 (2017). https://doi.org/10.1186/s40729-017-0063-9
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Received: 15 October 2016
Accepted: 13 January 2017
Published: 19 May 2017
DOI: https://doi.org/10.1186/s40729-017-0063-...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Division of Oral and Maxillofacial Surgery, Department of Oral Medicine and Surgery, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai, 980-8575, Miyagi, Japan
Kenko Tanaka, Yoshihiro Kataoka, Shinnosuke Nogami & Tetsu Takahashi
Division of Fixed Prosthodontics and Biomaterials Clinic of Dental Medicine, University of Geneva, 19 rue Barthélemy-Menn, CH-1205, ...
The authors thank Atumu Kouketu for his figure illustration support and Kouhei Shinmyouzu for the clinical support.
Authors Kenko Tanaka, Irena Sailer, Yoshihiro Kataoka, Shinnosuke Nogami, and Tetsu Takahashi declare that they have no competing interests.
Thoma DS, Zeltner M, Hüsler J, Hämmerle CH, Jung RE, EAO Supplement Working Group 4 - EAO CC. Short implants versus sinus lifting with longer implants to restore the posterior maxilla: a systematic review. Clin Oral Implants Res. 2015;26:154–169.
Lee SA, Lee CT, Fu MM, Elmisalati W, Chuang SK. Systematic review and meta-analysis of randomized controlled trials for the management of limited ve...
Adell R, Brånemark PI. A 15-year study of osseointegrated implant in the treatment of the edentulous jaw. Int J Oral Maxillofac Surg. 1981;10:387–416.
Albrektsson T, Zarb G, Worthington P, Eriksson AR. The long-term efficacy of currently used dental implants: a review and proposed criteria of success. Int J Oral Maxillofac Implants. 1986;1:11–25.
Cordo L, Terheyden H. ITI treatment guide vo...
We described in the present case a vertical lack of the bone from the alveolar ridge to the opposing teeth, the short distance from the reabsorbed ridge to the floor of the maxillary sinus, and the presence of septa and a thickened sinus membrane within the maxillary sinus. A sandwich bone graft was successfully applied and followed up in the long term. The resulting gains in ridge height and incr...
In this case, the alveolar ridge was Seibert class II, and septa and a thickened sinus membrane were evident within the maxillary sinus. Sinus floor elevation was limited because of the condition of the floor morphology, the presence of septa, and the thickness of sinus floor membrane [22, 23]. Considering these issues, we selected the interpositional bone graft technique using autologous bone in ...
This paper reports on a segmental osteotomy procedure with an interpositional graft in the posterior maxillary region with 9 years of follow-up.
The techniques used to overcome a lack of alveolar bone height rely on the placement supplemented by various vertical guided bone regeneration (GBR) procedures [4, 5] and the use of alveolar distraction osteogenesis [6], titanium mesh [7], or onlay bone...
Six months after surgery, radiological examinations were carried out and the patient underwent implant placement (Fig. 4). The postoperative bone height had increased to 10.1 mm at position 26 and 12.9 mm at position 27 compared with the preoperative heights of 6.1 and 7.5 mm, respectively. Postoperative clearance was reduced by 11 mm compared with the preoperative clearance. Careful separati...
A 67-year-old male patient sought implant rehabilitation for the purposes of restoration of occlusal support and assistance with chewing difficulties. Clinical and radiological examinations revealed that teeth were absent 26–27. The clearance from the alveolar ridge to the opposing teeth was 20 mm (Fig. 1). A CT scan showed that the distance from the reabsorbed ridge to the floor of the maxill...
In the literature, the technique of segmental osteotomy accompanied by interpositional grafting has been reported as a practical and predictable procedure with a low incidence of complications and a high probability of success [15,16,17,18,19]. This approach leaves the soft tissue on the oral side of the midcrestal incision attached to the crestal bone segment. Various studies have shown that alve...
Osseointegrated implants for the replacement of missing teeth have recently become a routine treatment option [1, 2]. However, any tooth loss may be followed by extensive resorption of the alveolar ridge, which usually makes implant placement difficult or impossible because of the lack of bone volume. There are a variety of defect situations with increasing complexity, ranging from fenestrations, ...
The loss of teeth followed by bone resorption often lead to defects in the alveolar ridge, making installation of dental implants difficult. Correction of such bone defects, especially lack of height of the ridge, is a difficult problem for all dental surgeons. This report describes the outcome of treatment after alveolar ridge augmentation in the atrophic posterior maxillary region via segmental ...
Fig. 7 Second stage surgery of patient in Fig. 1. a Vestibular depth reduction after augmentation and implant placement. b Partial thickness and apical repositioned flap. c CMX healing and soft tissue dehiscence with CCXBB exposure. d Dehiscence healing after re-contouring and buccal emergency profile. e Buccal aspect of the final restoration. f Buccal ridge contour
Fig. 6 Immunohistochemical analysis of slices from the same sample with four different markers. a TRAP. b OPN. c ALP. d OSC
Fig. 5. Survival rate of dental implants after autologous bone augmentation
Fig. 5. Survival rate of dental implants after autologous bone augmentation
Fig. 4. Postoperative nerve alterations. Single asterisk, N refers to the total number of the surgical approaches in the mandible (N = 155). Double asterisk, N refers to the total number of the surgical approaches in the maxilla (N = 225)
Fig. 4. Postoperative nerve alterations. Single asterisk, N refers to the total number of the surgical approaches in the mandible (N = 155). Dou...
Fig. 3. Surgical outcome after autologous augmentation procedures from different donor sites
Fig. 3. Surgical outcome after autologous augmentation procedures from different donor sites
Fig. 2. Survival rate of autologous bone grafts
Fig. 2. Survival rate of autologous bone grafts
Fig. 1. Postoperative complications at the donor and recipient site, N refers to the total number of the donor sites (N = 300), N refers to the total number of the recipient sites (N = 378)
Fig. 1. Postoperative complications at the donor and recipient site, N refers to the total number of the donor sites (N = 300), N refers to the total number of the recipient sites (N = 378)
Postoperative complications
%/procedures (N)
At donor sitea
Wound infection
2.6% (8/300)
At recipient site...
Donor site
Bone grafts (N)/patients (N)
Lateral zygomatic buttress
113/112
Mandibular ramus (retromolar)
...
Patient characteristics
N (%)
Gendera
Male
250 (89.6%)
Female
29 (10.4%)
...
Sakkas, A., Wilde, F., Heufelder, M. et al. Autogenous bone grafts in oral implantology—is it still a “gold standard”? A consecutive review of 279 patients with 456 clinical procedures.
Int J Implant Dent 3, 23 (2017). https://doi.org/10.1186/s40729-017-0084-4
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Received: 27 February 2017
Accepted: 22 May 2017
Published: 01 June 2017
DOI: https://doi...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Department of Oral and Plastic Maxillofacial Surgery, Military Hospital Ulm, Academic Hospital of the University of Ulm, Oberer Eselsberg 40, 89081, Ulm, Germany
Andreas Sakkas, Frank Wilde, Marcus Heufelder & Alexander Schramm
Institute of Anatomy, Medical Faculty of Leipzig University, Leipzig, Germany
Karsten Winter
Department of Oral and Plastic Maxillofacial Surgery, University Hospit...
The authors thank the patients for their kindness to participate as study cases and the whole medical team at the Bundeswehrkrankenhaus Ulm.
AS participated in its design and coordination, carried out the data selection, and drafted the manuscript, and is the corresponding author. FW participated in its design and coordination and helped in drafting the manuscript. MH participated in its design a...
Semper W, Kraft S, Mehrhof J, Nelson K. Impact of abutment rotation and angulation on marginal fit: theoretical considerations. Int J Oral Maxillofac Implants. 2010;25:752–8.
Wiltfang J, Jätschmann N, Hedderich J, Neukam FW, Schlegel KA, Gierloff M. Effect of deproteinized bovine bone matrix coverage on the resorption of iliac cortico-spongeous bone grafts—a prospective study of two cohorts....
Chiapasco M, Zaniboni M. Clinical outcomes of GBR procedures to correct peri-implant dehiscences and fenestrations: a systematic review. Clin Oral Implants Res. 2009;20:113–23.
Felice P, Pellegrino G, Checchi L, Pistilli R, Esposito M. Vertical augmentation with interpositional blocks of anorganic bovine bone vs. 7-mm-long implants in posterior mandibles: 1-year results of a randomized clinical...
Verdugo F, Castillo A, Moragues MD, Pontón J. Bone microbial contamination influences autogenous grafting in sinus augmentation. J Periodontol. 2009;80:1355–64.
Wiltfang J, Schultze-Mosgau S, Merten HA, Kessler P, Ludwig A, Engelke W. Endoscopic and ultrasonographic evaluation of the maxillary sinus after combined sinus floor augmentation and implant insertion. Oral Surg Oral Med Oral Pathol O...
von Arx T, Buser D. Horizontal ridge augmentation using autogenous block grafts and the guided bone regeneration technique with collagen membranes: a clinical study with 42 patients. Clin Oral Implants Res. 2006;17:359–66.
Levin L, Nitzan D, Schwartz-Arad D. Success of dental implants placed in intraoral block bone grafts. J Periodontol. 2007;78:18–21.
Andersson L. Patient self-evaluation of...
Aghaloo TL, Moy PK. Which hard tissue augmentation techniques are the most successful in furnishing bony support for implant placement? Int J Oral Maxillofac Implants. 2007;22:49–70.
Margonar R, dos Santos PL, Queiroz TP, Marcantonio E. Rehabilitation of atrophic maxilla using the combination of autogenous and allogeneic bone grafts followed by protocol-type prosthesis. J Craniofac Surg. 2010;2...
Schwartz-Arad D, Dori S. Intraoral autogenous onlay block bone grafting for implant dentistry. Refuat Hapeh Vehashinayim. 2002;19:35–9. 77.
Misch CM. Ridge augmentation using mandibular ramus bone grafts for the placement of dental implants: presentation of a technique. Pract Periodontics Aesthet Dent. 1996;8:127–35.
Altiparmak N, Soydan SS, Uckan S. The effect of conventional surgery and pi...
Jensen AT, Jensen SS, Worsaae N. Complications related to bone augmentation procedures of localized defects in the alveolar ridge. A retrospective clinical study. Oral Maxillofac Surg. 2016;20(2):115–22 [Epub ahead of print].
Buser D, Dula K, Hirt HP, Schenk RK. Lateral ridge augmentation using autografts and barrier membranes: clinical study with 40 partially edentulous patients. J Oral Maxill...
The results of the clinical study proves the reliability and low comorbidity of autologous bone grafts in preprosthetic alveolar ridge reconstructions prior to implant insertion. The high graft success rate (95.6%) and the low early implant failure rate (0.38%) in a surveillance of all patients treated in three following years with this technique showing no exclusion and no dropout of any case for...
Data on risk factors based on the original examination and documentation are difficult to assess the adverse effects of variable factors on the surgical prognosis because of the multifactorial genesis of surgical complications [73]. Factors such as gender, age, or smoking habit could be associated with postoperative complications after two-stage dentoalveolar reconstruction with autologous bone gr...
The results of the present study have to take into account the absence of a control group with patients undergoing bone augmentation procedures with bone substitutes (allogen, alloplastic, exogen). Without a comparative group of grafting surgeries using alternative bone material, only limited statements can be made.
However, the excellent surgical outcome of autologous surgical methods providing ...
The use of autologous bone in this study has shown excellent graft survival and success rate (95.6%). This is equal to the results from the studies on implants inserted in reconstructed sites [6, 8, 24]. The early implant survival rate of 99.7% found in the present material is very high comparable to that in the previous systematic reviews after staged horizontal ridge augmentation [9, 10, 22, 62,...
Of the sinus floor elevations performed in this study, 84.8% were defined absolutely successful. Only two of our 72 patients having sinus lift operations could not finally be treated with dental implants. These results are comparable to other studies considering the sinus graft to be a safe treatment modality with few complications [6, 8, 51,52,53]. Raghoebar et al. reported incidences of sinus co...
Postoperative morbidity after mandibular bone harvesting procedures was reported to be mainly related to temporary or permanent neural disturbances involving the inferior alveolar nerve and its branches [19]. In this study, only the incidence of the temporary hypoesthesia of the mandibular and lingual nerve after harvesting from the retromolar area could be detected. It was 10.4 and 2.8%, respecti...
Systematic reviews have failed to find evidence that one particular grafting technique is superior to others [10]. Intraoral bone grafts from the mandibular symphysis, mandibular ramus, and maxillary tuberosity provide a good treatment modality for ridge augmentation, and the amount of bone available for harvesting is sufficient for defects up to the width of three teeth [42]. Harvesting of retrom...
Several grafting procedures have been described to create sufficient volume of bone for implant placement [8, 9]. Autologous bone grafts can be harvested by an intraoral approach (mandibular ramus, mandibular symphysis, zygomatic buttress) or from distant sites (iliac crest, calvaria, and etc.) [17, 36, 37]. However, bone harvesting potentially causes donor site morbidity which is a major issue fo...
The average healing period until implant placement after bone harvesting was 4.53 months. Initially, 546 implants in 279 patients were planned. After the healing period, it was possible to place 525 implants in 436 successfully augmented areas in 259 patients. Three hundred implants were inserted in the maxilla and 225 in the mandible. The remaining 21 implants planned for 20 patients could not b...
Regarding intraoperative complications, all sinus membrane perforations were covered with a resorbable collagen membrane (Bio-Gide®, Geistlich Biomaterials, Baden-Baden, Germany) which applied as sealant to overlap the site of perforation prior to insertion of the graft material. These patients were advised to avoid physical stress, blowing their noses, or sneezing for a period of 3 weeks, and n...
No permanent damage to any trigeminal nerves was evident in any of our entire cohort. All cases of postoperative hypoesthesia of the mental, lingual, or infraorbital nerve were just a temporary nature. At the time of implant surgery, none of these patients reported any persisting neural disturbances (Fig. 4).
In eleven patients, hypoesthesia of the mental area was mentioned, and three of them al...
Thirty-eight patients underwent a total of 116 augmentation procedures harvesting from the iliac crest. In 20 patients, a bone graft augmentation of the maxilla and the mandible in combination with bilateral sinus floor augmentations was performed. Eighteen patients had augmentations only in the maxilla, involving bone grafting and sinus lift elevations. Totally, 76 sinus lifts with bone material ...
In six patients, a partial graft resorption was detected at the time of implantation and an additional simultaneous augmentation with bone chips harvested with the Safescraper device (C.G.M. S.p.A., Divisione Medicale META, Italy) was then necessary in order to ensure the osseointegration of the implants. Two out of these six cases had grafts from the crista zygomatico-alveolaris, two from the ram...
A total of 112 sinus floor elevations were performed. In all of the cases, implants were inserted in a two-stage procedure. The donor site for harvesting the bone for the sinus elevations was in 76 procedures in the iliac crest area, and in 36 procedures, the bone was harvested with a bone scraper device from the lateral sinus wall at the site of sinus lifting.
The distribution and number of tran...
Two hundred seventy-nine patients—250 men and 29 women—underwent 456 augmentation procedures involving autologous bone grafts prior to implant placement. The patients ranged in age from 18.5 to 71.5 years (average 43.1 years) at the moment of augmentation surgery.
Of those patients, 162 (58.1%) were younger than 40 years of age and 117 (41.9%) were older than 40 years of age. Caries or pe...
Early and late implant loss was documented in this study, defining the clinical success of osseointegration. Early implant failures were assessed before the acquisition of osseointegration, i.e., before the placement of prosthodontic restorations. Early implant failure could occur from the time of placement, during the healing phase and before abutment connection. The implant inserted after re-aug...
Medical history of patient
Age of patient at the time of bone harvesting and augmentation
History of periodontal disease
Smoking habits
Donor site
Jaw area and dental situation of the recipient site
Intraoperative complications
Postoperative complications after augmentation
Management of complications
Bone graft stability and clinical resorption prior to implant placement
Complications a...
In addition to the bone already gained with the bone scraper device from the sinus wall during the antrostomy, bone was harvested with the same device from the maxillary buccal buttress, if more volume was needed. By taking this approach, the collection of enough bone for the augmentation of at least two implantation sites was feasible with a mean surgical time of 5 to 10 min for harvesting. In c...
Grafting from the iliac crest was always performed under general anesthesia in a two-team approach. The iliac crest was exposed and autogenous grafts from the anterosuperior inner edge of the iliac wing were harvested with an oscillating saw and/or a chisel, keeping a safe distance of around 2 cm from the anterosuperior iliac spine. After harvesting the bone grafts, the corticocancellous bone blo...
A standardized two-stage surgical protocol was used, and all sites were treated in a similar fashion. In the first intervention, a bone block harvested from the donor site was fixed with osteosynthesis titanium screws to the recipient site as an onlay graft to achieve a horizontal and/or vertical enlargement of the alveolar ridge. Placement of the bone graft was always guided by an augmentation te...
For this retrospective cohort study, we reviewed the records of all patients without exclusion criteria who were referred to the department of oral and plastic maxillofacial surgery at the military hospital of Ulm, Germany, between January 2009 and December 2011 for alveolar ridge augmentations prior to implant insertions using autologous bone grafts harvested from different donor sites and unilat...
In our military outpatient center exclusively, autologous bone transplantations harvested from different donor sites were used intraorally (crista zygomatico-alveolaris, ramus mandible, symphysis mandible, anterior sinus wall) and extraorally (iliac crest) to reconstruct severe horizontal and/or vertical alveolar ridge atrophy prior to implant placement. The aim of this study was to assess the cli...
Although the iliac crest is most often used in jaw reconstruction, a significant bone resorption has been mentioned [12]. This disadvantage, and the fact that dental implants do not always require a large amount of bone, has increased the use of autologous block bone grafts from intraoral sources [13]. Bone grafts from intraoral donor sites offer several benefits like surgical accessibility, proxi...
Oral implantation has a significant role in the rehabilitation of patients. Bone reconstruction techniques have been advanced in order to optimize the esthetic and functional outcome. However, the restoration of the oral function of atrophic alveolar crests still remains a challenge in oral implantology. Bone augmentation procedures are often indicated to allow implant placement in an optimal thre...
This review demonstrates the predictability of autologous bone material in alveolar ridge reconstructions prior to implant insertion, independent from donor and recipient site including even autologous bone chips for sinus elevation. Due to the low harvesting morbidity of autologous bone grafts, the clinical results of our study indicate that autologous bone grafts still remain the “gold standar...
This study assessed the clinical outcomes of graft success rate and early implant survival rate after preprosthetic alveolar ridge reconstruction with autologous bone grafts.
A consecutive retrospective study was conducted on all patients who were treated at the military outpatient clinic of the Department of Oral and Plastic Maxillofacial Surgery at the military hospital in Ulm (Germany) in the ...
ple. a Ground section stained with Levai-Laczkó. b Tissue identification of the ROI. c Closer view a bone and CCXBB. d Closer view of b
Fig. 5. Histomorphometric analysis of the same sample. a Ground section stained with Levai-Laczkó. b Tissue identification of the ROI. c Closer view a arrow pointing a cement line between new mineralized bone and CCXBB. d Closer view of b
Fig. 4. Histological samples. a CCXBB control without implantation. b Histologic samples with acute inflammatory infiltration. c Histologic sample with limited remaining CCXBB and large bone ingrowth
Fig. 4. Histological samples. a CCXBB control without implantation. b Histologic samples with acute inflammatory infiltration. c Histologic sample with limited remaining CCXBB and large bone ingr...
Fig. 3. Re-entry procedure of patient in Fig. 1. a Buccal aspect of the augmented region. b Horizontal bone augmentation. c Screws and pins removal and bone trephine sampling. d Implants placement and buccal bone width from the implant shoulder. e Primary flap closure. f Implants submerged healing
Fig. 3. Re-entry procedure of patient in Fig. 1. a Buccal aspect of the augmented region. b Ho...
Fig. 2. Lateral bone augmentation of the alveolar crest (a) atrophic ridge. b Perforations and adaptation of the cortical layer. c Shaping, pre-wetting and fixation of CCXBB with titanium screws. d Horizontal contour and peripheral gap between CCXBB and bone layer. e Outlying DBBM filling. f CM stabilized with pins
Fig. 2. Lateral bone augmentation of the alveolar crest (a) atrophic ridge. b ...
Fig. 1. Study chart and follow-up visits
Fig. 1. Study chart and follow-up visits
Differentiated tissues
Implant lost (Yes/no)
Mean
SD
Percentage
SD (%)
...
Patient
TRAP (%)
OPN (%)
ALP (%)
OSC (%)
1
...
Tissue type
Mean
Standard deviation
Median
CI 95%
Mineralized bone
...
Patient
Soft tissue dehiscence
Mineralized bone (%)
CCXBB (%)
Bone marrow (%)
Connect...
Ortiz-Vigón, A., Martinez-Villa, S., Suarez, I. et al. Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant placement.
Int J Implant Dent 3, 24 (2017). https://doi.org/10.1186/s40729-017-0087-1
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Received: 21 March 2017
Accepted: 12 June 2017
Published: 21 Ju...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
ETEP Research Group, Facultad de Odontología, Universidad Complutense de Madrid, Plaza Ramón y Cajal, 28040, Madrid, Spain
Alberto Ortiz-Vigón, Sergio Martinez-Villa, Iñaki Suarez, Fabio Vignoletti & Mariano Sanz
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We wish to acknowledge the dedication and scientific advise of Prof. Dr. Tord Berglundh on the histological analysis as well as the diligent work in processing the histological samples to Estela Maldonado for the immunohistochemistry and Asal Shikhan and Fernando Muñoz for the histomorphometry. The work of Esperanza Gross on the statistical analysis is highly acknowledged.
This study was partial...
Patti A, Gennari L, Merlotti D, Dotta F, Nuti R. Endocrine actions of osteocalcin. Int J Endocrinol. 2013;2013:846480.
Schwarz F, Herten M, Sager M, Wieland M, Dard M, Becker J. Histological and immunohistochemical analysis of initial and early osseous integration at chemically modified and conventional SLA titanium implants: preliminary results of a pilot study in dogs. Clin Oral Implants Res. 2...
Araujo MG, Linder E, Lindhe J. Bio-Oss collagen in the buccal gap at immediate implants: a 6-month study in the dog. Clin Oral Implants Res. 2011;22:1–8.
Chiapasco M, Colletti G, Coggiola A, Di Martino G, Anello T, Romeo E. Clinical outcome of the use of fresh frozen allogeneic bone grafts for the reconstruction of severely resorbed alveolar ridges: preliminary results of a prospective study. I...
Jeno L, Geza L. A simple differential staining method for semi-thin sections of ossifying cartilage and bone tissues embedded in epoxy resin. Mikroskopie. 1975;31:1–4.
Dias RR, Sehn FP, de Santana Santos T, Silva ER, Chaushu G, Xavier SP. Corticocancellous fresh-frozen allograft bone blocks for augmenting atrophied posterior mandibles in humans. Clin Oral Implants Res. 2016;27:39–46.
Nissan ...
Cremonini CC, Dumas M, Pannuti C, Lima LA, Cavalcanti MG. Assessment of the availability of bone volume for grafting in the donor retromolar region using computed tomography: a pilot study. Int J Oral Maxillofac Implants. 2010;25:374–8.
Nkenke E, Weisbach V, Winckler E, Kessler P, Schultze-Mosgau S, Wiltfang J, et al. Morbidity of harvesting of bone grafts from the iliac crest for preprosthetic...
Sanz M, Vignoletti F. Key aspects on the use of bone substitutes for bone regeneration of edentulous ridges. Dent Mater. 2015;31:640–7.
Benic GI, Hammerle CH. Horizontal bone augmentation by means of guided bone regeneration. Periodontology. 2014;66:13–40.
Beretta M, Cicciu M, Poli PP, Rancitelli D, Bassi G, Grossi GB, et al. A Retrospective Evaluation of 192 Implants Placed in Augmented Bon...
Alkaline phosphatase
Cone beam computed tomography
Collagen containing xenogeneic bone block
Native collagen membrane
Deproteinized bovine bone mineral
Etiology and Therapy of Periodontal Diseases
Osteopontin
Osteocalcine
Tartrate-resistant acid phosphatase
Within the limitations of this clinical study, we may conclude that the use of CCXBB in combination with DBBM particles and a native bilayer collagen membrane for staged lateral bone augmentation in severe atrophic alveolar crests achieved significant horizontal crestal width allowing for staged implant placement in most of the patients. Histological analysis and implant survival records indicate ...
The immune-histochemical results reported expression of osteopontin mainly at the border between mineralized vital bone (MVB) with CCXBB, what coincides with findings from previous reports [38,39,40]. Alkaline phosphatase (ALP) is considered as an early osteoblast differentiation marker [41]. ALP-positive cells were detectable, in all specimens on the periphery of MVB, associated to areas of new b...
When correlating the clinical results and the histological outcomes, there was a positive association between the presence of soft tissue dehiscence with CCXBB exposure and a diminished amount of new mineralized bone (p = 0.06). This lower amount of new bone within the xenogeneic graft suggests a lack of full graft integration and diminished vascular supply, what may have caused the soft tissu...
The purpose of this investigation was to evaluate histologically and immunohistochemically the behavior of CCXBB blocks when used for staged lateral bone augmentation in severe human horizontal residual bone defects. Six months after the regenerative intervention using the CCXBB blocks, the mean increase in bone width was 4.12 mm and hence, this outcome allowed for the placement of dental implant...
The results from the histomorphometric measurements are depicted in Table 2. Bone biopsies were composed by 21.37% (SD 7.36) of residual CCXBB, 26.90% (SD 12.21) of mineralized vital bone (MVB), 47.13% (SD 19.15) of non-mineralized tissue and 0.92% of DBBM (Fig. 5b). Biopsies from patients who lost their implants had a statistical significant lower amount of MVB (p = 0.01u) and a statistical...
Twenty-eight CCXBB blocks were placed in 15 patients that fulfilled the selection criteria (12 women and 3 men) with a mean age of 54.5 (SD 8.34).
The detailed clinical and radiographical outcomes have been reported previously [21]. In brief, one patient experienced pain and soft tissue dehiscence leading to removal of the graft material 3 days after the regenerative procedure. Another patient r...
For the immunohistochemical analysis, the semi-thin sections were incubated over night with primary antibodies at 4 °C (Santa Cruz Biotechnology Inc., Santa Cruz, Calif., USA). The antibody dilutions used were alkaline phosphatase (ALP) 1:100, osteopontin (OPN) 1:100, osteocalcin (OSC) 1:100, and tatrate resistant acid phosphatase (TRAP) 1:100.
The obtained semi-thin sections were evaluated wit...
Twenty-six weeks after the regenerative procedure the patient returned for the re-entry intervention for placement of dental implants. After raising full-thickness flaps, the augmented area was exposed and horizontal crestal width measurements were performed. Then, the surgeon evaluated the bone availability and if implant placement was considered possible, a core bone biopsy was harvested with th...
CCXBB (Bio-Graft® Geistlich Pharma) is a bone substitute material in a natural block form. The dimensions of the Bio-Graft block are 10 mm in height, 10 mm in length and 5 mm in width. It consists of a natural cancellous bone structure of hydroxyapatite and endogenous collagen type I and III, equine origin and is a class III medical device according to the Medical Device Directive 93/42 EECs...
The present manuscript reports the histological outcomes of a prospective single arm study evaluating the safety and clinical performance of CCXBB blocks when used as replacement bone grafts for lateral bone augmentation prior to staged implant placement. The results of the clinical and radiographic outcomes have been reported in a previous publication [21]. For correlation of the histological wit...
Different techniques and grafting materials have been used for the horizontal reconstruction of deficient alveolar processes before implant placement, resulting in different degrees of predictability and clinical outcomes [1]. Among the grafting materials, particulated xenogeneic materials have been extensively studied in both experimental and clinical studies and when combined with porcine-derive...
The osteoconductive properties of collagen containing xenogeneic bone blocks (CCXBB) remain unclear. The aim of this prospective single-arm clinical study was to assess the histological outcomes of CCXBB blocks used as bone replacement grafts for lateral bone augmentation procedures.
In 15 patients with severe horizontal alveolar ridge resorption, lateral augmentation procedures were performed us...
Fig. 7. ing a trephine bur. a Overview image of coronal-apical cut through the entire core biopsy showing formation of new bone (NB) next to old bone of the extraction socket (B). easy-graft CRYSTAL particles (Gr) are embedded in well perfused connective tissue (CT) and new bone (NB) (Azur II and Pararosanilin, original magnification ×50). b Integration of easy-graft CRYSTAL particle (Gr) into ...
Fig. 6. ntegration and preservation of ridge without collapse of the buccal or lingual cortical plates also showing the cross sections in the grafted area
Fig. 6. a–c Four-month postoperative CBCT showing graft integration and preservation of ridge without collapse of the buccal or lingual cortical plates also showing the cross sections in the grafted area
Fig. 5. CBCT images of the extraction site. a Preoperative CBCT showing fractured and un-restorable teeth #45 and #46 planned to be extracted. b–d Cross sectional views
Fig. 5. CBCT images of the extraction site. a Preoperative CBCT showing fractured and un-restorable teeth #45 and #46 planned to be extracted. b–d Cross sectional views
Fig. 4. excellent width of keratinized tissue which was also preserved. b Implant crowns placed and loaded after 3 months of placement
Fig. 4. a Second stage surgery followed by impression making. Note the excellent width of keratinized tissue which was also preserved. b Implant crowns placed and loaded after 3 months of placement
Fig. 3. Postoperative X ray showing the implant positions in the mandible where the teeth were extracted and ridge preservation was accomplished
Fig. 3. Postoperative X ray showing the implant positions in the mandible where the teeth were extracted and ridge preservation was accomplished
Fig. 2. ssue approximation. A good width of keratinized tissue is visible along with ridge preservation. Ready for implant placement in the grafted areas. b Implant placed in 45 area. Core biopsy sample taken from area 46. Note the integration of graft particles in the preserved alveolar ridge also inside the osteotomy site of 46. c Two Xive (Dentsply) implants placed in the preserved ridge. d. ...
Fig. 1. ft tissue and no flap reflection on the surgical site. c Graft material condensed into the extraction sockets showing good initial graft stability. d Black silk sutures placed with tissue approximation and no releasing incision in the flaps
Fig. 1. a Clinical occlusal view with fractured 45 and 46. b Post-extraction view of the socket. Note minimal trauma to the soft tissue and no fla...
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...
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...
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ISQ level at loading
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Kakar, A., Rao, B.H.S., Hegde, S. et al. Ridge preservation using an in situ hardening biphasic calcium phosphate (β-TCP/HA) bone graft substitute—a clinical, radiological, and histological study.
Int J Implant Dent 3, 25 (2017). https://doi.org/10.1186/s40729-017-0086-2
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Received: 31 December 2016
Accepted: 25 May 2017
Published: 22 June 2017
DOI: htt...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Correspondence to
Ashish Kakar.
Yenepoya University Dental College, University Road, Mangalore, 575018, India
Ashish Kakar, Bappanadu H. Sripathi Rao & Shashikanth Hegde
Dental Foundations and Research Centre, Malad, Mumbai, 400064, India
Nikhil Deshpande
Department of Oral and Maxillofacial Surgery, Center for Dental Medicine, Medical Center—University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
Annette ...
We acknowledge Sunstar Suisse SA, Etoy, Switzerland, for partly supporting this clinical study with a study grant. The authors declare that there is no conflict of interest regarding the publication of this paper.
Ashish Kakar, Bappanadu H. Sripathi Rao, Shashikanth Hegde, Nikhil Deshpande, Annette Lindner, Heiner Nagursky, Aditya Patney, and Harsh Mahajan declare that they have no competing inte...
Lang NP, Pun L, Lau KY, Li KY, Wong MC. A systematic review on survival and success rates of implants placed immediately into fresh extraction sockets after at least 1 year. Clin Oral Implants Res. 2012;23 Suppl 5:39–66.
Smukler H, Landi L, Setayesh R. Hostomorphometric evaluation of extraction sockets and deficient alveolar ridges treated with allografts and barrier membrane. A pilot study. In...
Nair PNR, Luder H-U, Maspero FA, Fischer JH, Schug J. Biocompatibility of beta-tricalcium phosphateroot replicas in porcine tooth extraction sockets—a correlativehistological, ultrastructural, and x-ray microanalytical pilotstudy. J Biomater Appl. 2006;20(4):307–24.
Jensen SS, Terheyden H. Bone augmentation procedures in localized defects in the alveolar ridge: clinical results with different...
Araujo MG, Sukekava F, Wennstrom J, Lindhe J. Ridge alterations following implant placement in fresh extraction sockets: an experimental study in the dog. J Clin Periodontol. 2005;32:645–52.
Van der Weijden F, Dell'Acqua F, Slot DE DE. Alveolar bone dimensional changes of post-extraction sockets in humans: a systematic review. J Clin Periodontol. 2009;36(12):1048–58.
Schropp L, Wenzel A, Kos...
The results of this clinical study support the use of a biphasic in situ hardening alloplastic bone graft substitute for ridge preservation in intact post-extraction sites without the use of a dental membrane. Therefore, grafting of sockets without primary wound closure or using dental membranes or a soft tissue punch can be an effective minimally invasive method of preserving the contour and arch...
Likewise, the reported amount of residual grafting material in the defect site was similar. In average, only 26.2 ± 9.4% of the defect was occupied with residual graft material in this study which is well in line with 26.6 ± 5.2% reported for BCP but below the 37.7 ± 8.5% reported for xenograft [14].
All 15 implants could be placed without the need for additional bone augmentation....
As previously reported, secondary intention soft tissue healing of grafted post-extraction sites can be well achieved when using an in situ hardening and in situ stabilizing bone graft substitutes without the need of a dental membrane [18, 20]. Findings of the present report corroborate these results. The authors found that all sites healed uneventfully with coverage of soft tissue and no local co...
Ridge preservation following dental extractions is fundamental, preserving the ridge profile for subsequent implant placement and providing a sustained function and esthetics. This clinical trial reports on the successful application of an in situ hardening biphasic alloplastic bone graft substitute for ridge preservation and subsequent implant placement in 15 healthy patients. A routine but minim...
Cone beam computer tomography (CBCT) was performed before tooth extraction and at the time point of implant placement. Mean ridge width reduction before tooth extraction to implant placement was calculated to effect in 0.79 ± 0.73 mm horizontal bone loss (Table 2). Primary implant stability was achieved in all 15 cases, showed in average high ISQ levels 70.3 ± 9.7 (buccal/palatal), and...
Fifteen patients (4 females and 11 males) with a mean age of 51.3 + 14.8 years (range: 27 to 75 years) participated in this randomized clinical trial. The site specific areas and teeth numbers for the study are shown in Table 1.
In all cases, the postoperative healing was uneventful. Clinically, the soft tissue healing pattern observed was very similar in all cases. The soft tissue on all ...
Bone biopsies were harvested using a trephine bur at the site of implant placement. The trephine burs including the bone biopsies were fixed in 4% formalin for 5–7 days, rinsed in water, and dehydrated in serial steps of ethanol (70, 80, 90, and 100%), remaining for 1 day in each concentration. Specimens were then infiltrated, embedded, and polymerized in resin (Technovit 9100, Heraeus Kulzer,...
Antibiotic therapy consisting of 1 g amoxicillin every 12 h for 4 days and mouth rinsing with 0.2% chlorhexidine every 8 h for 10 days were prescribed. The suture was removed 1 week postoperatively. After 3 to 8 months (average 5.2 ± 2 months), the sites (Fig. 2a) were reentered for implant placement. A site-specific full thickness mucoperiosteal flap was elevated to expose the regen...
This study was approved by the Yenepoya University Ethics committee, Mangalore, India (Approval Number YOEC83/8/3/2014). Fifteen patients who required extraction of a maxillary or mandibular tooth and subsequent single-tooth implant placement and who met the inclusion and exclusion criteria were included in this prospective single-arm clinical study. The patients (4 females and 11 males) had a mea...
To our knowledge, this is the first systematic clinical, radiographic, and histological evaluation that assesses bone formation and ridge width preservation after socket grafting using an in situ hardening biphasic bone graft substitute in healthy patients.
Following tooth extraction, the alveolar ridge will decrease in volume and change its morphology [1, 2]. These changes are clinically significant [3] and can complicate the placement of a conventional bridge or an implant-supported crown. Post-extraction maintenance of the alveolar ridge following the principles of ridge preservation using bone graft substitutes minimizes ridge resorption and, thu...
Post-Extraction ridge preservation using bone graft substitutes is a conservative technique to maintain the width of the alveolar ridge. The objective of the present study was to evaluate an in situ hardening biphasic (HA/β-TCP) bone graft substitutes for ridge preservation without primary wound closure or a dental membrane.
A total of 15 patients reported for tooth extraction were enrolled in t...
Fig. 6. Patient # 1 (12-month healing time): increased bone formation following the shape of the grafted particles that are still present (magnification ×100)
Fig. 6. Patient # 1 (12-month healing time): increased bone formation following the shape of the grafted particles that are still present (magnification ×100)
Fig. 5. Patient # 4 (9-month healing time): increased bone formation following the shape of the grafted particles stained with Goldner trichrome staining (magnification ×100)
Fig. 5. Patient # 4 (9-month healing time): increased bone formation following the shape of the grafted particles stained with Goldner trichrome staining (magnification ×100)
Fig. 4. Patient # 1 (12-month healing time): overview of a typical example of a bone biopsy stained with Goldner trichrome staining (magnification ×10)
Fig. 4. Patient # 1 (12-month healing time): overview of a typical example of a bone biopsy stained with Goldner trichrome staining (magnification ×10)
Fig. 3. Alveolar tissue height (in true mm) over a 5-year period in the 12-month group
Fig. 3. Alveolar tissue height (in true mm) over a 5-year period in the 12-month group
Fig. 2. Aveolar tissue height (in true mm) over a 5-year period in the 9-month group
Fig. 2. Aveolar tissue height (in true mm) over a 5-year period in the 9-month group
Fig. 1. Images of patient # 5 (9-month healing time). a. Radiograph of the left maxillary sinus: situation 9 months after the maxillary sinus floor elevation procedure. b. With a trephine drill, the implant osteotomy is made and the biopsy is obtained. c. Clinical situation after placing two Straumann® SLA implants in the left posterior maxilla. d. Radiograph of two Straumann® SLA implants in...
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...
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...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Authors W.F. Bouwman, N. Bravenboer, J.W.F.H. Frenken, C.M. ten Bruggenkate and E.A.J.M. Schulten state that there are no conflicts of interest, either directly or indirectly.
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Correspondence to
E. A. J. M. Schulten.
Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center/Academic Centre for Dentistry Amsterdam (ACTA), P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
W. F. Bouwman, C. M. ten Bruggenkate & E. A. J. M. Schulten
Department of Clinical Chemistry, VU University Medical Center, Amsterdam, The Netherlands
N. Bravenboer
Department of Oral and Maxillofacial Su...
Groeneveld EH, van den Bergh JP, Holzmann P, ten Bruggenkate CM, Tuinzing DB, Burger EH. Mineralization processes in demineralized bone matrix grafts in human maxillary sinus floor elevations. J Biomed Mater Res. 1999;48:393–402.
Schulten EAJM, Prins HJ, Overman JR, Helder MN, ten Bruggenkate CM, Klein-Nulend JA. Novel approach revealing the effect of collagenous membrane on osteoconduction in ...
Schopper C, Ziya-Ghazvini F, Goriwoda W, Moser D, Wanschitz F, Spassova E, Lagogiannis G, Auterith A, Ewers R. HA/TCP compounding of a porous CaP biomaterial improves bone formation and scaffold degradation—a long-term histological study. J Biomed Mater Res B Appl Biomater. 2005;74:458–67.
Frenken JW, Bouwman WF, Bravenboer N, Zijderveld SA, Schulten EA, ten Bruggenkate CM. The use of Strauma...
Beirne JC, Barry HJ, Brady FA, Morris VB. Donor site morbidity of the anterior iliac crest following cancellous bone harvest. Int J Oral Maxillofac Surg. 1996;25:268–71.
Vermeeren JIJF, Wismeijer D, van Waas MAJ. One-step reconstruction of the severely resorbed mandible with onlay bone grafts and endosteal implants: a 5-year follow-up. Int J Oral Maxillofac Surg. 1996;2:112–5.
Nkenke E, Stel...
Boyne PJ, James RA. Grafting of the maxillary sinus floor with autogenous marrow and bone. J Oral Surg. 1980;38:613–6.
Tatum H Jr. Maxillary and sinus implant reconstructions. Dent Clin N Am. 1986;30:207–29.
Del Fabbro M, Rosano G, Taschieri S. Implant survival rates after maxillary sinus augmentation. Eur J Oral Sci. 2008;116:497–506.
Pjetursson BE, Tan WC, Zwahlen M, Lang NP. A systemat...
Based on clinical, radiological, histological, and histomorphometric analysis, this study confirms the suitability of BCP for vertical augmentation of the posterior maxilla by means of an MSFE procedure, allowing dental implant placement after 9 and 12 months healing times. Yet, complete degradation of the BCP particles does not occur within a 12-month healing time. From a histological and histom...
In the cranial part of the biopsy, some osteoid islands with osteogenic activity were detected, possibly caused by osteoinductive properties from the lifted bony trap-door. In the present study, histomorphometric analyses revealed that the vital bone volume was higher in the 9-month healing time group than in the 12-month healing time group, while one would expect to find more newly formed bone in...
This study presents the clinical, radiological, histological and histomorphometric results on the use of a biphasic calcium phosphate (Straumann® bone ceramic) in a MSFE procedure with healing times of 9 and 12 months. During the clinical evaluation, it appeared that both 9-month and 12-month healing times resulted in integration of the grafted BCP with the original maxillary bone (sinus floor),...
Histological observations did not show inflammatory cells in the tissue adjacent to the bone substitute particles. Bone marrow-like tissue, which included blood vessels, was observed in between the bone trabeculae (Fig. 4). Reinforcement by lamellar bone was shown in some areas after 9 and 12 months (Figs. 5 and 6). No Howship’s lacunae could be detected on the characteristic outlines of the su...
None of the 10 patients showed postoperative inflammation or infection after the MSFE procedure nor during surgical re-entry for dental implant placement. When opening the area for dental implant insertion, the grafted area proved to be well vascularized and the tissue at the site of the former trap-door location was slightly flexible and had a fibrous aspect. Between the periosteum and the bone g...
Parameters evaluating vital bone mass/bone structure:
1: Vital bone volume (BV): percentage of the grafted section that is vital bone tissue (%)
2: Bone surface (BS): BS expressed as a fraction of the total vital bone volume (mm2/mm3)
3: Thickness of bone trabeculae (Tb.Th) (μm)
Parameters evaluating bone turnover:
1: Osteoid volume (OV): fraction of the vital bone tissue section that is ost...
All 22 inserted dental implants were clinically tested for good primary stability. Osseointegration at abutment connection was tested with a 35-Ncm torque. One experienced oral and maxillofacial surgeon (CB) carried out all follow-up examinations.
Panoramic radiographs were made at patient’s intake (T0); immediately after the MSFE procedure (T1); immediately after dental implant placement (T2);...
A midcrestal incision was made with vertical release incisions at the canine and tuberosity region. A full-thickness mucoperiosteal flap was elevated. The lateral maxillary sinus wall was prepared using a diamond burr with copious irrigation with sterile isotonic saline, regarding the contour of the maxillary sinus as observed on the preoperative panoramic radiograph. A bony top-hinge trap-door wa...
In this study, 10 consecutive healthy patients were selected for a unilateral MSFE procedure. Five patients received dental implants 9 months after MSFE and five patients underwent dental implant surgery 12 months after MSFE. In the 9-month group (three men and two women), the average age was 56.6 years (range 40 to 64 years); in the 12-month group (one man and four women), the average age was...
β-TCP is a biocompatible osteoconductive calcium phosphate that may provide a scaffold for potential bony ingrowth [24]. β-TCP resorbs rather quickly but not necessarily at the same rate as new bone formation [25,26,27]. Most research focused on either using the relative unresorbable HA as a scaffold or β-TCP as a degradable component [19, 24,25,26, 28, 29]. Zerbo et al. [30] concluded that due...
Maxillary sinus floor elevation (MSFE) is a surgical procedure to enhance the bone height in the posterior maxilla with graft material, allowing dental implant placement (later or at the same time) [1, 2]. This pre-implant procedure is predictable and results in a dental implant survival of more than 93.8% 3 years after dental implant placement [3]. According to Pjetursson [4] in his systematic r...
This study evaluates the clinical, radiological, histological, and histomorphometric aspects of a fully synthetic biphasic calcium phosphate (BCP) (60% hydroxyapatite and 40% ß-tricalcium phosphate), used in a human maxillary sinus floor elevation (MSFE) procedure with 9- and 12-month healing time.
A unilateral MSFE procedure, using 100% BCP, was performed in two series of five patients with hea...
Sagheb, K., Schiegnitz, E., Moergel, M. et al. Clinical outcome of alveolar ridge augmentation with individualized CAD-CAM-produced titanium mesh.
Int J Implant Dent 3, 36 (2017). https://doi.org/10.1186/s40729-017-0097-z
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Received: 15 March 2017
Accepted: 13 July 2017
Published: 26 July 2017
DOI: https://doi.org/10.1186/s40729-017-0097-z
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Keyvan Sagheb reports personal fees and grants from Dentsply, Geistlich, and Nobel Biocare outside the submitted work. Eik Schiegnitz reports personal fees and grants from Septodont, Dentsply, Geistlich, and Straumann outside the submitted work. Maximilian Moergel reports grants from Camlog outside the submitted work. Christian Walter reports grants and personal fees from Straumann outside the sub...
Correspondence to
E. Schiegnitz.
K. Sagheb and E. Schiegnitz contributed equally to this work.
Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany
K. Sagheb, E. Schiegnitz, M. Moergel, C. Walter, B. Al-Nawas & W. Wagner
Mediplus, Oral and Maxillofacial Surgery, Private Praxis, Mainz, Germany
C. Walter
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Ali S, Bakry SA, Abd-Elhakam H. Platelet-rich fibrin in maxillary sinus augmentation: a systematic review. The Journal of oral implantology. 2015;41(6):746–53. PubMed PMID: 25536095
Moraschini V, Barboza ES. Effect of autologous platelet concentrates for alveolar socket preservation: a systematic review. Int J Oral Maxillofac Surg. 2015;44(5):632–41. PubMed PMID: 25631334
Torres J, Tamimi F,...
Pieri F, Corinaldesi G, Fini M, Aldini NN, Giardino R, Marchetti C. Alveolar ridge augmentation with titanium mesh and a combination of autogenous bone and anorganic bovine bone: a 2-year prospective study. J Periodontol. 2008;79(11):2093–103. PubMed PMID: 18980518
Proussaefs P, Lozada J. Use of titanium mesh for staged localized alveolar ridge augmentation: clinical and histologic-histomorphom...
von Arx T, Kurt B. Implant placement and simultaneous peri-implant bone grafting using a micro titanium mesh for graft stabilization. Int J Periodontics Restorative Dent. 1998;18(2):117–27. PubMed PMID: 9663090
von Arx T, Kurt B. Implant placement and simultaneous ridge augmentation using autogenous bone and a micro titanium mesh: a prospective clinical study with 20 implants. Clin Oral Implant...
Moraschini V, Poubel LA, Ferreira VF, Barboza ES. Evaluation of survival and success rates of dental implants reported in longitudinal studies with a follow-up period of at least 10 years: a systematic review. Int J Oral Maxillofac Surg. 2015;44(3):377–88. PubMed PMID: 25467739
Al-Nawas B, Kammerer PW, Morbach T, Ladwein C, Wegener J, Wagner W. Ten-year retrospective follow-up study of the TiO...
Within the limitations of this study, being retrospective and having no control group, the results show that individualized CAD-CAM-produced titanium meshes are a safe and predictable procedure for large vertical and horizontal ridge augmentations. The soft tissue covering remains one of the most critical steps using this technique. However, exposure of the mesh does not result in complete loss of...
The results showed that in all 21 augmented sites, a significant ridge augmentation was achieved, with a mean vertical augmentation of 6.5 ± 1.7 mm and a mean horizontal augmentation of 5.5 ± 1.9 mm. To our best knowledge, this is the first study investigating these parameters in individualized CAD-CAM-produced titanium meshes. For conventional titanium meshes, several studies were publish...
In our study, PRF membranes were additionally to collagen membranes used to cover the CAD-CAM mesh. The aim of this clinical approach was to improve and accelerate wound healing. The results with the low exposure rates and the sufficient augmentation heights indicated that these PRF membranes are a promising technique. However, due to low case number in the control group without a PRF membrane, de...
The vertical and horizontal regeneration of resorbed alveolar ridges remains a challenging surgical procedure, especially in the case of extensive bone atrophy. During the past years, different augmentation techniques have been proposed to restore an adequate bone volume. The aim of this study was to evaluate a technique for ridge augmentation in the maxilla and mandible using an individualized CA...
In the investigated time period, 17 patients received 21 TM augmentations. Fourteen of these patients were women and three men. Mean age at the time of augmentation was 37 ± 15 years (17–64 years). Twelve of the patients were non-smoker, and 5 patients were smoker. In 8 patients, a steady periodontal disease could be detected. Sixty-five percent (n = 11) of the patients presented a thin g...
Cone beam computed tomography (CBCT) of the treated sites was performed before augmentation procedure and 6 months postoperatively at time of reentry. Craniofacial bone and TM showed different radio-opacity, which allowed their easy differentiation on the scans after regulating the brightness and contrast. In our department, two different CBCTs were available (Accuitomo, J. Morita Corporation, Ja...
In a retrospective study, the clinical outcome of an individualized CAD-CAM-produced TM (Yxoss CBR®, Filderstadt, Germany) inserted by experienced surgeons in the Department of Oral and Maxillofacial Surgery of the University Medical Centre Mainz, Germany, between December 2014 and January 2017, was analyzed. Therefore, all patients with this CAD-CAM mesh augmentation and reentry operation for im...
The aim of this clinical study was to present the clinical outcome of individualized CAD-CAM-produced TM in combination with particulate autogenous bone mixed with deproteinized bovine bone mineral (DBBM) used to augment horizontal and/or vertical bony defects in both maxillary and mandibular arches, within a two-stage technique. Furthermore, gained horizontal and vertical bone height and the infl...
Dental implant placement is an effective treatment method for the replacement of lost teeth with high survival rates after long-term follow-up [1,2,3]. However, the long-term success and stability of implants in function are directly correlated with the quality and quantity of the available bone at the prospective implant site [4, 5]. Despite the development of various techniques and augmentation ...
The augmentation of the jaw has been and continues to be a sophisticated therapy in implantology. Modern CAD-CAM technologies lead to revival of old and established augmentation techniques such as the use of titanium mesh (TM) for bone augmentation. The aim of this retrospective study was to evaluate the clinical outcome of an individualized CAD-CAM-produced TM based on the CT/DVT-DICOM data of th...
Fig. 2. Clinical image of patient 4: a region 21 before implant placement. b, c Implant placement using the GBR procedure with a synthetic bone substitute material composed of HA + β-TCP
Fig. 2. Clinical image of patient 4: a region 21 before implant placement. b, c Implant placement using the GBR procedure with a synthetic bone substitute material composed of HA + β-TCP
Fig. 1. Schematic representation of the technical characteristics of the investigated C-Tech Esthetic Line implant system (provided by the manufacturer)
Fig. 1. Schematic representation of the technical characteristics of the investigated C-Tech Esthetic Line implant system (provided by the manufacturer)
Patient
Implant-localization (region)
Implant loss (+/−)
Buccal width of keratinized peri-implant gingiva (mm)
Buccal thickness of keratinized peri-implant gi...
Patient
Gender (m/f)
Age (years)
Implant localization (region)
Implant diameter (mm)
...
Lorenz, J., Lerner, H., Sader, R.A. et al. Investigation of peri-implant tissue conditions and peri-implant tissue stability in implants placed with simultaneous augmentation procedure: a 3-year retrospective follow-up analysis of a newly developed bone level implant system.
Int J Implant Dent 3, 41 (2017). https://doi.org/10.1186/s40729-017-0104-4
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Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
This study was conducted in compliance with the principles of the Declaration of Helsinki, and the approval of the ethics committee required for the study was obtained from the Ethics Committee of the Medical Center of the Goethe University Frankfurt. The procedures to be performed were explained in detail, and the patients signed the consent form.
Jonas Lorenz, Henriette Lerner, Robert Sader, an...
Department for Oral, FORM-Lab, Cranio-Maxillofacial, and Facial Plastic Surgery, Medical Center of the Goethe University Frankfurt, Frankfurt am Main, Germany
Jonas Lorenz, Robert A. Sader & Shahram Ghanaati
HL-Dentclinic, Baden-Baden, Germany
Henriette Lerner
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Lerner H, Lorenz J, Sader R, Ghanaati S. Two-year retrospective study of periimplant health and periimplant bone stability after immediate implant placement of a newly developed bone level implant system—a first report. EDI Journal (European Association of Dental Implantologists, Teamwork Media); 2017; ahead of print.
Ghanaati S, Lorenz J, Obreja K, Choukroun J, Landes C, Sader R. Nanocrystalli...
Gurgel BC, Montenegro SC, Dantas PM, Pascoal AL, Lima KC, Calderon PD. Frequency of peri-implant diseases and associated factors. Clin Oral Implants Res. 2016; doi: 10.1111/clr.12944
Qian J, Wennerberg A, Albrektsson T. Reasons for marginal bone loss around oral implants. Clin Implant Dent Relat Res. 2012;14(6):792–807.
Berglundh T, Lindhe J, Ericsson I, Marinello C, Liljenberg B, Thomsen P....
β-tricalcium phosphate
Bleeding on probing
Fixed prosthetics
Guided bone regeneration
Hydroxyapatite
Multinucleated giant cells
Pink Esthetic Score
Removable prosthetics
In the present study, the implant and peri-implant hard- and soft-tissue stability was analyzed in a bone level implant system placed simultaneously with a GBR procedure 3 years after prosthetic loading. Peri-implant hard- and soft-tissue parameters such as width and thickness of peri-implant keratinized gingiva, probing depth, BOP, PES, peri-implant bone loss, and the presence of peri-implant os...
Comparing the present results to the aforementioned study with the same implant system on immediately placed implants, it seems that the GBR augmentation procedure has no influence on the long-term stability of the implants. In both studies with different placement modalities and protocols, comparable clinical and radiological results were achieved. This leads to the assumption that the investigat...
The tissue reaction, however, did not only differ in bone substitute materials of different origin but also in bone substitute materials of the same origin. In an in vivo trial, two xenogeneic bone substitute materials processed with different techniques were implanted subcutaneously in CD-1 mice for up to 60 days. Both bone substitute materials showed good integration within the peri-implant tis...
In the present retrospective study, C-Tech bone level implants placed simultaneously with a GBR procedure around the implant shoulder were investigated clinically and radiologically after at least 3 years of loading to assess peri-implant tissue conditions and document peri-implant tissue stability.
A total of 47 implants were placed in the upper (23 implants) and lower jaw (24 implants) of 20 p...
Investigation of the esthetic appearance via PES revealed a mean point score of 10.1 (ranging from 7 to 13) from a maximum of 14. The highest values and therefore acceptance were found in the alveolar process deficiency and the soft-tissue level, which can be interpreted as a benefit of the augmentation procedure around the implant shoulder.
Peri-implant bone loss calculated using the average bon...
Altogether, 47 implants were placed in the upper and lower jaws of a total of 20 patients. In all implants, lateral augmentation in a GBR process was performed simultaneously with implant placement due to reduced horizontal or vertical height of the alveolar crest. A total of 23 implants were placed in the upper jaw and 24 implants in the lower jaw. The implant diameter varied between 3.5 mm (32 ...
Investigation parameters:
Implant being in situ
Width and thickness of peri-implant keratinized gingiva
Pink Esthetic Score (PES)
Probing depth
BOP
Peri-implant bone loss
Presence of peri-implant osteolysis
In the present retrospective study, bone level implants (C-Tech Esthetic Line implants) were investigated clinically and radiologically. The bone level implant system has a Morse-locking conical implant-abutment connection with platform switching and an indexing hex that allows subcrestal implant placement and aims to prevent peri-implant bone loss. The surface of the implant system is manufacture...
In the present retrospective study, 47 dental implants (C-Tech Esthetic Line implants) from 20 patients (11 female, 9 male) with a mean age of 58.5 years (45–75 years) were analyzed clinically and radiologically. Implant placement and follow-up investigation was performed at the HL Dentclinic in Baden-Baden, Germany. The study was approved by the ethics commission of the medical department of ...
The aim of the present retrospective investigation was to assess clinically and radiologically peri-implant tissue conditions and document peri-implant tissue stability in C-Tech implants when placed simultaneously with a GBR augmentation procedure after at least 3 years of loading.
The ability of bone substitute materials to form a sufficient and stable implantation bed has been proven in numerous clinical trials; however, it is still to a certain degree unclear if the different tissue reactions have an impact on the establishment of a peri-implant infection, especially when these biomaterials are used for augmentations around the implant shoulder. Due to the two-stage desig...
The prevalence of peri-implantitis has grown in the past few years and has become a major issue in implant dentistry. Long-term stable and healthy soft- and hard-tissue conditions should be achieved in combination with esthetically and functionally satisfying results. However, the rising number of placed implants in the past decades has come with an increase in the prevalence of peri-implantitis [...
Guided bone regeneration (GBR) has been proven to be a reliable therapy to regenerate missing bone in cases of atrophy of the alveolar crest. The aim of the present retrospective analysis was to assess peri-implant tissue conditions and document peri-implant tissue stability in C-Tech implants when placed simultaneously with a GBR augmentation procedure.
A total of 47 implants, which were placed ...
Fig. 3. Example of another case involved in the study. a Preoperative view –premolars and molars are missing in left mandible. b Preoperative CT scan. The width of the ridge was around 4 mm. c Baseline periapical radiograph. Four narrow diameter implants were placed to restore the area. d Buccal view of the final full-contour zirconia restoration. e Periapical radiograph at 1 year after loa...
Fig. 2. Case 1: Example of one case involved in the study. a Preoperative view of a partial edentulism in posterior mandible. b Preoperative CT scan. The width of the ridge was 4 mm. c Four narrow diameter implants were placed and left to a nonsubmerged healing. d Baseline periapical radiograph. e Buccal vieew of the final metal ceramic restoration. f Periapical radiograph at 1 year after loa...
Fig. 1. Characteristics of the implants used in the study: a external macro-design of JDIcon Ultra S, 2.75 mm diameter implant and b external macro-design of JDEvolution S, 3.25 mm diameter implant
Fig. 1. Characteristics of the implants used in the study: a external macro-design of JDIcon Ultra S, 2.75 mm diameter implant and b external macro-design of JDEvolution S, 3.25 mm diameter i...
Diameter 2.75 mm
Follow-up
Mean bone level changes (mm) (n = 69)
0–6 months (95% CI) (n = 67)
0–12 months (95% CI) (n = 67)
...
Follow-up
Mean bone level (mm) (n = 124)
Time
0–6 months (95% CI) (n = 121)
0–12 months (95% CI) (n = 121)
...
Length (mm)
8
18 (14.5%)
10
56 (45.2%)
11.5
...
Number of patients
42
Males (%)
18 (42.9%)
Females (%)
24 (57.1%)
...
Grandi, T., Svezia, L. & Grandi, G. Narrow implants (2.75 and 3.25 mm diameter) supporting a fixed splinted prostheses in posterior regions of mandible: one-year results from a prospective cohort study.
Int J Implant Dent 3, 43 (2017). https://doi.org/10.1186/s40729-017-0102-6
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Received: 23 March 2017
Accepted: 29 August 2017
Published: 08 September 2017
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Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Tommaso Grandi serves as a consultant for JDentalCare. Luigi Svezia and Giovanni Grandi declare that they have no competing interests.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Private practice, Via Contrada 323, 41126, Modena, Italy
Tommaso Grandi & Luigi Svezia
Department of Obstetrics, Gynecology and Pediatrics, University of Modena and Reggio Emilia, Modena, Italy
Giovanni Grandi
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Esposito M, Grusovin MG, Maghaireh H, Worthington HV. Interventions for replacing missing teeth: different times for loading dental implants (Review). Cochrane Database Syst Rev. 2013;(3):CD003878. https://doi.org/10.1002/14651858.CD003878.pub5.
Esposito M, Grusovin MG, Felice P, Karatzopoulos G, Worthington HV, Coulthard P. The efficacy of horizontal and vertical bone augmentation procedures for...
Within the limits of this prospective cohort study, narrow-diameter implants (2.75 to 3.25 mm) can be successfully used as a minimally invasive alternative to horizontal bone augmentation in posterior mandible up to 1 year of function. This outcome could be related to the fact that these implants have been all splinted to other implants by a fixed prosthesis. These preliminary results must be co...
On the one hand, due to the small sample size of this study and moreover, the short follow-up (only 1 year after loading), it would be hazardous to conclude that the placement of NDIs to support fixed prostheses in posterior mandible is a predictable treatment modality. In order to draw more reliable conclusions, we need to wait for longer follow-ups, since it may be possible that after several y...
Dental implants with a reduced diameter are commonly used where bone width is narrow or in cases of restricted mesiodistal anatomy such as laterally maxillary and mandibular incisors. They could also be a viable alternative to bone augmentation especially in challenging situations such as the posterior regions of the mandible. While it has been shown that it is possible to horizontally augment bon...
The radiographic data are summarized in Tables 3 and 4. The group lost statistically significant marginal peri-implant bone at 6 months (−0.20; 95% C −0.14: −0.26, p
Forty-eight patients were screened for eligibility, but six subjects were not included for the following reasons: five patients (10.4%) were hesitant to receive implant treatment, and one patient (2.1%) was treated with intravenous amino-bisphosphonates. Forty-two patients were then considered eligible and were consecutively enrolled in the study. All patients were treated according to the allocat...
Primary outcome measures were as follows:
Implant failure: evaluated as implant mobility and removal of stable implants dictated by progressive marginal bone loss or infection. The stability of each implant was measured manually by tightening the abutment screw with a wrench delivering a torque of 20 Ncm. Implant stability assessment was performed at delivery of definitive crowns (3 months afte...
The present prospective study was conducted at a private practice (Tommaso Grandi, Modena) in Italy between October 2014 and January 2016.
Any patient with partial edentulism in posterior regions of mandible (premolar/molar areas), requiring one multiple tooth implant-supported restoration (2-, 3-, or 4-unit bridge), having a residual bone height of at least 8 mm and a thickness of at least 4 m...
The aim of this cohort study was to evaluate the outcome of narrow-diameter implants (2.75 and 3.25 mm diameter) used as definitive implants in patients with insufficient bone ridge thickness for placing standard-diameter implants in posterior regions of the mandible. The present study reports the clinical outcome up to 1 year after loading. It is planned to follow up this patients’ cohort to ...
Historically, implants have been used and documented mainly with diameters between 3.7 and 4.3 mm. Employing these diameters for numerous indications, scientifically substantiated treatment protocols with excellent long-term results have been established [1]. One disadvantage of a standard-diameter implant is the fact that, in clinical use, the available horizontal crestal dimensions of the alveo...
Can multiple splinted narrow-diameter implants be used as definitive implants in patients with insufficient bone ridge thickness in posterior regions of the mandible? With this aim, we evaluated their outcomes in this set up to 1 year after loading.
Forty-two patients with a mean age of 61.3 years old (range 49–73) in need of fixed prosthetic implant-supported rehabilitations in the posterior...
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)
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 i3...
Fig. 4. n. Intraoral and perioral views of a rehabilitated female patient. (She asked explicitly only for implantological treatment in the mandible.)
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.)
Fig. 3. 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 70 [34]
Fig. 3. a Primary implant stability. The histogram visualises the distribution of the im...
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)
Fig. 2. Cumulative implant survival over the follow-up period. The Kaplan-Meyer diagram visualises the analysis of implant survival in the maxi...
Fig. 1. e 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 ...
Patient
Sex
Age (years)
Implant position (FDI)
Indication categorya
Bone quality
Prosthetic treatment
...
Type of prosthetic treatment
Session
Procedure
Fixed denture (bridge)
1
Open impression
...
Surgical protocol
Bone quality
D1
D2
D3
D4
1. Drilli...
Inclusion criteria
Exclusion criteria
1. Adult patients, male and female
1. Comorbidity ASA category ≥ III
2. Partially/totally edentulous patients
...
Reich, W., Schweyen, R., Heinzelmann, C. et al. Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results.
Int J Implant Dent 3, 46 (2017). https://doi.org/10.1186/s40729-017-0107-1
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Received: 18 August 2017
Accepted: 12 October 2017
Published: 30 October 2017
DOI: https://doi.org/10.1186/s40...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Dataset presenting relevant raw data. (SAV 3 kb)
WR is a senior physician at the University Hospital Halle, Martin Luther University Halle-Wittenberg, Department of Oral and Plastic Maxillofacial Surgery, Halle/Saale, Germany.
RS is a clinical research associate at the University School of Dental Medicine, Department of Prosthetic Dentistry, Martin Luther University Halle-Wittenberg, Halle/Saale, Germany.
CH is a consultant at the University H...
Correspondence to
Waldemar Reich.
Department of Oral and Plastic Maxillofacial Surgery, Martin Luther University Halle-Wittenberg, Ernst-Grube Str. 40, 06120, Halle (Saale), Germany
Waldemar Reich, Christian Heinzelmann, Bilal Al-Nawas & Alexander Walter Eckert
University School of Dental Medicine, Department of Prosthetic Dentistry, Martin Luther University Halle-Wittenberg, Magdeburger Straße 16, 06112, Halle (Saale), Ger...
The authors are grateful to the DenTack Company for providing some of the implants and components used in this study. The courtesy of Oz Vachtenberg is acknowledged for providing Fig. 1a–f and the movie clip. There are no financial supports or conflicts of interest associated with this publication that could have influenced its outcome. We thank the Osstell Company, which supplied the RFA devic...
Mishra SK, Chowdhary R, Kumari S. Microleakage at different implant abutment interface: a systematic review. J Clin Diagn Res. 2017;11(6):ZE10–5.
Feichtinger M, Gaggl A, SChultes G, Kärcher H. Evaluation of distraction implants for prosthetic treatment after vertical alveolar ridge distraction: a clinical investigation. Int J Prosthodont. 2003;16(1):19–24.
Pradeep PR, Kasti KJ, Ananthakrish...
Gehrke SA, Pérez-Albacete Martinez C, Piattelli A, Shibli JA, Markovic A, Calvo Guirado JL. The influence of three different apical implant designs at stability and osseointegration process: experimental study in rabbits. Clin Oral Implants Res. 2017;28(3):355–61.
Herrero-Climent M, Santos-Garcia R, Jaramillo-Santos R, Romero-Ruiz MM, Fernandez-Palacin Lazaro-Calvo P, Bullon P, Rios-Santos JV....
Malmstrom H, Gupta B, Ghanem A, Cacciato R, Ren Y, Romanos GE. Success rate of short dental implants supporting single crowns and fixed bridges. Clin Oral Implants Res. 2016;27(9):1093–8.
Garfield RE. An expandable implant fixture. Dent Implantol Updat. 1998;9(5):37–40.
Nowzari H, Chee W, Tuan A, Abou-Rass M, Landesman HM. Clinical and microbiological aspects of the Sargon immediate load imp...
Brenner M, Brandt J, Lauer HC. Prothetische Versorgung auf kurzen Implantaten. Zahnmedizin up2date. 2014;2:123–42. (German)
Eitner S, Wichmann M, Schlegel KA, Kollmannberger JE, Nickenig HJ. Oral health-related quality of life and implant therapy: an evaluation of preoperative, intermediate, and post-treatment assessments of patients and physicians. J Craniomaxillofac Surg. 2012;40(1):20–3.
...
De Moraes SL, Verri FR, Santiago JF Jr, Almeida DA, de Mello CC, Pellizzer EP. A 3-D finite element study of the influence of crown-implant ratio on stress distribution. Braz Dent J. 2013;24(6):635–41.
Moraes SL, Pellizzer EP, Verri FR, Santiago JF Jr, Silva JV. Three-dimensional finite element analysis on stress distribution in retention screws of different crown-implant ratios. Comput Methods...
Thoma DS, Haas R, Tutak M, Garcia A, Schincaglia GP, Hämmerle CH. Randomised controlled multicenter study comparing short dental implants (6 mm) versus longer dental implants (11-15 mm) in combination with sinus floor elevation procedures. Part 1: demographic and patient-reported outcomes at 1 year of loading. J Clin Periodontol. 2015;42(1):72–80.
Hentschel A, Herrmann J, Glauche I, Vollmer A,...
Schwarz F, Terheyden H. Significance of dental implants for health care. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2011;54(9):1097–101. (German)
Gates WD, Cooper LF, Sanders AE, Reside GJ, De Kok IJ. The effect of implant-supported removable partial dentures on oral health quality of life. Clin Oral Impl Res. 2014;25:207–13.
Fretwurst T, Nack C, Al-Ghrairi M, Raguse JD, ...
Bone quality (density)
World Dental Federation
Implant stability quotient
Resonance frequency analysis
Initial results of the ongoing study confirm the feasibility and safety of the employed system. The implant type seems to be useful for all bone qualities and shows high initial and secondary biomechanical stability in the maxilla and mandible. Long-term follow-up will be needed in validating these initial results in a larger 3-year clinical trial. Crestal bone changes should be evaluated in a la...
Comparable studies displayed at 24 months a crestal bone loss of 0.5–0.6 mm [15]. Other authors reported at 2, 3 and 5 years a mean loss of 0.57, 0.55 and 0.53 mm, respectively, in the mandible (without significant change after 1 year) [10]. On the other hand, randomised controlled trials demonstrated 1 year after loading periimplant marginal bone loss of 0.7 mm [70] and 1.1 mm [7] in th...
Contrary to conventional hollow-screw implants (only marginal gap), a problem of the expandable implant is the presence of gaps down to the apical region. Former microbial assessment of different implant-abutment interfaces displayed that none of the marginal connections had the capacity to prevent microbial leakage [63,64,65]. Therefore, an apical microleakage (comparable to distractable implants...
Regarding resonance frequency analysis, the values are related to bone quality and quantity as well as the exposed implant height above the alveolar crest, which depends on the type of implant and insertion technique [55,56,57]. Our results (primary stability in the maxilla 66.9 ± 8.9 ISQ units and in the mandible 72.5 ± 11.1 ISQ units; secondary stability in the maxilla 66.4 ± 10.0...
Several investigators analysed the preferred indications of short dental implants in the posterior mandible or maxilla and outlined the cost efficiency compared to additional vertical augmentations. In the present trial, we used a new short implant in both jaws and nearly all possible indication categories were represented, which proves the broad versatility (Table 4).
In our study, two implant ...
Recent literature has shown that short implants have achieved growing acceptance in the field of oral implantology [9, 10, 39, 40]. Since the last years, concern has decreased about the length of endosseous implants; it should be noted that all extraoral screw implants are short implants [41, 42]. Nevertheless, there are local physiological and biomechanical differences regarding long-term stabili...
Over the follow-up period, the mean crestal bone changes after loading were as follows (each compared to the baseline): in the first year, 1.0 ± 0.9 mm 95% CI (0.5; 1.5) in the maxilla and 0.7 ± 0.4 mm 95% CI (0.5; 1.0) in the mandible (p = 0.011; independent t test), and in the second year, 1.3 ± 0.8 mm 95% CI (0.8; 1.7) in the maxilla and 1.0 ± 0.7 mm 95% CI (0.6; 1.4...
The first results of this longitudinal study include data from 9 patients with an average age of 57 years (range from 44 to 80) in whom 30 implants were inserted (maxilla n = 15, mandible n = 15). All 30 implants in the 9 patients could be inserted without intraoperative problems. Based on intraoperative and radiological findings, the bone quality was assessed as follows: D1 in n = 2,...
All patients were pseudonymised, parameters were attached to a databank and analysed statistically (Additional file 2). Statistical analyses were performed using statistics software (IBM SPSS statistics, version 20, Chicago, IL, USA). The descriptive statistics presented the frequency and distribution of several occurrences as well as combinations of certain features. Analytical statistics were p...
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 necess...
The study was designed as a prospective monocentric longitudinal cohort study according to the STROBE criteria. The participants of this study were recruited at the university hospital of Martin Luther University Halle-Wittenberg, Department of Oral and Plastic Maxillofacial Surgery, implantological consultation from 2014 (June) until 2015 (June). Inclusion and exclusion criteria of adult patients...
It is known that achievement of primary stability is one precondition for osseointegration and treatment success. There are few reports of immediate [14] and early (6 weeks) functional loading of short implants [28]. This is related to good bone quality, implant design or implant site preparation (e.g. under-drilling). However, under-drilling of the crestal aspect may lead to decreased bone-to-im...
Endosseous implants have been established over several decades. The evaluation of treatment results under biomechanical, physiological, psychological, social and economic aspects has been well documented [1]. Furthermore, patient-based outcomes reveal a predictable gain in oral health-related quality of life [2].
Especially in patients with limited vertical bone height, process of treatment is ex...
Short implants often have the disadvantage of reduced primary stability. The present study was conducted to evaluate the feasibility and safety of a new expandable short dental implant system intended to increase primary stability.
As a “proof of concept”, a prospective clinical cohort study was designed to investigate intraoperative handling, primary and secondary implant stability (resonanc...
Valdec, S., Pasic, P., Soltermann, A. et al. Alveolar ridge preservation with autologous particulated dentin—a case series.
Int J Implant Dent 3, 12 (2017). https://doi.org/10.1186/s40729-017-0071-9
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Received: 07 December 2016
Accepted: 15 March 2017
Published: 30 March 2017
DOI: https://doi.org/10.1186/s40729-017-0071-9
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, University Hospital Zurich, Plattenstrasse 11, 8032, Zürich, Switzerland
Silvio Valdec, Pavla Pasic, Bernd Stadlinger & Martin Rücker
Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland
Alex Soltermann
Clinic of Fixed and Removable Prosthodontics and Dental Mater...
We would like to express our thanks to Dr. Gabriel Bosch for the superimposition, calculation and illustration of the intraoral scans.
SV, BS and MR created the conception and study design. MR performed the surgical and DT the prosthodontic treatment. SV, PP and DT performed the data collection and AS the histological examination. SV, BS and AS analysed and interpreted the data. SV drafted the ma...
Sculean A, Berakdar M, Chiantella GC, Donos N, Arweiler NB, Brecx M. Healing of intrabony defects following treatment with a bovine-derived xenograft and collagen membrane. A controlled clinical study. J Clin Periodontol. 2003;30(1):73–80.
Sutton DN, Lewis BR, Patel M, Cawood JI. Changes in facial form relative to progressive atrophy of the edentulous jaws. Int J Oral Maxillofac Surg. 2004;33(7...
Liu X, Li Q, Wang F, Wang Z. Maxillary sinus floor augmentation and dental implant placement using dentin matrix protein-1 gene-modified bone marrow stromal cells mixed with deproteinized boving bone: a comparative study in beagles. Arch Oral Biol. 2016;64:102–8. doi:10.1016/j.archoralbio.2016.01.004.
Pang KM, Um IW, Kim YK, Woo JM, Kim SM, Lee JH. Autogenous demineralized dentin matrix from ex...
Furhauser R, Florescu D, Benesch T, Haas R, Mailath G, Watzek G. Evaluation of soft tissue around single-tooth implant crowns: the pink esthetic score. Clin Oral Implants Res. 2005;16(6):639–44. doi:10.1111/j.1600-0501.2005.01193.x.
Guirado JL, Troiano M, Lopez-Lopez PJ, Ramirez-Fernandez MP, de Val JE, Marin JM, Gehrke SA. Different configuration of socket shield technique in peri-implant bone...
Al-Asfour A, Andersson L, Kamal M, Joseph B. New bone formation around xenogenic dentin grafts to rabbit tibia marrow. Dent Traumatol. 2013;29(6):455–60. doi:10.1111/edt.12045.
Albrektsson T, Zarb G, Worthington P, Eriksson AR. The long-term efficacy of currently used dental implants: a review and proposed criteria of success. Int J Oral Maxillofac Implants. 1986;1(1):11–25.
Andersson L. Den...
Within the limits of this case series, it has been shown that particulated dentin of autologous teeth may serve as an alternative to autologous bone for alveolar ridge preservation prior to implant therapy. However, randomized studies on this treatment option are necessary.
In humans, particulated tooth material has been used for sinus augmentation in order to enhance implant therapy. Preliminary results from five patients histologically showed an osteoconductive osteogenesis with partial resorption of tooth components [25].
In the present case series, all patients underwent socket preservation with AutoPD. In all cases, one or two upper frontal central incisors wer...
The aim of this case series is to demonstrate the efficacy and safety of this novel augmentative procedure for ridge preservation prior to implant therapy. This shall serve as a basis for a prospective study.
In all four cases, patients showed a stable volume of soft and hard tissues after the augmentation with AutoPD and good osseointegration of titanium implants, having been placed in this augm...
Four months post-extraction and augmentation with autologous, particulated dentin, all four patients received an implant placement in the augmented area. In all cases, a CBCT was taken in between the dentin augmentation and the implant placement.
During implant placement, a biopsy of the bone from the augmented area was taken for histological examination (Fig. 17).
The final prosthetic solution...
The 1-year follow-up examination of the presented case showed an implant success, according to the appropriate clinical criteria [2] (Figs. 14, 15 and 16).
The pink esthetic score (PES) was used for the evaluation of reproducible soft tissue around the final implant crown as a parameter for the aesthetic outcome [12]. Seven variables were evaluated comparing the soft tissue around the implant wi...
An autologous soft tissue graft was harvested from the patient’s palate using a soft tissue punch (Biopsy Punch, kai Europe GmbH, Solingen, Germany) (Fig. 9). The graft had a comparable dimension as the recipient site. The gingival graft was placed on top of the augmentation material, adapted and carefully sutured to the marginal gingiva after the sulcus epithelium was removed with a rotating d...
Four patients between 36 and 65 years of age are presented in this case series. There was no financial compensation. All four patients suffered from a trauma, causing damage to one or two teeth of the anterior maxilla. The frontal tooth/teeth has/had to be extracted. The pulp of the extracted teeth of three patients and the root canal filling of one patient had to be removed. All patients were in...
Subsequent to tooth extraction, a resorption of the host bone as defined by atrophy of the alveolar ridge can be observed. Sutton et al. classified the different degrees of alveolar ridge atrophy [32]. Bone resorption especially occurs in the frontal and premolar area of the jaw in the region of the thin buccal lamella. This may lead to a change in contour [11, 28]. Physiological reason for this a...
Ridge preservation can be performed with autologous bone, alloplastic bone substitute material or a combination of both. Dentin is similar to bone in its chemical composition. In its use as bone substitute material, it undergoes a remodelling process and transforms to bone. The presented case report introduces a technique in which the extraction socket is augmented with autologous, particulated de...
Fig. 6. Micro CT scan images of the MDIs and Ankylos® embedded in rabbit bone 6 weeks post implantation
Fig. 6. Micro CT scan images of the MDIs and Ankylos® embedded in rabbit bone 6 weeks post implantation
Fig. 5. Histological section of standard implant in rabbit tibia stained with methylene blue and basic fuchsin
Fig. 5. Histological section of standard implant in rabbit tibia stained with methylene blue and basic fuchsin
Fig. 4. Histological section of mini dental implant in rabbit tibia stained with methylene blue and basic fuchsin
Fig. 4. Histological section of mini dental implant in rabbit tibia stained with methylene blue and basic fuchsin
Fig. 3. Histological sections being obtained with Leica SP 1600 saw microtome
Fig. 3. Histological sections being obtained with Leica SP 1600 saw microtome
Fig. 2. Leica SP 1600 saw microtome
Fig. 2. Leica SP 1600 saw microtome
Fig. 1. Radiograph showing implants in the rabbit tibia
Fig. 1. Radiograph showing implants in the rabbit tibia
BIC
3M™ ESPE™ MDIs
Ankylos® Friadent (Dentsply)
Median
58.5
57
...
Sample
3M™ESPE™ MDIs
Ankylos®
1.
67
54
2.
...
Dhaliwal, J.S., Albuquerque, R.F., Murshed, M. et al. Osseointegration of standard and mini dental implants: a histomorphometric comparison.
Int J Implant Dent 3, 15 (2017). https://doi.org/10.1186/s40729-017-0079-1Download citationReceived: 22 February 2017Accepted: 26 April 2017Published: 01 May 2017DOI: https://doi.org/10.1186/s40729-017-0079-1
Dhaliwal, J.S., Albuquerque, R.F., Murshed, M. et al. Osseointegration of standard and mini dental implants: a histomorphometric comparison.
Int J Implant Dent 3, 15 (2017). https://doi.org/10.1186/s40729-017-0079-1
Download citation
Received: 22 February 2017
Accepted: 26 April 2017
Published: 01 May 2017
DOI: https://doi.org/10.1186/s40729-017-0079-1
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
This article was ammended to correct discrpencies in the Abstract. An erratum has also been published for this manuscript.
An erratum to this article is available at http://dx.doi.org/10.1186/s40729-017-0088-0.
Faculty of Dentistry, McGill University, 2001 McGill College Avenue, Suite 500, Montreal, Quebec, H3A 1G1, Canada
Jagjit S. Dhaliwal, Monzur Murshed & Jocelyne S. Feine
Faculty of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
Rubens F. Albuquerque Jr
Department of Medicine, McGill University, Montreal, Quebec, Canada
Monzur Murshed
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Schwartz Z, Lohmann CH, Oefinger J, Bonewald LF, Dean DD, Boyan BD. Implant surface characteristics modulate differentiation behavior of cells in the osteoblastic lineage. Adv Dent Res. 1999;13:38–48.
Boyan BD, Lossdorfer S, Wang L, Zhao G, Lohmann CH, Cochran DL, et al. Osteoblasts generate an osteogenic microenvironment when grown on surfaces with rough microtopographies. Eur Cell Mater. 2003...
Hayakawa T, Yoshinari M, Kiba H, Yamamoto H, Nemoto K, Jansen JA. Trabecular bone response to surface roughened and calcium phosphate (Ca-P) coated titanium implants. Biomaterials. 2002;23(4):1025–31.
Sul YT, Byon ES, Jeong Y. Biomechanical measurements of calcium-incorporated oxidized implants in rabbit bone: effect of calcium surface chemistry of a novel implant. Clin Implant Dent Relat Res. ...
Park JW, Kim HK, Kim YJ, An CH, Hanawa T. Enhanced osteoconductivity of micro-structured titanium implants (XiVE S CELLplus) by addition of surface calcium chemistry: a histomorphometric study in the rabbit femur. Clin Oral Implants Res. 2009;20(7):684–90.
Yang GL, He FM, Yang XF, Wang XX, Zhao SF. Bone responses to titanium implants surface-roughened by sandblasted and double etched treatments...
Buser D, Schenk RK, Steinemann S, Fiorellini JP, Fox CH, Stich H. Influence of surface characteristics on bone integration of titanium implants. A histomorphometric study in miniature pigs. J Biomed Mater Res. 1991;25(7):889–902.
Gotfredsen K, Wennerberg A, Johansson C, Skovgaard LT, Hjorting-Hansen E. Anchorage of TiO2-blasted, HA-coated, and machined implants: an experimental study with rabbi...
Trisi P, Lazzara R, Rao W, Rebaudi A. Bone-implant contact and bone quality: evaluation of expected and actual bone contact on machined and osseotite implant surfaces. Int J Periodontics Restorative Dent. 2002;22(6):535–45.
Froum SJ, Simon H, Cho SC, Elian N, Rohrer MD, Tarnow DP. Histologic evaluation of bone-implant contact of immediately loaded transitional implants after 6 to 27 months. In...
Hong RK, Heo JM, Ha YK. Lever-arm and mini-implant system for anterior torque control during retraction in lingual orthodontic treatment. Angle Orthod. 2005;75(1):129–41.
Mazor Z, Steigmann M, Leshem R, Peleg M. Mini-implants to reconstruct missing teeth in severe ridge deficiency and small interdental space: a 5-year case series. Implant Dent. 2004;13(4):336–41.
Siddiqui AA, Sosovicka M, Go...
Branemark PI, Adell R, Breine U, Hansson BO, Lindstrom J, Ohlsson A. Intra-osseous anchorage of dental prostheses. I. Experimental studies. Scand J Plast Reconstr Surg. 1969;3(2):81–100.
Boerrigter EM, Stegenga B, Raghoebar GM, Boering G. Patient satisfaction and chewing ability with implant-retained mandibular overdentures: a comparison with new complete dentures with or without preprosthetic ...
The results of this study show that MDIs as well as regular implants osseointegrate in rabbits.
Our study is also in concordance with the results of a removal torque study by Simon et al. [63] in immediately loaded “transitional endosseous implants” in humans. The percentage BIC for MDIs was similar to standard implants.
The surface topography also affects the BIC, Wennerberg et al. [32] measured and compared removal torque values on screw-shaped titanium implants with three surface typ...
The osseointegration potential of 3M™ESPE™ MDIs has not been studied. The MDI is a one-piece implant that simplifies the restorative phase resulting in a reduced cost for the patient. Titanium-aluminum-vanadium alloy (Ti 6Al-4V-ELI) is used for increased strength. The success of these implants led to its use in long-term fixed and removable dental prostheses [51]. Conventional implant treatmen...
On the whole, postoperative wound healing in all the rabbits was good. None of them exhibited any signs of wound infection or exposure. A total of 36 specimens were retrieved for histological examination.
All of the implants in both groups showed osseointegration and displayed a good amount of bone contact length (Figs. 4 and 5). No discernible differences were noticed between both the groups. T...
The saw blade has a thickness of 280 μm and a feed of 310 μm was selected to obtain the final section thickness of 30 μm. The knurled screw was used for the setting of the section thickness. The prepared section was finally removed from the saw blade. The specimens were prepared for histology by the method as described by Donath and Breuner [49].
Subsequently, the sections were stained with...
The specimens were dehydrated in the ascending graded ethanol solution and kept in a pre-filtration solution for 3 h at room temperature and then in the filtration solution at 4 °C for 17 h. The specimens were then embedded in a light curing resin Technovit 9100 NEW (Kulzer & Co., Wehrheim, Germany) polymerization system based on methyl methacrylate, specially developed for embedding mineraliz...
Expected length of the procedure was approximately 1 h. Following placement of the implants, the wound was sutured in layers. The underlying muscle, fascia, and dermal layers were sutured with the help of Vicryl (Polyglactin 910) suture with 3/8 circle reverse cutting needle. The skin was sutured to a primary closer with the same suture material.
Plain X-ray images of all the rabbit tibia were t...
A small longitudinal skin incision just distal to the tibia-femur joint was made. The tibia/femur head was exposed subperiosteally and an osteotomy performed with the delicately placed pilot drill over the entry point and lightly pumped up and down under copius saline irrigation just to enter the cortical bone for the MDIs. This was used for initial bone drilling to depth of 0.5 mm. The 3M™ESPE...
Nine clinically healthy New Zealand white rabbits weighing 3.5 kg and more were used for the study, and the animals were housed in the central animal house facility. The head of tibia/femur of the animals were used for the implantation of samples. Rabbits’ tibiae and femur have been widely used as an animal model by various other authors to study osseointegration of dental implants [36–45].
...
Despite the advantages of the mini dental implants, evidence on their efficacy and long-term success is lacking. The success of these implants will depend on their union with the surrounding bone. New implant systems entering into the market have to be studied with the help of animal models first, to demonstrate the osseointegration potential for their probable success in humans. There is a limite...
The term “osseointegration” was first introduced to explain the phenomenon for stable fixation of titanium to bone by Brånemark et al. in the 1960s [1]. Osseointegrated implants were introduced, a new era in oral rehabilitation began, and many studies were conducted [2, 3]. A success rate of over 90% has been reported [4, 5]. Further, a success rate of 81% in the maxillary bone and 91% in the...
Mini dental implants (MDIs) are becoming increasingly popular for rehabilitation of edentulous patients because of their several advantages. However, there is a lack of evidence on the osseointegration potential of the MDIs. The objective of the study was to histomorphometrically evaluate and compare bone apposition on the surface of MDIs and standard implants in a rabbit model.
Nine New Zealand ...
Nery, J.C., Pereira, L.A.V.D., Guimarães, G.F. et al. β-TCP/HA with or without enamel matrix proteins for maxillary sinus floor augmentation: a histomorphometric analysis of human biopsies.
Int J Implant Dent 3, 18 (2017). https://doi.org/10.1186/s40729-017-0080-8
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Received: 08 December 2016
Accepted: 22 April 2017
Published: 04 May 2017
DOI: https://do...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
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James Carlos Nery.
Department of Implantology, São Leopoldo Mandic Research Center, Brasília, DF, Brazil
James Carlos Nery, George Furtado Guimarães & Fabiana Mantovani Gomes França
Department of Biochemistry and Tissue Biology, UNICAMP – State University of Campinas, Institute of Biology, Campinas, São Paulo, Brazil
Luís Antônio Violin Dias Pereira
Department of Periodontology, UNESP – Univ. Estad...
Wikesjo UM, Sorensen RG, Kinoshita A, Wozney JM. RhBMP-2/alphaBSM induces significant vertical alveolar ridge augmentation and dental implant osseointegration. Clin Implant Dent Relat Res. 2002;4:174–82.
Carinci F, Brunelli G, Franco M, Viscioni A, Rigo L, Guidi R, et al. A retrospective study on 287 implants installed in resorbed maxillae grafted with fresh frozen allogenous bone. Clin Implant...
Miron RJ, Sculean A, Cochran DL, Froum S, Zucchelli G, Nemcovsky C, et al. Twenty years of enamel matrix derivative: the past, the present and the future. J Clin Periodontol. 2016;43:668–83.
Sculean A, Nikolidakis D, Nikou G, Ivanovic A, Chapple IL, Stavropoulos A. Biomaterials for promoting periodontal regeneration in human intrabony defects: a systematic review. Periodontol 2000. 2015;68:182...
Esposito M, Felice P, Worthington HV. Interventions for replacing missing teeth: augmentation procedures of the maxillary sinus. Cochrane Database Syst Rev. 2014;17:CD008397.
Jungner M, Cricchio G, Salata LA, Sennerby L, Lundqvist C, Hultcrantz M, et al. On the early mechanisms of bone formation after maxillary sinus membrane elevation: an experimental histological and immunohistochemical study. ...
The present study showed that maxillary sinus floor augmentation with BC resulted in adequate amounts of new bone formation allowing successful implant installation, while adding EMD did not have a significant effect.
Nevertheless, the amount of bone generated with BC or BC + EMD herein was adequate to support successful implant placement and osseointegration of implants. In fact, more or less similar amounts of bone formation have been reported in studies evaluating human sinus biopsies after grafting with a variety of biomaterials (bone formation ranging approximately from 30 to 50%) [19]. On the other ha...
The present study compared the histological and histomorphometrical outcome of healing after maxillary sinus floor augmentation with BC with or without EMD, based on human biopsies. The results showed that addition of EMD did not enhance the outcome of healing, neither in terms of quality nor quantity of new bone. Nevertheless, the amount of bone generated after maxillary sinus floor augmentation ...
All ten patients showed uneventful healing after the sinus floor augmentation procedure as well as after dental implant placement, with no overt postoperative inflammation or infection. Consistently, in all ten patients, no significant jiggling of the drill was noticed during biopsy harvesting, while subjective drilling resistance during implant placement was similar in both groups and all implant...
The data for each tissue component from the three histological sections were averaged to represent the biopsy. Commercially available software (GraphPad Prism 5.0 for Windows, GraphPad Software Inc., USA) was utilized for statistical comparisons between groups and for drawing the graphics. The assumption of normality was checked using D’Agostino & Pearson omnibus test. The data for each evaluate...
Six months after grafting, another CBCT examination was carried out for implant planning. In the sequence, following the previously described antiseptic and anesthetic procedures, two implants with a sand-blasted and acid etching surface were installed in each of the grafted sinuses, i.e., 40 implants in total (32—Neoporous, Neodent, Curitiba, Paraná, Brazil; 8—SLA, Straumann, Basel, Switzerl...
This research project was approved by the Ethics Committee of the School of Dentistry and Dental Research Center São Leopoldo Mandic, Brazil, under the protocol 2010/0360.
Ten consecutive patients (age range 35–75 years) with the need of bilateral maxillary sinus floor augmentation prior to the placement of four dental implants (two in each side of posterior maxilla) were selected for the stu...
The aim of the present study was to compare histomorphometrically the outcome of maxillary sinus floor augmentation with β-TCP/HA with or without enamel matrix proteins (BC + EMD and EMD, respectively) in humans.
Reconstruction of the edentulous and severely atrophied posterior maxilla is often performed by means of maxillary sinus floor augmentation in combination with dental implants [1, 2]. Various bone graft materials are typically used for enhancing bone formation within the sinus cavity; autogenous bone (AB) is considered as the gold standard due to its osteogenic, osteoinductive, and osteoconductive...
It is still unclear whether enamel matrix proteins (EMD) as adjunct to bone grafting enhance bone healing. This study compared histomorphometrically maxillary sinus floor augmentation (MSFA) with β-TCP/HA in combination with or without EMD in humans.
In ten systemically healthy patients needing bilateral MSFA, one side was randomly treated using β-TCP/HA mixed with EMD (BC + EMD) and the ot...
Tanaka, K., Sailer, I., Kataoka, Y. et al. Sandwich bone graft for vertical augmentation of the posterior maxillary region: a case report with 9-year follow-up.
Int J Implant Dent 3, 20 (2017). https://doi.org/10.1186/s40729-017-0063-9
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Received: 15 October 2016
Accepted: 13 January 2017
Published: 19 May 2017
DOI: https://doi.org/10.1186/s40729-017-0063-...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Division of Oral and Maxillofacial Surgery, Department of Oral Medicine and Surgery, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai, 980-8575, Miyagi, Japan
Kenko Tanaka, Yoshihiro Kataoka, Shinnosuke Nogami & Tetsu Takahashi
Division of Fixed Prosthodontics and Biomaterials Clinic of Dental Medicine, University of Geneva, 19 rue Barthélemy-Menn, CH-1205, ...
The authors thank Atumu Kouketu for his figure illustration support and Kouhei Shinmyouzu for the clinical support.
Authors Kenko Tanaka, Irena Sailer, Yoshihiro Kataoka, Shinnosuke Nogami, and Tetsu Takahashi declare that they have no competing interests.
Thoma DS, Zeltner M, Hüsler J, Hämmerle CH, Jung RE, EAO Supplement Working Group 4 - EAO CC. Short implants versus sinus lifting with longer implants to restore the posterior maxilla: a systematic review. Clin Oral Implants Res. 2015;26:154–169.
Lee SA, Lee CT, Fu MM, Elmisalati W, Chuang SK. Systematic review and meta-analysis of randomized controlled trials for the management of limited ve...
Adell R, Brånemark PI. A 15-year study of osseointegrated implant in the treatment of the edentulous jaw. Int J Oral Maxillofac Surg. 1981;10:387–416.
Albrektsson T, Zarb G, Worthington P, Eriksson AR. The long-term efficacy of currently used dental implants: a review and proposed criteria of success. Int J Oral Maxillofac Implants. 1986;1:11–25.
Cordo L, Terheyden H. ITI treatment guide vo...
We described in the present case a vertical lack of the bone from the alveolar ridge to the opposing teeth, the short distance from the reabsorbed ridge to the floor of the maxillary sinus, and the presence of septa and a thickened sinus membrane within the maxillary sinus. A sandwich bone graft was successfully applied and followed up in the long term. The resulting gains in ridge height and incr...
In this case, the alveolar ridge was Seibert class II, and septa and a thickened sinus membrane were evident within the maxillary sinus. Sinus floor elevation was limited because of the condition of the floor morphology, the presence of septa, and the thickness of sinus floor membrane [22, 23]. Considering these issues, we selected the interpositional bone graft technique using autologous bone in ...
This paper reports on a segmental osteotomy procedure with an interpositional graft in the posterior maxillary region with 9 years of follow-up.
The techniques used to overcome a lack of alveolar bone height rely on the placement supplemented by various vertical guided bone regeneration (GBR) procedures [4, 5] and the use of alveolar distraction osteogenesis [6], titanium mesh [7], or onlay bone...
Six months after surgery, radiological examinations were carried out and the patient underwent implant placement (Fig. 4). The postoperative bone height had increased to 10.1 mm at position 26 and 12.9 mm at position 27 compared with the preoperative heights of 6.1 and 7.5 mm, respectively. Postoperative clearance was reduced by 11 mm compared with the preoperative clearance. Careful separati...
A 67-year-old male patient sought implant rehabilitation for the purposes of restoration of occlusal support and assistance with chewing difficulties. Clinical and radiological examinations revealed that teeth were absent 26–27. The clearance from the alveolar ridge to the opposing teeth was 20 mm (Fig. 1). A CT scan showed that the distance from the reabsorbed ridge to the floor of the maxill...
In the literature, the technique of segmental osteotomy accompanied by interpositional grafting has been reported as a practical and predictable procedure with a low incidence of complications and a high probability of success [15,16,17,18,19]. This approach leaves the soft tissue on the oral side of the midcrestal incision attached to the crestal bone segment. Various studies have shown that alve...
Osseointegrated implants for the replacement of missing teeth have recently become a routine treatment option [1, 2]. However, any tooth loss may be followed by extensive resorption of the alveolar ridge, which usually makes implant placement difficult or impossible because of the lack of bone volume. There are a variety of defect situations with increasing complexity, ranging from fenestrations, ...
The loss of teeth followed by bone resorption often lead to defects in the alveolar ridge, making installation of dental implants difficult. Correction of such bone defects, especially lack of height of the ridge, is a difficult problem for all dental surgeons. This report describes the outcome of treatment after alveolar ridge augmentation in the atrophic posterior maxillary region via segmental ...
Fig. 5. Survival rate of dental implants after autologous bone augmentation
Fig. 5. Survival rate of dental implants after autologous bone augmentation
Fig. 4. Postoperative nerve alterations. Single asterisk, N refers to the total number of the surgical approaches in the mandible (N = 155). Double asterisk, N refers to the total number of the surgical approaches in the maxilla (N = 225)
Fig. 4. Postoperative nerve alterations. Single asterisk, N refers to the total number of the surgical approaches in the mandible (N = 155). Dou...
Fig. 3. Surgical outcome after autologous augmentation procedures from different donor sites
Fig. 3. Surgical outcome after autologous augmentation procedures from different donor sites
Fig. 2. Survival rate of autologous bone grafts
Fig. 2. Survival rate of autologous bone grafts
Fig. 1. Postoperative complications at the donor and recipient site, N refers to the total number of the donor sites (N = 300), N refers to the total number of the recipient sites (N = 378)
Fig. 1. Postoperative complications at the donor and recipient site, N refers to the total number of the donor sites (N = 300), N refers to the total number of the recipient sites (N = 378)
Postoperative complications
%/procedures (N)
At donor sitea
Wound infection
2.6% (8/300)
At recipient site...
Donor site
Bone grafts (N)/patients (N)
Lateral zygomatic buttress
113/112
Mandibular ramus (retromolar)
...
Patient characteristics
N (%)
Gendera
Male
250 (89.6%)
Female
29 (10.4%)
...
Sakkas, A., Wilde, F., Heufelder, M. et al. Autogenous bone grafts in oral implantology—is it still a “gold standard”? A consecutive review of 279 patients with 456 clinical procedures.
Int J Implant Dent 3, 23 (2017). https://doi.org/10.1186/s40729-017-0084-4
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Received: 27 February 2017
Accepted: 22 May 2017
Published: 01 June 2017
DOI: https://doi...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Department of Oral and Plastic Maxillofacial Surgery, Military Hospital Ulm, Academic Hospital of the University of Ulm, Oberer Eselsberg 40, 89081, Ulm, Germany
Andreas Sakkas, Frank Wilde, Marcus Heufelder & Alexander Schramm
Institute of Anatomy, Medical Faculty of Leipzig University, Leipzig, Germany
Karsten Winter
Department of Oral and Plastic Maxillofacial Surgery, University Hospit...
The authors thank the patients for their kindness to participate as study cases and the whole medical team at the Bundeswehrkrankenhaus Ulm.
AS participated in its design and coordination, carried out the data selection, and drafted the manuscript, and is the corresponding author. FW participated in its design and coordination and helped in drafting the manuscript. MH participated in its design a...
Semper W, Kraft S, Mehrhof J, Nelson K. Impact of abutment rotation and angulation on marginal fit: theoretical considerations. Int J Oral Maxillofac Implants. 2010;25:752–8.
Wiltfang J, Jätschmann N, Hedderich J, Neukam FW, Schlegel KA, Gierloff M. Effect of deproteinized bovine bone matrix coverage on the resorption of iliac cortico-spongeous bone grafts—a prospective study of two cohorts....
Chiapasco M, Zaniboni M. Clinical outcomes of GBR procedures to correct peri-implant dehiscences and fenestrations: a systematic review. Clin Oral Implants Res. 2009;20:113–23.
Felice P, Pellegrino G, Checchi L, Pistilli R, Esposito M. Vertical augmentation with interpositional blocks of anorganic bovine bone vs. 7-mm-long implants in posterior mandibles: 1-year results of a randomized clinical...
Verdugo F, Castillo A, Moragues MD, Pontón J. Bone microbial contamination influences autogenous grafting in sinus augmentation. J Periodontol. 2009;80:1355–64.
Wiltfang J, Schultze-Mosgau S, Merten HA, Kessler P, Ludwig A, Engelke W. Endoscopic and ultrasonographic evaluation of the maxillary sinus after combined sinus floor augmentation and implant insertion. Oral Surg Oral Med Oral Pathol O...
von Arx T, Buser D. Horizontal ridge augmentation using autogenous block grafts and the guided bone regeneration technique with collagen membranes: a clinical study with 42 patients. Clin Oral Implants Res. 2006;17:359–66.
Levin L, Nitzan D, Schwartz-Arad D. Success of dental implants placed in intraoral block bone grafts. J Periodontol. 2007;78:18–21.
Andersson L. Patient self-evaluation of...
Aghaloo TL, Moy PK. Which hard tissue augmentation techniques are the most successful in furnishing bony support for implant placement? Int J Oral Maxillofac Implants. 2007;22:49–70.
Margonar R, dos Santos PL, Queiroz TP, Marcantonio E. Rehabilitation of atrophic maxilla using the combination of autogenous and allogeneic bone grafts followed by protocol-type prosthesis. J Craniofac Surg. 2010;2...
Schwartz-Arad D, Dori S. Intraoral autogenous onlay block bone grafting for implant dentistry. Refuat Hapeh Vehashinayim. 2002;19:35–9. 77.
Misch CM. Ridge augmentation using mandibular ramus bone grafts for the placement of dental implants: presentation of a technique. Pract Periodontics Aesthet Dent. 1996;8:127–35.
Altiparmak N, Soydan SS, Uckan S. The effect of conventional surgery and pi...
Jensen AT, Jensen SS, Worsaae N. Complications related to bone augmentation procedures of localized defects in the alveolar ridge. A retrospective clinical study. Oral Maxillofac Surg. 2016;20(2):115–22 [Epub ahead of print].
Buser D, Dula K, Hirt HP, Schenk RK. Lateral ridge augmentation using autografts and barrier membranes: clinical study with 40 partially edentulous patients. J Oral Maxill...
The results of the clinical study proves the reliability and low comorbidity of autologous bone grafts in preprosthetic alveolar ridge reconstructions prior to implant insertion. The high graft success rate (95.6%) and the low early implant failure rate (0.38%) in a surveillance of all patients treated in three following years with this technique showing no exclusion and no dropout of any case for...
Data on risk factors based on the original examination and documentation are difficult to assess the adverse effects of variable factors on the surgical prognosis because of the multifactorial genesis of surgical complications [73]. Factors such as gender, age, or smoking habit could be associated with postoperative complications after two-stage dentoalveolar reconstruction with autologous bone gr...
The results of the present study have to take into account the absence of a control group with patients undergoing bone augmentation procedures with bone substitutes (allogen, alloplastic, exogen). Without a comparative group of grafting surgeries using alternative bone material, only limited statements can be made.
However, the excellent surgical outcome of autologous surgical methods providing ...
The use of autologous bone in this study has shown excellent graft survival and success rate (95.6%). This is equal to the results from the studies on implants inserted in reconstructed sites [6, 8, 24]. The early implant survival rate of 99.7% found in the present material is very high comparable to that in the previous systematic reviews after staged horizontal ridge augmentation [9, 10, 22, 62,...
Of the sinus floor elevations performed in this study, 84.8% were defined absolutely successful. Only two of our 72 patients having sinus lift operations could not finally be treated with dental implants. These results are comparable to other studies considering the sinus graft to be a safe treatment modality with few complications [6, 8, 51,52,53]. Raghoebar et al. reported incidences of sinus co...
Postoperative morbidity after mandibular bone harvesting procedures was reported to be mainly related to temporary or permanent neural disturbances involving the inferior alveolar nerve and its branches [19]. In this study, only the incidence of the temporary hypoesthesia of the mandibular and lingual nerve after harvesting from the retromolar area could be detected. It was 10.4 and 2.8%, respecti...
Systematic reviews have failed to find evidence that one particular grafting technique is superior to others [10]. Intraoral bone grafts from the mandibular symphysis, mandibular ramus, and maxillary tuberosity provide a good treatment modality for ridge augmentation, and the amount of bone available for harvesting is sufficient for defects up to the width of three teeth [42]. Harvesting of retrom...
Several grafting procedures have been described to create sufficient volume of bone for implant placement [8, 9]. Autologous bone grafts can be harvested by an intraoral approach (mandibular ramus, mandibular symphysis, zygomatic buttress) or from distant sites (iliac crest, calvaria, and etc.) [17, 36, 37]. However, bone harvesting potentially causes donor site morbidity which is a major issue fo...
The surgical outcome after augmentation and implantation procedures is presented in Fig. 5.
The average healing period until implant placement after bone harvesting was 4.53 months. Initially, 546 implants in 279 patients were planned. After the healing period, it was possible to place 525 implants in 436 successfully augmented areas in 259 patients. Three hundred implants were inserted in the maxilla and 225 in the mandible. The remaining 21 implants planned for 20 patients could not b...
Regarding intraoperative complications, all sinus membrane perforations were covered with a resorbable collagen membrane (Bio-Gide®, Geistlich Biomaterials, Baden-Baden, Germany) which applied as sealant to overlap the site of perforation prior to insertion of the graft material. These patients were advised to avoid physical stress, blowing their noses, or sneezing for a period of 3 weeks, and n...
No permanent damage to any trigeminal nerves was evident in any of our entire cohort. All cases of postoperative hypoesthesia of the mental, lingual, or infraorbital nerve were just a temporary nature. At the time of implant surgery, none of these patients reported any persisting neural disturbances (Fig. 4).
In eleven patients, hypoesthesia of the mental area was mentioned, and three of them al...
Thirty-eight patients underwent a total of 116 augmentation procedures harvesting from the iliac crest. In 20 patients, a bone graft augmentation of the maxilla and the mandible in combination with bilateral sinus floor augmentations was performed. Eighteen patients had augmentations only in the maxilla, involving bone grafting and sinus lift elevations. Totally, 76 sinus lifts with bone material ...
A total of 104 retromolar bone graft procedures in 86 patients were conducted. Twenty-two harvesting procedures were performed for augmentation of the maxilla and 82 for the mandible. Seven retromolar bone grafts (93.2%) in seven single-tooth gap dental regions by seven patients had been lost. Therefore, seven implants could not be inserted in augmented alveolar sites after graft failure. Three of...
In six patients, a partial graft resorption was detected at the time of implantation and an additional simultaneous augmentation with bone chips harvested with the Safescraper device (C.G.M. S.p.A., Divisione Medicale META, Italy) was then necessary in order to ensure the osseointegration of the implants. Two out of these six cases had grafts from the crista zygomatico-alveolaris, two from the ram...
A total of 112 sinus floor elevations were performed. In all of the cases, implants were inserted in a two-stage procedure. The donor site for harvesting the bone for the sinus elevations was in 76 procedures in the iliac crest area, and in 36 procedures, the bone was harvested with a bone scraper device from the lateral sinus wall at the site of sinus lifting.
The distribution and number of tran...
Two hundred seventy-nine patients—250 men and 29 women—underwent 456 augmentation procedures involving autologous bone grafts prior to implant placement. The patients ranged in age from 18.5 to 71.5 years (average 43.1 years) at the moment of augmentation surgery.
Of those patients, 162 (58.1%) were younger than 40 years of age and 117 (41.9%) were older than 40 years of age. Caries or pe...
Early and late implant loss was documented in this study, defining the clinical success of osseointegration. Early implant failures were assessed before the acquisition of osseointegration, i.e., before the placement of prosthodontic restorations. Early implant failure could occur from the time of placement, during the healing phase and before abutment connection. The implant inserted after re-aug...
Medical history of patient
Age of patient at the time of bone harvesting and augmentation
History of periodontal disease
Smoking habits
Donor site
Jaw area and dental situation of the recipient site
Intraoperative complications
Postoperative complications after augmentation
Management of complications
Bone graft stability and clinical resorption prior to implant placement
Complications a...
In addition to the bone already gained with the bone scraper device from the sinus wall during the antrostomy, bone was harvested with the same device from the maxillary buccal buttress, if more volume was needed. By taking this approach, the collection of enough bone for the augmentation of at least two implantation sites was feasible with a mean surgical time of 5 to 10 min for harvesting. In c...
Grafting from the iliac crest was always performed under general anesthesia in a two-team approach. The iliac crest was exposed and autogenous grafts from the anterosuperior inner edge of the iliac wing were harvested with an oscillating saw and/or a chisel, keeping a safe distance of around 2 cm from the anterosuperior iliac spine. After harvesting the bone grafts, the corticocancellous bone blo...
A standardized two-stage surgical protocol was used, and all sites were treated in a similar fashion. In the first intervention, a bone block harvested from the donor site was fixed with osteosynthesis titanium screws to the recipient site as an onlay graft to achieve a horizontal and/or vertical enlargement of the alveolar ridge. Placement of the bone graft was always guided by an augmentation te...
For this retrospective cohort study, we reviewed the records of all patients without exclusion criteria who were referred to the department of oral and plastic maxillofacial surgery at the military hospital of Ulm, Germany, between January 2009 and December 2011 for alveolar ridge augmentations prior to implant insertions using autologous bone grafts harvested from different donor sites and unilat...
In our military outpatient center exclusively, autologous bone transplantations harvested from different donor sites were used intraorally (crista zygomatico-alveolaris, ramus mandible, symphysis mandible, anterior sinus wall) and extraorally (iliac crest) to reconstruct severe horizontal and/or vertical alveolar ridge atrophy prior to implant placement. The aim of this study was to assess the cli...
Although the iliac crest is most often used in jaw reconstruction, a significant bone resorption has been mentioned [12]. This disadvantage, and the fact that dental implants do not always require a large amount of bone, has increased the use of autologous block bone grafts from intraoral sources [13]. Bone grafts from intraoral donor sites offer several benefits like surgical accessibility, proxi...
Oral implantation has a significant role in the rehabilitation of patients. Bone reconstruction techniques have been advanced in order to optimize the esthetic and functional outcome. However, the restoration of the oral function of atrophic alveolar crests still remains a challenge in oral implantology. Bone augmentation procedures are often indicated to allow implant placement in an optimal thre...
This review demonstrates the predictability of autologous bone material in alveolar ridge reconstructions prior to implant insertion, independent from donor and recipient site including even autologous bone chips for sinus elevation. Due to the low harvesting morbidity of autologous bone grafts, the clinical results of our study indicate that autologous bone grafts still remain the “gold standar...
This study assessed the clinical outcomes of graft success rate and early implant survival rate after preprosthetic alveolar ridge reconstruction with autologous bone grafts.
A consecutive retrospective study was conducted on all patients who were treated at the military outpatient clinic of the Department of Oral and Plastic Maxillofacial Surgery at the military hospital in Ulm (Germany) in the ...
Fig. 8. Soft tissue dehiscence (a) CCXBB exposure 15 weeks after bone augmentation, the dehiscence healed 2 weeks later after reducing the graft exposure (b) after soft tissue augmentation and abutment connection leading to the loss of the mesial implant. After partial removal of the bone graft and place a connective tissue graft the area healed properly and a month later it was possible to re...
Fig. 7. Second stage surgery of patient in Fig. 1. a Vestibular depth reduction after augmentation and implant placement. b Partial thickness and apical repositioned flap. c CMX healing and soft tissue dehiscence with CCXBB exposure. d Dehiscence healing after re-contouring and buccal emergency profile. e Buccal aspect of the final restoration. f Buccal ridge contour
Fig. 7. Second stage sur...
Fig. 6. Immunohistochemical analysis of slices from the same sample with four different markers. a TRAP. b OPN. c ALP. d OSC
Fig. 6. Immunohistochemical analysis of slices from the same sample with four different markers. a TRAP. b OPN. c ALP. d OSC
section stained with Levai-Laczkó. b Tissue identification of the ROI. c Closer view aized bone and CCXBB. d Closer view of b
Fig. 5. Histomorphometric analysis of the same sample. a Ground section stained with Levai-Laczkó. b Tissue identification of the ROI. c Closer view a arrow pointing a cement line between new mineralized bone and CCXBB. d Closer view of b
Fig. 4. Histological samples. a CCXBB control without implantation. b Histologic samples with acute inflammatory infiltration. c Histologic sample with limited remaining CCXBB and large bone ingrowth
Fig. 4. Histological samples. a CCXBB control without implantation. b Histologic samples with acute inflammatory infiltration. c Histologic sample with limited remaining CCXBB and large bone ingr...
Fig. 3. Re-entry procedure of patient in Fig. 1. a Buccal aspect of the augmented region. b Horizontal bone augmentation. c Screws and pins removal and bone trephine sampling. d Implants placement and buccal bone width from the implant shoulder. e Primary flap closure. f Implants submerged healing
Fig. 3. Re-entry procedure of patient in Fig. 1. a Buccal aspect of the augmented region. b Ho...
Fig. 2. Lateral bone augmentation of the alveolar crest (a) atrophic ridge. b Perforations and adaptation of the cortical layer. c Shaping, pre-wetting and fixation of CCXBB with titanium screws. d Horizontal contour and peripheral gap between CCXBB and bone layer. e Outlying DBBM filling. f CM stabilized with pins
Fig. 2. Lateral bone augmentation of the alveolar crest (a) atrophic ridge. b ...
Fig. 1. Study chart and follow-up visits
Fig. 1. Study chart and follow-up visits
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Ortiz-Vigón, A., Martinez-Villa, S., Suarez, I. et al. Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant placement.
Int J Implant Dent 3, 24 (2017). https://doi.org/10.1186/s40729-017-0087-1
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Received: 21 March 2017
Accepted: 12 June 2017
Published: 21 Ju...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
ETEP Research Group, Facultad de Odontología, Universidad Complutense de Madrid, Plaza Ramón y Cajal, 28040, Madrid, Spain
Alberto Ortiz-Vigón, Sergio Martinez-Villa, Iñaki Suarez, Fabio Vignoletti & Mariano Sanz
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We wish to acknowledge the dedication and scientific advise of Prof. Dr. Tord Berglundh on the histological analysis as well as the diligent work in processing the histological samples to Estela Maldonado for the immunohistochemistry and Asal Shikhan and Fernando Muñoz for the histomorphometry. The work of Esperanza Gross on the statistical analysis is highly acknowledged.
This study was partial...
Patti A, Gennari L, Merlotti D, Dotta F, Nuti R. Endocrine actions of osteocalcin. Int J Endocrinol. 2013;2013:846480.
Schwarz F, Herten M, Sager M, Wieland M, Dard M, Becker J. Histological and immunohistochemical analysis of initial and early osseous integration at chemically modified and conventional SLA titanium implants: preliminary results of a pilot study in dogs. Clin Oral Implants Res. 2...
Araujo MG, Linder E, Lindhe J. Bio-Oss collagen in the buccal gap at immediate implants: a 6-month study in the dog. Clin Oral Implants Res. 2011;22:1–8.
Chiapasco M, Colletti G, Coggiola A, Di Martino G, Anello T, Romeo E. Clinical outcome of the use of fresh frozen allogeneic bone grafts for the reconstruction of severely resorbed alveolar ridges: preliminary results of a prospective study. I...
Jeno L, Geza L. A simple differential staining method for semi-thin sections of ossifying cartilage and bone tissues embedded in epoxy resin. Mikroskopie. 1975;31:1–4.
Dias RR, Sehn FP, de Santana Santos T, Silva ER, Chaushu G, Xavier SP. Corticocancellous fresh-frozen allograft bone blocks for augmenting atrophied posterior mandibles in humans. Clin Oral Implants Res. 2016;27:39–46.
Nissan ...
Cremonini CC, Dumas M, Pannuti C, Lima LA, Cavalcanti MG. Assessment of the availability of bone volume for grafting in the donor retromolar region using computed tomography: a pilot study. Int J Oral Maxillofac Implants. 2010;25:374–8.
Nkenke E, Weisbach V, Winckler E, Kessler P, Schultze-Mosgau S, Wiltfang J, et al. Morbidity of harvesting of bone grafts from the iliac crest for preprosthetic...
Sanz M, Vignoletti F. Key aspects on the use of bone substitutes for bone regeneration of edentulous ridges. Dent Mater. 2015;31:640–7.
Benic GI, Hammerle CH. Horizontal bone augmentation by means of guided bone regeneration. Periodontology. 2014;66:13–40.
Beretta M, Cicciu M, Poli PP, Rancitelli D, Bassi G, Grossi GB, et al. A Retrospective Evaluation of 192 Implants Placed in Augmented Bon...
Alkaline phosphatase
Cone beam computed tomography
Collagen containing xenogeneic bone block
Native collagen membrane
Deproteinized bovine bone mineral
Etiology and Therapy of Periodontal Diseases
Osteopontin
Osteocalcine
Tartrate-resistant acid phosphatase
Within the limitations of this clinical study, we may conclude that the use of CCXBB in combination with DBBM particles and a native bilayer collagen membrane for staged lateral bone augmentation in severe atrophic alveolar crests achieved significant horizontal crestal width allowing for staged implant placement in most of the patients. Histological analysis and implant survival records indicate ...
The immune-histochemical results reported expression of osteopontin mainly at the border between mineralized vital bone (MVB) with CCXBB, what coincides with findings from previous reports [38,39,40]. Alkaline phosphatase (ALP) is considered as an early osteoblast differentiation marker [41]. ALP-positive cells were detectable, in all specimens on the periphery of MVB, associated to areas of new b...
When correlating the clinical results and the histological outcomes, there was a positive association between the presence of soft tissue dehiscence with CCXBB exposure and a diminished amount of new mineralized bone (p = 0.06). This lower amount of new bone within the xenogeneic graft suggests a lack of full graft integration and diminished vascular supply, what may have caused the soft tissu...
The purpose of this investigation was to evaluate histologically and immunohistochemically the behavior of CCXBB blocks when used for staged lateral bone augmentation in severe human horizontal residual bone defects. Six months after the regenerative intervention using the CCXBB blocks, the mean increase in bone width was 4.12 mm and hence, this outcome allowed for the placement of dental implant...
The results from the histomorphometric measurements are depicted in Table 2. Bone biopsies were composed by 21.37% (SD 7.36) of residual CCXBB, 26.90% (SD 12.21) of mineralized vital bone (MVB), 47.13% (SD 19.15) of non-mineralized tissue and 0.92% of DBBM (Fig. 5b). Biopsies from patients who lost their implants had a statistical significant lower amount of MVB (p = 0.01u) and a statistical...
Twenty-eight CCXBB blocks were placed in 15 patients that fulfilled the selection criteria (12 women and 3 men) with a mean age of 54.5 (SD 8.34).
The detailed clinical and radiographical outcomes have been reported previously [21]. In brief, one patient experienced pain and soft tissue dehiscence leading to removal of the graft material 3 days after the regenerative procedure. Another patient r...
For the immunohistochemical analysis, the semi-thin sections were incubated over night with primary antibodies at 4 °C (Santa Cruz Biotechnology Inc., Santa Cruz, Calif., USA). The antibody dilutions used were alkaline phosphatase (ALP) 1:100, osteopontin (OPN) 1:100, osteocalcin (OSC) 1:100, and tatrate resistant acid phosphatase (TRAP) 1:100.
The obtained semi-thin sections were evaluated wit...
Twenty-six weeks after the regenerative procedure the patient returned for the re-entry intervention for placement of dental implants. After raising full-thickness flaps, the augmented area was exposed and horizontal crestal width measurements were performed. Then, the surgeon evaluated the bone availability and if implant placement was considered possible, a core bone biopsy was harvested with th...
CCXBB (Bio-Graft® Geistlich Pharma) is a bone substitute material in a natural block form. The dimensions of the Bio-Graft block are 10 mm in height, 10 mm in length and 5 mm in width. It consists of a natural cancellous bone structure of hydroxyapatite and endogenous collagen type I and III, equine origin and is a class III medical device according to the Medical Device Directive 93/42 EECs...
The present manuscript reports the histological outcomes of a prospective single arm study evaluating the safety and clinical performance of CCXBB blocks when used as replacement bone grafts for lateral bone augmentation prior to staged implant placement. The results of the clinical and radiographic outcomes have been reported in a previous publication [21]. For correlation of the histological wit...
Different techniques and grafting materials have been used for the horizontal reconstruction of deficient alveolar processes before implant placement, resulting in different degrees of predictability and clinical outcomes [1]. Among the grafting materials, particulated xenogeneic materials have been extensively studied in both experimental and clinical studies and when combined with porcine-derive...
The osteoconductive properties of collagen containing xenogeneic bone blocks (CCXBB) remain unclear. The aim of this prospective single-arm clinical study was to assess the histological outcomes of CCXBB blocks used as bone replacement grafts for lateral bone augmentation procedures.
In 15 patients with severe horizontal alveolar ridge resorption, lateral augmentation procedures were performed us...
Fig. 7. image of coronal-apical cut through the entire core biopsy showing formation of new bone (NB) next to old bone of the extraction socket (B). easy-graft CRYSTAL particles (Gr) are embedded in well perfused connective tissue (CT) and new bone (NB) (Azur II and Pararosanilin, original magnification ×50). b Integration of easy-graft CRYSTAL particle (Gr) into newly formed bone (NB) and conn...
Fig. 6. graft integration and preservation of ridge without collapse of the buccal or lingual cortical plates also showing the cross sections in the grafted area
Fig. 6. a–c Four-month postoperative CBCT showing graft integration and preservation of ridge without collapse of the buccal or lingual cortical plates also showing the cross sections in the grafted area
Fig. 5. CBCT images of the extraction site. a Preoperative CBCT showing fractured and un-restorable teeth #45 and #46 planned to be extracted. b–d Cross sectional views
Fig. 5. CBCT images of the extraction site. a Preoperative CBCT showing fractured and un-restorable teeth #45 and #46 planned to be extracted. b–d Cross sectional views
Fig. 4. lant crowns placed and loaded after 3 months of placement
Fig. 4. a Second stage surgery followed by impression making. Note the excellent width of keratinized tissue which was also preserved. b Implant crowns placed and loaded after 3 months of placement
Fig. 3. Postoperative X ray showing the implant positions in the mandible where the teeth were extracted and ridge preservation was accomplished
Fig. 3. Postoperative X ray showing the implant positions in the mandible where the teeth were extracted and ridge preservation was accomplished
Fig. 2. ximation. A good width of keratinized tissue is visible along with ridge preservation. Ready for implant placement in the grafted areas. b Implant placed in 45 area. Core biopsy sample taken from area 46. Note the integration of graft particles in the preserved alveolar ridge also inside the osteotomy site of 46. c Two Xive (Dentsply) implants placed in the preserved ridge. d. Postoperat...
Fig. 1. traction sockets showing good initial graft stability. d Black silk sutures placed with tissue approximation and no releasing incision in the flaps
Fig. 1. a Clinical occlusal view with fractured 45 and 46. b Post-extraction view of the socket. Note minimal trauma to the soft tissue and no flap reflection on the surgical site. c Graft material condensed into the extraction sockets sho...
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Kakar, A., Rao, B.H.S., Hegde, S. et al. Ridge preservation using an in situ hardening biphasic calcium phosphate (β-TCP/HA) bone graft substitute—a clinical, radiological, and histological study.
Int J Implant Dent 3, 25 (2017). https://doi.org/10.1186/s40729-017-0086-2
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Received: 31 December 2016
Accepted: 25 May 2017
Published: 22 June 2017
DOI: htt...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Correspondence to
Ashish Kakar.
Yenepoya University Dental College, University Road, Mangalore, 575018, India
Ashish Kakar, Bappanadu H. Sripathi Rao & Shashikanth Hegde
Dental Foundations and Research Centre, Malad, Mumbai, 400064, India
Nikhil Deshpande
Department of Oral and Maxillofacial Surgery, Center for Dental Medicine, Medical Center—University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
Annette ...
We acknowledge Sunstar Suisse SA, Etoy, Switzerland, for partly supporting this clinical study with a study grant. The authors declare that there is no conflict of interest regarding the publication of this paper.
Ashish Kakar, Bappanadu H. Sripathi Rao, Shashikanth Hegde, Nikhil Deshpande, Annette Lindner, Heiner Nagursky, Aditya Patney, and Harsh Mahajan declare that they have no competing inte...
Lang NP, Pun L, Lau KY, Li KY, Wong MC. A systematic review on survival and success rates of implants placed immediately into fresh extraction sockets after at least 1 year. Clin Oral Implants Res. 2012;23 Suppl 5:39–66.
Smukler H, Landi L, Setayesh R. Hostomorphometric evaluation of extraction sockets and deficient alveolar ridges treated with allografts and barrier membrane. A pilot study. In...
Nair PNR, Luder H-U, Maspero FA, Fischer JH, Schug J. Biocompatibility of beta-tricalcium phosphateroot replicas in porcine tooth extraction sockets—a correlativehistological, ultrastructural, and x-ray microanalytical pilotstudy. J Biomater Appl. 2006;20(4):307–24.
Jensen SS, Terheyden H. Bone augmentation procedures in localized defects in the alveolar ridge: clinical results with different...
Araujo MG, Sukekava F, Wennstrom J, Lindhe J. Ridge alterations following implant placement in fresh extraction sockets: an experimental study in the dog. J Clin Periodontol. 2005;32:645–52.
Van der Weijden F, Dell'Acqua F, Slot DE DE. Alveolar bone dimensional changes of post-extraction sockets in humans: a systematic review. J Clin Periodontol. 2009;36(12):1048–58.
Schropp L, Wenzel A, Kos...
The results of this clinical study support the use of a biphasic in situ hardening alloplastic bone graft substitute for ridge preservation in intact post-extraction sites without the use of a dental membrane. Therefore, grafting of sockets without primary wound closure or using dental membranes or a soft tissue punch can be an effective minimally invasive method of preserving the contour and arch...
Likewise, the reported amount of residual grafting material in the defect site was similar. In average, only 26.2 ± 9.4% of the defect was occupied with residual graft material in this study which is well in line with 26.6 ± 5.2% reported for BCP but below the 37.7 ± 8.5% reported for xenograft [14].
All 15 implants could be placed without the need for additional bone augmentation....
As previously reported, secondary intention soft tissue healing of grafted post-extraction sites can be well achieved when using an in situ hardening and in situ stabilizing bone graft substitutes without the need of a dental membrane [18, 20]. Findings of the present report corroborate these results. The authors found that all sites healed uneventfully with coverage of soft tissue and no local co...
Ridge preservation following dental extractions is fundamental, preserving the ridge profile for subsequent implant placement and providing a sustained function and esthetics. This clinical trial reports on the successful application of an in situ hardening biphasic alloplastic bone graft substitute for ridge preservation and subsequent implant placement in 15 healthy patients. A routine but minim...
Cone beam computer tomography (CBCT) was performed before tooth extraction and at the time point of implant placement. Mean ridge width reduction before tooth extraction to implant placement was calculated to effect in 0.79 ± 0.73 mm horizontal bone loss (Table 2). Primary implant stability was achieved in all 15 cases, showed in average high ISQ levels 70.3 ± 9.7 (buccal/palatal), and...
Fifteen patients (4 females and 11 males) with a mean age of 51.3 + 14.8 years (range: 27 to 75 years) participated in this randomized clinical trial. The site specific areas and teeth numbers for the study are shown in Table 1.
In all cases, the postoperative healing was uneventful. Clinically, the soft tissue healing pattern observed was very similar in all cases. The soft tissue on all ...
Bone biopsies were harvested using a trephine bur at the site of implant placement. The trephine burs including the bone biopsies were fixed in 4% formalin for 5–7 days, rinsed in water, and dehydrated in serial steps of ethanol (70, 80, 90, and 100%), remaining for 1 day in each concentration. Specimens were then infiltrated, embedded, and polymerized in resin (Technovit 9100, Heraeus Kulzer,...
Antibiotic therapy consisting of 1 g amoxicillin every 12 h for 4 days and mouth rinsing with 0.2% chlorhexidine every 8 h for 10 days were prescribed. The suture was removed 1 week postoperatively. After 3 to 8 months (average 5.2 ± 2 months), the sites (Fig. 2a) were reentered for implant placement. A site-specific full thickness mucoperiosteal flap was elevated to expose the regen...
This study was approved by the Yenepoya University Ethics committee, Mangalore, India (Approval Number YOEC83/8/3/2014). Fifteen patients who required extraction of a maxillary or mandibular tooth and subsequent single-tooth implant placement and who met the inclusion and exclusion criteria were included in this prospective single-arm clinical study. The patients (4 females and 11 males) had a mea...
To our knowledge, this is the first systematic clinical, radiographic, and histological evaluation that assesses bone formation and ridge width preservation after socket grafting using an in situ hardening biphasic bone graft substitute in healthy patients.
Following tooth extraction, the alveolar ridge will decrease in volume and change its morphology [1, 2]. These changes are clinically significant [3] and can complicate the placement of a conventional bridge or an implant-supported crown. Post-extraction maintenance of the alveolar ridge following the principles of ridge preservation using bone graft substitutes minimizes ridge resorption and, thu...
Post-Extraction ridge preservation using bone graft substitutes is a conservative technique to maintain the width of the alveolar ridge. The objective of the present study was to evaluate an in situ hardening biphasic (HA/β-TCP) bone graft substitutes for ridge preservation without primary wound closure or a dental membrane.
A total of 15 patients reported for tooth extraction were enrolled in t...
Fig. 6. Patient # 1 (12-month healing time): increased bone formation following the shape of the grafted particles that are still present (magnification ×100)
Fig. 6. Patient # 1 (12-month healing time): increased bone formation following the shape of the grafted particles that are still present (magnification ×100)
Fig. 5. Patient # 4 (9-month healing time): increased bone formation following the shape of the grafted particles stained with Goldner trichrome staining (magnification ×100)
Fig. 5. Patient # 4 (9-month healing time): increased bone formation following the shape of the grafted particles stained with Goldner trichrome staining (magnification ×100)
Fig. 4. Patient # 1 (12-month healing time): overview of a typical example of a bone biopsy stained with Goldner trichrome staining (magnification ×10)
Fig. 4. Patient # 1 (12-month healing time): overview of a typical example of a bone biopsy stained with Goldner trichrome staining (magnification ×10)
Fig. 3. Alveolar tissue height (in true mm) over a 5-year period in the 12-month group
Fig. 3. Alveolar tissue height (in true mm) over a 5-year period in the 12-month group
Fig. 2. Aveolar tissue height (in true mm) over a 5-year period in the 9-month group
Fig. 2. Aveolar tissue height (in true mm) over a 5-year period in the 9-month group
Fig. 1. Images of patient # 5 (9-month healing time). a. Radiograph of the left maxillary sinus: situation 9 months after the maxillary sinus floor elevation procedure. b. With a trephine drill, the implant osteotomy is made and the biopsy is obtained. c. Clinical situation after placing two Straumann® SLA implants in the left posterior maxilla. d. Radiograph of two Straumann® SLA implants in...
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Bouwman, W.F., Bravenboer, N., Frenken, J.W.F.H. et al. The use of a biphasic calcium phosphate in a maxillary sinus floor elevation procedure: a clinical, radiological, histological, and histomorphometric evaluation with 9- and 12-month healing times.
Int J Implant Dent 3, 34 (2017). https://doi.org/10.1186/s40729-017-0099-x
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Received: 22 May 2017
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Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Authors W.F. Bouwman, N. Bravenboer, J.W.F.H. Frenken, C.M. ten Bruggenkate and E.A.J.M. Schulten state that there are no conflicts of interest, either directly or indirectly.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Correspondence to
E. A. J. M. Schulten.
Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center/Academic Centre for Dentistry Amsterdam (ACTA), P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
W. F. Bouwman, C. M. ten Bruggenkate & E. A. J. M. Schulten
Department of Clinical Chemistry, VU University Medical Center, Amsterdam, The Netherlands
N. Bravenboer
Department of Oral and Maxillofacial Su...
Groeneveld EH, van den Bergh JP, Holzmann P, ten Bruggenkate CM, Tuinzing DB, Burger EH. Mineralization processes in demineralized bone matrix grafts in human maxillary sinus floor elevations. J Biomed Mater Res. 1999;48:393–402.
Schulten EAJM, Prins HJ, Overman JR, Helder MN, ten Bruggenkate CM, Klein-Nulend JA. Novel approach revealing the effect of collagenous membrane on osteoconduction in ...
Schopper C, Ziya-Ghazvini F, Goriwoda W, Moser D, Wanschitz F, Spassova E, Lagogiannis G, Auterith A, Ewers R. HA/TCP compounding of a porous CaP biomaterial improves bone formation and scaffold degradation—a long-term histological study. J Biomed Mater Res B Appl Biomater. 2005;74:458–67.
Frenken JW, Bouwman WF, Bravenboer N, Zijderveld SA, Schulten EA, ten Bruggenkate CM. The use of Strauma...
Beirne JC, Barry HJ, Brady FA, Morris VB. Donor site morbidity of the anterior iliac crest following cancellous bone harvest. Int J Oral Maxillofac Surg. 1996;25:268–71.
Vermeeren JIJF, Wismeijer D, van Waas MAJ. One-step reconstruction of the severely resorbed mandible with onlay bone grafts and endosteal implants: a 5-year follow-up. Int J Oral Maxillofac Surg. 1996;2:112–5.
Nkenke E, Stel...
Boyne PJ, James RA. Grafting of the maxillary sinus floor with autogenous marrow and bone. J Oral Surg. 1980;38:613–6.
Tatum H Jr. Maxillary and sinus implant reconstructions. Dent Clin N Am. 1986;30:207–29.
Del Fabbro M, Rosano G, Taschieri S. Implant survival rates after maxillary sinus augmentation. Eur J Oral Sci. 2008;116:497–506.
Pjetursson BE, Tan WC, Zwahlen M, Lang NP. A systemat...
Based on clinical, radiological, histological, and histomorphometric analysis, this study confirms the suitability of BCP for vertical augmentation of the posterior maxilla by means of an MSFE procedure, allowing dental implant placement after 9 and 12 months healing times. Yet, complete degradation of the BCP particles does not occur within a 12-month healing time. From a histological and histom...
In the cranial part of the biopsy, some osteoid islands with osteogenic activity were detected, possibly caused by osteoinductive properties from the lifted bony trap-door. In the present study, histomorphometric analyses revealed that the vital bone volume was higher in the 9-month healing time group than in the 12-month healing time group, while one would expect to find more newly formed bone in...
This study presents the clinical, radiological, histological and histomorphometric results on the use of a biphasic calcium phosphate (Straumann® bone ceramic) in a MSFE procedure with healing times of 9 and 12 months. During the clinical evaluation, it appeared that both 9-month and 12-month healing times resulted in integration of the grafted BCP with the original maxillary bone (sinus floor),...
Histological observations did not show inflammatory cells in the tissue adjacent to the bone substitute particles. Bone marrow-like tissue, which included blood vessels, was observed in between the bone trabeculae (Fig. 4). Reinforcement by lamellar bone was shown in some areas after 9 and 12 months (Figs. 5 and 6). No Howship’s lacunae could be detected on the characteristic outlines of the su...
None of the 10 patients showed postoperative inflammation or infection after the MSFE procedure nor during surgical re-entry for dental implant placement. When opening the area for dental implant insertion, the grafted area proved to be well vascularized and the tissue at the site of the former trap-door location was slightly flexible and had a fibrous aspect. Between the periosteum and the bone g...
Parameters evaluating vital bone mass/bone structure:
1: Vital bone volume (BV): percentage of the grafted section that is vital bone tissue (%)
2: Bone surface (BS): BS expressed as a fraction of the total vital bone volume (mm2/mm3)
3: Thickness of bone trabeculae (Tb.Th) (μm)
Parameters evaluating bone turnover:
1: Osteoid volume (OV): fraction of the vital bone tissue section that is ost...
All 22 inserted dental implants were clinically tested for good primary stability. Osseointegration at abutment connection was tested with a 35-Ncm torque. One experienced oral and maxillofacial surgeon (CB) carried out all follow-up examinations.
Panoramic radiographs were made at patient’s intake (T0); immediately after the MSFE procedure (T1); immediately after dental implant placement (T2);...
A midcrestal incision was made with vertical release incisions at the canine and tuberosity region. A full-thickness mucoperiosteal flap was elevated. The lateral maxillary sinus wall was prepared using a diamond burr with copious irrigation with sterile isotonic saline, regarding the contour of the maxillary sinus as observed on the preoperative panoramic radiograph. A bony top-hinge trap-door wa...
In this study, 10 consecutive healthy patients were selected for a unilateral MSFE procedure. Five patients received dental implants 9 months after MSFE and five patients underwent dental implant surgery 12 months after MSFE. In the 9-month group (three men and two women), the average age was 56.6 years (range 40 to 64 years); in the 12-month group (one man and four women), the average age was...
β-TCP is a biocompatible osteoconductive calcium phosphate that may provide a scaffold for potential bony ingrowth [24]. β-TCP resorbs rather quickly but not necessarily at the same rate as new bone formation [25,26,27]. Most research focused on either using the relative unresorbable HA as a scaffold or β-TCP as a degradable component [19, 24,25,26, 28, 29]. Zerbo et al. [30] concluded that due...
Maxillary sinus floor elevation (MSFE) is a surgical procedure to enhance the bone height in the posterior maxilla with graft material, allowing dental implant placement (later or at the same time) [1, 2]. This pre-implant procedure is predictable and results in a dental implant survival of more than 93.8% 3 years after dental implant placement [3]. According to Pjetursson [4] in his systematic r...
This study evaluates the clinical, radiological, histological, and histomorphometric aspects of a fully synthetic biphasic calcium phosphate (BCP) (60% hydroxyapatite and 40% ß-tricalcium phosphate), used in a human maxillary sinus floor elevation (MSFE) procedure with 9- and 12-month healing time.
A unilateral MSFE procedure, using 100% BCP, was performed in two series of five patients with hea...
Sagheb, K., Schiegnitz, E., Moergel, M. et al. Clinical outcome of alveolar ridge augmentation with individualized CAD-CAM-produced titanium mesh.
Int J Implant Dent 3, 36 (2017). https://doi.org/10.1186/s40729-017-0097-z
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Received: 15 March 2017
Accepted: 13 July 2017
Published: 26 July 2017
DOI: https://doi.org/10.1186/s40729-017-0097-z
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Keyvan Sagheb reports personal fees and grants from Dentsply, Geistlich, and Nobel Biocare outside the submitted work. Eik Schiegnitz reports personal fees and grants from Septodont, Dentsply, Geistlich, and Straumann outside the submitted work. Maximilian Moergel reports grants from Camlog outside the submitted work. Christian Walter reports grants and personal fees from Straumann outside the sub...
Correspondence to
E. Schiegnitz.
K. Sagheb and E. Schiegnitz contributed equally to this work.
Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany
K. Sagheb, E. Schiegnitz, M. Moergel, C. Walter, B. Al-Nawas & W. Wagner
Mediplus, Oral and Maxillofacial Surgery, Private Praxis, Mainz, Germany
C. Walter
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Ali S, Bakry SA, Abd-Elhakam H. Platelet-rich fibrin in maxillary sinus augmentation: a systematic review. The Journal of oral implantology. 2015;41(6):746–53. PubMed PMID: 25536095
Moraschini V, Barboza ES. Effect of autologous platelet concentrates for alveolar socket preservation: a systematic review. Int J Oral Maxillofac Surg. 2015;44(5):632–41. PubMed PMID: 25631334
Torres J, Tamimi F,...
Pieri F, Corinaldesi G, Fini M, Aldini NN, Giardino R, Marchetti C. Alveolar ridge augmentation with titanium mesh and a combination of autogenous bone and anorganic bovine bone: a 2-year prospective study. J Periodontol. 2008;79(11):2093–103. PubMed PMID: 18980518
Proussaefs P, Lozada J. Use of titanium mesh for staged localized alveolar ridge augmentation: clinical and histologic-histomorphom...
von Arx T, Kurt B. Implant placement and simultaneous peri-implant bone grafting using a micro titanium mesh for graft stabilization. Int J Periodontics Restorative Dent. 1998;18(2):117–27. PubMed PMID: 9663090
von Arx T, Kurt B. Implant placement and simultaneous ridge augmentation using autogenous bone and a micro titanium mesh: a prospective clinical study with 20 implants. Clin Oral Implant...
Moraschini V, Poubel LA, Ferreira VF, Barboza ES. Evaluation of survival and success rates of dental implants reported in longitudinal studies with a follow-up period of at least 10 years: a systematic review. Int J Oral Maxillofac Surg. 2015;44(3):377–88. PubMed PMID: 25467739
Al-Nawas B, Kammerer PW, Morbach T, Ladwein C, Wegener J, Wagner W. Ten-year retrospective follow-up study of the TiO...
Within the limitations of this study, being retrospective and having no control group, the results show that individualized CAD-CAM-produced titanium meshes are a safe and predictable procedure for large vertical and horizontal ridge augmentations. The soft tissue covering remains one of the most critical steps using this technique. However, exposure of the mesh does not result in complete loss of...
The results showed that in all 21 augmented sites, a significant ridge augmentation was achieved, with a mean vertical augmentation of 6.5 ± 1.7 mm and a mean horizontal augmentation of 5.5 ± 1.9 mm. To our best knowledge, this is the first study investigating these parameters in individualized CAD-CAM-produced titanium meshes. For conventional titanium meshes, several studies were publish...
In our study, PRF membranes were additionally to collagen membranes used to cover the CAD-CAM mesh. The aim of this clinical approach was to improve and accelerate wound healing. The results with the low exposure rates and the sufficient augmentation heights indicated that these PRF membranes are a promising technique. However, due to low case number in the control group without a PRF membrane, de...
The vertical and horizontal regeneration of resorbed alveolar ridges remains a challenging surgical procedure, especially in the case of extensive bone atrophy. During the past years, different augmentation techniques have been proposed to restore an adequate bone volume. The aim of this study was to evaluate a technique for ridge augmentation in the maxilla and mandible using an individualized CA...
In the investigated time period, 17 patients received 21 TM augmentations. Fourteen of these patients were women and three men. Mean age at the time of augmentation was 37 ± 15 years (17–64 years). Twelve of the patients were non-smoker, and 5 patients were smoker. In 8 patients, a steady periodontal disease could be detected. Sixty-five percent (n = 11) of the patients presented a thin g...
Cone beam computed tomography (CBCT) of the treated sites was performed before augmentation procedure and 6 months postoperatively at time of reentry. Craniofacial bone and TM showed different radio-opacity, which allowed their easy differentiation on the scans after regulating the brightness and contrast. In our department, two different CBCTs were available (Accuitomo, J. Morita Corporation, Ja...
In a retrospective study, the clinical outcome of an individualized CAD-CAM-produced TM (Yxoss CBR®, Filderstadt, Germany) inserted by experienced surgeons in the Department of Oral and Maxillofacial Surgery of the University Medical Centre Mainz, Germany, between December 2014 and January 2017, was analyzed. Therefore, all patients with this CAD-CAM mesh augmentation and reentry operation for im...
The aim of this clinical study was to present the clinical outcome of individualized CAD-CAM-produced TM in combination with particulate autogenous bone mixed with deproteinized bovine bone mineral (DBBM) used to augment horizontal and/or vertical bony defects in both maxillary and mandibular arches, within a two-stage technique. Furthermore, gained horizontal and vertical bone height and the infl...
Dental implant placement is an effective treatment method for the replacement of lost teeth with high survival rates after long-term follow-up [1,2,3]. However, the long-term success and stability of implants in function are directly correlated with the quality and quantity of the available bone at the prospective implant site [4, 5]. Despite the development of various techniques and augmentation ...
The augmentation of the jaw has been and continues to be a sophisticated therapy in implantology. Modern CAD-CAM technologies lead to revival of old and established augmentation techniques such as the use of titanium mesh (TM) for bone augmentation. The aim of this retrospective study was to evaluate the clinical outcome of an individualized CAD-CAM-produced TM based on the CT/DVT-DICOM data of th...
Fig. 5.
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)
mandible.)
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.)
Fig. 3. ution 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 70 [34]
Fig. 3. a Primary ...
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)
Fig. 2. Cumulative implant survival over the follow-up period. The Kaplan-Meyer diagram visualises the analysis of implant survival in the maxi...
Fig. 1. he 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...
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1. Adult patients, male and female
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2. Partially/totally edentulous patients
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Reich, W., Schweyen, R., Heinzelmann, C. et al. Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results.
Int J Implant Dent 3, 46 (2017). https://doi.org/10.1186/s40729-017-0107-1
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Received: 18 August 2017
Accepted: 12 October 2017
Published: 30 October 2017
DOI: https://doi.org/10.1186/s40...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Dataset presenting relevant raw data. (SAV 3 kb)
WR is a senior physician at the University Hospital Halle, Martin Luther University Halle-Wittenberg, Department of Oral and Plastic Maxillofacial Surgery, Halle/Saale, Germany.RS is a clinical research associate at the University School of Dental Medicine, Department of Prosthetic Dentistry, Martin Luther University Halle-Wittenberg, Halle/Saale, Germany.CH is a consultant at the University Hospi...
WR is a senior physician at the University Hospital Halle, Martin Luther University Halle-Wittenberg, Department of Oral and Plastic Maxillofacial Surgery, Halle/Saale, Germany.
RS is a clinical research associate at the University School of Dental Medicine, Department of Prosthetic Dentistry, Martin Luther University Halle-Wittenberg, Halle/Saale, Germany.
CH is a consultant at the University H...
Correspondence to
Waldemar Reich.
Department of Oral and Plastic Maxillofacial Surgery, Martin Luther University Halle-Wittenberg, Ernst-Grube Str. 40, 06120, Halle (Saale), Germany
Waldemar Reich, Christian Heinzelmann, Bilal Al-Nawas & Alexander Walter Eckert
University School of Dental Medicine, Department of Prosthetic Dentistry, Martin Luther University Halle-Wittenberg, Magdeburger Straße 16, 06112, Halle (Saale), Ger...
The authors are grateful to the DenTack Company for providing some of the implants and components used in this study. The courtesy of Oz Vachtenberg is acknowledged for providing Fig. 1a–f and the movie clip. There are no financial supports or conflicts of interest associated with this publication that could have influenced its outcome. We thank the Osstell Company, which supplied the RFA devic...
Mishra SK, Chowdhary R, Kumari S. Microleakage at different implant abutment interface: a systematic review. J Clin Diagn Res. 2017;11(6):ZE10–5.
Feichtinger M, Gaggl A, SChultes G, Kärcher H. Evaluation of distraction implants for prosthetic treatment after vertical alveolar ridge distraction: a clinical investigation. Int J Prosthodont. 2003;16(1):19–24.
Pradeep PR, Kasti KJ, Ananthakrish...
Gehrke SA, Pérez-Albacete Martinez C, Piattelli A, Shibli JA, Markovic A, Calvo Guirado JL. The influence of three different apical implant designs at stability and osseointegration process: experimental study in rabbits. Clin Oral Implants Res. 2017;28(3):355–61.
Herrero-Climent M, Santos-Garcia R, Jaramillo-Santos R, Romero-Ruiz MM, Fernandez-Palacin Lazaro-Calvo P, Bullon P, Rios-Santos JV....
Malmstrom H, Gupta B, Ghanem A, Cacciato R, Ren Y, Romanos GE. Success rate of short dental implants supporting single crowns and fixed bridges. Clin Oral Implants Res. 2016;27(9):1093–8.
Garfield RE. An expandable implant fixture. Dent Implantol Updat. 1998;9(5):37–40.
Nowzari H, Chee W, Tuan A, Abou-Rass M, Landesman HM. Clinical and microbiological aspects of the Sargon immediate load imp...
Brenner M, Brandt J, Lauer HC. Prothetische Versorgung auf kurzen Implantaten. Zahnmedizin up2date. 2014;2:123–42. (German)
Eitner S, Wichmann M, Schlegel KA, Kollmannberger JE, Nickenig HJ. Oral health-related quality of life and implant therapy: an evaluation of preoperative, intermediate, and post-treatment assessments of patients and physicians. J Craniomaxillofac Surg. 2012;40(1):20–3.
...
De Moraes SL, Verri FR, Santiago JF Jr, Almeida DA, de Mello CC, Pellizzer EP. A 3-D finite element study of the influence of crown-implant ratio on stress distribution. Braz Dent J. 2013;24(6):635–41.
Moraes SL, Pellizzer EP, Verri FR, Santiago JF Jr, Silva JV. Three-dimensional finite element analysis on stress distribution in retention screws of different crown-implant ratios. Comput Methods...
Thoma DS, Haas R, Tutak M, Garcia A, Schincaglia GP, Hämmerle CH. Randomised controlled multicenter study comparing short dental implants (6 mm) versus longer dental implants (11-15 mm) in combination with sinus floor elevation procedures. Part 1: demographic and patient-reported outcomes at 1 year of loading. J Clin Periodontol. 2015;42(1):72–80.
Hentschel A, Herrmann J, Glauche I, Vollmer A,...
Schwarz F, Terheyden H. Significance of dental implants for health care. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2011;54(9):1097–101. (German)
Gates WD, Cooper LF, Sanders AE, Reside GJ, De Kok IJ. The effect of implant-supported removable partial dentures on oral health quality of life. Clin Oral Impl Res. 2014;25:207–13.
Fretwurst T, Nack C, Al-Ghrairi M, Raguse JD, ...
Bone quality (density)
World Dental Federation
Implant stability quotient
Resonance frequency analysis
Initial results of the ongoing study confirm the feasibility and safety of the employed system. The implant type seems to be useful for all bone qualities and shows high initial and secondary biomechanical stability in the maxilla and mandible. Long-term follow-up will be needed in validating these initial results in a larger 3-year clinical trial. Crestal bone changes should be evaluated in a la...
Comparable studies displayed at 24 months a crestal bone loss of 0.5–0.6 mm [15]. Other authors reported at 2, 3 and 5 years a mean loss of 0.57, 0.55 and 0.53 mm, respectively, in the mandible (without significant change after 1 year) [10]. On the other hand, randomised controlled trials demonstrated 1 year after loading periimplant marginal bone loss of 0.7 mm [70] and 1.1 mm [7] in th...
Contrary to conventional hollow-screw implants (only marginal gap), a problem of the expandable implant is the presence of gaps down to the apical region. Former microbial assessment of different implant-abutment interfaces displayed that none of the marginal connections had the capacity to prevent microbial leakage [63,64,65]. Therefore, an apical microleakage (comparable to distractable implants...
Regarding resonance frequency analysis, the values are related to bone quality and quantity as well as the exposed implant height above the alveolar crest, which depends on the type of implant and insertion technique [55,56,57]. Our results (primary stability in the maxilla 66.9 ± 8.9 ISQ units and in the mandible 72.5 ± 11.1 ISQ units; secondary stability in the maxilla 66.4 ± 10.0...
Several investigators analysed the preferred indications of short dental implants in the posterior mandible or maxilla and outlined the cost efficiency compared to additional vertical augmentations. In the present trial, we used a new short implant in both jaws and nearly all possible indication categories were represented, which proves the broad versatility (Table 4).
In our study, two implant ...
Recent literature has shown that short implants have achieved growing acceptance in the field of oral implantology [9, 10, 39, 40]. Since the last years, concern has decreased about the length of endosseous implants; it should be noted that all extraoral screw implants are short implants [41, 42]. Nevertheless, there are local physiological and biomechanical differences regarding long-term stabili...
Over the follow-up period, the mean crestal bone changes after loading were as follows (each compared to the baseline): in the first year, 1.0 ± 0.9 mm 95% CI (0.5; 1.5) in the maxilla and 0.7 ± 0.4 mm 95% CI (0.5; 1.0) in the mandible (p = 0.011; independent t test), and in the second year, 1.3 ± 0.8 mm 95% CI (0.8; 1.7) in the maxilla and 1.0 ± 0.7 mm 95% CI (0.6; 1.4...
The first results of this longitudinal study include data from 9 patients with an average age of 57 years (range from 44 to 80) in whom 30 implants were inserted (maxilla n = 15, mandible n = 15). All 30 implants in the 9 patients could be inserted without intraoperative problems. Based on intraoperative and radiological findings, the bone quality was assessed as follows: D1 in n = 2,...
All patients were pseudonymised, parameters were attached to a databank and analysed statistically (Additional file 2). Statistical analyses were performed using statistics software (IBM SPSS statistics, version 20, Chicago, IL, USA). The descriptive statistics presented the frequency and distribution of several occurrences as well as combinations of certain features. Analytical statistics were p...
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 necess...
The study was designed as a prospective monocentric longitudinal cohort study according to the STROBE criteria. The participants of this study were recruited at the university hospital of Martin Luther University Halle-Wittenberg, Department of Oral and Plastic Maxillofacial Surgery, implantological consultation from 2014 (June) until 2015 (June). Inclusion and exclusion criteria of adult patients...
It is known that achievement of primary stability is one precondition for osseointegration and treatment success. There are few reports of immediate [14] and early (6 weeks) functional loading of short implants [28]. This is related to good bone quality, implant design or implant site preparation (e.g. under-drilling). However, under-drilling of the crestal aspect may lead to decreased bone-to-im...
Endosseous implants have been established over several decades. The evaluation of treatment results under biomechanical, physiological, psychological, social and economic aspects has been well documented [1]. Furthermore, patient-based outcomes reveal a predictable gain in oral health-related quality of life [2].
Especially in patients with limited vertical bone height, process of treatment is ex...
Short implants often have the disadvantage of reduced primary stability. The present study was conducted to evaluate the feasibility and safety of a new expandable short dental implant system intended to increase primary stability.
As a “proof of concept”, a prospective clinical cohort study was designed to investigate intraoperative handling, primary and secondary implant stability (resonanc...
Fig. 1. Search strategy for BMAC
Fig. 1. Search strategy for BMAC
Study
Treatment groups
No. of patients (age range)
No. of maxillary sinuses evaluated
Donor site for BMAC
C...
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de Oliveira et al. [12]
Pasquali et al. [7]
Payer et al. [2]
Sauerbier et al. [11]
...
Ting, M., Afshar, P., Adhami, A. et al. Maxillary sinus augmentation using chairside bone marrow aspirate concentrates for implant site development: a systematic review of histomorphometric studies.
Int J Implant Dent 4, 25 (2018). https://doi.org/10.1186/s40729-018-0137-3
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Received: 20 February 2018
Accepted: 21 May 2018
Published: 03 September 2018
DOI:...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
This is a systematic review of published data; no patients were involved in the conduct of this review.
Miriam Ting, Philip Afshar, Arik Adhami, Stanton M. Braid, and Jon B. Suzuki declare that they have no competing interests.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Correspondence to
Miriam Ting.
Private practice in Periodontology, and Think Dental Learning Institute, Paoli, PA, 19301, USA
Miriam Ting
Temple University Kornberg School of Dentistry, 3223 North Broad Street, Philadelphia, PA, 19140, USA
Philip Afshar & Arik Adhami
Division of Oral and Maxillofacial Surgery, Department of Oral Medicine, Pathology and Surgery, Temple University Kornberg School of Dentistry, 3223 North Br...
All the data generated during this systematic review were included in this manuscript.
Rooney AA, Boyles AL, Wolfe MS, Bucher JR, Thayer KA. Systematic review and evidence integration for literature-based environmental health science assessments. Environ Health Perspect. 2014;122(7):711–8.
Sauerbier S, Rickert D, Gutwald R, Nagursky H, Oshima T, Xavier SP, et al. Bone marrow concentrate and bovine bone mineral for sinus floor augmentation: a controlled, randomized, single-blinded...
Tatum H Jr. Maxillary and sinus implant reconstructions. Dent Clin N Am. 1986;30(2):207–29.
Payer M, Lohberger B, Strunk D, Reich KM, Acham S, Jakse N. Effects of directly autotransplanted tibial bone marrow aspirates on bone regeneration and osseointegration of dental implants. Clin Oral Implants Res. 2014;25(4):468–74.
Chaushu G, Vered M, Mardinger O, Nissan J. Histomorphometric analysis a...
Bone marrow aspirate concentrate
Confidence limits
Ethylenediaminetetraacetic acid
Technique involving bone marrow-derived mononuclear cell isolation by synthetic polysaccharide
Mononuclear cells
Mesenchymal stem cells
Office of Health Assessment and Translation
Standard deviation
Within the limits of this systematic review, the chairside method to harvest BMAC is a viable option for maxillary sinus augmentation for implant site development. The implant survival of the BMAC group was similar to the laboratory FICOLL concentration of BMAC group, without the additional cost and time of laboratory cell isolation techniques. Single or double centrifugation of BMAC does not appe...
In addition, the parameters to evaluate new bone formation were variable. New bone formation and percentage of vital bone are different methods to measure bone formation, and the data from different methods could not be combined or analyzed together. Furthermore, the BMAC evaluated in test groups were prepared differently and were harvested from different sources (tibia or iliac). The control grou...
Although the variations of the materials and methods for BMAC preparation were discussed, this review was not aimed to compare materials and methods for BMAC preparation, but rather the end clinical result for new bone formation and implant survival. Although implant survival and new bone formation were not the only parameters to consider when evaluating sinus augmentation, these parameters were t...
It appears that BMAC offers no statistically significant advantage for regeneration of bone in the maxillary sinus for site preparation of dental implants. BMAC + bovine bone graft results in similar regeneration outcome measures histologically as alveolar bone alone at 3–4 months. Measured histomorphometrically MSCs treated by FICOLL–Hypaque centrifugation to consolidate osteogenic and osteo...
Pasquali et al. [7], in eight patients compared BMAC + bovine bone graft (test group) with bovine bone graft alone (control group). New bone (55.15%) was reported in the test group compared with new bone (27.3%) in the control group based on histomorphometric analyses. This reported observation indicating statistically more new bone regeneration in the BMAC + bovine bone graft group compared with ...
Sauerbier et al. [14] further compared BMAC + bovine bone grafts (test group) with alveolar bone, autologous + bovine bone grafts (control group) for maxillary sinus site preparation. New bone (31.3%) for the test group compared with new bone (19.3%) for the control group statistically indicated equivalence in histomorphometric outcome. Histologic images showing impressive new bone formation were ...
Mesenchymal stem cells (MSCs) in BMAC have the potential to renew, experience clonal expansion, and differentiate into musculoskeletal tissues [16]. MSCs are also known to have an immunoregulatory role and may enhance the normal healing response and angiogenesis [10]. BMAC has been used in bone, cartilage, and tendon injuries with encouraging results [16]. BMAC is a minimally invasive procedure, a...
The search generated 797 reviews in PubMed, 114 in Web of Science, 97 in Cochrane Library, and 319 in Google Scholar (Fig. 1). The following were selected after the title and abstract screening: 18 were selected from PubMed, 23 from Web of Science, 6 from Cochrane Library, 2 from Google Scholar, and 2 from hand searching the reference list of the selected article. After the duplicates were remove...
What are the histomorphometric outcomes of sinus augmentation with bone marrow aspirate concentrates obtained chairside?
PubMed, Web of Science, Cochrane Library, and Google Scholar were searched up to January 2017. Google scholar was searched for gray literature. The following keywords were used: “bone marrow aspirate concentrates,” “stem cells,” “histomorphometric,” and “bone graf...
Maxillary sinus augmentation is indicated when there is an inadequate vertical alveolar bone height to effectively support surgically placed dental implants. The sinus elevation procedure requires grafting bone material onto the sinus floor to regenerate sufficient vertical alveolar bone height [1, 2]. The ideal bone grafting material should be biocompatible, possess no risk of disease transmissio...
Maxillary sinus pneumatization following dental tooth extractions and maxillary alveolar bone resorption frequently leaves inadequate bone levels for implant placement. The objectives of this systematic review are to evaluate the effects of bone marrow aspirate concentrates (BMACs) used in maxillary sinus augmentation for implant site development.
A systematic search was conducted using PubMed, E...
Fig. 3. One possible missing category (depicted as “X”) would be a bone type with thick cortical layer and sparse trabecular bone, which would have intermediate characteristics and behavior between the types with thick (2) or thin (3) cortical bones
Fig. 3. One possible missing category (depicted as “X”) would be a bone type with thick cortical layer and sparse trabecular bone, which ...
Fig. 2. Preoperative CT image showing the site for the definition of the ROI (simulated area delimited by a yellow dashed line for illustration purpose) in the axial (a), coronal (b), and sagittal (6 × 6 mm) (c) sections
Fig. 2. Preoperative CT image showing the site for the definition of the ROI (simulated area delimited by a yellow dashed line for illustration purpose) in the axial (...
Fig. 1. Clinical case of a short implant (4.1 × 6 mm) placed in the region of the left maxillary first molar. a Implant installed. b Insertion torque measurement using the manual torque wrench. c Implant with healing cap and flap suture. d Immediate periapical radiograph after surgery
Fig. 1. Clinical case of a short implant (4.1 × 6 mm) placed in the region of the left maxillar...
Variable
Meana
Std error
95% confidence interval
P value (F; DF)
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Torque
Tactile
CT visual
MGV_avg
MGV_axial
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Mean
SD
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Triches, D.F., Alonso, F.R., Mezzomo, L.A. et al. Relation between insertion torque and tactile, visual, and rescaled gray value measures of bone quality: a cross-sectional clinical study with short implants.
Int J Implant Dent 5, 9 (2019). https://doi.org/10.1186/s40729-019-0158-6
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Received: 07 October 2018
Accepted: 06 January 2019
Published: 11 February...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
This study was conducted in accordance with the tenets of the Declaration of Helsinki, and all procedures involving human subjects were approved by the ethics committee of the Pontifical Catholic University of Rio Grande do Sul/UBEA (ethical approval letter OF.CEP-772/10; research protocol CEP 10/05074).
Written informed consent was obtained from all study participants.
Diego Fernandes Triches, ...
All authors (1) made substantial contributions to the conception and/or design of the work or the acquisition, analysis, or interpretation of data for the work; (2) drafted the paper or revised it critically; (3) approved the final version of this manuscript; and (4) agreed to be accountable for all aspects of the work. Categories of authors’ contribution are as follows: concept/design (RSS, DFT...
Postgraduate Program in Dentistry, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Dental School, Avenida Ipiranga, 6681 – Prédio 6, Porto Alegre, RS, 90619-900, Brazil
Diego Fernandes Triches, Fernando Rizzo Alonso, Danilo Renato Schneider, Eduardo Aydos Villarinho, Maria Ivete Rockenbach, Eduardo Rolim Teixeira & Rosemary Sadami Shinkai
Postgraduate Program in Dentistry,...
The authors would like to thank Professor Helena de Oliveira and Dr. Geisa Medeiros for their early assistance with CT software.
The work was supported by a research grant from Coordination for the Improvement of Higher Education Personnel (CAPES, Brazil; PNPD grant), the National Counsel of Technological and Scientific Development (CNPq, Brazil; Universal grant), and the International Team for I...
Kaya S, Yavuz I, Uysal I, Akkus Z. Measuring bone density in healing periapical lesions by using cone beam computed tomography: a clinical investigation. J Endod. 2012;38:28–31.
Brosh T, Yekaterina BE, Pilo R, Shpack N, Geron S. Can cone beam CT predict the hardness of interradicular cortical bone? Head Face Med. 2014;10:12.
Tatli U, Salimov F, Kürkcü M, Akoğlan M, Kurtoğlu C. Does cone be...
Nomura Y, Watanabe H, Honda E, Kurabayashi T. Reliability of voxel values from cone-beam computed tomography for dental use in evaluating bone mineral density. Clin Oral Implants Res. 2010;21:558–62.
Reeves TE, Mah P, McDavid WD. Deriving Hounsfield units using gray levels in cone beam CT: a clinical application. Dentomaxillofac Radiol. 2012;41:500–8.
Cassetta M, Stefanelli LV, Pacifici A, P...
Degidi M, Daprile G, Piattelli A. Determination of primary stability: a comparison of the surgeon’s perception and objective measurements. Int J Oral Maxillofac Implants. 2010;25:558–61.
Alonso FR, Triches DF, Mezzomo LAM, Teixeira ER, Shinkai RSA. Primary and secondary stability of single short implants. J Craniofac Surg. 2018. https://doi.org/10.1097/SCS.0000000000004567.
Ribeiro-Rotta RF,...
Cone beam computed tomography
Computed tomographic
Digital Imaging and Communications in Medicine
Field of view
Mean gray values
Region of interest
In summary, within the conditions and limitations of this study, the results suggest that bone quality has a significant effect on the primary stability of short implants as measured by insertion torque. Insertion torque had significant correlation with all assessment methods of bone quality. For preoperative CT evaluation of bone quality, mean gray values (optical density) had stronger associatio...
The present study also used the same preoperative CT images for visual evaluation of bone quality at the exact implant site, using the axial, coronal, and sagittal sections in a standardized procedure. There was a fairly moderate correlation between CT visual assessment and mean gray values, but no statistical difference was found in average mean gray values between the visual classification of bo...
In this study, low- and medium-density values (air and a central FOV soft tissue) were used as reference calibration points for image normalization. The use of a reference object in the FOV containing at least two materials of known density could allow for a calibration similar to the use of reference phantoms in quantitative CT, rather than the “standard” automatic normalization function avai...
This study showed that low bone quality, as assessed by clinical and image methods, is related with low primary stability of 6-mm short implants placed at the posterior region of the maxilla and mandible. Higher insertion torque values were associated with better bone types and higher mean gray values in CT images. Insertion torque had a negative moderate association with bone type categorization ...
Descriptive statistics of the sample are shown in Table 1. For statistical analysis, some data were missing: one implant had mobility after surgery and was lost and four CT scans, containing 11 ROIs, were not used for bone quality analysis due to technical problems. As only one case was categorized as bone type 1 by CT visual or by tactile evaluation, the corresponding mean gray values were exclu...
The mean gray value of each rescaled ROI was measured on the three orthogonal planes: axial, coronal, and sagittal, totaling three ROIs per implant site. The average of the rescaled gray values for the three ROIs was computed for each implant site.
Data were analyzed by descriptive and inferential statistics using the software XLSTAT version 2018 (Addinsoft SARL, New York, USA), and a two-tailed ...
Axial ROI: Using the reference implant location line, the ROI was defined as the alveolar bone area with a 6-mm width corresponding to 3 mm on each side of the future implant center, including the buccal and lingual cortical layers.
Coronal ROI: Area defined by the outer border of the cortical bone with a 6-mm height and a line joining the buccal and lingual cortical layers.
Sagittal ROI: A 6...
The insertion torque was measured using the manual torque wrench (Straumann Dental Implant System®, Waldenburg, Switzerland) (Fig. 1b), according to three categories: 35 N cm. A healing cap was installed, and the suture was made with nylon 5-0 (Fig. 1c). The patients were prescribed with antibiotics (amoxicillin 500 mg, 8/8 h for 7 days), anti-inflammatory drugs (nimesulide 100 mg,...
This study reports cross-sectional, correlational data of a prospective clinical research project [2] approved by the university Institutional Review Board (10/05074). The research protocol followed the precepts of the Declaration of Helsinki and its amendments. All patients signed an informed consent form.
A consecutive, non-probabilistic sample consisted of 45 implants placed in 20 patients tre...
Both multislice CT and cone beam CT are used for presurgical assessment of bone density and quality [4,5,6,7,8,9,10,11]. There is a strong correlation between gray values in cone beam CT and Hounsfield units in multislice CT [4, 12,13,14]. The visual inspection of CT sections avoids the superimposition of anatomical structures seen in radiographs; thus, the region of interest in trabecular bone ca...
The early clinical success of short implants can be affected by poor bone quality and low primary stability because implant micromovement can promote the formation of a fibrous capsule during the osseointegration process. It has been reported that the greater the insertion torque, the greater the resistance of the bone-implant interface to the shear forces that tend to rotate the implant [1]. Clin...
This study assessed the relationship between insertion torque and bone quality evaluated during surgery and in preoperative computed tomographic (CT) images analyzed either visually or by rescaled mean gray values (MGVs). The study also tested the correlation between the clinical and radiographic measures of bone quality.
The consecutive sample was composed of 45 short implants (4.1 × 6 mm...
Fig. 6. Forest plot on differences in implant mean marginal bone loss between MS and RS groups in alle included RCT's
Fig. 6. Forest plot on differences in implant mean marginal bone loss between MS and RS groups in alle included RCT's
Fig. 5. Forest plot on differences in implant survival between MS and RS groups in all included RCT's
Fig. 5. Forest plot on differences in implant survival between MS and RS groups in all included RCT's
Fig. 4. Forest plot on differences in implant mean marginal bone loss between MS and RS groups in all included studies
Fig. 4. Forest plot on differences in implant mean marginal bone loss between MS and RS groups in all included studies
Fig. 3. Forest plot on differences in implant survival between MS and RS groups in all included studies
Fig. 3. Forest plot on differences in implant survival between MS and RS groups in all included studies
Fig. 2. a Presentation of risk of bias evaluation for included RCTs according to the Cochrane Collaboration’s tool. b Presentation of risk of bias evaluation for included non-RCTs according to the Newcastle-Ottawa assessment scale
Fig. 2. a Presentation of risk of bias evaluation for included RCTs according to the Cochrane Collaboration’s tool. b Presentation of risk of bias evaluation fo...
Fig. 1. Flowchart of the search strategy
Fig. 1. Flowchart of the search strategy
Study (first author and year of publication)
Design
General health
Perio health
Perio status
...
Dank, A., Aartman, I.H.A., Wismeijer, D. et al. Effect of dental implant surface roughness in patients with a history of periodontal disease: a systematic review and meta-analysis.
Int J Implant Dent 5, 12 (2019). https://doi.org/10.1186/s40729-019-0156-8
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Received: 14 August 2018
Accepted: 06 January 2019
Published: 13 February 2019
DOI: https://doi.org/...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
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Not applicable.
All authors read and approved the final manuscript.
Anton Dank, Irene H.A. Aartman, Daniël Wismeijer, and Ali Tahmaseb declare that they have no competing interests (Additional files 1, 2, 3 and 4).
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Section of Oral Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Gustav Mahlerlaan 3004, 1081 LA, Amsterdam, The Netherlands
Anton Dank, Daniël Wismeijer & Ali Tahmaseb
Department of Social Dentistry, Academic Centre for Dentistry Amsterdam (ACTA) University of Amsterdam and Vrije Universiteit Ams...
The authors would like to thank Dr. Elena Nicu for providing missing information about her study.
None.
This paper is distributed under the terms of the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the author gives appropriate credit to the original author(s) and the source, provide a link to the Cr...
Jungner M, Legrell PE, Lundgren S. Follow-up study of implants with turned or oxidized surfaces placed after sinus augmentation. Int J Oral Maxillofac Implants. 2014;29:1380–7.
Esposito M, Ardebili Y, Worthington HV. Intervention for replacing missing teeth: different types of dental implants. Cochrane Database Syst Rev. 2014;22:CD003815.
Doornewaard R, Christiaens V, De Bruyn H, Jacobsson M, ...
Nemli SK, Güngör MB, Aydin C, Yilmaz H, Türkcan I, Demirköprülü H. Clinical evaluation of submerged and non-submerged implants for posterior single-tooth replacements: a randomized split-mouth clinical trial. Int J Oral Maxillofac Surg. 2014;43:1484–92.
Sánchez-Siles M, Munoz-Cámara D, Salazar-Sánchez N, Camacho-Alonso F, Calvo-Guirado JL. Crestal bone loss around submerged and non-sub...
Wennström JL, Ekestubbe A, Gröndahl K, Karlsson S, Lindhe J. Oral rehabilitation with implant-supported fixed partial dentures in periodontitis-susceptible subjects. J Clin Periodontol. 2004;31:713–24.
Matarasso S, Rasperini G, Siciliano V, Salvi GE, Lang NP, Aglietta M. A 10-year retrospective analysis of radiographic bone-level changes of implants supporting single-unit crowns in periodonta...
Kumar A, Jaffin RA, Berman C. The effect of smoking on achieving osseointegration of surface-modified implants: a clinical report. Int J Oral Maxillofac Implants. 2002;17:816–9.
Albouy JP, Abrahamsson I, Persson LG, Berghlundh T. Spontaneous progression of peri-implantitis of different types of implants: an experimental study in dogs. I: clinical and radiographic observations. Clin Oral Implant...
Rosenberg ES, Dent HD, Cho S, Elian N, Jalbout ZN, Froum S. A comparison of characteristics of implant failure and survival in periodontally compromised and periodontally healthy patients: a clinical report. Int J Oral Maxillofac Implants. 2004;19:873–9.
Balshe AA, Eckert SE, Koka S, Assad DA, Weaver AL. The effects of smoking on the survival of smooth- and rough-surface dental implants. Int J ...
Quirynen M, Abarca M, Van Assche N, Nevins M, Van Steenberghe D. Impact of supportive periodontal therapy and implant surface roughness on implant outcome in patients with a history of periodontitis. J Clin Periodontol. 2007;34:805–15.
Albrektsson T, Wennerberg A. Oral implant surfaces: part 1–review focusing on topographic and chemical properties of different surfaces and in vivo responses t...
Acid-etched
Anterior
Fixed partial denture
Fully edentulous
Hydroxyl apatite
Hybrid surface
Mandible
Maxilla
Machined surface
No data
Not reported
Non-smoking
Partially edentulous
Periodontally compromised patient
Periodontally healthy patient
Posterior
Prospective
Retrospective
Rough surface
Smoking
Sandblasted acid-etched
Titanium plasma sprayed
Due to lack of long-term data (> 5 years), the heterogeneity and variability in study designs and lack of reporting on confounding factors, definitive conclusions on differences in implant survival, and mean marginal bone loss between machined and moderate rough implants in periodontally compromised patients cannot be drawn. In order to understand whether or not machined surfaces are superior to...
The heterogeneity and the variability in the study designs, together with the fact that most previous studies have not reported on confounding factors, make it difficult to draw definitive conclusions. In addition, the broad confidence intervals provide an uncertain outcome. In spite of their relatively higher failure rate, machined implants have possible advantages on the long term, because they ...
Bias is present in the included papers, and this can have a substantial impact on our findings. For example, in the studies by Wennström et al. and Nicu et al., smoking is a confounding factor, since both non-smokers and smokers have been combined [38, 40]. However, Cavalcanti et al. have performed a retrospective multicenter cohort study and have demonstrated almost twice as many implant failure...
The current study reviews the literature on the effect of dental implant surfaces in patients with a history of periodontal disease. The six included papers comprised both retrospective and prospective studies [36,37,38,39,40,41]. The two prospective randomized clinical trials were analyzed separately [38, 40]. As demonstrated by equality of the risk ratios and on account of the limited amount of ...
Figure 3 illustrates a forest plot showing no significant differences in implant survival between MS and RS groups in all included studies [36,37,38,39,40,41]. The implant mean marginal bone loss in the remaining group of six included studies containing 1342 implants ranged from 0.33 to 3.77 mm, with a minimum and maximum of − 0.74 and 5.20 mm, respectively [36,37,38,39,40,41]. The forest ...
There is some variation in the follow-up between the different studies. Two studies had a follow-up of 5 years (Sayardoust et al. and Wennström et al.), two had a follow-up of 10 years (Aglietta et al. and Matarasso et al.), and for two studies, it was 3 years (Nicu et al. and Gallego et al.) [36,37,38,39,40,41]. All included periodontally compromised patients participated in a regular periodo...
The initial electronic database search on PubMed/MEDLINE and Cochrane library resulted in 2411 titles. Thirteen articles were cited in both databases (duplicates). After screening the abstracts, 45 relevant titles were selected by two independent reviewers and 2353 were excluded for not being related to the topic. Following examination and discussion by the reviewers, 43 articles were selected for...
Two reviewers independently extracted data from the included studies. Disagreements were again resolved through discussion. Corresponding authors were contacted when data were incomplete or unclear. With respect to the listed PICO question, data were sought for (P) periodontally compromised and patients without a history of periodontitis receiving dental implant placement, (I) machined surface den...
This study followed the PRISMA statement guidelines and is registered at PROSPERO under registration code CRD42018093063. A review protocol does not exist.
The listed PICO question is used in the present systematic search strategy. The electronic data resources consulted were PubMed/MEDLINE and Cochrane Library, including all published clinical studies until May 2018. The results were limited to ...
Several animal studies have suggested that the roughness of the implant surface influences the progression of peri-implantitis and the outcome of peri-implantitis treatment [27,28,29,30,31]. There is some evidence in men showing that machined implants are less prone to peri-implantitis compared with implants with rougher surfaces [32]. Moreover, implants with a rough surface have higher rates of l...
Rough titanium implants are currently the standard treatment in implant dentistry [1]. They are roughly divided into three different types of surface roughness (Sa): machined/minimal (± 0.5 μm), moderate (1.0–2.0 μm), and rough (> 2.0 μm) [2]. Generally, rougher implant surfaces have greater bone-to-implant contact [3]. In a randomized controlled clinical trial, it has been demonstra...
To review the literature on the effect of dental implant surface roughness in patients with a history of periodontal disease. The present review addresses the following focus question: Is there a difference for implant survival, mean marginal bone loss, and the incidence of bleeding on probing in periodontally compromised patients receiving a machined dental implant or rough surface dental implant...
Fig. 1. Anatomical location of the control and Ca2+-modified dental implants
Fig. 1. Anatomical location of the control and Ca2+-modified dental implants
Variable
Experimental
Control
P
Diameter (mm)
Total
4.25
5.00
5.50
6.00
6.25
...
Diameter (mm)
Total
4.25
5.00
5.50
6.00
6.25
...
Anitua, E., Piñas, L. & Alkhraisat, M.H. Early marginal bone stability of dental implants placed in a transalveolarly augmented maxillary sinus: a controlled retrospective study of surface modification with calcium ions.
Int J Implant Dent 3, 49 (2017). https://doi.org/10.1186/s40729-017-0111-5
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Received: 04 September 2017
Accepted: 15 November 2017
Publi...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
An exemption from IRB approval of the study protocol was granted by the author’s institution as it was a retrospective study, and the evaluated medical device had already been approved for clinical use. This study was performed following the Helsinki declaration regarding the investigation with human subjects.
Not applicable.
Eduardo Anitua is the Scientific Director of BTI Biotechnology Insti...
Private practice in oral implantology, Clínica Eduardo Anitua, Vitoria, Spain
Eduardo Anitua
University Institute for Regenerative Medicine and Oral Implantology - UIRMI (UPV/EHU-Fundación Eduardo Anitua), Vitoria, Spain
Eduardo Anitua & Mohammad Hamdan Alkhraisat
BTI Biotechnology Institute, Vitoria, Spain
Eduardo Anitua & Mohammad Hamdan Alkhraisat
Universidad Europea de Madrid, Madr...
Not applicable
No funding was received for this study.
The data will not be shared but are available upon request.
Schulze R, Krummenauer F, Schalldach F, d'Hoedt B. Precision and accuracy of measurements in digital panoramic radiography. Dentomaxillofac Radiol. 2000;29:52–6.
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Jaffin RA, Berman CL. The excessive loss of Branemark fixtures in type IV bone: a 5-year analysis. J Periodontol. 1991;62:2–4.
Anitua E, Alkhraisat MH, Pinas L, Orive G. Efficacy of biologically guided implant site preparation to obtain adequate primary implant stability. Ann Anat. 2015;199:9–15.
Anitua E, Alkhraist MH, Piñas L, Orive G. Association of transalveolar sinus floor elevation, p...
Moraschini V, Poubel LA, Ferreira VF, Barboza Edos S. Evaluation of survival and success rates of dental implants reported in longitudinal studies with a follow-up period of at least 10 years: a systematic review. Int J Oral Maxillofac Surg. 2015;44:377–88.
Berglundh T, Abrahamsson I, Lang NP, Lindhe J. De novo alveolar bone formation adjacent to endosseous implants. Clin Oral Implants Res. 200...
Plasma rich in growth factors
Strengthening the Reporting of Observational studies in Epidemiology
The modification of an acid-etched surface with calcium ions (UnicCa®) seems to enhance the marginal bone stability of dental implants, placed after transalveolar sinus floor elevation.
Unlike Ca2+-modified dental implants, two early implant losses were observed for the same dental implants but without Ca2+. Moderately rough implant surface has enhanced implant osseointegration and has increased the implant secondary stability [2, 3, 19]. Hydrophilic moderately rough surfaces showed faster osseointegration compared to those with hydrophobic characteristics [20, 21]. Ca2+ ions hav...
In this study, 51 patients participated with 65 dental implants. The mean age of the patients was 58 ± 11 years (range 38 to 72 years) at the time of surgery, and 28 were females.
The experimental group had 34 Ca2+-modified dental implants, and the control group had 31 dental implants (without surface modification with calcium ions).
Tables 1 and 2 show the diameters and lengths of the p...
The plasma rich in growth factors (PRGF) was prepared using the Endoret® system following the manufacturer instructions (BTI Biotechnology Institute, Vitoria, Spain). The technique for transalveolar sinus floor elevation is explained elsewhere [15]. Briefly, conventional drills working at low speed (150 rpm) without irrigation was used to prepare the implant site. A frontal cutting drill was the...
The manuscript was written following STROBE (Strengthening the Reporting of Observational studies in Epidemiology) guidelines. All described data and treatments were obtained from a single dental clinic in Vitoria, Spain. The time period of the study was between December 2014 and April 2016. Patients’ records were retrospectively reviewed to identify patients that fulfilled the following inclusi...
Dental implants are nowadays the treatment of choice to replace missing teeth due to their high predictability and long-term success [1]. This success is the outcome of several cellular and molecular events that take place at the implant-bone interface. Although the process of osseointegration is not fully understood, research is ongoing to enhance and accelerate this process. Moderately rough imp...
Recently, components of the extracellular cellular matrix have been assessed to enhance the biological response to dental implants. This study aims to assess the effect of surface modification with calcium ions on the early marginal bone loss of dental implants placed in a transalveolarly augmented maxillary sinus.
A retrospective study of transalveolar sinus floor augmentation was conducted in a...
Fig. 2. PTG observed in radiographs at the 8-year follow-up
Fig. 2. PTG observed in radiographs at the 8-year follow-up
Fig. 1. Consort flowchart
Fig. 1. Consort flowchart
Patient/implants
Radiographic defect height at deepest site (mm)
The site with the deepest PPD (mm)
PlI
BoP
...
Characteristic
Case (PTG) group (n = 6)
Control group (n = 6)
Age (year), mean ± SD
67 ± 12.9 range, 45–79
...
Andersen, H., Aass, A.M. & Wohlfahrt, J.C. Porous titanium granules in the treatment of peri-implant osseous defects—a 7-year follow-up study.
Int J Implant Dent 3, 50 (2017). https://doi.org/10.1186/s40729-017-0106-2
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Received: 03 July 2017
Accepted: 12 October 2017
Published: 04 December 2017
DOI: https://doi.org/10.1186/s40729-017-0106-2
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
The present study was approved by the Regional Committee for Medical and Health Research Ethics, South East Norway (REK 2015/90). A writen informed consent was signed by all study participants
Dr. Johan Caspar Wohlfahrt has received lecture fees from the producers of the material used in the study and is a previous shareholder in the company (Tigran AB, Malmoe, Sweden). Heidi Andersen and Anne Me...
Department of Periodontology, Institute of Clinical Dentistry, University of Oslo, Pb. 1109 Blindern, 0317, Oslo, Norway
Heidi Andersen, Anne Merete Aass & Johan Caspar Wohlfahrt
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The authors would like to thank Dr. Christine Dæhli Oppedal for her participation in the data collection phase of the study and Dr. Janet M. Østrem for English proof-reading of the manuscript.
Roccuzzo M, et al. Surgical therapy of peri-implantitis lesions by means of a bovine-derived xenograft: comparative results of a prospective study on two different implant surfaces. J Clin Periodontol. 2011;38(8):738–45.
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Jepsen K, et al. Reconstruction of peri-implant osseous defects: a multicenter randomized trial. J Dent Res. 2016;95(1):58–66.
Serino G, Turri A. Outcome of surgical treatment of peri-implantitis: results from a 2-year prospective clinical study in humans. Clin Oral Implants Res. 2011;22(11):1214–20.
Faggion CM Jr, Listl S, Tu YK. Assessment of endpoints in studies on peri-implantitis treatm...
Mombelli A, et al. The microbiota associated with successful or failing osseointegrated titanium implants. Oral Microbiol Immunol. 1987;2(4):145–51.
Lindhe J, Meyle J. Peri-implant diseases: consensus report of the Sixth European Workshop on Periodontology. J Clin Periodontol. 2008;35(8 Suppl):282–5.
Zitzmann NU, Berglundh T. Definition and prevalence of peri-implant diseases. J Clin Periodo...
This long-term follow-up of surgical treatment of peri-implant osseous defects showed unpredictable results. Loss of implants was only recorded in PTG-treated patients.
The present study used a non-resorbable, alloplastic material (PTG) in intra-osseous defects as a reconstructed material. This technique attempts to fill the osseous defect and not solve the disease. With regard to defect fill, it is very important to keep in mind that a non-resorbable graft material such as PTG will be left unresorbed. In this study, PTG graft particles were easily seen on radiog...
A strict maintenance program every 3–6 months followed by a high standard of oral hygiene may hold a stable peri-implant condition after peri-implantitis surgery [16].
In the present study, access to perform sufficient plaque control at the treated implants was considered acceptable due to previous corrections of the prostheses. The frequency of supportive periodontal care (SPT) was reported t...
Few studies report long-term results after treatment of peri-implantitis. In this context, it is important to remember that the only true end point for such therapies will be the loss of implants, but most studies solely report clinical and subclinical parameters which are only surrogate markers for the disease state and true result of the performed therapy [17].
In a meta-analysis by Khoskham et...
Radiographic findings demonstrated similar values after 7 years as the baseline regarding defect depth height in 6/12 treated implants. Three implants, one in the PTG group and two in the OFD group, had progression of radiographic defect depth height, measured at the deepest site, compared to baseline.
Assessing the results after 12 months, five of the implants in the PTG group and five of the ...
Three different manufactures represented the implants included in the analysis. Seven subjects had Brånemark implants, four subjects had been treated with Astra Tech implants and one subject had a Straumann implant. Eleven subjects had periodontal supportive care performed by their hygienist or general dentist at a frequency of 6 months to once yearly. One subject reported sporadic visits. About...
For each radiograph, the width of the implant was used for image calibration.
The defect height was measured from a well-defined reference point at the most coronal part of the implant body, on radiographs taken at baseline, 12 months and 7 years. The radiographic measurements were performed by one investigator (AMA), blinded to the examination timepoint. The changes in vertical defect depth we...
After 7 years (7.3 years [6.7–8]), all patients who completed the original study were invited for a re-examination. After a multitude of recall strategies including telephone and letters, 17 subjects responded and were recalled to the university dental clinic between April and November 2015. After signing the written informed consent, medical and dental history were recorded and a clinical exa...
In 2012, the same group of researchers presented results from a randomized parallel arm case-control clinical study, using porous titanium granules as a bone substitute in the corrective surgical treatment of peri-implant osseous defects. Grafting of the defects with PTG was compared with open flap debridement alone. No clinical differences between groups were found after 12 months, but a better ...
Peri-implantitis was suggested [1] as an infectious and pathological site-specific disease in surrounding peri-implant tissues.
At the 6th European Workshops on Periodontology, consensus was made on the definitions related to the peri-implant diseases, peri-implant mucositis and peri-implantitis, respectively [2].
Peri-implant mucositis describes an established inflammatory lesion in the soft ti...
A great number of different treatment protocols for peri-implantitis have been suggested but there is no consensus regarding the most effective intervention. The aim of the present study was to evaluate the long-term clinical and radiographic results from a study on peri-implant osseous defect reconstruction.
Patients having participated in a randomized clinical study 7 years earlier were invit...
Fig. 7. Multiple graphs comparing A-B distance (height bone) (a) and the C-D distance (tissue thickness) (b) among different groups. Differences between groups were assessed by Dunn’s multiple comparison test (*P
Fig. 6. Graph comparing the data of buccal (B) and lingual (L) measured the C-D distance (tissue thickness). Group 1 = implant installed in fresh extraction and submerged; group 2 = implants in fresh extraction and immediately exposed; group 3 = implants installed in healed site and submerged; and group 4 = implants in healed site and immediately exposed
Fig. 6. Graph comparing the data of bu...
Fig. 5. Graph comparing the data of buccal (B) and lingual (L) measured the A-B distance (bone height). Group 1 = implant installed in fresh extraction and submerged; group 2 = implants in fresh extraction and immediately exposed; group 3 = implants installed in healed site and submerged; and group 4 = implants in healed site and immediately exposed
Fig. 5. Graph comparing the data of buc...
Fig. 4. Images of groups 3 and 4 representing the implants place in healed alveolar sites. Picrosirius red staining. Original magnification × 4
Fig. 4. Images of groups 3 and 4 representing the implants place in healed alveolar sites. Picrosirius red staining. Original magnification × 4
Fig. 3. Images of groups 1 and 2 representing the implants place in fresh sockets sites. Picrosirius red staining. Original magnification × 4
Fig. 3. Images of groups 1 and 2 representing the implants place in fresh sockets sites. Picrosirius red staining. Original magnification × 4
Fig. 2. Parameters measured in each group. Crestal bone loss is the distance between the implant collar (A) and the first bone contact of the crestal bone (B) = A-B bone height; and, the tissue thickness that is the distance from the implant collar (C) to the more external portion of the tissues (D) = C-D tissue thickness. Picrosirius red staining. Original magnification × 16
Fig. 2. Param...
Fig. 1. Image of the implant (a) and surface (b) used in the present study
Fig. 1. Image of the implant (a) and surface (b) used in the present study
Group
1
2
3
4
Friedman test
...
Tissue thickness (C-D distance in mm)
Buccal
Lingual
Group 1
Group 2
Group 3
...
Crestal bone loss (A-B distance in mm)
Buccal
Lingual
Group 1
Group 2
Group 3
...
Gehrke, S.A., Bragança, L.K., Velasco-Ortega, E. et al. Evaluation of dimensional behavior of peri-implant tissues in implants immediately exposed or submerged in fresh extraction and healed sites: a histological study in dogs.
Int J Implant Dent 4, 5 (2018). https://doi.org/10.1186/s40729-018-0120-z
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Received: 02 October 2017
Accepted: 10 January 2018
Pu...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
Sergio Alexandre Gehrke, Leana Kathleen Bragança, Eugenio Velasco-Ortega, and Jose Luis Calvo-Guirado declare that they have no competing interests.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Biotecnos Research Center, Calle Cuareim, 1483, CP: 11.100, Montevideo, Uruguay
Sergio Alexandre Gehrke
University Catholica San Antonio de Murcia (UCAM), Murcia, Spain
Sergio Alexandre Gehrke
Implant Dentistry, Seville University, Seville, Spain
Leana Kathleen Bragança
General Dentistry, Seville University, Seville, Spain
Eugenio Velasco-Ortega
Implant Dentistry Master, Seville Universit...
Trisi P, Lazzara R, Rao W, Rebaudi A. Bone-implant contact and bone quality: evaluation of expected and actual bone contact on machined and osseotite implant surfaces. Int J Periodontics Restorative Dent. 2002;22(6):535–45.
Calvo-Guirado JL, Ortiz-Ruiz AJ, Negri B, López-Marí L, Rodriguez-Barba C, Schlottig F. Histological and histomorphometric evaluation of immediate implant placement on a d...
Spray JR, Black CG, Morris HF, Ochi S. The influence of bone thickness on facial marginal bone response: stage 1 placement through stage 2 uncovering. Ann Periodontol. 2000;5(1):119–28.
Bornstein MM, Lussi A, Schmid B, Belser UC, Buser D. Early loading of nonsubmerged titanium implants with a sandblasted and acid-etched (SLA) surface: 3-year results of a prospective study in partially edentulou...
Lang NP, Pun L, Lau KY, Li KY, Wong MC. A systematic review on survival and success rates of implants placed immediately into fresh extraction sockets after at least 1 year. Clin Oral Implants Res. 2012;23(Suppl 5):39–66.
Bornstein MM, Valderrama P, Jones AA, Wilson TG, Seibl R, Cochran DL. Bone apposition around two different sandblasted and acid-etched titanium implant surfaces: a histomorpho...
Chen ST, Buser D. Esthetic outcomes following immediate and early implant placement in the anterior maxilla—a systematic review. Int J Oral Maxillofac Implants. 2014;29(Suppl):186–215.
Berberi AN, Tehini GE, Noujeim ZF, Khairallah AA, Abousehlib MN, Salameh ZA. Influence of surgical and prosthetic techniques on marginal bone loss around titanium implants. Part I: immediate loading in fresh ex...
Botticelli D, Berglundh T, Lindhe J. Hard-tissue alterations following immediate implant placement in extraction sites. J Clin Periodontol. 2004;31(10):820–8.
Araújo MG, Lindhe J. Dimensional ridge alterations following tooth extraction. An experimental study in the dog. J Clin Periodontol. 2005;32(2):212–8.
Araújo MG, Sukekava F, Wensström JL, Lindhe J. Ridge alterations following implan...
Within the limitations of this study, our findings suggest that the crestal bone height is larger when implants are inserted in healed areas in comparison with implants installed in fresh extraction sites. Moreover, significant differences were found between non-exposed and immediately exposed implants with regards to crestal bone height position, and higher thickness tissue values in the groups o...
New studies are needed to define the influence of other surface compositions and neck configurations for implants placed in fresh extraction sockets with/or without submerged and the influence of abutment change on crestal bone stabilization during the remodeling process. These would appear to be important factors for improving peri-implant bone and soft tissue stability and clinical outcomes, inc...
In the present study, the implants were positioned in the crestal bone level, by following Bornstein et al. [34, 35] which reported that the implants are often inserted within the bone crest. Tomasi et al. [36] in a clinical trial observed that the implant position conditioned the amount of buccal crest resorption. Moreover, the thickness of the buccal bone plate and the tridimensional positioning...
The immediate implants in fresh sockets have demonstrated a great success rate [18, 22,23,24]. However, the removal of a single tooth followed by immediate placement of an implant results in marked alterations of the ridge in the horizontal as well as in the vertical dimension. The early phases of tissue integration in immediate post-extraction implants have been well documented [1, 25, 26]. The i...
The surgical sites healed uneventfully. All animals presented appropriate healing during the first week following the surgical procedure. Post-surgical inspections for 2 weeks post-operatively indicated the absence of infection or inflammation. All implants presented osseointegration after the proposed period and were available for histological analysis.
Direct contact was observed between livin...
A power analysis was conducted to determine appropriate sample size; although it was determined that 6 samples from each group would generate a 95% confidence limit (G3Power), 10 samples were proposed for each situation to increase the level of significance.
The hemimandibles were removed with care to preserve the integrity of both peri-implant hard and soft tissues, washed in saline solution and fixed in 10% buffered formalin, and sent for processing at the Laboratory of Ucam-Biotecnos (Murcia, Spain). Specimens were dehydrated in ascending series of alcohol rinses and embedded in a glycol methacrylate resin (Technovit 7200 VLC; Kulzer, Wehrheim, Ger...
A total of 40 implants were installed (ICI implant, Galimplant, Sarria, Spain), with 3.5 mm in diameter by 10 mm in length. Eight implants in each dog, half per hemimandible. The surface treatment of this implant model is developed by blasting with three different granulometries of Al2O3 and pickling using a hydrofluoric solution (HF) at low temperature and short time, which aims to remove any t...
Then, the good results were obtained with both techniques (implants placed into fresh alveolus and implants non-submerged); these have been joined together with the objective to reduce the time of the treatment. However, the esthetic results can directly influence by the peri-implant tissue dimension (vertical or horizontal) and position in relationship of the cervical implant portion. In this way...
After the tooth loss, there is a progressive involution of the alveolar bone both in the horizontal and the vertical dimensions [1, 2]. Moreover, the most rapid reduction in the alveolar bone after tooth extraction occurs during the first 3 months [3, 4]. Implants immediately positioned in alveolus after the surgical extraction of the tooth exhibit a success ranging from 92.7 to 98.0% [5]. Some a...
The aim of this study was to compare histologically the dimensional behavior of peri-implant tissues during osseointegration of immediately exposed or submerged implant placement in fresh extraction and healed sites.
Four fresh extraction and four delayed implant sites were placed in each hemimandible of five dogs at the bone crest level. In 2 implants of each side were installed a healing abutme...
Fig. 1. PRISMA flow diagram
Fig. 1. PRISMA flow diagram
Risk of bias
Study
Maïmoun et al. 2010 [29]
Li et al. 2010 [32]
Li et al. 2012 [33]
...
Study
Tests and overall results
Bone mineral density
Histomorphometric
Biomechanical
...
Study
Sample characteristics
Animal model
Study groups
Treatment start
Duration of ...
Scardueli, C.R., Bizelli-Silveira, C., Marcantonio, R.A.C. et al. Systemic administration of strontium ranelate to enhance the osseointegration of implants: systematic review of animal studies.
Int J Implant Dent 4, 21 (2018). https://doi.org/10.1186/s40729-018-0132-8
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Received: 14 November 2017
Accepted: 23 April 2018
Published: 17 July 2018
DOI: https:/...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
This review was executed in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), and the Cochrane Handbook for Systematic Reviews of Interventions, and no approval by an ethics committee is demanded.
All participants consented to publish their information details.
Cássio Rocha Scardueli, Carolina Bizelli-Silveira, Rosemary Adriana C. Marcantonio, Elcio Ma...
Correspondence to
Cassio Rocha Scardueli.
Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
Cassio Rocha Scardueli, Carolina Bizelli-Silveira & Rubens Spin-Neto
Department of Periodontology, São Paulo State University (Unesp), School of Dentistry, Araraquara, São Paulo, Brazil
Cassio Rocha Scardueli, Rosemary Adriana C. Marcantonio & Elcio Marcantonio Jr
Department of Periodontology, Faculty of Odonto...
Berardi D, Carlesi T, Rossi F, Calderini M, Volpi R, Perfetti G. Potential applications of biphosphonates in dental surgical implants. Int J Immunopathol Pharmacol. 2007;20:455–65.
Javed F, Almas K. Osseointegration of dental implants in patients undergoing bisphosphonate treatment: a literature review. J Periodontol. 2010;81:479–84.
Jonville-Bera A, Autret-Leca E. Ranélate de strontium (Pr...
Marie PJ, Felsenberg D, Brandi ML. How strontium ranelate, via opposite effects on bone resorption and formation, prevents osteoporosis. Osteoporos Int. 2011;22:1659–67.
Canalis E, Hott M, Deloffre P, Tsouderos Y, Marie PJ. The divalent strontium salt S12911 enhances bone cell replication and bone formation in vitro. Bone. 1996;18:517–23.
Peng S, Liu XS, Wang T, Li Z, Zhou G, Luk KD, et al. ...
Arlot ME, Jiang Y, Genant HK, Zhao J, Burt-Pichat B, Roux JP, et al. Histomorphometric and microCT analysis of bone biopsies from postmenopausal osteoporotic women treated with strontium ranelate. J Bone Miner Res. 2008;23:215–22.
Moher D, Liberati A, Tetzlaff J, Altman DG, Group P. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ. 2009;339:b2535.
J...
Pemmer B, Hofstaetter JG, Meirer F, Smolek S, Wobrauschek P, Simon R, et al. Increased strontium uptake in trabecular bone of ovariectomized calcium-deficient rats treated with strontium ranelate or strontium chloride. J Synchrotron Radiat. 2011;18:835–41.
Peng S, Liu XS, Zhou G, Li Z, Luk KD, Guo XE, et al. Osteoprotegerin deficiency attenuates strontium-mediated inhibition of osteoclastogenes...
Davies JE. Mechanisms of endosseous integration. Int J Prosthodont. 1998;11:391–401.
Davies JE. Understanding peri-implant endosseous healing. J Dent Educ. 2003;67:932–49.
Sakka S, Baroudi K, Nassani MZ. Factors associated with early and late failure of dental implants. J Investig Clin Dent. 2012;3:258–61.
Bastos AS, Spin-Neto R, Conte-Neto N, Galina K, Boeck-Neto RJ, Marcantonio C, et al...
Medical Literature Analysis and Retrieval System Online
Ovariectomy
Strontium
Strontium ranelate
Systematic Review Centre for Laboratory animal Experimentation
Based on the few studies included in this systematic review, it is possible to state that the systemic administration of Sr, in the form of SRAN, seems to enhance peri-implant bone quality and implant osseointegration, however, to a moderate extent. Further studies should focus on standardization of the study designs to properly assess the effects of Sr, including parameters such SRAN dose, admini...
The variability in the results of the studies included in this review, may not only relate to SRAN dose, but may somehow relate to differences in the time-period after ovariectomy, before the animals were included in the study, which differed greatly among studies (from 4 to 12 weeks). Although it is already defined in the literature that initial osteoporosis features appear already at 4 weeks a...
All studies included in this review tested the hypothesis that non-radioactive Sr supplementation would enhance implant osseointegration. Overall, the results of the included studies suggest that the systemic Sr administration enhances peri-implant bone quality and implant osseointegration, however to a moderate extent. Positive results regarding implant osseointegration and the quality of peri-im...
Sr is a metabolic trace element closely related to calcium. Sr2+ ions are incorporated into bone by two main mechanisms: (a) a rapid uptake mechanism, dependent on osteoblast activity, whereby Sr2+ becomes absorbed via ion exchange processes with Ca2+ or binding to osteoid proteins, and (b) Sr2+ ions incorporate into the crystal lattice of the bone mineral phase. [34] When Sr2+ is present in highe...
In three studies from the same research group, female rats with ovariectomy-induced (OVX) osteoporosis were included [31,32,33]. Although the same research group performed the studies, the results were based on diverse animal populations, as it can be inferred from the studies. Rats receiving a high dose of SRAN (SRANH, 1000 mg/kg/day) showed an increased ratio between bone and total voxels in di...
The initial search for publications yielded 578 titles in MEDLINE (PubMed) database, and 152 in Scopus database. After duplicates were removed, there were a total of 553 titles to be screened. After initial screening, using the abstracts and key words, 37 publications remained (31 from PubMed and 6 from Scopus), that potentially met the inclusion criteria. Hand-searching did not reveal any additio...
Three independent researchers (CRS, CBS, and RSN) conducted data extraction and validity assessment of the studies that met the inclusion criteria. Data was extracted focusing on the animal model, study groups, treatment start, duration of the treatment, period of examination, implant specification, evaluation methods, and results (outcomes), according to what was reported in each study (i.e., his...
This review was executed in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) [26], and the Cochrane Handbook for Systematic Reviews of Interventions [27].
Animal studies in which the methodology/results included parameters regarding the use of systemic administration of non-radioactive Sr to enhance the osseointegration of implants and/or the remodeling ...
Thus, the aim of this review was to undertake a systematic review of the literature on the available evidence—deriving from animal studies—on the systemic administration of non-radioactive Sr to enhance the osseointegration of titanium implants and/or the bone regeneration (i.e., remodeling) in association with bone grafting techniques.
Following the trauma induced to the bone tissue during dental implant installation, wound healing involves the fine-tuned coupling of bone resorption and formation [1, 2], which finally leads to the direct bone-to-implant contact, i.e., implant osseointegration [3]. The same biological mechanisms are involved in the wound healing (i.e., remodeling) of a bone defect filled with bone graft and/or bo...
The literature states that Strontium (Sr) is able to simultaneously stimulate bone formation and suppress bone resorption. Recent animal studies suggest that the systemic administration of Sr, in the form of strontium ranelate (SRAN), would enhance the osseointegration of implants. The purpose of the present study was to undertake a systematic review on animal studies evaluating the systemic admin...
Fig. 6. Funnel plot for anchorage loss in the vertical dimension (MD mean difference, SE standard error)
Fig. 6. Funnel plot for anchorage loss in the vertical dimension (MD mean difference, SE standard error)
Fig. 5. Funnel plot for anchorage loss in the horizontal dimension (MD mean difference, SE standard error)
Fig. 5. Funnel plot for anchorage loss in the horizontal dimension (MD mean difference, SE standard error)
Fig. 4. Forest plot for anchorage loss in the vertical dimension
Fig. 4. Forest plot for anchorage loss in the vertical dimension
Fig. 3. Forest plot for anchorage loss in the horizontal dimension
Fig. 3. Forest plot for anchorage loss in the horizontal dimension
Fig. 2. Graphic visualization of the risk of bias judgements
Fig. 2. Graphic visualization of the risk of bias judgements
Fig. 1. PRISMA study flow diagram
Fig. 1. PRISMA study flow diagram
NoneTable 3 Risk of bias judgment according to the Cochrane Collaboration
Reference
Number of patients
Type of study (RCT/CCT/other)
Control intervention
Type of implant (length, material)
...
Reference
Reason for exclusion
Barros et al. (2017) [3]
Anchorage loss at first molar not specified
Borsos et al. (2012) [7]...
Becker, K., Pliska, A., Busch, C. et al. Efficacy of orthodontic mini implants for en masse retraction in the maxilla: a systematic review and meta-analysis.
Int J Implant Dent 4, 35 (2018). https://doi.org/10.1186/s40729-018-0144-4
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Received: 04 May 2018
Accepted: 27 August 2018
Published: 25 October 2018
DOI: https://doi.org/10.1186/s40729-018-0144-4
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
Data extraction template. (CSV 2 kb)
Not applicable
Not applicable
Kathrin Becker, Annika Pliska, Caroline Busch, Benedict Wilmes, Michael Wolf, and Dieter Drescher declare that they have no competing interests.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Correspondence to
Kathrin Becker.
Michael Wolf and Dieter Drescher contributed equally to this work.
Department of Orthodontics, Universitätsklinikum Düsseldorf, 40225, Düsseldorf, Germany
Kathrin Becker, Annika Pliska, Caroline Busch, Benedict Wilmes & Dieter Drescher
Department of Orthodontics, Universitätsklinikum RWTH Aachen, Aachen, Germany
Michael Wolf
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We acknowledge the work of S. Moscarino, E. Burceck, and J. Bartz who assisted in the abstract screening and hand searching.
The study was self-funded by the authors.
The data extracted for the meta-analysis are available in the Additional file 1.
Xun CL, Zeng XL, Wang X. Clinical application of miniscrew implant for maximum anchorage cases. Zhonghua Kou Qiang Yi Xue Za Zhi. 2004;39(6):505–8.
Yao CC, Lai EH, Chang JZ, Chen I, Chen YJ. Comparison of treatment outcomes between skeletal anchorage and extraoral anchorage in adults with maxillary dentoalveolar protrusion. Am J Orthod Dento Orthoped. 2008;134(5):615–24.
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...
Upadhyay M, Yadav S, Patil S. Mini-implant anchorage for en-masse retraction of maxillary anterior teeth: a clinical cephalometric study. Am J Orthod Dentofac Orthop. 2008b;134(6):803–10.
Upadhyay M, Yadav S, Nagaraj K, Uribe F, Nanda R. Mini-implants vs fixed functional appliances for treatment of young adult Class II female patients: a prospective clinical trial. Angle Orthod. 2012;82(2):294...
Nienkemper M, Wilmes B, Pauls A, Drescher D. Impact of mini-implant length on stability at the initial healing period: a controlled clinical study. Head Face Med. 2013;9:30.
Papageorgiou SN, Zogakis IP, Papadopoulos MA. Failure rates and associated risk factors of orthodontic miniscrew implants: a meta-analysis. Am J Orthod Dentofac Orthop. 2012;142(5):577–595.e577.
Park HS, Kwon TG, Sung JH. ...
Kawa D, Kunkel M, Heuser L, Jung BA. What is the best position for palatal implants? A CBCT study on bone volume in the growing maxilla. Clin Oral Investig. 2017;21(2):541–9.
Kuhlberg AJ, Burstone CJ. T-loop position and anchorage control. Am J Orthod Dentofac Orthop. 1997;112(1):12–8.
Kuhlberg AJ, Priebe DN. Space closure and anchorage control. Semin Orthod. 2001;7(1):42–9.
Kuroda S, Yam...
de Almeida MR, Herrero F, Fattal A, Davoody AR, Nanda R, Uribe F. A comparative anchorage control study between conventional and self-ligating bracket systems using differential moments. Angle Orthod. 2013;83(6):937–42.
Durrani OK, Shaheed S, Khan A, Bashir U. Comparison of in-vivo failure of single-thread and dualthread temporary anchorage devices over 18 months: A split-mouth randomized contr...
Al-Sibaie S, Hajeer MY. Assessment of changes following en-masse retraction with mini-implants anchorage compared to two-step retraction with conventional anchorage in patients with class II division 1 malocclusion: a randomized controlled trial. Eur J Orthod. 2014;36(3):275–83.
Alharbi F, Almuzian M, Bearn D. Miniscrews failure rate in orthodontics: systematic review and meta-analysis. Eur J O...
The present systematic review and meta-analysis revealed that orthodontic mini implants are associated with a significantly lower anchorage loss at the first upper molars compared to conventional anchorage devices for en-masse retraction in the maxilla. However, the ideal implant location (anterior palate versus alveolar ridge) and the most beneficial concept (direct or indirect anchorage) need t...
Indirect anchorage through implants in the alveolar ridge was associated with mesial molar migration in all studies included in the present review [5, 9, 54, 57]. Nonetheless, anchorage loss with indirect anchorage was significantly lower compared to the conventional devices [5, 9, 57]. It has been suggested that the anchorage loss at indirectly anchored mid-palatal implants may be caused by a sli...
The present systematic review was conducted to address the following focused question: “In patients with a need for en masse retraction of the upper front teeth, what is the efficacy of orthodontic mini implants for anchorage control compared with conventional anchorage devices?”
The literature search revealed that efficacy of anchorage control of orthodontic mini implants in comparison to co...
Meta-analysis was performed on RCTs reporting on anchorage loss at the first molar.
Based on seven studies [1, 4, 11, 28, 49, 50, 52], the weighted mean differences (WMD) [95% CI, p] in horizontal anchorage loss between test and control groups amounted up to − 2.79 mm [− 3.56 to − 2.03 mm, p
The overall success rates of the orthodontic mini implants varied among the studies. A success rate of 95.7% with a loss of 2 from 46 implants was reported by Upadhyay et al. [48], and the implants could be replaced immediately. Two patients developed a peri-implant inflammation which was resolved through improved oral hygiene. A loss of 5 of 72 implants was reported by Upadhyay et al. [49], and i...
In detail, anchorage loss associated with indirect anchorage and a mid-palatal implant amounted to 1.5 ± 2.6 mm versus 3 ± 3.4 mm [5], 0.7 ± 0.4 (right molar) and 1.1 ± 0.3 mm (left molar) [54], 1.73 ± 0.39 mm (horseshoe), and 0.36 ± 0.11 mm (posterior reinforcement) versus 4.21 ± 1.17 mm [57]. An anchorage loss of 0.2 ± 0.35 mm versus 2.0 mm ± ...
The study samples considered for the qualitative synthesis consisted of females exhibiting Angle Class II,1 malocclusion with upper dental protrusion and an overjet of at least 7 mm [48], patients with a dental Class II, a need for extraction of the first upper premolars and front retraction [54], or Class III patients with a need for pre-surgical decompensation through premolar extraction and fr...
The search for the review was undertaken at December 31, 2017. A total of 2046 potentially relevant titles and abstracts were found during the electronic and manual search (676 after duplicate removal) of which 99 titles were considered relevant for abstract screening. During the first stage of study selection, 58 publications were excluded based on the abstract. For the second phase, the complete...
When data were not available in the printed report, we calculated the missing information whenever possible (e.g., by subtracting pre- and post en masse retraction values). In cases where a zero variance (0.00 mm) was presented in the summary tables, these values were changed to 0.01 mm to enable meta-analysis. The corresponding authors of the published studies were contacted when needed.
Heter...
Inclusion of less than five patients
Lack of clinical data on anchorage loss
Measurement of anchorage loss not by superimposition of lateral cephalograms or superimposition of study casts
Previous orthodontic treatment
Treatment in control group not specified
Inclusion of diseased patients, e.g., patients with systemic diseases, periodontal disease, and syndromes
Other treatment than en mass...
AND (“anchorage loss” OR “anchorage quality” OR “quality of life” OR “benefit” or “harm” OR “efficacy” OR “side effects” OR “effect” OR “orthodontic anchorage procedures”[mh] OR “treatment outcome”[mh])
Search terms EMBASE (including EMTREE terms)
(“en-masse retraction” OR “incisor retraction” OR “front retraction” OR “orthodontic gap clo...
This systematic review was structured and conducted according to the preferred reporting items of the PRISMA statement [34].
The focused question serving for literature search was structured according to the PICO (Patients, Intervention, Control, Outcome) format: “In patients with a need for en masse retraction of the upper front teeth, what is the efficacy of orthodontic mini implants for anch...
Extraction of the permanent teeth for retraction of the protruded front teeth is a routine approach in orthodontics. Various techniques such as headgear, Nance button, and transpalatal arches (TPA) have been proposed to achieve sufficient anchorage [5, 8, 9, 12, 28, 31, 45]. Nevertheless, anchorage control turned out to be highly demanding as the conventional approaches were commonly associated wi...
Retraction of the upper incisors/canines requires maximum anchorage. The aim of the present study was to analyze the efficacy of mini implants in comparison to conventional devices in patients with need for en masse retraction of the front teeth in the upper jaw.
An electronic search of PubMed, Web of Science, and EMBASE and hand searching were performed. Relevant articles were assessed, and data...
Fig. 1. The clinical images of patient 4, with implant-supported single crowns in regions 26 and 27. No signs of a peri-implant infection, mucositis, peri-implantitis, or marginal bone loss were detected. a Occlusal view. b Left-side view. c Orthopantogram. d Close-up radiographic view
Fig. 1. The clinical images of patient 4, with implant-supported single crowns in regions 26 and 27. No sign...
Lorenz, J., Blume, M., Korzinskas, T. et al. Short implants in the posterior maxilla to avoid sinus augmentation procedure: 5-year results from a retrospective cohort study.
Int J Implant Dent 5, 3 (2019). https://doi.org/10.1186/s40729-018-0155-1
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Received: 19 September 2018
Accepted: 20 December 2018
Published: 22 January 2019
DOI: https://doi.org/10.11...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
The study was approved by the ethics commission of the medical department of Goethe University in Frankfurt am Main, Germany (79/18). All participating patients gave informed written consent to participate in the retrospective study and for publication of the obtained data.
All participating patients gave informed written consent to participate in the retrospective study and for publication of th...
Correspondence to
Jonas Lorenz.
FORM-Lab, Department for Oral, Cranio-Maxillofacial, and Facial Plastic Surgery, Medical Center of the Goethe University Frankfurt, Frankfurt am Main, Germany
Jonas Lorenz, Shahram Ghanaati & Robert A. Sader
Private Dental Practice, Mainz, Germany
Maximilian Blume
Private Practice, Bokštų 9, LT-92125, Klaipeda, Lithuania
Tadas Korzinskas
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Not applicable
This study was supported by a grant from the Camlog Foundation.
The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.
Lorenz J, Lerner H, Sader R, Ghanaati S. Investigation of peri-implant tissue conditions and peri-implant tissue stability in implants placed with simultaneous augmentation procedure: a 3-year retrospective follow-up analysis of a newly developed bone level implant system. Int J of Impl Dent. 2017;5(1):41.
Del Fabbro M, Rosano G, Taschieri S. Implant survival rates after maxillary sinus augmentat...
Lorenz J, Barbeck M, Kirkpatrick CJ, Sader R, Lerner H, Ghanaati S. Injectable bone substitute material on the basis of β-TCP and hyaluronan achieves complete bone regeneration while undergoing nearly complete degradation. Int J Oral Maxillofac Implants. 2018;33(3):636–44.
Lorenz J, Kubesch A, Korzinskas T, Barbeck M, Landes C, Sader R, Kirkpatrick CJ, Ghanaati S. TRAP-positive multinucleated ...
Absent
Present
Bleeding on probing
Disto-buccal
Disto-oral
Female
Fixed prosthetics
Male
Mesio-buccal
Marginal bone loss
Mesio-oral
Probing pocket depth
Removable prosthetics
The present retrospective study analyzed the clinical and radiological performance of dental implants of 7-mm length in the posterior maxilla used to avoid sinus augmentation procedures. After a mean period of loading of 5 years, a survival rate of 100% and an absence of peri-implant infections were detected, which leads to the conclusion that “short implants” are a reliable treatment option...
In a systematic review, Lemos et al. compared short implants with a length of 8 mm or less to standard implants (larger than 8 mm) placed in posterior regions of the maxilla and mandible. The authors reviewed 13 studies with a total of 1269 patients who had received a total of 2631 dental implants. Short implants showed marginal bone loss, prosthetic failures, and complication rates similar to...
In the present retrospective study, dental implants of reduced length (7 mm) that were placed in the posterior maxilla to avoid sinus augmentation procedure were clinically and radiologically followed up after a mean loading period of 5 years. The clinical and radiological results demonstrate successful midterm results regarding implant survival and peri-implant hard and soft tissue health. Lo...
To analyze peri-implant bone loss over the study period of 5 years, digitally recorded perpendicular single-tooth images recorded immediately after implant placement and at the follow-up investigation were compared.
A mean total peri-implant marginal bone loss of 0.5 mm, ranging from 0 to 1.5 mm, was shown. Sub-analysis indicated mesial peri-implant bone loss of 0.4 mm and distal peri-impl...
After patient screening was performed, 30 implants in the premolar and molar regions of the upper jaw in 14 patients met the inclusion criteria and were clinically and radiologically followed up according to the study protocol. The aim of the follow-up investigation was to analyze whether implants of 7-mm length are suitable for prosthetic rehabilitation in the atrophic maxilla to avoid a sinus au...
Implant being in situ and suitable for prosthetic rehabilitation
Buccal width and thickness of peri-implant keratinized gingiva
Probing depth (at 4 sites per implant)
BoP (per implant)
Peri-implant bone loss
Presence of peri-implant osteolysis
After a mean loading period of 5 years (range 2–7 years), the implants were clinically and radiologically analyzed to determine the overall implant success, mean survival and suitability for prosthetic rehabilitation, peri-implant hard and soft tissue health, and patient acceptance. Furthermore, peri-implant hard and soft tissue indices, such as bleeding on probing (BoP), probing pocket dept...
In the present retrospective study, 14 patients (5 females and 9 males) with a mean age of 63 years (34–80 years) received Conelog® Screw-line implants (Camlog Biotechnologies, Basle, Suisse) with a length of 7 mm. In total, 30 implants were clinically and radiologically investigated after a mean loading period of 5 years (range 2–7 years).
All patients from the Department for Oral...
In the present retrospective study, implants of 7-mm length and a specific implant design, including a conical implant-abutment connection and platform switching, placed in the posterior maxilla were investigated by means of a clinical and radiological analysis after a mean loading period of 5 years. The aim of this study was to analyze whether a reduced implant length has any impact on implant s...
In the past few decades, technical developments of dental implants in combination with continuous development of surgical techniques and biomaterials have led to an expansion of the indications for implant-retained prosthetics. Prevention of atrophy after tooth extraction by socket or ridge preservation or reconstruction of the alveolar crest in cases of atrophy by augmentation with autologous bon...
Short implants present a promising approach for patients with advanced atrophy to avoid augmentative procedures. However, concerns about increased biological and technical complications due to an unfavorable implant-crown ratio are still present.
The aim of the present retrospective study was to evaluate whether a reduced implant length has any impact on implant success and peri-implant hard and ...
Fig. 4. Statistical analysis for different variables. a Weighted mean survival rate. b Implant survival rate according to degree of penetration. c Analysis of clinical complications. d Analysis of radiographic complications
Fig. 4. Statistical analysis for different variables. a Weighted mean survival rate. b Implant survival rate according to degree of penetration. c Analysis of clinical com...
Fig. 3. Graphic representation of group 1 ≤ 4 mm penetration and group 2 > 4 mm penetrations
Fig. 3. Graphic representation of group 1 ≤ 4 mm penetration and group 2 > 4 mm penetrations
Fig. 1. Graphic representation of implants intruding sinus perforating or not the Schneiderian membrane
Fig. 1. Graphic representation of implants intruding sinus perforating or not the Schneiderian membrane
Fig. 2. PRISMA flowchart of the screening process
Fig. 2. PRISMA flowchart of the screening process
Reason for exclusion
Investigations
Study design (case series or case report)
Kim et al. (2017), Hatano et al. (2007)
Different grafting techn...
Author (year)
Study design
Follow-up (months)
N of patients
N of implants
Smokers
Le...
Clinical complications
Radiographic complications
Sinusitis
Thickening of Schneiderian membrane
Nasal bleeding, nasal obstruction, nasal secre...
Ragucci, G.M., Elnayef, B., Suárez-López del Amo, F. et al. Influence of exposing dental implants into the sinus cavity on survival and complications rate: a systematic review.
Int J Implant Dent 5, 6 (2019). https://doi.org/10.1186/s40729-019-0157-7
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Received: 09 October 2018
Accepted: 06 January 2019
Published: 05 February 2019
DOI: https://doi.org/10...
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Gian Maria Ragucci, Basel Elnayef, Fernando Suárez López del Amo, Hom-Lay Wang, Federico Hernández-Alfaro, and Jordi Gargallo-Albiol declare that they have no competing interests.
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Correspondence to
Basel Elnayef.
Department of Oral and Maxillofacial Surgery, International University of Catalonia, C/Josep Trueta Sn, Sant Cugat del Vallés, C.P 08195, Barcelona, Spain
Gian Maria Ragucci, Basel Elnayef, Federico Hernández-Alfaro & Jordi Gargallo-Albiol
Department of Periodontics, University of Oklahoma Health Sciences Center – College of Dentistry, Oklahoma City, OK, USA
Fernando Suárez-López del ...
The authors want to thank Mr Juan Luis Gómez Martínez for the support in the statistical analysis.
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The authors do not have any financial interests, either directly or indirectly, in the products or information listed in the paper.
Schwarz L, Schiebel V, Hof M, Ulm C, Watzek G, Pommer B. Risk factors of membrane perforation and postoperative complications in sinus floor elevation surgery: review of 407 augmentation procedures. J Oral Maxillofac Surg. 2015;73:1275–82.
Jung JA, Choi BH, Zhu SJ, Lee SH, Huh JY, You TM, Lee HJ, Li J. The effects of exposing dental implants to the maxillary sinus cavity on sinus complications....
Ardekian L, Oved-Peleg E, Mactei EE, Peled M. The clinical significance of sinus membrane perforation during augmentation of the maxillary sinus. J Oral Maxillofac Surg. 2006 Feb;64(2):277–82.
Anavi Y, Allon DM, Avishai G, Calderon S. Complications of maxillary sinus augmentations in a selective series of patients. Oral Surg Oral Med Oral Patho Oral RadiolEndod. 2008;106(1):34–8.
Van den Ber...
Curi MM, Cardoso CL, de Ribeiro C. Retrospective study of pterygoid implants in the atrophic posterior maxilla: implant and prosthesis survival rates up to 3 years. Int J Oral Maxillofac Implants. 2015;30(2):378–83.
Boyne PJ, James RA. Grafting of the maxillary sinus floor with autogenous marrow and bone. J Oral Surg. 1980;38(8):613–6.
Tatum H.Jr. Maxillary and sinus implant reconstructions....
Roccuzzo M, Bonino L, Dalmasso P, Aglietta M. Long-term results of a three arms prospective cohort study on implants in periodontally compromised patients: 10-year data around sandblasted and acid-etched (SLA) surface. Clin Oral Implants Res. 2014;25(10):1105–12.
Esposito M, Grusovin MG, Rees J, Karasoulos D, Felice P, Alissa R, Worthington H, Coulthard P. Effectiveness of sinus lift procedures...
The current review showed that the exposure of dental implants in the sinus cavity without the augmentation procedure or graft materials shows a high survival rate of 95.6%, without statistically significant differences according to the level of penetration (lower or higher to 4 mm). Changes in maxillary sinuses in relation to protruding implants within the sinus cavity do not statically affect ...
Consequently, it seems that maxillary sinus changes in relation to protruded implants inside the sinus cavity and does not statically affect to implant survival rate neither to clinical nor radiographic complications.
Several limitations could be described for the present review. Firstly, there is a lack of a control group in the included studies, to compare outcomes and complications, with impla...
Pneumatization of the maxillary sinus and resorption of the residual alveolar ridge following tooth extraction can compromise the dental implant placement. Similarly, extension of the dental implants inside the maxillary sinus cavity is not rare. Some studies have observed some differences in relation to the depth of the implant extension inside the sinus cavity. When the implants penetrate inside...
Seven studies [27,28,29,30,31,32,33] provide information on clinical complications with a global sample of 232 patients. Clinical complications among the different authors range from 0 to 14.3%, being the weighted mean complication rate 3.4% with an IC 95% [0 7.5] (Fig. 4c) Clinical complications analyzed in the studies were sinusitis, nasal bleeding, nasal obstruction, nasal secretion, mucopurul...
An initial screening yielded a total of 3551 publications of which 26 potentially relevant articles were selected after an evaluation of their titles and abstracts. Full text of these articles was obtained and evaluated thoroughly. Of these, eight articles [26,27,28,29,30,31,32,33] (Table 2) fulfilled the inclusion criteria and subsequently were included in the qualitative analysis (Fig. 2). Rea...
Heterogeneity was assessed based on calculation of the I2 statistic (percentage variability of estimated effect that can be attributed to the heterogeneity of the effects) and the null statistic test. Galbraith graphs displayed the degree of heterogeneity. In studies where great heterogeneity was detected, a sensitivity analysis was performed to determine its source. Funnel plots and the Egger tes...
Articles were included in this systematic review if they met the following inclusion criteria: human prospective or retrospective studies, reporting outcomes of implant placed perforating the sinus floor with implant burs, and without regenerative procedure (lateral sinus lift or transalveolar technique) and graft material. The intrusion into the sinus cavity can occur during drilling or implant p...
This systematic review and subsequent meta-analysis follow the guidelines of the PRISMA statement.
The following focus question was developed: Is the intrusion of dental implants into the sinus cavity during implant drilling or implant placement, without regenerative procedure (lateral sinus lift or transalveolar technique) and graft material, has an effect on implant survival or increase clinica...
Intrusion of dental implants into the maxillary sinus perforating through the Schneiderian membrane is considered a cause of undesirable complications [24, 25]. However, this phenomenon has never been properly evaluated and systematically studied. For this reason, the aim of this systematic review was to assess the implant survival and complication rates of implants intruding into the sinus cavity...
The edentulous posterior maxillary region often presents with unique challenging conditions in implant dentistry [1]. Limited bone height secondary to pneumatization of the maxillary sinus and the resorption of the alveolar ridge preclude in many instances the installation of dental implants. To compensate for the lack of bone height, several treatment options have been proposed.
The most conserv...
The overall survival rate of the implants into the sinus cavity was 95.6%, without statistical differences according to the level of penetration. The clinical and radiological complications were 3.4% and 14.8% respectively. The most frequent clinical complication was the epistaxis, and the radiological complication was thickening of the Schneiderian membrane, without reaching statistical significa...
After tooth loss, the posterior maxilla is usually characterized by limited bone height secondary to pneumatization of the maxillary sinus and/or collapse of the alveolar ridge that preclude in many instances the installation of dental implants. In order to compensate for the lack of bone height, several treatment options have been proposed. These treatment alternatives aimed at the installation o...
Figure 7. Post-operative occlusal photograph of the maxilla
Figure 6. Post-operative lateral view of the right maxillary arch
Figure 5. Post-operative lateral view of the left maxillary arch
Figure 4. Post-operative frontal view with teeth in occlusion
Date
Site number
Implant diameter (mm)
Implant length (mm)
Immediate load
Bone graft augmentation
3/26/14
12
4.3
10
Yes
Allograft
3/26/14
14
4.3
10
Yes
None
11/10/14
10
3.5
13
Yes
Allograft
3/5/15
7
3.5
13
Yes
Allograft
4/19/16
11
4.3
11.5
Yes
None
2/22/17
3
4.3
10
Yes
Allograft
2/22/17
4
5.0
10
Yes
Allograft
...
Figure 1. Characteristic blue sclerae
Table 1 Osteogenesis imperfecta classifications
Type
Inheritance
Gene
Locus
Clinical features
OMIM
I
AD
COL1A1 or COL1A2
17q21.33 or 7q21.3
Variable bone fragility, moderate bone deformity, blue sclerae, possible dentinogenesis imperfecta
166,200
II
AD
COL1A1 or COL1A2
17q21.33 or 7q21.3
Perinatally lethal
166,210
III
AD
COL1A1 or COL1A2
17q21....
References
Sillence DO, Senn A, Danks DM. Genetic heterogeneity in osteogenesis imperfecta. J Med Genet. 1979;16:101–16.
Orioli IM, Castilla EE, Barbosa-Neto JG. The birth prevalence rates for the skeletal dysplasias. J Med Genet. 1986;23:328–32.
Stevenson DA, Carey JC, Byrne JL, Srisukhumbowornchai S, Feldkamp ML. Analysis of skeletal dysplasias in the Utah population. Am J Med Genet...
Discussion
The vast majority of published articles regarding OI type I revolve around fractures of the long bones and treatment strategies. An extensive literature search for manuscripts detailing the implant therapy for patients diagnosed with OI produced a marginal amount of literature (Table 3). Our case posits that oral restoration is attainable without implant failure for OI type I patien...
Surgical technique
The patient underwent implant therapy in stages under general anesthesia with immediate load protocol. Intravenous access was obtained, and the patient was anesthetized under general anesthesia by our anesthesiologist. Carpules of 2% lidocaine with 1:100,000 epinephrine, 4% articaine hydrochloride with 1:100,000 epinephrine (Septocaine), and 0.5% bupivacaine hydrochloride w...
Case presentation
Evaluation
A 53-year-old male diagnosed with OI type I was referred to our clinic for extraction of the remaining maxillary teeth and evaluation for full arch immediate load hybrid prosthesis. His clinical history included osteogenesis type 1, bipolar disorder, alopecia, and hypothyroidism. The patient presented with normal stature, measuring 170.18 cm and weighing 81.65 kg...
Introduction
Osteogenesis imperfecta (OI), colloquially known as “brittle bone disease,” is a broad term for a group of congenital disorders affecting the connective tissue resulting in a susceptibility to fractures. In 1979, Sillence et al. conducted an epidemiological and genetic study of OI patients [1]. These patients were grouped according to four distinct syndromes: (1) dominantly inh...
Implant therapy for a patient with osteogenesis imperfecta type I: review of literature with a case report
Abstract
Bone fragility and skeletal irregularities are the characteristic features of osteogenesis imperfecta (OI). Many patients with OI have weakened maxillary and mandibular bone, leading to poor oral hygiene and subsequent loss of teeth. Improvements in implant therapy have allowed f...
Figure 2. Clinical image of patient 4: a region 21 before implant placement. b, c Implant placement using the GBR procedure with a synthetic bone substitute material composed of HA + β-TCP
Figure 1. Schematic representation of the technical characteristics of the investigated C-Tech Esthetic Line implant system (provided by the manufacturer)
Patient
Implant-localization (region)
Implant loss (+/−)
Buccal width of keratinized peri-implant gingiva (mm)
Buccal thickness of keratinized peri-implant gingiva (mm)
Pink Esthetic Score (PES)
Probing depth (mm) at four sites (mb, db, mo, do)
Bleeding on Probing (+/−) at four sites (mb, db, mo, do)
Peri-implant bone loss (mm)
Presence of peri-implant osteolysis (+/−)
...
Patient
Gender (m/f)
Age (years)
Implant localization (region)
Implant diameter (mm)
Implant length (mm)
Augmentation material
Prosthetic rehabilitation
1
f
50
32
3.5
13
HA + β-TCP
r.p
34
4.3
11
HA + β-TCP
r.p
42
3.5
13
HA + β-TCP
r.p
44
4.3
11
HA + β-TCP
r.p
2
m
61
36
3.5
11
HA + β-TCP
...
Abbreviations
β-TCP:
β-tricalcium phosphate
BOP:
Bleeding on probing
F.P.:
Fixed prosthetics
GBR:
Guided bone regeneration
HA:
Hydroxyapatite
MNGCs:
Multinucleated giant cells
PES:
Pink Esthetic Score
R.P.:
Removable prosthetics
References
Gurgel BC, Montenegro SC, Dantas PM, Pascoal AL, Lima KC, Calderon PD. Frequency o...
Comparing the present results to the aforementioned study with the same implant system on immediately placed implants, it seems that the GBR augmentation procedure has no influence on the long-term stability of the implants. In both studies with different placement modalities and protocols, comparable clinical and radiological results were achieved. This leads to the assumption that the inve...
The tissue reaction, however, did not only differ in bone substitute materials of different origin but also in bone substitute materials of the same origin. In an in vivo trial, two xenogeneic bone substitute materials processed with different techniques were implanted subcutaneously in CD-1 mice for up to 60 days. Both bone substitute materials showed good integration within the peri-impla...
Discussion
In the present retrospective study, C-Tech bone level implants placed simultaneously with a GBR procedure around the implant shoulder were investigated clinically and radiologically after at least 3 years of loading to assess peri-implant tissue conditions and document peri-implant tissue stability.
A total of 47 implants were placed in the upper (23 implants) and lower jaw (24...
Results
Altogether, 47 implants were placed in the upper and lower jaws of a total of 20 patients. In all implants, lateral augmentation in a GBR process was performed simultaneously with implant placement due to reduced horizontal or vertical height of the alveolar crest. A total of 23 implants were placed in the upper jaw and 24 implants in the lower jaw. The implant diameter varied between 3...
C-Tech implant system
In the present retrospective study, bone level implants (C-Tech Esthetic Line implants) were investigated clinically and radiologically. The bone level implant system has a Morse-locking conical implant-abutment connection with platform switching and an indexing hex that allows subcrestal implant placement and aims to prevent peri-implant bone loss. The surface of the implan...
Methods
Patient population
In the present retrospective study, 47 dental implants (C-Tech Esthetic Line implants) from 20 patients (11 female, 9 male) with a mean age of 58.5 years (45–75 years) were analyzed clinically and radiologically. Implant placement and follow-up investigation was performed at the HL Dentclinic in Baden-Baden, Germany. The study was approved by the ethics commissio...
Regarding the stability of peri-implant hard and soft tissue, biological or anatomical factors are not the only elements that could be proven to have an impact. Technical factors such as the implant-abutment connection are also known to be key factors for long-term stable hard- and soft-tissue health [11]. Regarding the implant-abutment connection, which seems to be the key issue, located on the i...
However, in most patients, the local bone amount is reduced due to atrophy, inflammatory processes, or resectional defects. Therefore, in the past few years, different techniques have been described to enlarge the local bone amount in prospective implant sites [7]. Besides methods such as GBR or the sinus augmentation technique, different augmentation materials have been investigated and establish...
Background
The prevalence of peri-implantitis has grown in the past few years and has become a major issue in implant dentistry. Long-term stable and healthy soft- and hard-tissue conditions should be achieved in combination with esthetically and functionally satisfying results. However, the rising number of placed implants in the past decades has come with an increase in the prevalence of ...
Investigation of peri-implant tissue conditions and peri-implant tissue stability in implants placed with simultaneous augmentation procedure: a 3-year retrospective follow-up analysis of a newly developed bone level implant system
Abstract
Background
Guided bone regeneration (GBR) has been proven to be a reliable therapy to regenerate missing bone in cases of atrophy of the alveolar crest. T...
Figure 3. Example of another case involved in the study. a Preoperative view –premolars and molars are missing in left mandible. b Preoperative CT scan. The width of the ridge was around 4 mm. c Baseline periapical radiograph. Four narrow diameter implants were placed to restore the area. d Buccal view of the final full-contour zirconia restoration. e Periapical radiograph at 1...
Figure 2. Case 1: Example of one case involved in the study. a Preoperative view of a partial edentulism in posterior mandible. b Preoperative CT scan. The width of the ridge was 4 mm. c Four narrow diameter implants were placed and left to a nonsubmerged healing. d Baseline periapical radiograph. e Buccal vieew of the final metal ceramic restoration. f Periapical radiograph at ...
Diameter 2.75 mm
Follow-up
Mean bone level changes (mm) (n = 69)
0–6 months (95% CI) (n = 67)
0–12 months (95% CI) (n = 67)
p inter-groups
Baseline
0.02 ± 0.07
−0.18 (−0.09; −0.27)
−0.47 (−0.27; −0.67)
p = 0.786
6 months
0.20 ± 0.12
p intra-group
12 months
0.49 ± 0.30
p
Length (mm)
8
18 (14.5%)
10
56 (45.2%)
11.5
43 (34.7%)
13
7 (5.6%)
Diameter (mm)
2.75
69 (55.6%)
3.25
55 (44.4%)
Insertion torque (Ncm)
30
21 (16.9%)
35
16 (12.9%)
40
10 (8.1%)
45
11 (8.9%)
50
32 (25.8%)
55
7 (5.6%)
60
16 (12.9%)
65
5 (4.1%)
70
6 (4.8%)
Number of patients
42
Males (%)
18 (42.9%)
Females (%)
24 (57.1%)
Mean age at insertion (range)
62.6 (49–73)
Smokers (less than 10 cigarettes/die)
12 (28.6%)
Diseases in history
Controlled diabetes type 2
11 (26.2%)
Hypertension
19 (45.2%)
Site of insertion
Premolar
81 (65.3%)
Molar
43 (34.7%)
Opposite dentition
...
Figure 1. Characteristics of the implants used in the study: a external macro-design of JDIcon Ultra S, 2.75 mm diameter implant and b external macro-design of JDEvolution S, 3.25 mm diameter implant
References
Esposito M, Grusovin MG, Maghaireh H, Worthington HV. Interventions for replacing missing teeth: different times for loading dental implants (Review). Cochrane Database Syst Rev. 2013;(3):CD003878. https://doi.org/10.1002/14651858.CD003878.pub5.
Esposito M, Grusovin MG, Felice P, Karatzopoulos G, Worthington HV, Coulthard P. The efficacy of horizontal and vertical bone augmenta...
Klein et al., in a recent systematic review, reported that the survival rate of implants with a diameter of
Discussion
Dental implants with a reduced diameter are commonly used where bone width is narrow or in cases of restricted mesiodistal anatomy such as laterally maxillary and mandibular incisors. They could also be a viable alternative to bone augmentation especially in challenging situations such as the posterior regions of the mandible. While it has been shown that it is possible to horizo...
Results
Forty-eight patients were screened for eligibility, but six subjects were not included for the following reasons: five patients (10.4%) were hesitant to receive implant treatment, and one patient (2.1%) was treated with intravenous amino-bisphosphonates. Forty-two patients were then considered eligible and were consecutively enrolled in the study. All patients were treated according to ...
Secondary outcome measures were as follows:
Peri-implant marginal bone level changes: evaluated on intraoral radiographs taken with the paralleling technique at implant placement, 6 months and 1 year after loading. All measurements were taken by an independent assessor (LS). Radiographs were scanned, digitized in JPG format, converted to TIFF format with a 600 dpi resolution, and stored in...
On the day of surgery, patients were treated under local anesthesia.
Full-thickness crestal flaps were elevated with a minimal extension to reduce patient discomfort. The implant sites were prepared according to the procedure recommended by the implant manufacturer (JDentalCare, Modena, Italy).
Tapered narrow-diameter implants titanium grade 5 (2.75 and 3.25 mm diameter, respectively, JDIcon Ult...
Methods
The present prospective study was conducted at a private practice (Tommaso Grandi, Modena) in Italy between October 2014 and January 2016.
Any patient with partial edentulism in posterior regions of mandible (premolar/molar areas), requiring one multiple tooth implant-supported restoration (2-, 3-, or 4-unit bridge), having a residual bone height of at least 8 mm and a thickness of at ...
Background
Historically, implants have been used and documented mainly with diameters between 3.7 and 4.3 mm. Employing these diameters for numerous indications, scientifically substantiated treatment protocols with excellent long-term results have been established [1]. One disadvantage of a standard-diameter implant is the fact that, in clinical use, the available horizontal crestal dimension...
Narrow implants (2.75 and 3.25 mm diameter) supporting a fixed splinted prostheses in posterior regions of mandible: one-year results from a prospective cohort study
Abstract
Background
Can multiple splinted narrow-diameter implants be used as definitive implants in patients with insufficient bone ridge thickness in posterior regions of the mandible? With this aim, we evaluated their out...
Figure 3. Data from the VAS of patient-related outcome measures at the time of mounting of the implant-supported crown and at the final follow-up of the PRF and control group
Figure 2. Box plot of the radiographic peri-implant marginal bone level at different time points in millimeter. Baseline: the time of implant placement; abutment: the time of abutment operation; impression: the time of impression taking; follow-up: the time of the final follow-up
Figure 1. Intraoperative photos illustrating bone harvesting and lateral bone augmentation in the PRF group. Initially, an incision is made at the lateral aspect of the posterior part of the mandibular corpus (a) followed by exposing the mucoperiosteal flap (b), before making the osteotomy line (c). The bone block (d) is then retrieved before adjusted to the contour at the recipient site and...
Table 4 Patient-related outcome measures at baseline and at the final follow-up
Test group
Control group
Difference
p value
Mean (95% CI)
Mean (95% CI)
Mean (95% CI)
Baseline
9.44 (9.09 to 9.78)
9.57 (9.20 to 9.95)
0.13 (− 0.40 to 0.66)
0.61
Follow-up
9.66 (9.30 to 10.02)
9.55 (9.15 to 9.96)
− 0.10 (-0.66 to 0.46)
0.71
Difference
0.22 (...
Table 3 Radiographic marginal bone level and clinical recession on neighbouring tooth surface
Group
Baseline (mean, 95% CI)
Follow-up (mean, 95% CI)
Difference (mean, 95% CI)
p value
Radiographic marginal bone level in mm
Test
1.94 (1.50 to 2.38)
2.07 (1.64 to 2.51)
− 0.14 (− 0.25 to − 0.02)
p = 0.03
Control
2.34 (1.62 to 3.08)
2.49 (1.73...
Table 2 Radiographic peri-implant marginal bone level in mm
Test group
Control group
Mean difference
95% CI
p value
Obs
Mean
95% CI
Obs
Mean
95% CI
Baseline
14
− 0.24
− 0.48 to 0.00
13
− 0.28
− 0.52 to 0.03
0.04
− 0.314 to 0.39
p = 0.82
Abutment
14
0.07
− 0.17 to 0.30
13
− 0.01
− 0.26 to 0.25
0.08
− 0.278...
Table 1 Demographics and survival rates of implants and implant crowns
Test group (PRF)
Control group
Number of implants
14
13
Mean age, years (range)
47.9 (23–66)
52.3 (24–72)
Gender
Female
6
6
Male
8
7
Smokers
Total
2
1
20 cigarettes per day
1
1
Number of implants
14
13
Implant length (mm) and imp...
Abbreviations
ASC:
Angulated screw channel
BOP:
Bleeding on probing
DBBM:
Deproteinised bovine bone mineral
GBR:
Guided bone regeneration
ICC:
Intraclass correlation coefficient
KT:
Keratinised peri-implant tissue
PCR:
Plaque control record
PD:
Probing depth
PRF:
Platelet-rich fibrin
PROM:
Patient-related outcome measures
RCF:
...
A minor, but statistically significant, radiographic bone loss occurred from baseline to the final follow-up at the neighbouring tooth surfaces in both groups. Moreover, both groups experienced a minor recession of the marginal gingiva from baseline to the final follow-up, but the change was not significant. Recession and the bone level of the neighbouring tooth surfaces to implants placed in ...
The combination of the NobelParallel CC implant launched in 2015 and an abutment with ASC is relatively new and has so far been lined to only few mechanical problems [39, 40], among which rotation of the crown when torqueing the abutment screw was not stated. In both patients, a new implant was placed without any need for additional bone augmentation and without further complications. ...
Discussion
The present study focused on clinical and radiographic characteristics of staged implants placed in autogenous bone grafts covered by either a PRF membrane (PRF group) or a standard procedure (gold standard) involving coverage of the autogenous bone graft using a deproteinised bovine bone mineral and a resorbable collagen membrane (control group).
The PRF group demonstrated a hi...
One patient (control group) expressed minimally changed extraoral sensation in the chin region at both the 1- and 2-week follow-up. However, the extra- and intraoral clinical examination revealed no sensory disturbances. The patient was not affected by this and described the same changed sensation at the final clinical follow-up after 29 months.
Another patient (PRF group) experienced sensory d...
Radiographic peri-implant marginal bone change
The mean peri-implant marginal bone level at the different time points is shown in Table 2 and Fig. 2. The mean marginal bone level at follow-up was 0.26 mm (95% CI: 0.01–0.50 mm) in the PRF group and 0.68 mm (95% CI: 0.41–0.96 mm) in the control group. The difference between the groups was − 0.43 mm (95% CI: − 0.80 to − 0....
Bleeding on probing
The estimated probability or observed proportion of BOP for implants was 0.31 (95% CI: 0.14–0.70) in the PRF group and 0.30 (95% CI: 0.12–0.77) in the control group. The ratio of the probability of observing BOP was 1.046 (95% CI: 0.91–1.20), indicating that the probability of observing BOP is 4.6% higher in the PRF group than in the control group. No statistical differe...
Results
Implant survival
Two of the 27 initially placed implants were lost in the control group (Table 1). Twenty months after placement of the implant-supported crown, one implant (first premolar, regular platform (4.3 mm), length: 13 mm) was lost due to failed osseointegration. No periodontitis or peri-implant marginal bone resorption was obvious at the time of implant removal. A second...
The distance from the implant-abutment connection to the peri-implant marginal bone level was measured mesially and distally in parallel with the long axis of the implant using open-source software (ImageJ, National Institutes of Health, Bethesda, MD, USA). The distance from the cemento-enamel junction to the marginal bone level at the neighbouring tooth surfaces was also measured in parallel with...
Prosthodontic treatment
Forty-nine days (range: 27–113 days) after placement of the healing abutment, the abutment was removed and the implant position was registered by an impression coping on the implant.
The final implant-supported restoration was fabricated by using an individually designed angulated screw channel (ASC) zirconium abutment (Nobel Biocare®, Zürich, Switzerland) and venee...
Methylprednisolone was prescribed the following morning (16 mg) and evening (16 mg). Additionally, postoperative ibuprofen (400 mg, four times daily) and paracetamol (1000 mg, four times daily) were prescribed for 1 week. The patients were instructed to rinse with 0.12% chlorhexidine digluconate twice daily and discontinue the use of their prostheses (if any). Patients were seen for ...
The bone graft was retrieved by making a continuous osteotomy line with a cylindrical and a round bur at the lateral part of the mandible, with a uniform size of approximately 15 × 25 mm (Fig. 1c, d). The bone block containing mainly cortical bone was then gently separated from the mandible using a raspartorium. The block graft was covered with a saline-moistened gauze until used. In the PRF g...
At the time of the bone augmentation procedure, two patients (14%) in the PRF group and one (8%) patient in the control group were smokers. Patients were partially edentulous due to trauma (n = 22), agenesis (n = 3) or marginal periodontitis [2]. Two patients were unavailable for the final follow-up. The referring dentist followed the non-attenders, and telephone interview revealed no subjective o...
Material and methods
The study was performed according to the Declaration of Helsinki and internationally accepted guidelines for RCT, including the CONSORT statement (www.consort-statement.org). The volumetric changes of the augmented bone [26], the histological composition of the augmented bone [27] and pain after the primary bone augmentation procedure [28] were previously described in d...
Despite the shape of a membrane, the PRF membrane does not have the properties of a resorbable barrier membrane [21, 22], due to its fast degradation in the same manner as a natural blood clot (1–2 weeks) [23]. Therefore, the PRF membrane is not believed to replace a barrier membrane in the classic understanding of guide bone regeneration (GBR), but rather to enhance the healing capacity of t...
Background
Implant-supported single crowns are characterised by high long-term survival and few biological and technical complications, which typically includes peri-implant marginal bone loss, screw-loosening and fracture of veneering material complications [1,2,3]. To achieve a successful treatment outcome, the implants must be inserted in sufficient bone volume of an adequate quality to obta...
A clinical and radiographic study of implants placed in autogenous bone grafts covered by either a platelet-rich fibrin membrane or deproteinised bovine bone mineral and a collagen membrane: a pilot randomised controlled clinical trial with a 2-year follow-up
Abstract
Purpose
To compare the survival and clinical performance of implants placed in sites previously augmented with autogenous ...
Code
IT(N•cm)
RT(N•cm)
ISQ
12S
13.67 (1.88)
11.68 (1.06)
51.40 (2.95)
06D
20.19 (1.61)
17.45 (1.28)
53.77 (2.73)
06S
22.30 (1.78)
20.25 (2.47)
55.66(1.62)
Implant code
Thread type
Pitch (mm)
Lead (mm)
Lead angle (degree)
Total thread length (mm)
12S
Single-threaded
1.2
1.2
8.1
64
06D
Double-threaded
0.6
1.2
8.1
129
06S
Single-threaded
0.6
0.6
4.65
129
Figure 6. Bone debris at the contact interfaces. a Numbers of debris particles. b Number and size of debris particles. Each dot indicates a debris particle, and dashes indicate median particle sizes. Particle sizes: small, < 1000 μm2; medium, 1000–10000 μm2, and large, ≥ 10,000 μm2. c Particle size distribution
Figure 5. Microscopic analysis of contact interfaces. Microscopic observations of the artificial bone-implant and number of debris particles. The small arrows in the panel indicate voids in the implant-bone interface
Figure 4. Torque kinetics. Immediately after insertion terminated, the implant was removed using the same load and rotation speed. Torque kinetics were measured during implant insertion (top) and removal (bottom)
Figure 3. Comparison between IT and RT. Maximum IT value was measured when insertion was terminated. Immediately after insertion, the implant was removed, and the RT value was measured when removal commenced
Figure 2. Insertion torque (IT), removal torque (RT), and implant stability quotient (ISQ)
Figure 1. Implants. Implant code 12S is similar to a commercially available standard single-threaded implant with equal thread pitch and a 1.2-mm lead. The thread length of implant code 06D is doubled by adding the second thread (light blue). The thread length of implant code 06S is doubled by a 50% reduction in pitch and lead angles. Characteristics of each implant are summarized in Table 1
Fi...
References
Javed F, Ahmed HB, Crespi R, Romanos GE. Role of primary stability for successful osseointegration of dental implants: factors of influence and evaluation. Interv Med Appl Sci. 2013;5:162–7.
Falco A, Berardini M, Trisi P. Correlation between implant geometry, implant surface, insertion torque, and primary stability: in vitro biomechanical analysis. Int J Oral Maxillofac Implan...
Although bone models composed of a combination of cortical and cancellous bone are also available, this study used a single bone model with a homogeneous density to eliminate any effect of cortical bone and evaluate only the effect of design features on torque and ISQ values.
Experimental implant placement using artificial bone models is generally conducted to si...
Clinicians are advised to recognize the risk associated with using a multithreaded implant with a high lead angle, which may compromise primary stability because of greater bone tissue damage despite faster insertion. The question of placement speed warrants further consideration. Indeed, another advantage of double-threaded implants is placement speed. The implantation speed...
Moreover, the IT and RT values of 12S were consistent with those of the standard implant (Straumann) measured in our previous study. Here, the RT value of each implant was lower compared with their respective IT values, consistent with other reports. The IT and RT values of 06S were highest, followed by 06D and 12S. In contrast, the differences between RT and IT values were highest for...
In the artificial bone adjacent to 06D, there were more voids compared with those associated with 06S or 12S, which accounts for the increase in torque. The highest numbers and larger sizes of debris particles were associated with 06D, followed by 0S and 12S, indicating the potential for greater tissue damage. These results likely explain the lower (50%) torque value of 06S compared with tho...
Discussion
We show here that increasing thread length and reducing pitch can increase primary implant stability without changing the size of an implant. Compared with the standard single-threaded implant with a 1.2-mm pitch/lead (12S), torque values and ISQ were significantly increased by doubling the thread length by adding the second thread (06D) or by reducing pitch/lead and lead angle o...
Results
The IT, RT, and ISQ values revealed significant differences among the implants (Table 2).
The IT and RT values of 12S were not significantly different compared with published data (IT, 13.13 ± 1.763 N cm; RT, 12.37 ± 1.746 N cm) (Student t test, df = 9, t = 2.91, p < .017). Compared with 12S, the IT and RT values of 06D and 06S were significantly different (147% and 150%, a...
Methods
Implants
Three types of grade-4 titanium cylindrical nonself-tapping implants (codes 12S, 06D, and 06S) were specially designed and manufactured (Suwa Co., Ltd., Fujiyoshida, Yamanashi, Japan) (Fig. 1 and Table 1). The code 12S single-threaded implant served as a reference. Codes 06D and 06S were designed to double the thread length compared to 12S. Code 06D was a double-threated impla...
Introduction
Secure primary stability is positively associated with successful long-term implant integration to ensure a successful clinical outcome. Initial implant stability is defined as biomechanical stability upon insertion, which is influenced by factors such as bone quantity and quality, geometry of the implant, surgical technique, and insertion torque (IT). New bone develops around the ...
Effects of implant thread design on primary stability—a comparison between single- and double-threaded implants in an artificial bone model
Abstract
Background
Primary implant stability is essential for osseointegration. To increase stability without changing the implant size, the thread length must be extended by reducing pitch, using a double-threaded implant, or reducing pitch/lead a...
RDX
No RDX
Author
Year of publication
No. of implants placed into autogenous bone grafts with RDX (and failures)
Overall implant survival of implants placed into autogenous bone grafts with RDX
No. of patients who had implants placed into autogenous bone grafts with RDX (and failures)
Patient based implant survival of implant placed into autogenous bone grafts with RDX
No. of...
Non-vascularised bone graft
Vascularised bone graft
Author
Year of publication
No. of patients who had implants placed into non-vascularised autogenous bone grafts (and failures)
Overall patient implant survival in non-vascularised autogenous bone grafts
No. of implants placed into non-vascularised autogenous bone grafts (and failures)
Overall implant survival in non-vasculari...
Implant survival
Implant success
Author
Year of publication
Donor site of autogenous bone graft
Radiotherapy/chemotherapy to bone graft site
Complications
No. of patients who had implants placed into autogenous bone grafts (and failures)
Overall patient implant survival in autogenous bone grafts
No. of implants placed into autogenous bone grafts (and failures)
Overall i...
Author
Year of publication
Study design
Outcome measure
Criteria—survival
Criteria—success
Quality assessment using the MINORS assessment tool
Head and neck cancer diagnosis
Patients age range
Follow-up period
Implant site
Implant system
Implant placement protocol
Prosthodontic rehabilitation
Studies with an average follow-up of 3 years or greater
Watzinger et...
Figure 1. Flow chart of study selection procedure
References
Schoen PJ, Reintsema H, Raghoebar GM, Vissink A, Roodenburg JLN. The use of implant retained mandibular prostheses in the oral rehabilitation of head and neck cancer patients. A review and rationale for treatment planning. Oral Oncol. 2004;40:862–71.
Müller F, Schädler M, Wahlmann U, Newton JP. The use of implant-supported prostheses in the functional and psychosocial rehabi...
Conclusion
Within the limitations of the current review, it can be concluded that implant survival in autogenous bone grafts in H&N oncology patients appears to be promising with implant survival being reported at over 80% in 16 of the 20 studies included with 11 of these reporting implant survival of over 90% in follow-up ranging from 3 months [28] to 15 years [5]. However, there i...
A clear deficiency of many of the studies was the imprecise and inconsistent definitions of implant survival or implant success, as detailed in Table 1. In addition, in a number of studies, the terminology ‘implant success’ and ‘implant survival’ were used interchangeably within the narrative making comparison of the studies challenging and rendering statistical analysis of the surv...
The implant placement protocol with regard to primary (immediate) or secondary (delayed) implant placement was also reviewed, and there is limited evidence from Fenlon et al. that implant failure is significantly worse in immediately placed implants in comparison with a delayed approach in free vascularized grafts.
Implant success was shown to be lower than implant survival and was related ...
Discussion
Summary of evidence
Dental implants are now perceived to be a vital part of the clinician’s armamentarium in the provision of oral and dental rehabilitation for patients with acquired deformity following management of their H&N cancer, and therefore, this systematic review is relevant to clinicians and stakeholders involved in the treatment and management of H&N cancer patient...
Six of these studies (Schultes et al., Wang et al., Zou et al., Chiapasco et al., Chiapasco et al., Wu et al.) reported some of this lack of success to the peri-implant soft tissue which was most frequently the soft tissue component of a combined bone and soft tissue free flap (most commonly the external skin).
Complications
A variety of implant-based complications were documented. Complicatio...
Implant survival and Peri-implant soft tissue
Only one study (Linsen et al. ) reported on the effect of the peri-implant soft tissue and implant survival of implants placed into autogenous bone grafts. Linsen et al. reported a higher implant failure of implants placed into bone and soft tissue grafts in comparison to implants placed into a bone grafts with residual soft tissues. This difference...
However, in two studies (Teoh et al., Burgess et al.), no statistical significance was found despite higher implant failure.
Primary and secondary implant placement and implant survival
Six studies clearly reported the use of both primary and secondary implant placement within their study (Fenlon et al., Ch’ng et al., Zou et al., Burgess et al., Watzinger et al., Wu et al.); however, only on...
Two studies (Fenlon et al., Burgess et al. ) reported no significant effect on implant survival in varying graft donor sites; however, three studies (Hessling et al., Shaw et al., Chiapasco et al.) reported varying implant survival rates within different autogenous bone grafts but only one study (Hessling et al.) reported that implant loss was significant with this being for implants placed into...
Autogenous bone graft type and implant survival
Seventeen studies reported on the specific bone graft type (non-vascularised or vascularised) into which the implants were placed. In the remaining three studies (Buddula et al., Fierz et al., Yerit et al.), this distinction was not possible.
Of these 17 studies, 8 studies reported on implant survival in non-vascularised bone grafts and 14 studie...
The surgical and loading implant protocols were reported in 17 studies with no description given in 3 studies (Barrowman et al., Fierz et al., Hessling et al.). The implant placement protocols were diverse with variables including the use of surgical templates/guides, primary and/or secondary implant placement following autogenous bone grafting, and immediate and/or delayed implant loading; howe...
These 20 studies were published over a range of 21 years (1996 to 2017) and provide cumulative data on 1905 implants placed into autogenous bone grafts in H&N cancer patients with both benign and malignant tumours being reported. The exact patient number for this intervention within some of the studies was unclear as a result of the studies reporting on implant rather than patient number or ther...
Results
Study selection
Searches of EMBASE, the Cochrane Central Register of Controlled Trials, Science Direct and MEDLINE generated 619 articles. After duplicate articles were removed, 566 unique articles were remaining. After the review of the titles and abstracts, 151 articles were accepted for further consideration, and 415 were rejected. After the full text was attained and reviewed for t...
Data items
Data was collected for implant survival, implant success, implant failure, implant complications, surgical implant placement protocol, implant system used, clinical follow-up, how the author defined success/survival, the type of autogenous bone graft, implant site, the prosthodontic rehabilitation and type of cancer, and the use of radiotherapy were documented where possible.
Risk of ...
Information sources
Four electronic databases were used to systematically search the available literature: (1) The National Library of Medicine (MEDLINE via PubMed), (2) EMBASE, (3) Cochrane Central Register of Controlled Trials and (4) Science Direct. The searches were limited to studies involving human subjects and publication dates from January 1980 to August 2017 that satisfied the inclusion ...
Methods
Protocol
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) for describing and summarising the results of our review was used.
A quality assessment of all selected full-text articles was performed using the Methodological Index for Non-Randomized Studies (MINORS) assessment tool to assess the risk of bias of the included studies. The MINORS scoring list co...
Introduction
Rationale
The use of implants to retain prostheses as part of oral and dental rehabilitation of head and neck (H&N) cancer patients is becoming an increasingly common treatment approach. A number of benefits advocating implant anchorage over conventionally secured prostheses have been proposed but importantly include a significant improvement in the reported quality of life (QoL) of...
Survival of dental implants placed in autogenous bone grafts and bone flaps in head and neck oncology patients: a systematic review
Abstract
Using implants to retain prostheses as part of the oral rehabilitation of head and neck cancer patients is an increasingly common treatment modality, particularly in transported bone which is used to reconstruct defects following oncological surgical ...
Patient
Implant region(FDI)
Implant parameters
Dimensions of implantDiameter [mm]/length [mm]
Explantation[Days after placement]
1
3637
First placementStraumannRN SLactive®(TiZr)
First placementØ: 4.1; L: 10Ø: 4.1; L: 8
3
3637
Second placementStraumannTissue level(TiZr)
Second placementØ :4.1, L: 8Ø :4.1, L: 8
3
36
Third placementConelog ScrewLine(...
Figure 2. a Patient 2. Postoperative orthopantomogram one day after implant placement. b Patient 2. Postoperative orthopantomogram after second Implant placement
Figure 1. a Patient 1. Post grafting orthopantomogram. The bone block was secured with a single microscrew. b Patient 1. The radiograph demonstrates veritable inserted Straumann bone level implants after the first implant placement (1 day after implant placement). A peri-implant osteolysis is not visible. c Patient 1. Postoperative orthopantomogram (1 day after implant placement) afte...
References
Esposito M, Thomsen P, Ericson LE, Lekholm U. Histopathologic observations on early oral implant failures. Int J Oral Maxillofac Implants. 1999;14:798–810.
Olmedo-Gaya MV, Manzano-Moreno FJ, Cañaveral-Cavero E, de Dios Luna-Del Castillo J, Vallecillo-Capilla M. Risk factors associated with early implant failure: a 5-year retrospective clinical study. J Prosthet Dent. 2016;115...
However, a synergistic effect with other factors is conceivable. Some authors stated that implant osseointegration is not simply a wound healing phenomenon but rather complex foreign body reaction with activation of the immune system. Titanium and metal particle release is discussed as cause for implant failure as well as implant dentistry. It is assumed that metal particles influence the ma...
However, a present human study cannot confirm an effect due to vitamin D supplementation on bone formation or graft resorption after maxillary sinus augmentation. Satue et al. found a positive influence of 7-dehydrocholesterol (7-DHC), the precursor of vitamin D, coated implants on osteoblast differentiation in vitro. But whether vitamin D-coated dental implants have an effect of osseo...
Discussion
This article demonstrated that implant placement was successful after vitamin D supplementation in patients with vitamin D deficiency and early failed implants. None of the patients showed systemic disease or did take regular medication, alcohol, nicotine, or drugs. The patients were not immunosuppressed, irradiated, or received chemotherapy. All implants were inserted with the s...
After vitamin D supplementation and a healing period of 6 months, a third surgical intervention was planned and one implant (Conelog ScrewLine) was inserted in region 36 (see Table 1 and Fig. 1d). During implant placement, the former explantation site appeared clinically fully re-ossified. The patient received an intraoperative intravenous single-dose antibiotic therapy with Isocillin 1.2 mega. At...
Patient
The medical history of this 48-year-old male patient showed a high blood pressure; otherwise, the patient was healthy. A successfully completed periodontal therapy was done before implant therapy. The patient demonstrated stable marginal bone levels. Autologous retromolar bone grafting using local anesthesia was performed in the left mandible (see Fig. 1a). This patient received a pos...
Case presentation
Patients and surgical procedure
Patients treated consecutively in one center (Department of Oral- and Craniomaxillofacial Surgery, University Medical Center Freiburg). None of the patients showed systemic disease. Both patients did not take regular medication and were negative for alcohol, nicotine, and drug use. Bothe male patients (48 and 51 years of age) were not immunosu...
Background
Long-term stable osseointegrated implants are the primary goal in dental implantology. Although dental implants have proven clinical reliable in the long term, the failure of implants at a very early stage of osseointegration has been described. The pursuit to identify the mechanisms leading to early implant failure is ongoing to date and include the following: tobacco usage, diabete...
Abstract
An association between vitamin D deficiency and early dental implant failure is not properly verified, but its role in osteoimmunology is discussed. This article illustrates two case reports with vitamin D deficiency and early implant failure. Prior to implant placement, the first patient received crestal bone grafting with autologous material. Both patients received dental implants fr...
BIC
3M™ ESPE™ MDIs
Ankylos® Friadent (Dentsply)
Median
58.5
57
Mean
57
56.5
Interquartile range
8
5.5
First quartile
53.25
53.75
Third quartile
61.25
59.25
Sample
3M™ESPE™ MDIs
Ankylos®
1.
67
54
2.
59
67
3.
54
45
4.
51
58
5.
47
57
6.
64
49
7.
50
54
8.
60
56
9.
56
60
10.
61
53
11.
62
59
12.
61
55
13.
59
59
14.
45
51
15.
58
59
16.
54
62
17.
66
62
18.
56
57
Figure 6. Micro CT scan images of the MDIs and Ankylos® embedded in rabbit bone 6 weeks post implantation
Figure 5. Histological section of standard implant in rabbit tibia stained with methylene blue and basic fuchsin
Figure 4. Histological section of mini dental implant in rabbit tibia stained with methylene blue and basic fuchsin
Figure 3. Histological sections being obtained with Leica SP 1600 saw microtome
Figure 2. Leica SP 1600 saw microtome
Figure 1. Radiograph showing implants in the rabbit tibia
Our study is also in concordance with the results of a removal torque study by Simon et al. in immediately loaded “transitional endosseous implants” in humans. The percentage BIC for MDIs was similar to standard implants.
The surface topography also affects the BIC, Wennerberg et al. measured and compared removal torque values on screw-shaped titanium implants with three surface types. ...
Discussion
The osseointegration potential of 3M™ESPE™ MDIs has not been studied. The MDI is a one-piece implant that simplifies the restorative phase resulting in a reduced cost for the patient. Titanium-aluminum-vanadium alloy (Ti 6Al-4V-ELI) is used for increased strength. The success of these implants led to its use in long-term fixed and removable dental prostheses. Conventional imp...
Results
Clinical findings
On the whole, postoperative wound healing in all the rabbits was good. None of them exhibited any signs of wound infection or exposure. A total of 36 specimens were retrieved for histological examination.
Histological observations
All of the implants in both groups showed osseointegration and displayed a good amount of bone contact length (Figs. 4 an...
The built-in water cooling device prevents overheating of the object and removes saw dust from the cutting edge and thus prolongs the lift time of the saw blade. The most favorable feed rate was determined (Fig. 3). After trimming, the first undefined slice was removed from the saw blade. The desired section thickness was selected, considering the thickness of the saw blade and added to the desire...
Sample preparation for embedding
The specimens were dehydrated in the ascending graded ethanol solution and kept in a pre-filtration solution for 3 h at room temperature and then in the filtration solution at 4 °C for 17 h. The specimens were then embedded in a light curing resin Technovit 9100 NEW (Kulzer & Co., Wehrheim, Germany) polymerization system based on methyl methacrylate, speci...
The skin was sutured to a primary closer with the same suture material.
Radiograph
Plain X-ray images of all the rabbit tibia were taken after suturing to confirm the position of implants and to detect any injury/fracture of the bone (Fig. 1).
Post surgical treatment
After the surgical procedure, the animals were housed in a cage under the supervision of a veterinary doctor until they came out...
After mobilizing the mucoperiosteal flap, the 3-mm center punch was used to register a guide for the twist drill. The twist drill was used to establish the axial alignment of the implant and to assist in the guidance of the depth drill. The depth drills were sequentially used to create osteotomy to the subcrestal axial depth of 0.5 mm. The conical reamer was used to develop the conical shape of t...
Antiseptic skin preparation was done starting at the center of the surgical site and moved to the outside of the prepared area in a circular manner. Three scrubs with 2% chlorhexidine solution and three alternating rinses with alcohol were performed. The animal was draped and fixed with clamps on a sterile, impermeable covering to isolate the disinfected area. This was performed by the gloved and ...
Methods
Animal model
Nine clinically healthy New Zealand white rabbits weighing 3.5 kg and more were used for the study, and the animals were housed in the central animal house facility. The head of tibia/femur of the animals were used for the implantation of samples. Rabbits’ tibiae and femur have been widely used as an animal model by various other authors to study osseointegration of dent...
Considerable confusion exists in the literature regarding the best method to monitor the status of a dental implant. Various methods have been used to demonstrate the osseointegration of dental implants. A common and time-tested method to evaluate biological responses to an implant is to measure the extent of bone implant contact (BIC), referred to as histomorphometry at the light microscopic leve...
Background
The term “osseointegration” was first introduced to explain the phenomenon for stable fixation of titanium to bone by Brånemark et al. in the 1960s. Osseointegrated implants were introduced, a new era in oral rehabilitation began, and many studies were conducted. A success rate of over 90% has been reported. Further, a success rate of 81% in the maxillary bone and 91% in the man...
Abstract
Background
Mini dental implants (MDIs) are becoming increasingly popular for rehabilitation of edentulous patients because of their several advantages. However, there is a lack of evidence on the osseointegration potential of the MDIs. The objective of the study was to histomorphometrically evaluate and compare bone apposition on the surface of MDIs and standard implants in a rabbit m...
Figure 3. Erythroid, granulocytic, monocytic and lymphocytic series are illustrated, as well as megakaryocytes (hematoxylin and eosin, original magnification ×400)
Figure 2. Normal hematopoietic cells, fat cells and bone trabeculae (hematoxylin and eosin, original magnification ×200)
Figure 1. The periapical radiograph revealed the presence of an extensive and poorly circumscribed osteoporotic area around the proximal implant
Only few cases of the focal osteoporotic bone marrow defect associated with dental implants has been described in the English literature. Sençimen et al. (2011) reported a clinical case in which the focal osteoporotic bone marrow defect occurred 2 years postoperatively apical to a dental implant in posterior mandible region and the diagnosis was established based on the combination of clini...
Case presentation
An 84-year-old white woman was referred to private dental clinic for an implant rehabilitation treatment. Intraoral examination revealed healthy mucosa and there was not any sign of infection. Her past medical history was unremarkable. The radiography of the molar region showed with a quite ill-defined radiolucent area presenting irregular borders associated to dental impl...
Abstract
In oral implantology, the most serious complications occur intraoperatively or within a short period. We describe an unusual case of focal osteoporotic bone marrow defect involving dental implant in the posterior mandibular region of the adult woman. Despite the fact that this condition requires no treatment, it could lead to the displacement of the dental implant. Additionally, th...
Figure 5. Torque-time curves of the MK3 and MK4. a Insertion torque. b Removal torque
Figure 4. Torque-time curves of the TE. a Insertion torque. b Removal torque
Figure 3. Torque-time curves of the BL. a Insertion torque. b Removal torque
Figure 2. Torque-time curves of the ST. a Insertion torque. b Removal torque
Figure 1. Compressed longitudinally to one third for characteristics of implant design. ST Straumann standard implant, MK3 Nobel Biocare MKIII, BL Straumann bone level implant, TE Straumann tapered effect implant, MK4 Nobel Biocare MKIV. Outer surface of implant (solid line). Inner surface of implant (dotted line)
Figure 1. Compressed longitudinally to one third for characteristics of implant d...
Initial area
Parallel area
Tapered area
Platform area
ST6
1.42 ± 0.43
0.31 ± 0.14
–
–
ST8
3.57 ± 1.62
0.35 ± 0.09
–
–
ST10
2.49 ± 0.81
0.45 ± 0.05
–
–
BL8
2.16 ± 0.21
0.50 ± 0.08
2.32 ± 0.52
–
BL10
1.96 ± 0.49
0.35+0.04
2.45+0.23
–
BL12
1.82 ± 0.27
0.33 ±...
Code
Insertion torque
Removal torque
Effective thread length (ETL)
(N · cm)
(N · cm)
(×π mm)
ST6
6.19 ± 0.716
5.95 ± 0.718
11.53
ST8
8.06 ± 1.038
9.09 ± 1.093
15.11
ST10
13.13 ± 1.763
12.37 ± 1.746
21.48
BL8
17.67 ± 1.290
16.67 ± 2.140
20.88
BL10
23.56 ± 1.628
21.99 ± 1.530
31....
System
Length
Pitch
Lead
Code
Manufacturer
(mm)
(mm)
(mm)
Standard RN
6, 8, 10
1.2
1.2
ST
Straumann
Bone Level RC
8, 10, 12
0.8
0.8
BL
Straumann
Tapered Effect RN
10
0.8
0.8
TE
Straumann
Brånemark MKIII
10
0.6
1.2
MK3
Nobel Biocare
Brånemark MKIV
10
0.6
1.2
MK4
Nobel Biocare
Abbreviations
BL:
Bone Level RC
IT:
insertion torque value
MK3:
Brånemark MKIII
MK4:
Brånemark MKIV
RT:
removal torque value
ST:
Standard RN
TE:
Tapered Effect RN
References
Friberg B, Sennerby L, Roos J, Johansson P, Strid CG, Lekholm U. Evaluation of bone density using cutting resistance measurements and microradiography. An...
Influence of cortical bone
The reason why a simulation test for only cancellous bone without cortical bone was performed in the present study has already been described. It was reported that bone density and the ratio of cortical bone and cancellous bone have influence on the primary stability of an implant and that higher primary stability is achieved with thread, even at the slightest lev...
Although the removal torque curves measured in the present study had similar shapes to one another, they were divided into two groups upon detailed observation, comprising a group of ST with parallel only, and a group of BL, TE, MK3, and MK4 having tapers and platforms. Since the thread contacts the artificial bone sequentially at the time of insertion, the torque curves showed the character...
This indicates that the friction at the time of rotating and pressing is greater than that at the time of rotating and cutting the bones with a tap and is a reasonable result. In the parallel area, the torque curve was a line with a moderate gradient, and the torque rise rate obtained from the gradient of the line was 0.36 N · cm/s. From this, it is estimated that the torque increase w...
Discussion
Insertion torque curve
In 2000, O’Sullivan reported torque curves for a prosthetic implant for the first time, and evaluated the characteristics of the tapered type by torque curves obtained by inserting five kinds of implants into the maxillary bone of unembalmed human cadavers. In a subsequent review, Meredith cited six kinds of torque curves when the final osteotomy diamete...
For the TE, the lower part of the implant was parallel and the lateral surface and axial surface had the same taper in the cervical region. TE10 in Fig. 4a showed a torque curve with a similar form to BL10 in Fig. 3 and had three kinds of areas. The torque curves for MK3 and MK4 in Fig. 4a had an area in which the torque finally rose suddenly after reaching its critical point and became moderate...
Results
Insertion torque
The insertion torque curve was divided into four regions. The first was the region where the torque rose suddenly immediately after insertion, which was seen in all implant bodies (shown as ① in the figure, and hereinafter called the initial area). The second was the region where the torque rose linearly with a moderate gradient, which was seen in all implant bodie...
Methods
Implants
The type of implant used for the experiments and the characteristics of its design are shown in Table 1 and Fig. 1, respectively. Figure 1 shows that the implant is compressed longitudinally to one third. The outer surface of the implant is indicated with a solid line, and the inner surface of the implant is indicated with a dotted line.
Preparation of an implant socket in ...
Background
Primary stability following implant placement is an essential condition for osseointegration. The primary stability is affected by the implant design, including surface-modifying or implant cavity-forming techniques, as well as by the bone quantity and bone density of the patient. In recent years, the interest of implant manufacturers and clinicians has shifted to the acquisition of ...
Abstract
Background
Primary stability following implant placement is essential for osseointegration and is affected by both implant design and bone density. The aim of this study was to compare the relationships between torque-time curves and implant designs in a poor bone quality model.
Methods
Nine implant designs, with five implants in each category, were compared. A total of 90 implants ...
Reason for exclusion
Investigations
Study design (case series or case report)
Kim et al. (2017), Hatano et al. (2007)
Different grafting technique (lateral sinus lift or transalveolar technique)
Jensen et al. (1994), Winter et al. (2002), Toffler et al. (2004), Chappuis et al. (2009), Soltan et al. (2011), Xiao et al. (2011), Cricchio et al. (2011), Scala et al. (2012), Brus...
Author (year)
Study design
Follow-up (months)
N of patients
N of implants
Smokers
Length and diameter (mm)
Implant system
Shihab 2017
Retrospective
60
35
70
NA
5–12 × 3.0–5.7
IDI FMD Nucleoss
Ghanem 2014
Retrospective
72
10
10
NA
NA
NA
Nooh 2013
Prospective
12
56
63
0
4 × 8 4.3 × 10 5 × 8 5 × 10
Nobel Biocare
...
Clinical complications
Radiographic complications
Sinusitis
Thickening of Schneiderian membrane
Nasal bleeding, nasal obstruction, nasal secretion
Bone reaction to the implants
Headache and pain or tenderness in the region of the sinus
Sinus pathology
Decreased sense of smell
Figure 4. Statistical analysis for different variables. a Weighted mean survival rate. b Implant survival rate according to degree of penetration. c Analysis of clinical complications. d Analysis of radiographic complications
Figure 3. Graphic representation of group 1 ≤ 4 mm penetration and group 2 > 4 mm penetrations
Figure 2. PRISMA flowchart of the screening process
The secondary outcome of this review was the analysis of the clinical and radiological complications related to the penetration of implants in the maxillary sinus. Clinical complication among the different authors ranges from 0 to 14.3%, with a weighted mean complication rate of 3.4%, without finding statistical difference according to the level of implant penetration. The most common clinic...
Figure 1. Graphic representation of implants intruding sinus perforating or not the Schneiderian membrane
Analysis of clinical complications
Seven studies provide information on clinical complications with a global sample of 232 patients. Clinical complications among the different authors range from 0 to 14.3%, being the weighted mean complication rate 3.4% with an IC 95% [0 7.5] (Fig. 4c) Clinical complications analyzed in the studies were sinusitis, nasal bleeding, nasal obstruction, nasal sec...
Results
Study screening
An initial screening yielded a total of 3551 publications of which 26 potentially relevant articles were selected after an evaluation of their titles and abstracts. Full text of these articles was obtained and evaluated thoroughly. Of these, eight articles (Table 2) fulfilled the inclusion criteria and subsequently were included in the qualitative analysis (Fig. 2). Re...
Eligibility criteria
Articles were included in this systematic review if they met the following inclusion criteria: human prospective or retrospective studies, reporting outcomes of implant placed perforating the sinus floor with implant burs, and without regenerative procedure (lateral sinus lift or transalveolar technique) and graft material. The intrusion into the sinus cavity can occur du...
Materials and methods
This systematic review and subsequent meta-analysis follow the guidelines of the PRISMA statement.
Focus question
The following focus question was developed: Is the intrusion of dental implants into the sinus cavity during implant drilling or implant placement, without regenerative procedure (lateral sinus lift or transalveolar technique) and graft material, has an effec...
Introduction
The edentulous posterior maxillary region often presents with unique challenging conditions in implant dentistry. Limited bone height secondary to pneumatization of the maxillary sinus and the resorption of the alveolar ridge preclude in many instances the installation of dental implants. To compensate for the lack of bone height, several treatment options have been proposed.
The ...
Influence of exposing dental implants into the sinus cavity on survival and complications rate: a systematic review
Abstract
Background
After tooth loss, the posterior maxilla is usually characterized by limited bone height secondary to pneumatization of the maxillary sinus and/or collapse of the alveolar ridge that preclude in many instances the installation of dental implants. In order ...
Figure 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)
Figure 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.)
Figure 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 stabil...
Figure 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)
Figure 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. The microthread concept and platform switching concept are implemented in the implant shoulder to reduce periimplant bone strain. b...
Patient
Sex
Age (years)
Implant position (FDI)
Indication categorya
Bone quality
Prosthetic treatment
Follow-up (months)
Implant failure
1. T. I.
F
80
Maxilla 15, 13, 11, 21, 25 (Σ = 5)
IIa
D4
Telescope
37
n = 1c
2. G. S.
F
65
Mandible 34, 32, 42, 44 (Σ = 4)
IIIb
D1
Ball attachment
34
None
3. S. Sa.
F
64
Maxilla 14, 12, 22, 24 (Σ = 4)
...
Type of prosthetic treatment
Session
Procedure
Fixed denture (bridge)
1
Open impression
2
Abutment check, set-up • Titanium abutments • Non-precious metal framework, completely lined • Neighbouring crowns interlocked
3
Check and insertion of the suprastructure • Cementation (ImProv™, Dentegris, Duisburg, Germany)
Combined fixed-removable dentur...
Surgical protocol
Bone quality
D1
D2
D3
D4
1. Drilling sequence (splint)
Last drill
Last drill
Second to last drill
Second to last drill
2. Condensing preparation
–
–
(Analogue to last drill)
Analogue to last drill
3. Implant insertion (maximum torque ≤ 40 N cm)
4. Expansion (maximum torque ≤ 40 N cm)
5. Evaluation of primary ...
Inclusion criteria
Exclusion criteria
1. Adult patients, male and female
1. Comorbidity ASA category ≥ III
2. Partially/totally edentulous patients
2. Pregnancy, bruxism
3. Alveolar process atrophy Cawood et Howell category ≥ IV
3. Smoking ≥ 10 cigarettes/day
4. Minimum vertical bone height of 7–9 mm for placement of short implants (5–7-mm length)...
Based on an earlier animal histologic study, as well as a clinical up-to-40-month study, which referred to comparable apically expandable implants, authors did not report any periapical inflammatory complications. To eliminate the potential risk of deep intrabony microleakage, it is questionable whether equal biomechanical stability values can be achieved only by the macroth...
In relation to the results by McCullough and Klokkevold, who found that the macrothread design appears to play a positive role in implant stability in the early healing period, this can also be assumed for the employed implant system.
Additionally, with regard to the results by Marković and co-authors, a critical stability drop down due to bone remodeling after bone condensing (impla...
The expansion procedure presents an additional bicortical anchorage in the oro-vestibular direction. In hard bone, this might be a disadvantage and lead to asymmetrical expansion. Manufacturers’ recommendations for hard bone should be strongly considered.
Regarding resonance frequency analysis, the values are related to bone quality and quantity as well as the exposed impl...
Several investigators analysed the preferred indications of short dental implants in the posterior mandible or maxilla and outlined the cost efficiency compared to additional vertical augmentations. In the present trial, we used a new short implant in both jaws and nearly all possible indication categories were represented, which proves the broad versatility (Table 4).
In our study, two imp...
Discussion
Recent literature has shown that short implants have achieved growing acceptance in the field of oral implantology. Since the last years, concern has decreased about the length of endosseous implants; it should be noted that all extraoral screw implants are short implants. Nevertheless, there are local physiological and biomechanical differences regarding long-term stability.
Th...
Results
The first results of this longitudinal study include data from 9 patients with an average age of 57 years (range from 44 to 80) in whom 30 implants were inserted (maxilla n = 15, mandible n = 15). All 30 implants in the 9 patients could be inserted without intraoperative problems. Based on intraoperative and radiological findings, the bone quality was assessed...
Surgical and prosthetic protocol
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. The drilling sequence, condensing preparation (where necessary) and manual implant insertion as well as expansion are described in detail...
Material and methods
Study population and measures
The study was designed as a prospective monocentric longitudinal cohort study according to the STROBE criteria. The participants of this study were recruited at the university hospital of Martin Luther University Halle-Wittenberg, Department of Oral and Plastic Maxillofacial Surgery, implantological consultation from 2014 (June...
... the diameter of an implant has greater influence on primary stability than implant length.
Based on in vitro analysis, they concluded additionally that especially in patients with poor bone quality, a variation of implant dimensions is expected to lead to a significant increase of primary stability. Furthermore, stress distribution on short implants is affected by the bone-to-...
Introduction
Endosseous implants have been established over several decades. The evaluation of treatment results under biomechanical, physiological, psychological, social and economic aspects has been well documented. Furthermore, patient-based outcomes reveal a predictable gain in oral health-related quality of life.
Especially in patients with limited vertical bone height, process of treatme...
Novel expandable short dental implants in situations with reduced vertical bone height—technical note and first results
Abstract
Purpose
Short implants often have the disadvantage of reduced primary stability. The present study was conducted to evaluate the feasibility and safety of a new expandable short dental implant system intended to increase primary stability.
Methods
As a “pr...
Figure 6. Bone debris at the contact interfaces. a Numbers of debris particles. b Number and size of debris particles. Each dot indicates a debris particle, and dashes indicate median particle sizes. Particle sizes: small, < 1000 μm2; medium, 1000–10000 μm2, and large, ≥ 10,000 μm2. c Particle size distribution
Figure 5. Microscopic analysis of contact interfaces. Microscopic observations of the artificial bone-implant and number of debris particles. The small arrows in the panel indicate voids in the implant-bone interface
Figure 4. Torque kinetics. Immediately after insertion terminated, the implant was removed using the same load and rotation speed. Torque kinetics were measured during implant insertion (top) and removal (bottom)
Figure 2. Insertion torque (IT), removal torque (RT), and implant stability quotient (ISQ)
Table 2. Implants. Implant code 12S is similar to a commercially available standard single-threaded implant with equal thread pitch and a 1.2-mm lead. The thread length of implant code 06D is doubled by adding the second thread (light blue). The thread length of implant code 06S is doubled by a 50% reduction in pitch and lead angles. Characteristics of each implant are summarized in Table 1....
Code
IT(N•cm)
RT(N•cm)
ISQ
12S
13.67 (1.88)
11.68 (1.06)
51.40 (2.95)
06D
20.19 (1.61)
17.45 (1.28)
53.77 (2.73)
06S
22.30 (1.78)
20.25 (2.47)
55.66(1.62)
Implant code
Thread type
Pitch (mm)
Lead (mm)
Lead angle (degree)
Total thread length (mm)
12S
Single-threaded
1.2
1.2
8.1
64
06D
Double-threaded
0.6
1.2
8.1
129
06S
Single-threaded
0.6
0.6
4.65
129
The question of placement speed warrants further consideration. Indeed, another advantage of double-threaded implants is placement speed. The implantation speed of 06D was twice that of 06S, and implantation was completed twice as fast. Nevertheless, while plastic bottles and emergency valves have double-threaded screws for faster opening and closing, the effect...
Here, the RT value of each implant was lower compared with their respective IT values, consistent with other reports. The IT and RT values of 06S were highest, followed by 06D and 12S. In contrast, the differences between RT and IT values were highest for 12S, followed by 06D, and in 06S. We reported that the RT decreased more than IT. Thus, 06S had the lowest rate of decline (IT...
In the artificial bone adjacent to 06D, there were more voids compared with those associated with 06S or 12S, which accounts for the increase in torque. The highest numbers and larger sizes of debris particles were associated with 06D, followed by 0S and 12S, indicating the potential for greater tissue damage. These results likely explain the lower (50%) torque value of 06S compared wi...
In the artificial bone adjacent to 06D, there were more voids compared with those associated with 06S or 12S, which accounts for the increase in torque. The highest numbers and larger sizes of debris particles were associated with 06D, followed by 0S and 12S, indicating the potential for greater tissue damage. These results likely explain the lower (50%) torque value of 06S compared wi...
Discussion
We show here that increasing thread length and reducing pitch can increase primary implant stability without changing the size of an implant. Compared with the standard single-threaded implant with a 1.2-mm pitch/lead (12S), torque values and ISQ were significantly increased by doubling the thread length by adding the second thread (06D) or by reducing pitch/lead and lead angle o...
Results
The IT, RT, and ISQ values revealed significant differences among the implants (Table 2).
The IT and RT values of 12S were not significantly different compared with published data (IT, 13.13 ± 1.763 N cm; RT, 12.37 ± 1.746 N cm) (Student t test, df = 9, t = 2.91, p < .017). Compared with 12S, the IT and RT values of 06D and 06S were significantly different (147% and 150%, a...
Implants
Three types of grade-4 titanium cylindrical nonself-tapping implants (codes 12S, 06D, and 06S) were specially designed and manufactured (Suwa Co., Ltd., Fujiyoshida, Yamanashi, Japan) (Fig. 1 and Table 1). The code 12S single-threaded implant served as a reference. Codes 06D and 06S were designed to double the thread length compared to 12S. Code 06D was a double-threated implant with t...
Unfortunately, the effects of double- or triple-threaded implants on primary stability are known for only a few procedures, such as finite element analysis. An excessive lead angle for these implants may jeopardize their ability to sustain axial load despite faster insertion. Further, when micromotion is compared among implants with different lead angles with the same thread pitch, single-threaded...
Introduction
Secure primary stability is positively associated with successful long-term implant integration to ensure a successful clinical outcome. Initial implant stability is defined as biomechanical stability upon insertion, which is influenced by factors such as bone quantity and quality, geometry of the implant, surgical technique, and insertion torque (IT). New bone develops around the ...
Abstract
Background
Primary implant stability is essential for osseointegration. To increase stability without changing the implant size, the thread length must be extended by reducing pitch, using a double-threaded implant, or reducing pitch/lead and lead angle to half that of a single-threaded implant.
Materials and methods
We tested the stabilities of these configurations using artificial...
Figure 6. Marginal bone loss (MBL) in SLA and MK-III implants within the abnormal group. MBL is significantly larger in MK-III implants than SLA implants during the follow-up period.
Figure 5. Cancellous bone densities in SLA and MK-III implants within the abnormal group. The cancellous bone density shows no significant difference between SLA and MK-III implants at baseline
Figure 4. Cancellous bone densities in the normal and abnormal groups of women are shown. Cancellous bone density is significantly higher in the normal group than in the abnormal group
Figure 3. The overview on BTM values are shown. The bone turnover markers measured are osteocalcin (OC), bone-specific alkaline phosphatase (BAP), pyridinoline cross-linked carboxyterminal telopeptide of type I collagen (ICTP), and crosslinked N-telopeptide of type I collagen (NTX)
Normal group
Abnormal group
P value
r
Age [years]
57.3
63.1
0.038*
0.49
Male (%)
7 (100)
0 (0)
0.0043*
0.66
Female (%)
2 (18)
9 (82)
Follow-up period [months]
21.3
21.4
0.85
Case no.
Gender
Age [years]
Bone turnover marker
Position
Implant
Bone Density [HU]
Follow-up period [m]
Marginal bone loss [mm]
OC
BAP
ICTP
NTX
1
M
60.2
5.8
8.1
2.7
11.4
7┐
SLA
1112.63
10
-
6┐
SLA
815.75
10
-
2
M
51.3
4.9
9.9
3.0
12.0
6┐
SLA
746.00
6
0.32
5┐
SLA...
Figure 2. Measurement of marginal bone loss (MBL) on dental radiography. MBL is measured using Image J software (National Institutes of Health, Bethesda, MD, USA). The reference points for the measurements are the implant platform (the horizontal interface between the implant and the abutment), the implant tip, and the first bone-implant contact (FBIC). The length from the implant platform to th...
Figure 1. Measurements on computed tomography (CT) images. The imaging data are stored in Digital Imaging and Communications in Medicine format and loaded into an implant planning software program (Simplant®, Dentsply Implants, Leuven, Belgium). Buccopalatal or buccolingual cross-sectional CT slices are used to measure the bone density at the implant placement sites in Hounsfield units. The mea...
Many reports of the relationship between dental implants and osteoporosis have been published, but few have focused on bone quality. Bone quality is multifactorial and difficult to classify because it varies from patient to patient. The present study focused on BTM, which is one of the clinical indicators of bone quality. A prospective study confirmed that elevation of a BTM can predict frac...
The cancellous bone density in the abnormal BTM group was significantly lower than that in the normal BTM group. This suggests that cancellous bone with a high BTM was likely to actually be poor medullary bone. There were three patterns of low BMD: high values of bone formation markers only, high values of both bone formation and bone resorption markers, and high values of bone resorption ma...
Discussion
Nine (82%) of the11 female patients in this study had at least one BTM measurement outside the normal range. The abnormal BTM values in these women were pronounced. No abnormal BTM valued were observed among the men. According to the Japanese Guidelines for the Prevention and Treatment of Osteoporosis, the diagnostic criteria for osteoporosis include the following: (1) fragility ...
Results
Eighteen patients (11 women, 7 men; mean age 60.2 years) fulfilled the inclusion criteria. There was no significant difference between men (57.3 ± 5.0 years) and women (63.1 ± 6.0 years). After measuring the BTMs and assessing bone density, 35 implants were placed (18 MK-III, 17 SLA). The mean follow-up duration was 21.4 months (Table 1), during which time follow-up observatio...
Patient selection
Patients treated at Hiroshima University Hospital were included in the study if they remained partially edentulous in the planning area for at least 3 months, if one or two splinting fixed prostheses in the mandible posterior area were planned, if they had never been treated for osteoporosis, and if they had no subjective or objective symptoms of osteoporosis, such as back pai...
Surgery
Implants (SLA® (sandblasted and acid-etched, internal connection system), Straumann AG, Basel, Switzerland, or Branemark® System Mk-III (TiUnite, external connection system), Nobel Biocare, Gothenburg, Sweden) were used depending on the patient’s clinical characteristics. The operating surgeon was blinded to the bone analysis results and was unaware of the bone density...
Materials and methods
Patient selection
Patients treated at Hiroshima University Hospital were included in the study if they remained partially edentulous in the planning area for at least 3 months, if one or two splinting fixed prostheses in the mandible posterior area were planned, if they had never been treated for osteoporosis, and if they had no subjective or objective symptoms of osteo...
Background
Dental implants have become an established prosthodontic treatment for missing teeth, with survival rates now exceeding 97%. The most popular current method of bone quality assessment is that developed by Lekholm and Zarb, who introduced a scale that ranges from 1–4 and is based on a radiographic assessment and the sensation of resistance experienced by the surgeon when preparing t...
Abstract
Background
Bone quality is as important as bone mineral density in terms of bone strength. Bone turnover markers (BTMs) are clinical indicators of bone quality. In implant dentistry, bone quality is considered equivalent to bone density on radiographic assessments. The purpose of this study was to determine whether the BTM values are reflected in jawbone condition by evaluating the re...
5 CONCLUSION
This open cohort, retrospective study evaluated risk indicators associated with marginal bone loss (MBL) through the analysis of 4,591 dental implants, of various designs, placed in private practice and followed‐up for 5 to 10 years. Significant risk indicators for bone loss were found to include autoimmune disease, heavy smoking, bisphosphonate therapy, implant location, diamete...
In this study, prevalence of mucositis varied from nearly 50% of patients using a “strict” BOP threshold (IMI ≥1) (49.5%) compared with 18.2% if using the “relaxed” IMI threshold (IMI ≥2) (see supplementary Tables 3 and 4 in online Journal of Periodontology).
As the implants used in the current study were either platform shift or 1‐stage design 3 mm and BOP+ but no co...
This is in support of systematic reviews of ridge augmentation that often show some loss of grafted bone volume and furthermore, it has been speculated that although the bone graft at time of placement may provide stable hard tissue, the basal bone may be the actual bone that is integrated to the implant.
4.1 Effect of threshold selection on reported prevalence of peri‐implantitis
The choi...
However, the one‐stage tapered effect (TE) design was found to have increased initial MBL at base line (stage 2) (Figure 2C). For the TE design, the increased early MBL may be related to bone compression and a learning curve associated with placement of tapered implants. Two stage platform switch implants typically have bone loss of about 0.5 mm. For the bone level platform shift design, the...
The posterior mandible and posterior maxilla had equivalent crestal bone levels at the start but then the rate of MBL in the posterior maxilla was found to increase at a faster rate when compared with other locations (Figure 2A). This may be a result of crestal compression in lower density bone leading to MBL as described in finite element analysis. Indeed it was noted that about 6% of sites h...
This is a unique finding in the literature and may reflect altered remodeling potential of bone, or it may also be the effect of a few outlier cases where sudden MBL was noted in some but not all bisphosphonate cases. Conclusions drawn are limited however as the duration or dose of bisphosphonate therapy was not recorded in this study.
Interestingly, diabetes (pooled type 1 and type 2) was not ...
DISCUSSION
An analysis of risk indicators for changes in crestal bone level, as a measure of bone loss (MBL), surrounding dental implants has been reported in this study. Furthermore, the impact of the choice of thresholds in determining prevalence of mucositis and peri‐implantitis has been considered. Importantly, this private practice report includes conventional patients and sites as well ...
3.3.3 Implant design
Pairwise comparisons for CBL at the start between the four implant design groups revealed a similarity between standard and standard plus implants as well as between bone level and tapered effect implants (Figure 2C). However, a significant difference (P value
3.1 Risk indicators for bone loss (MBL)
All potential factors and related correlations were evaluated. Table 1 shows only variables that related significantly to changes in CBL over time in a multivariate model. Figures 1 through 3 illustrate the results of Table 1. The “start” refers to baseline at 3 months).
3.2 Patient‐related risk indicators
No significant effect on CBL was observ...
RESULTS
The study cohort of 2,060 patients and 4,591 implants was followed for up to 133 months, with a mean of 32.2 ± 26.8 months. The number of implants for each time period was; n = 2,372 at 2 to 3 years, n = 1,178 at 4 to 5 years, and n = 560 at 6 to 10 years. There were 32 implant failures resulting in cumulative survival rates of 99.3%, 99.0%, and 98.4% at 3, 5, and 7 years, respectively, ...
Mucositis was determined using either the “strict” criteria, IMI ≥1, as an indication for mucositis or the “relaxed” criteria, IMI ≥2, as an indication of mucositis. We defined peri‐implantitis as the combination of mucositis and MBL ≥1.0 mm, at least 1 year after installation.
2.1 Statistical analysis
CBL and MBL are scale variables and have been summarized by calculating the m...
Radiographs were taken and evaluated by the same examiner that placed the implants (DF). For each case the real implant length served as the calibration value to derive the Distance from Implant shoulder to the first Bone to implant contact (DIB). CBL was defined as DIB minus the neck length (NL) of an implant with the following standardization values to account for different implant neck designs...
MATERIALS AND METHODS
A description of the study cohort presenting explanatory variables and univariate and multivariate implant survival analysis has been previously published. Details on recall and follow up are further described in a companion paper. In brief, this was a retrospective study consisting of 2,060 patients with an initial total of 4,591 implants. All implants were placed between...
INTRODUCTION
Although dental implants have been reported to have fairly high survival rates of 95.7% at 5 years and 92.8% at 10‐years, it is also known that progressive marginal bone loss and peri‐implantitis remain a significant potential complication. The 2012 European academy of osseointegration (EAO) consensus report estimated the prevalence of peri‐implantitis to be at 10% of implants ...
Retrospective cohort study of 4,591 dental implants: Analysis of risk indicators for bone loss and prevalence of peri‐implant mucositis and peri‐implantitis
Abstract
Background
Due to the risk of peri‐implantitis, following dental implant placement, this study aimed to evaluate risk indicators associated with marginal bone loss from a retrospective open cohort study of 4,591 denta...
CONCLUSIONS
The present study found no significant difference between the clinical performance, including peri‐implant bone level changes and implant survival, of implants with 6 mm and 11 mm lengths, inserted in minimally resorbed edentulous spaces in the posterior maxilla and mandible, during a 5‐year follow‐up period.
AUTHOR CONTRIBUTIONS
Felix L. Guljé: Conceptualization (eq...
No analysis was performed if there was a possible difference in outcomes between the different centers. One reason is that the number of patients was not equally divided between the centers, making exploration for significant differences hardly reasonable. Next to this, randomization was performed using a block randomization sequence to provide equal distribution of subjects treate...
In the publication of Thoma et al. (2018), it was mentioned that there was 2% peri‐implantitis in the 6‐mm group and 0% in the longer‐implant group. Guljé et al. (2019) observed no peri‐implantitis in either groups. These numbers are low and very much alike the present study, although it should be noted that these studies used a slightly different definition of peri‐impl...
Thoma et al. (2018) reported a mean marginal bone level change of −0.12 ± 0.54 in the 6‐mm group and −0.18 ± 0.96 in the group with longer implants, without a significant difference between the groups. Guljé et al. (2019) reported a mean marginal bone level change of −0.12 ± 0.36 mm and −0.14 ± 0.63 mm in the 6‐mm group and the 11‐mm group, respectively, without ...
DISCUSSION
Both 6‐mm short implants and 11‐mm conventional length implants performed well to support a fixed denture prosthesis in the posterior region of maxilla and mandible. A high implant survival rate, limited peri‐implant bone change, healthy peri‐implant soft tissues and limited biological and technical complications were noticed during the 5‐year functional period.
There was a ...
Table 4. Number of technical complications at implant level and patient level (between brackets) during 5 years of follow‐up
6‐mm group
n implants = 97
(npatients = 46)
11‐mm group
n implants = 86
(npatients = 39)
Fracture of provisional restoration
3 (3)
3 (3)
Fracture of definitive restoration
0 (0)
0 (0)
Fracture of veneering
0 (0)...
Table 3. Clinical measures of implants with plaque (in percentages), implants with bleeding on probing (in percentages) and mean (±SD) probing depth at implant level (in mm) at T0 (placement and loading of provisional restoration) and at T60 (5‐year follow‐up after loading of provisional restoration), and p‐value of differences between the groups at both evaluation periods
...
Table 2. Mean value (in mm), standard deviation (SD), and frequency distribution in (number and percentages) of marginal bone change between loading and 5 years in function
6‐mm group (n = 94)
11‐mm group (n = 80)
mean bone change (SD)
+0.01 (0.45)
−0.12 (0.93)
bone loss>−2.0 down
1 (1.1%)
6 (7.5%)
bone loss>−2.0 up to and including −1.5
1 (1.1...
Table 1. Baseline characteristics of the 6‐mm group (49 participants with 108 implants) and the 11‐mm group (46 participants with 101 implants)
Group 6‐mm
Group 11‐mm
Mean age in years
55 ± 9, range 26–69
54 ± 10, range 34–70
Gender (number male/female)
21/28
27/19
Received a 2‐implant restoration
39
37
Received a 3‐implant restorati...
Forty‐nine patients were randomized to receive 6‐mm implants (test group) and 46 patients to receive 11‐mm implants (control group). The baseline characteristic of the patients is depicted in Table 1. A flow‐diagram from enrollment to 5‐year follow‐up can be found in Figure 3. A total of 209 implants were inserted: 108 implants in the 6‐mm group and 101 implants in the 11‐mm group....
2.4 Statistical analysis
The number of patients required per group was calculated after assuming a two‐sided hypothesis to be rejected if the p‐value was below 5% and with a power of 80%. Primary outcome was mean peri‐implant bone level change, measured per implant, and a mean difference of 0.5 mm (standard deviation 0.8 mm) was chosen as a meaningful level of difference to be detected. ...
2.3 Outcome
Evaluated parameters were:
Implant failure (noted at any time throughout the 5‐year follow‐up period);
Presence of plaque, probing depth (PPD) and bleeding on probing (BoP) was measured on four sites (mesial, distal, buccal, and lingual) around the implant (measured at time of provisional restoration, at time of definitive restoration and at annual follow‐up visits);
Ra...
2.2 Surgical and prosthetic procedures
To be included in the study, participants had to have an edentulous space during at least 4 months, spanning 2–3 teeth in the posterior maxilla or mandible and presence of natural teeth, partial prosthesis and/or implants in the opposite jaw in contact with the planned bridge. Patients also had to be able to receive an 11 mm long and 4 mm wide dental im...
Figure 2b. Five‐year follow‐up photograph of patient with two 11‐mm implants
Figure 2a. Five‐year follow‐up radiograph of patient with two 11‐mm implants
Figure 2. Five‐year follow‐up radiograph (a) and clinical photograph (b) of patient with two 11‐mm implants
Figure 1b. Five year follow‐up clinical photograph of patient with two 6 mm implants
Figure 1a. Five‐year follow‐up radiograph of patient with two 6‐mm implants
Figure 1. Five‐year follow‐up radiograph (a) and clinical photograph (b) of patient with two 6‐mm implants
Figure 1. Five‐year follow‐up radiograph (a) and clinical photograph (b) of patient with two 6‐mm implants
2 MATERIAL AND METHODS
2.1 Study design
The study outline has been described before in the 1‐year report of Guljé et al. (2013) and the 3‐year report of Zadeh et al. (2018). Inclusion/exclusion criteria, treatment and evaluation procedures are described in detail in these publications. The present report has been prepared in accordance with guidelines outlined in the CONSORT statement for...
Comparison of 6‐mm and 11‐mm dental implants in the posterior region supporting fixed dental prostheses: 5‐year results of an open multicenter randomized controlled trial
First published: 06 October 2020 | https://doi.org/10.1111/clr.13674
Abstract
Objective
The aim of this multicenter, randomized controlled trial was to compare the clinical and radiographic outcomes of 6‐mm or 11...
Setelah bertahun-tahun melakukan percobaan klinis, Jepang wusananya membolehkan komersialisasi OCP/Col untuk bedah oral.
OCP/ Col kepanjangan dari Octacalcium Phospate/ Collagen. Selama 15 tahun pungkasan, Octacalcium Phosphate menjadi kandidat alternatif baru untuk menyediakan basis kristal mineral yang menyusun tulang dalam kombinasinya dengan kolagen. Bahan ini menjadi kandidat yang cenderung ...
Figure 50. Buccal wall
The margin of the buccal wall is shifted apically by approximately 2 mm over the 8 weeks of healing, as indicated by the yellow arrow. Bone loss is greater in the buccal wall than in the lingual wall during socket healing for several reasons. First, the crestal portion of the buccal bone wall, especially in the anterior region, is occupied by bundle bone. As mentioned e...
Figure 49. Dimensional ridge alternation : 8 weeks
At 8 weeks after tooth extraction, the entrance to the extraction site is bridged with cortical bone. The woven bone in the socket is replaced with bone marrow and some trabeculae of lamellar bone. At the crests of the buccal and lingual cortical plates, there are signs of ongoing bone resorption.
Figure 48. Dimensional ridge alterations: 4 weeks
At 4 weeks after tooth extraction, the socket is filled with woven bone. Osteoclasts are present on the outer surfaces at the margin of the buccal and lingual walls, signaling resorption of cortical plates. The resorption of the bundle bone is almost complete. Osteoclasts also line the trabeculae of woven bone present in the central and latera...
Figure 47. Dimensional ridge alterations: 2 weeks
At 2 weeks after tooth extraction, the apical and lateral parts of the socket are filled with woven bone, while the central and marginal portions of the socket are occupied by provisional connective tissue. On the inner and outer surfaces of the socket walls, numerous osteoclasts can be seen. In several areas of the socket wall, the bundle bon...
Figure 45. Radiographic height reduction
The mean crestal height change as assessed on the radiographs was 1.53 mm.
Figure 44. Mean height reduction
The mean reduction in height was approximately 1.7 mm.
Figure 43. Mean width reduction
The weighted means showed that the clinical loss in width is greater than the loss in height. The mean reduction in width of the alveolar ridge was calculated to be approximately 4 mm.
Figure 42. Dimensional change in alveolar bone
A recent systematic review evaluated the amount of change in height and width of the residual ridge after tooth extraction.
Figure 36. Day 60 - 180 : Initial periosteum formation
After 60 to 90 days, newly formed woven bone forms a bridge across the entrance of the socket. The epithelium covering the bone is keratinized. Soft tissue healing at this stage has been completed. At 90 to 180 days after tooth extraction, the woven bone is gradually remodeled into cortical bone. A periosteum is established with collagen ...
Figure 30. Quantitative tissue analysis
Trombelli and coworkers monitored the healing of human extraction sockets for a 6-month period and presented a semi-quantitative analysis of tissues and cell populations involved in various stages of socket healing. They showed that granulation tissue was present in comparatively large amounts in the early phases of socket healing. At 6 to 8 weeks, th...
Figure 29. Day 180 : large marrow spaces
After 180 days of healing, beneath the marginal cortical bone at the entrance of the socket as denoted by the arrow, most of the socket is filled with trabecular bone that includes large marrow spaces. The bone is characterized by a limited number of trabeculae of lamellar bone. The bone marrow contains large numbers of adipocytes but only a few inflam...
Figure 28. Day 120 : cortical bone & trabecular bone
At 120 days of healing, the entrance of the socket, denoted with an arrow, has become reinforced by layers of cortical bone that are deposited over the previously formed woven bone.
Figure 26. Day 14: woven bone & connective tissue
After 14 days of healing woven bone, which appears as a loose, unstructured network of bone, has started to fill the socket except in the central region, where significant amounts of the provisional connective tissue matrix still remain. This is because the woven bone forms first at the periphery of the socket and gradually extends from the wa...
Figure 20. Ridge of edentulous site
The outer walls of the alveolar ridge consist of cortical bone. The buccal bone plate is comparatively thinner than the lingual or palatal plate. The cortical plates enclose trabecular bone that consists of bony trabeculae and marrow. As a rule, the ridge of an edentulous site in the maxilla contains comparatively more trabecular bone than a site in the man...
Figure 19. Bone resorption forms alveolar ridge
The term alveolar ridge refers to the alveolar bone following loss of teeth. After a tooth is extracted, the alveolar process heals with formation of bone within the socket and external resorption or shrinkage of the bone, forming the alveolar ridge.
Figure 18. Extraction socket wall
The buccal bone plate is usually thin, less than 1 mm, especially in the anterior dentition, and it consists mainly of bundle bone. On the contrary, the lingual or palatal wall of the socket is usually thicker than its buccal counterpart, and some trabecular bone may be present.
Figure 15. Trabecular bone
The trabecular bone is located between the alveolar bone proper and the cortical bone plates. Trabecular bone, also known as cancellous bone, consists of bony trabeculae and marrow spaces. In adult patients the marrow spaces are rich in adipocytes and mesenchymal cells. Mesenchymal cells have bone-forming potential and may be induced to form bone, but they also supp...
Figure 14. Cortical bone
The cortical bone is comprised of functional units called osteons that consist of concentric lamellae and canaliculi surrounding a central Haversian canal.
Figure 13. Cortical plate
The cortical plates of the supporting bone are continuous with the alveolar bone proper lining the tooth sockets. The cortical plates are thicker in the mandible than in the maxilla, and they are thickest in the molar and premolar regions of the mandible.
Figure 12. Supporting bone
In addition to the alveolar bone proper, the rest of the bone that supports the teeth is the supporting bone. This portion of the alveolar process consists of two parts: the outer cortical plates, buccal and lingual to the tooth, and the trabecular bone between the cortical plates and the tooth socket.
Figure 10. Alveolar bone proper
The gross anatomic term is alveolar bone proper, which is synonymous with the term cribriform plate, so-called because it is perforated by many minute openings for vascular and nervous components.
Figure 9. Alveolar bone proper
The histologic term for alveolar bone proper is bundle bone. In histologic sections, the alveolar bone proper appears as a thin lamella of cortical bone lined with bundle bone. Extrinsic collagen fiber bundles of the periodontal ligament known as Sharpey's fibers are embedded into the bundle bone. Their purpose is to connect the bundle bone with the root cementu...
Figure 11. Attachment apparatus
As shown in this histologic section, bundle bone, periodontal ligament, and cementum form an anatomic unit. When a tooth is extracted, the cementum and much of the periodontal ligament are removed. The bundle bone resorbs after tooth extraction.
Figure 9. Lamina dura
The radiographic term for alveolar bone proper is lamina dura. This structure appears more dense than adjacent bone on radiographs. Widening or disruption of the lamina dura may indicate periodontal pathology.
Figure 8. Different terms for the alveolar bone proper
There are several different terms used to describe the alveolar bone proper.
The gross anatomic term is alveolar bone proper, which is synonymous with the term cribriform plate, so-called because it is perforated by many minute openings for vascular and nervous components.
The histologic term is bundle bone. In histologic sections, the ...
CS class
CS modification
Posterior maxilla
Posterior mandible
Conventional treatment: maxilla / mandible
Suggested implant treatment of maxillary arch (based on bone availability)
I
1
Moderate hypertrophy
Moderate atrophy
FUD / bilateral distal extension RPD
Placement of 2 to 4 implants in the posterior maxilla on each side, alveoloplasty ± sinus lift; implant-retained or...
CS class
CS modification
Type of Maxillary edentulism
Type of Mandibular edentulism
Anterior Maxilla
Anterior Mandible
I
1
Completely edentulous arch
Partial edentulism with anterior teeth present only (or recently removed)
Severe atrophy
Severe hypertrophy; teeth extrusion
2
Completely edentulous arch
Fixed dentition
Severe atrophy
Severe hypertrophy
...
Glossary of Implant Terms. J Oral Implantol 2003. 29:31..
Jameson, W. S. Various clinical situations and their influence on linear occlusion in treating combination syndrome: a discussion of treatment options. Gen Dent. 2003. 51:443–447.
Kelly, E. Changes caused by a mandibular removable partial denture opposing a maxillary complete denture. J Prosthet Dent. 1972. 27:140–150.
Saunders...
Conclusion
A progressive anterior maxillary bone loss can be seen in cases of complete maxillary denture opposed by the distal extension RPD. A variety of similar situations when a maxillary partial denture with missing front teeth is functioning against an anterior fixed dentition or an implant-supported prosthesis (root-form, subperiosteal, ramus frame, transmandibular implant designs) can ...
Discussion
Treatment of patients with combination syndrome can be a challenge for a dental practitioner. A significant resorption of anterior maxillary alveolar ridge is often seen when mandibular molars and premolars are lost and the anterior mandibular teeth with a distal extension RPD oppose the edentulous maxilla. When the lower RPD is constantly adjusted and properly maintained as the bo...
Classification of Combination Syndrome
Kelly was the first person to use the term “combination syndrome.”5 He believed that the key to many symptoms of the combination syndrome is the “early loss of bone from the anterior part of the maxillary jaw.”3 The other consistent features of this dental condition include enlargement of maxillary tuberosities and mandibular posterior bone res...
Restorative stage
Bar type attachments are often used to connect abutment teeth or implants and provide retention for removable dentures and overdentures. Retention is achieved by using riders/clips, retention sleeves, O-rings, etc. There are several bar type attachments that are available commercially, including the Dolder Bar System, the Hader Bar System, the Acherman Clip, and others. Any ...
Operative phase
The procedure (surgical stage 1) was started with the administration of two capsules of lidocaine 2% with epinephrine 1:100 000 for the upper right quadrant. The buccal full-thickness flap from the right maxillary tuberosity to the premolar area with the anterior releasing incision was developed. The maxillary sinus was exposed by removing a small amount of anterior maxillar...
Treatment plan
During the initial surgical consultation, the overall oral condition and severe bone atrophy was discussed with the patient. The remaining tooth No. 2 was not salvageable and had to be removed. Teeth No. 12-13-14 connected in the bridge were stable. A surgical treatment with a large bone graft (hip graft) to the premaxillary region to correct severe atrophy which would require ...
Diagnosis
On the basis of the clinical and radiographic evaluation, the diagnosis of combination syndrome was made. An extended diagnosis also included a class III malocclusion, severe anterior maxillary bone atrophy between first premolars, failing tooth No. 2 (advanced periodontal condition), a functional mandibular blade implant, an extrusion of the lower front teeth, and a...
Case Report
A 76-year-old woman with Sjogren syndrome presented complaining of a poor fit of an upper denture and difficulty chewing and speaking clearly. Patient had Sjogren syndrome for the previous 20 years in a mild and controlled form. She had been using water to compensate for dryness of her mouth and was taking prednisone 10 mg every other day for the last 2 years. Otherwise, patient's...
Introduction
Combination syndrome (CS) is defined as “a condition caused by the presence of the lower anterior teeth and the absence of the posteriors and resulting in significant maxillary anterior alveolar resorption.”1 This condition often develops in cases of a complete maxillary denture opposing a bilateral distal extension mandibular partial denture2 (Figures 1 - 3). The resulting...
Abstract
Combination syndrome (CS) is a dental condition that is commonly seen in patients with a completely edentulous maxilla and partially edentulous mandible with preserved anterior teeth. This syndrome consists of severe anterior maxillary resorption combined with hypertrophic and atrophic changes in different quadrants of maxilla and mandible. This makes it a challenging condition in ...
The present report showed that short implants may achieve optimal clinical and radiographic outcomes at the 1-year follow-up when used for single restoration or when connected with other implants in substituting for more than one tooth. There was no difference in outcomes between mandibular and maxillary restorations even though a higher quantity of bone volume was required in mandibular restora...
Weton
Sebaran panjang dan diameter implant ditampilkan dalam Tabel 1. Tabel 2 merinkes posisi implant dan ciri prostetik. Rerata tinggi tulang sisa adalah 6.21 ± 1.05 mm di rahang atas dan 10.73 ± 1.63 mm di rahang bawah. Perbedaan di antara 2 rahang itu signifikan (P < 0.05). Tidak ada komplikasi bedah atau pasca bedah yang dilaporkan.
Tabel 2. Posisi implant dan ciri prostetik; implant ante...
Implant length and diameter distribution are shown in Table 1. Table 2 summarizes implant positions and prosthetic characteristics. Mean residual bone height was 6.21 ± 1.05 mm in the upper jaw and 10.73 ± 1.63 mm in the mandible, and it was significantly different between the 2 jaws (P < .05). No surgical or postsurgical complications were reported.
Table 2. Implant positions and prostheti...
In this ad interim report, 1-year data regarding bone resorption were assessed. Implant survival and success rates were evaluated by comparing maxillary and mandibular implants, splinted and single implants, and implants of different lengths. A Student t test was used to compare bone resorption between mandibular and maxillary implants and splinted and single implants. Analysis of variance was u...
Clinical evaluation was performed every 6 months for the first 2 years then yearly. Survival and success rates were evaluated and recorded, following the definitions and parameters described elsewhere. Any surgical, prosthetic, or clinical complication was recorded. Prosthetic success was evaluated as follows: prosthesis in function, without mobility and pain, even if in the face of the loss of o...
Antibiotic prophylaxis with amoxicillin 2 g was administered to all patients 1 hour before surgery in all patients. All implants were placed in healed sites and the bone socket was prepared using a standard atraumatic technique with a sequence of drills of increasing diameter at the decided length. The implant site was always underprepared, taking in consideration the bone density. All implants ...
This prospective single-cohort study was designed and conducted following the principles of the World Medical Association Helsinki Declaration of 1975 for biomedical research involving human subjects, as revised in 2000. Ethical approval for the study was obtained by the review board of the IRCCS Istituto Ortopedico Galeazzi. All patients were informed about the study aims and design and gave w...
Introduction
Implant rehabilitation in the posterior regions of the maxilla and mandible can be complicated in cases of reduced bone volume due to bone resorption after teeth extraction or to particular anatomic conditions. In fact, reduced bone height can prevent long implants (>10 mm long) from being placed because of the risk of involving anatomic structures, such as ...
Short Implants in Maxillary and Mandibular Rehabilitations: Interim Results (6 to 42 Months) of a Prospective Study
J Oral Implantol (2015) 41 (1): 50–55.
https://doi.org/10.1563/AAID-JOI-D-12-00206
The aim of this single-cohort study was to evaluate clinical survival and success of partial rehabilitation supported by reduced-length implants in maxilla and ...
Conclusions
The porous Col-HA composites developed in the present study are biocompatible and can be used as scaffolds for bone tissue regeneration. The Col-HA ratio is an important factor in promoting the attachment and proliferation of mouse MSCs. The Col-HA composite complexes have strong potentials in bone tissue regeneration applications. hPDSCs may be a suitable resource of cells for maxi...
Discussion
The findings of the presented study indicate that the porous sponge-like Col-HA composites have good biocompatibility and biomimetic properties and may be used as scaffolds for bone tissue regeneration. The Col-HA composites with ratios 80:20 and 50:50 supported the attachments and proliferations of mouse MSCs and hPDSCs. These findings indicate that Col-HA composite complexes have str...
Results
The sponge-like plugs of prototype Col-HA composites were successfully fabricated with different collagen and HA ratios. The macroscopic and SEM views of the prototype type I collagen without HA and 3 different ratios of collagen-HA (20%Col-80%HA; 50%Col-50%HA; 80%Col-20%HA) composites are shown in Figure 1. The SEM views show the inside microstructures of the prototype pure type I colla...
Materials and Methods
Synthesis of the Col-HA composites by direct precipitation in situ
Solutions of calcium salt and phosphoric acid (Ca/P = 1.66 mol) were used to synthesize HA particles and incorporate them on bovine type I collagen fibrils by a direct precipitation technique in situ. This technique was optimized to produce 3 different ratios of Col-HA composites (20%Col-80%HA; 50%Col-50%H...
Introduction
Combining a scaffold and living cells to form a tissue-engineering construct is an important concept for promoting the repair and regeneration of bone tissues. Mesenchymal stem cells are often used in such constructs due to their abilities to proliferate and differentiate toward bone-forming cells. The design and fabrication of scaffolds, stem cell isolation and characterization, and...
Abstract
Current bone grafting materials have significant limitations for repairing maxillofacial and dentoalveolar bone deficiencies. An ideal bone tissue-engineering construct is still lacking. The purpose of the present study was first to synthesize and develop a collagen-hydroxyapatite (Col-HA) composite through controlled in situ mineralization on type I collagen fibrils with nanometer-sized...
RESEARCH
Porous Collagen-Hydroxyapatite Scaffolds With Mesenchymal Stem Cells for Bone Regeneration
Li Ning, DDS, PhD , Hans Malmström, DDS , Yan-Fang Ren, DDS, MPH, PhD
Correspondence:
* Corresponding author, e-mail: yanfang_ren@urmc.rochester.edu
Article Citation:
Li Ning, Hans Malmström, Yan-Fang Ren, Porous Collagen-Hydroxyapatite Scaffolds With Mesench...
Operasi bone graft-nya saja hanya berlangsung antara 1 sampai 2 jam, tergantung tingkat kesulitan kasus per individu pasien. Karena tubuh pasien tidak ada yang sama persis, maka lama operasi bone graft juga tidak ada yang sama persis.Setelah operasi selesai, Anda perlu waktu sampai bone graft jadi. Kasus yang paling ringan bisa sembuh hanya dalam waktu 2 minggu. Kasus yang paling berat bisa ...
Pemasangan implan gigi selalu melibatkan pembentukan tulang anyam (woven bone). Tulang ini dicirikan dengan organisasi serat kolagen yang tampak seolah serampangan. Secara mekanik, tulang ini sebetulnya tulang yang lemah. Tulang anyaman dihasilkan ketika osteoblas membentuk osteoid cepat. Semua tulang janin awalnya adalah tulang anyaman. Kemudian, tulang itu diganti dengan tulang lamelar. ...
Kesannya, bone graft itu teknologi baru. Padahal, perawatan ini ditemukan pertama kali pada sekitar pertengahan abad 17 Masehi, kira-kira 3,5 abad yang lalu.Sejarahnya, seorang dokter Belanda yang bernama Jacob van Meekeren merawat seorang pasien tentara dengan tengkorak kepala terbuka karena bertempur. Dokter mencari tulang apa yang bisa menyatu dengan tengkorak manusia. Singkat cerita, dokter ...
Bone graft alloplastis dikembangkan untuk mengatasi perkara yang berpotensi timbul dari penggunakan autograft. Alloplas terutama bersifat osteokonduktif tanpa potensi osteogenesis atau pun osteoinduksi.KeuntunganKeuntungan utama bahan alloplastis adalah:bahan baku tersedia berlimpah ruahtidak ada risiko transmisi penyakitantigenisitas sangat rendahdapat diproduksi dengan aneka bentuk dengan beraga...
Anda mungkin ingin pasang implant tapi dokter berkata, tulang rahang Anda tidak cukup besar untuk menopang implan. Jangan kuatir. Sekarang ada teknologi bone graft untuk memperbesar tulang penyangga implan. Asalkan kondisi tulang rahang Anda belum parah, tulang Anda masih bisa diperbesar dengan metode ini.Xenograft didefinisikan sebagai graft jaringan yang berasal dari spesies selain manusia. Misa...
Bone Morphogenitic Proteins (BMP) atau Protein Morfogenetik Tulang diperkenalkan pada tahun 1965. Tetapi, protein yang bertanggung jawab atas induksi tulang belum diketahui sampai dasawarsa 1980an ketika sekelompok peneliti berhasil melakukan purifikasi dan sekuens BMP-3 sapi (osteogenin) dan mengkloning BMP-2 dan BMP-4 manusia. Kelompok protein BMP diketahui termasuk dalam kelompok TGF-β...
Autograft dan allograft punya persamaan, yaitu sama-sama diambil dari manusia. Perbedaan di antara keduanya adalah autograf diambil dari tubuh pasien itu sendiri, sementara allograft diambil dari orang lain lalu dipasangkan pada pasien. Orang lain yang dimaksud bisa orang yang masih hidup atau orang yang sudah meninggal (kadaver). Alograft ada 3 jenis, yaitu:Tulang segar atau segar bekuFDBADFDBAT...
Bone graft berbasis allograft menggunakan tulang allograft. Bone graft ini digunakan sendirian atau digunakan bersama-sama dengan materi lain. Kelebihan autograftKelebihan autograft meliputi:Autogenous bone graft memanfaatkan tulang yang diperoleh dari pasien itu sendiri.Rendahnya risiko penolakan graft oleh tubuh (reaksi imunologi), mengingat graft diambil dari tubuh pasien sendiri. Ini sebab...
Di bidang kedokteran gigi implan, materi bone graft merujuk pada materi yang ditanam dalam mulut pasien untuk meningkatkan pembentukan tulang baru melalui proses osteogenik, osteoinduktif, atau osteokonduktif. Osteogenik berarti materi bone graft mengandung sel-sel osteoprogenitor yang hidup dan yang mampu berdiferensiasi menjadi osteoblas sehingga menghasilkan tulang baru. Osteoinduktif berarti ...
Tanya:Tulang rahang saya sudah menciut. Apa masih bisa dipasangi implan?Jawab:Ada teknologi bone graft (cangkok tulang). Dengan teknologi masa kini, pasien yang mengalami penciutan tulang rahang masih punya kemungkinan untuk menerima implan. Hal itu tergantung pada seberapa parah penciutan yang terjadi, kualitas tulang, tebal tulang, dsb.Dokter akan memeriksa foto rontgen panoramik, foto 3D, atau...