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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Published: 18 December 2019
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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...
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...
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
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. 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
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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
You can also search for this author in PubMed Google Scholar
You can also search for this author in PubMed Google Scholar
AGG collecte...
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...
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
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...
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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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You can also search for this author in PubMed Google Scholar
You c...
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. 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...
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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
You can also search for this author in PubMed Google Scholar
You can also search for this author in PubMed Google Scholar
AGG collecte...
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...
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. 3. Site of evaluation. (1) Corner of the mouth: 5 mm below the corner of the mouth. (2) Lower lip: 5 mm laterally from the midline. (3) Mental region: at the midpoint of the perpendicular from the lower edge to the lower lip to the chin and 5 mm laterally from the midline
Fig. 3. Site of evaluation. (1) Corner of the mouth: 5 mm below the corner of the mouth. (2) Lower lip: 5 mm lat...
Fig. 2. started from a filament of 0.165 mm in diameter of the most weak force, and performed three times at one site
Fig. 2. a SW perception tester is composed of different diameters (a: 0.165 mm, b: 0.215 mm, c: 0.315 mm). b The use of SW perception tester started from a filament of 0.165 mm in diameter of the most weak force, and performed three times at one site
Fig. 1. Alveolar nerve repositioning in a partially edentulous mandible. a Preoperative radiograph. b The inferior alveolar nerve was transposed from the mental foramen. c Postoperative radiograph after implant insertion
Fig. 1. Alveolar nerve repositioning in a partially edentulous mandible. a Preoperative radiograph. b The inferior alveolar nerve was transposed from the mental foramen. c Po...
No.
Sex
Age (years)
Range of IAN lateralization (width)
Implant site
Follow-up period (months)
...
Stage 0
Complete sensory loss
Stage 1
Advent of deep pain
Stage 2
Some degree of tactile recovery and pain ...
Nishimaki, F., Kurita, H., Tozawa, S. et al. Subjective and qualitative assessment of neural disturbance after inferior alveolar nerve transposition for dental implant placement.
Int J Implant Dent 2, 14 (2016). https://doi.org/10.1186/s40729-016-0047-1
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Received: 25 July 2015
Accepted: 26 April 2016
Published: 14 May 2016
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...
Fumihiro Nishimaki, Hiroshi Kurita, Shinya Tozawa, Yuji Teramoto, Rishiho Nishizawa, and Shin-ichi Yamada declare that they have no competing interests.
FN and HK conceived and designed the study, performed the experiments, and wrote the manuscript. ST and YT performed data analysis. RN and SY participated in manuscript preparation. All authors read and approved the final version of the manuscrip...
Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, 3-3-1, Asahi, Matsumoto-shi, Nagano, 390-0804, Japan
Fumihiro Nishimaki, Hiroshi Kurita, Shinya Tozawa, Yuji Teramoto, Rishiho Nishizawa & Shin-ichi Yamada
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Morrison A, Chiaro M, Kirby S. Mental nerve function after inferior alveolar nerve transposition for placement of dental implants. J Can Dent Assoc. 2002;62:46–50.
Vetromilla BM, Moura LB, Sonegi CL, et al. Complications associated with inferior alveolar nerve repositioning for dental implant placement: a systematic review. Int J Oral Maxillofac Surg. 2014;43(11):1360–6.
Eggers G, Klein J, e...
Levin L, Sadet P, Grossmann Y. A retrospective evaluation of 1387 single-tooth implants: a six-year follow-up. J Periodontol. 2006;77:2080–3.
Levin L. Dealing with dental implant failures. J Appl Oral Sci. 2008;16:171–5.
Lorean A, Kablan F, Mazor Z, et al. Inferior alveolar nerve transposition and reposition for dental implant placement in edentulous or partially edentulous mandibles: a mult...
In conclusion, we investigated the quality of postoperative neurosensory function after IAN transposition for dental implant placement. IAN transposition is a useful method for placing implants in the atrophic posterior mandible. However, the procedure is complicated, with the possibility of some degree of neurosensory disturbance, although in most of our cases, it resolved within a clinically acc...
Dental restoration by means of dental implants can provide good functional rehabilitation, particularly in patients with atrophic mandibles. IAN lateralization is a useful method for placing implants in the atrophic posterior mandible. However, there is a possibility of the neurosensory function of the IAN being disturbed, although in most cases, it resolves within a clinically acceptable period.
...
Although the previous studies reported good results concerning ND in IAN transposition surgery, the methods for evaluating ND differed, and most of the studies did not fully describe the evaluation procedure. The evaluation of ND of the IAN can be performed by purely subjective (questionnaire), relatively objective (static light touch, 2-point discrimination, etc.), and purely objective methods (t...
IAN reposition may serve as a viable treatment option in the severely resorbed mandibles. Repositioning is performed via one of the two surgical techniques, lateralization, or transposition, with lateralization yielding lower degrees of nerve deficiency. In lateralization, the IAN is exposed and retracted laterally, held in this position during implant placement, then released to rest against the ...
In total, eight IAN transposition procedures were performed in seven patients. One patient underwent bilateral surgery. Surgery was performed under general anesthesia in four patients and under local anesthesia in three patients. The IAN was lateralized for a four-tooth breadth on one side, three-tooth breadth on three sides, and two-tooth breadth on three sides. In total, 22 dental implants were ...
This study was conducted in compliance with the principles of the Declaration of Helsinki, and was approved by the Committee for Ethics at Shinshu University School of Medicine. Patients who underwent dental rehabilitation by insertion of dental implants between 2000 and 2012 in our hospital were reviewed. Of these, seven patients underwent transposition of the IAN for dental implant placement and...
Tooth loss is one of the common causes of reduced quality of life in adults. Dental implants have become a widely accepted treatment option for both partially and completely edentulous patients [1–3]. However, in cases of posterior mandibular atrophy, suitably sized implants cannot be placed without encroaching on the inferior alveolar nerve (IAN). In such cases, restorative options include the ...
The purpose of this retrospective study was to accumulate data regarding the quality of postoperative neurosensory function after inferior alveolar nerve (IAN) transposition for dental implant placement.
The study included seven consecutive patients who underwent IAN transposition surgery for the insertion of a dental implant into the atrophic posterior mandible. Of these, six patients (seven sid...
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. 2. Figure illustrating the proposed mucosal thickening index. A ≤1 mm, indicating no thickening; B >1 mm but ≤2 mm, indicating minimal thickening; C >2 mm but ≤5 mm, indicating moderate thickening; D >5 mm, indicating severe thickening
Fig. 2. Figure illustrating the proposed mucosal thickening index. A ≤1 mm, indicating no thickening; B >1 mm but ≤2 mm, indicating min...
Fig. 1. Figure illustrating the reference points of the CBCT measurements. A: most posterior point of the sinus wall; B: most anterior point of the sinus wall; C: mid-point between A and B; C1: measurement of mucosal thickening perpendicular to A–B line at point C; D: mid-point between A and C; D1: measurement of mucosal thickening perpendicular to A–B line at point D; E: mid-point between B...
Gender
Respiratory diseases
Cardio-vascular diseases
Diabetes mellitus
Smoking
Hist...
Patient
Anterior
(E1-floor of the sinus)
Middle
(C1-floor of the sinus)
Posterior
(D1-floor of the sinus)
...
Maska, B., Lin, GH., Othman, A. et al. Dental implants and grafting success remain high despite large variations in maxillary sinus mucosal thickening.
Int J Implant Dent 3, 1 (2017). https://doi.org/10.1186/s40729-017-0064-8
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Received: 18 October 2016
Accepted: 13 January 2017
Published: 18 January 2017
DOI: https://doi.org/10.1186/s40729-017-0064-8
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...
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Correspondence to
Yvonne Kapila.
Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, 1011 N University Ave, Ann Arbor, MI, USA
Bartosz Maska, Guo-Hao Lin, Abdullah Othman, Shabnam Behdin, Suncica Travan, Erika Benavides & Yvonne Kapila
Department of Surgical Sciences, School of Dentistry, Marquette University, 1801 W Wisconsin Ave, Milwaukee, WI, USA
Guo-Hao Lin
Department of Peri...
The authors thank Ms. Victoria Zakrzewski for her help with the figure generation and preparation.
Co-primary author BM contributed to the CBCT measurement and preparation of the manuscript. Co-primary author G-HL contributed to the data analysis and preparation of the manuscript. Second author AO contributed to the protocol preparation, case review, case selection, and preparation of the manuscr...
Romanos GE, Froum S, Costa-Martins S, Meitner S, Tarnow DP. Implant periapical lesions: etiology and treatment options. J Oral Implantol. 2011;37:53–63.
Acharya A, Hao J, Mattheos N, Chau A, Shirke P, Lang NP. Residual ridge dimensions at edentulous maxillary first molar sites and periodontal bone loss among two ethnic cohorts seeking tooth replacement. Clin Oral Implants Res. 2014;25:1386–94...
Pazera P, Bornstein MM, Pazera A, Sendi P, Katsaros C. Incidental maxillary sinus findings in orthodontic patients: a radiographic analysis using cone-beam computed tomography (CBCT). Orthod Craniofac Res. 2011;14:17–24.
Ritter L, Lutz J, Neugebauer J, et al. Prevalence of pathologic findings in the maxillary sinus in cone-beam computerized tomography. Oral Surg Oral Med Oral Pathol Oral Radiol...
Gardner DG. Pseudocysts and retention cysts of the maxillary sinus. Oral Surg Oral Med Oral Pathol. 1984;58:561–7.
Chiapasco M, Palombo D. Sinus grafting and simultaneous removal of large antral pseudocysts of the maxillary sinus with a micro-invasive intraoral access. Int J Oral Maxillofac Surg. 2015;44:1499–505.
Cano J, Campo J, Alobera MA, Baca R. Surgical ciliated cyst of the maxilla. Cl...
Beretta M, Poli PP, Grossi GB, Pieroni S, Maiorana C. Long-term survival rate of implants placed in conjunction with 246 sinus floor elevation procedures: results of a 15-year retrospective study. J Dent. 2015;43:78–86.
Del Fabbro M, Corbella S, Weinstein T, Ceresoli V, Taschieri S. Implant survival rates after osteotome-mediated maxillary sinus augmentation: a systematic review. Clin Implant D...
Cone-beam computed tomographic
Protected Health Information
Sinus floor elevation
Our study found that the largest tissue thickening was present in the middle section of the maxillary sinus. This tissue thickening did not vary based on gender, age, or smoking status, nor did it relate to the underlying alveolar ridge height. However, patients with a history of periodontal diseases demonstrated a significant association with mucosal thickening. A mucosal thickening index was pro...
Although residual alveolar ridge height has been associated with sinus mucosal thickening [36], our study did not find a significant association between these two parameters. Acharya et al. [36] reported that lower available bone height in the subsinus region was related to thickened sinus membranes within an Asian-Indian and Hong Kong-based Chinese population. Differences in the ethnic compositio...
Based on the findings of the current study, a history of periodontal disease is the only identified parameter significantly associated with sinus mucosal thickening. This finding indicates that clinicians should expect some degree of mucosal thickening when performing sinus augmentation procedures in a previously periodontally involved site. This finding is consistent with several previously publi...
CBCT imaging has been recognized as a more sensitive imaging modality for identifying sinus thickening and pathoses in the posterior maxilla compared to panoramic radiography [21, 22]. This could explain why the current study identified a higher prevalence of mucosal thickening compared to earlier studies [23]. However, compared to other similar CBCT studies [21, 24, 25], the prevalence reported i...
Twenty-nine CBCT images (11 females and 18 males) were included in this study. All the implants placed in these included cases survived, representing a 100% implant survival rate. With regards to measurements of mucosal thickening, the intra-examiner reproducibility revealed an exact intra-examiner correlation of 99%, with a p value of 0.40 for a t test for independent samples, indicating a high r...
The sites that were measured are specified in the image below (Fig. 1). The most posterior and anterior aspects of the visible maxillary sinus were measured. The ½ point along with the ¼ and ¾ points were then selected, and the measurements of the mucosal thickening were then completed at these three sites. The thickest portion of the mucosa was also measured if it did not coincide with one of...
The study required access to University of Michigan Protected Health Information (PHI). PHI was necessary in order to track and coordinate the CBCT data and dental and medical history for each subject. Corresponding subject charts and electronic records were reviewed for retrieval of relevant implant placement and restorative history, medical history, and demographic information, including gender ...
Our study hypothesis was that mucosal thickening of more than 2 mm and up to 1/3 of the volume of the sinus would not alter the predictability for SFE and dental implant placement. The primary outcome was to determine the success rate of dental implant placement in augmented maxillary sinus areas with mucosal thickening. A secondary outcome was to evaluate the effect of gender, age, and smoking o...
Despite the high survival rate of dental implants inserted in maxillary sinuses that have undergone sinus floor elevation (SFE) with bone grafting, complications still occur [1–3]. Sinus membrane perforation is reported to be the most common complication [4, 5]. Postoperative maxillary sinusitis is less common (0–22%) [6, 7]; nevertheless, it could potentially compromise the outcome of SFE and...
Although mucosal thickening is the most common radiographic finding observed regarding sinus pathology, the knowledge regarding its clinical significance on the outcomes of dental implants and grafting in the maxillary sinuses is still limited. We hypothesized that mucosal thickening would not alter the predictability for sinus floor augmentation and dental implant placement. The purpose of this r...
Fig. 5. Periapical X ray after 1 year of follow-up, the bone was stable and no sign of peri-implantitis was shown
Fig. 5. Periapical X ray after 1 year of follow-up, the bone was stable and no sign of peri-implantitis was shown
Fig. 4. Follow-up after 1 year, no radiographic sign was appreciating and the osseointegration was satisfactory
Fig. 4. Follow-up after 1 year, no radiographic sign was appreciating and the osseointegration was satisfactory
Fig. 3. Final restaurations: The parallelism of the implants is achieved by carving the non-submerged part a occlusal view and b lingual view
Fig. 3. Final restaurations: The parallelism of the implants is achieved by carving the non-submerged part a occlusal view and b lingual view
Fig. 2. Flapless surgical technique, atraumatic surgical procedure for zirconium implants using the circular scalpel (a)–sharp, clean cut without bleeding (b)
Fig. 2. Flapless surgical technique, atraumatic surgical procedure for zirconium implants using the circular scalpel (a)–sharp, clean cut without bleeding (b)
Fig. 1. Diagnostic radiographic exploration previous to treatment
Fig. 1. Diagnostic radiographic exploration previous to treatment
Parmigiani-Izquierdo, J.M., Cabaña-Muñoz, M.E., Merino, J.J. et al. Zirconia implants and peek restorations for the replacement of upper molars. Int J Implant Dent 3, 5 (2017). https://doi.org/10.1186/s40729-016-0062-2
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Received: 13 October 2016
Accepted: 22 December 2016
Published: 20 February 2017
DOI: https://doi.org/10.1186/s40729-016-0062-2
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 m...
Periodontics Unit, Faculty of Medicine and Dentistry, University of Murcia (Spain), Murcia, Spain
Arturo Sánchez-Pérez
Clínica CIROM, Murcia, 30001, Spain
José María Parmigiani-Izquierdo, María Eugenia Cabaña-Muñoz & José Joaquín Merino
Clínica Odontologíca Universitaria, Hospital Morales Meseguer, 2ª planta, C/ Marqués de los Vélez s/n, Murcia, 30008, Spain
Arturo Sánchez-...
Bormann K-H, Gellrich N-C, Kniha H, Dard M, Wieland M, Gahlert M. Biomechanical evaluation of a microstructured zirconia implant by a removal torque comparison with a standard Ti-SLA implant. Clin oral implants res. 2012;23:1210–6.
Oliva J, Oliva X, Oliva JD. One-year follow-up of first consecutive 100 zirconia dental implants in humans: a comparison of 2 different rough surfaces. Int j oral ma...
Brånemark PI, Hansson BO, Adell R, Breine U, Lindström J, Hallén O, et al. Osseointegrated implants in the treatment of the edentulous jaw. Experience from a 10-year period. Scand j plast reconstr surg suppl. 1977;16:1–132.
Parmigiani-Izquierdo JM. TécnicaAtraumática en Implantología. Rev esp odontoestomatológica implant. 11:30–5.
Parmigiani-Izquierdo JM, Sánchez-Pérez A, Cabaña-Mu...
Zirconia implants with PEEK restorations can be considered a good alternative for replacing natural teeth. Their biocompatibility and biostability make them a promising material for those patients who suffer from allergies and sensitivity to metal alloys.
PEEK restorations are a valid and alternative recommendation when using zirconia implants because of their cushioning effect and elastic modulu...
In addition to PEEK, new coatings based on PMMA or composite materials (Anaxblent®Anaxdent®, Nexco®Ivoclar®, Solidex®Shofu®, Novo.lign®Bredent®, etc.) which incorporate ceramic fillings have been developed. Due to their molecular structure, these materials have excellent density and homogeneity [24]. The micro filling integrated into the polymer matrix increases abrasion resistance, at the...
In terms of the load-cushioning capacity of the prosthetic elements, the use of PEEK as a prosthetic structure on implants has increased in recent years [14]. PEEK is a high-density thermoplastic polymer with a linear aromatic semi-crystalline structure that has exceptional physical and chemical properties as regards toughness, hardness and elasticity. Also, its low molecular weight, combined with...
Fifteen days after surgery, the appearance of the soft tissue was excellent, with no signs of inflammation in the mucosa. The patient mentioned the absence of bleeding and pain during the post-operation period. At the same time, we made a clinical and radiological evaluation. Three months after surgery, the stumps of the implants were carved to improve their parallelism with a special diamond dril...
A patient who is a 45-year-old woman and non-smoker has no medical record of interest. The patient complained of pain in the right second upper molar. She said that she felt intense pain while chewing. The pain was accentuated with occlusion and while chewing, making normal functioning impossible. The patient mentioned the absence of piece 16, which had been extracted 8 years previously.
Clinica...
In the field of implant dentistry, the most widely used implants over the past 40 years are those manufactured from titanium [1], which are still the most popular.
The recent demands for materials without metal alloys in dentistry, together with the increased sensitivity and allergies of some patients, have promoted the development of new materials.
An example of this is zirconia-based dental i...
One of the disadvantages of the zirconia implants is the lack of elasticity, which is increased with the use of ceramic or zirconia crowns. The consequences that could result from this lack of elasticity have led to the search for new materials with improved mechanical properties.
A patient who is a 45-year-old woman, non-smoker and has no medical record of interest with a longitudinal fracture i...
Fig. 4. Comparative illustration of mean ISQ values
Fig. 4. Comparative illustration of mean ISQ values
Fig. 3. Implants were placed after application of CGF membrane
Fig. 3. Implants were placed after application of CGF membrane
Fig. 2. CGF membrane was applied in study group implant sockets
Fig. 2. CGF membrane was applied in study group implant sockets
Fig. 1. CGF was obtained after centrifugation
Fig. 1. CGF was obtained after centrifugation
Control group
Study group
Immediate–1st week
−2.25 ± 1.713
1.40 ± 1.847
Immediate–4th week
−2.30 ± 2.774
0.60 ± 2.798
1st Week–4th week
−0.05 ± 1.572
−0.80 ± 2.215
Table 3 Mean ISQ value changes between study and control groups
Control group
Study group
Immediate
75.75 ± 5.552
78.00 ± 2.828
1st week
73.50 ± 5.226
79.40 ± 2.604
4th week
73.45 ± 5.680
78.60 ± 3.136
Table 2 Mean ISQ values in the study and control groups
Case no.
Age
Sex
Group
Implant number
1
20
F
Study
1
2
28
M
Control
3
3
35
F
Study
4
4
32
F
Study
4
5
60
M
Control
5
6
64
F
Study
5
7
52
F
Study
5
8
34
M
Study
1
9
45
F
Control
3
10
48
F
Control
2
11
42
M
Control
3
12
68
F
Control
4
Table 1 Demographic data of patien...
Pirpir, C., Yilmaz, O., Candirli, C. et al. Evaluation of effectiveness of concentrated growth factor on osseointegration. Int J Implant Dent 3, 7 (2017). https://doi.org/10.1186/s40729-017-0069-3
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Received: 16 December 2016
Accepted: 16 February 2017
Published: 03 March 2017
DOI: https://doi.org/10.1186/s40729-017-0069-3
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...
Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Karadeniz Technical University, Trabzon, Turkey
Cagasan Pirpir, Onur Yilmaz, Celal Candirli & Emre Balaban
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Prakash S, Thakur A. Platelet concentrates: past, present and future. J Maxillofac Oral Surg. 2011;10(1):45–9.
Rodella LF, Favero G, Boninsegna R, Buffoli B, Labanca M, Scari G, et al. Growth factors, CD34 positive cells, and fibrin network analysis in concentrated growth factors fraction. Microsc Res Tech. 2011;74(8):772–7.
Ademokun JA, Chapman C, Dunn J, Lander D, Mair K, Proctor SJ, et al...
Huwiler MA, Pjetursson BE, Bosshardt DD, Salvi GE, Lang NP. Resonance frequency analysis in relation to jawbone characteristics and during early healing of implant installation. Clin Oral Implants Res. 2007;18(3):275–80.
Kroese-Deutman HC, Vehof JW, Spauwen PH, Stoelinga PJ, Jansen JA. Orthotopic bone formation in titanium fiber mesh loaded with platelet-rich plasma and placed in segmental defe...
Nurden AT, Nurden P, Sanchez M, Andia I, Anitua E. Platelets and wound healing. Front Biosci. 2008;13:3532–48.
Anitua E, Sanchez M, Zalduendo MM, de la Fuente M, Prado R, Orive G, et al. Fibroblastic response to treatment with different preparations rich in growth factors. Cell Prolif. 2009;42(2):162–70.
He L, Lin Y, Hu X, Zhang Y, Wu H. A comparative study of platelet-rich fibrin (PRF) and ...
Raghavendra S, Wood MC, Taylor TD. Early wound healing around endosseous implants: a review of the literature. Int J Oral Maxillofac Implants. 2005;20(3):425–31.
Oncu E, Bayram B, Kantarci A, Gulsever S, Alaaddinoglu EE. Positive effect of platelet rich fibrin on osseointegration. Med Oral Patol Oral Cir Bucal. 2016;21(5):e601–7.
Anitua E. Plasma rich in growth factors: preliminary results o...
Bone morphogenetic protein
Concentrated growth factor
Computed tomography
Insulin-like growth factor
Platelet-derived growth factor
Platelet-rich fibrin
Platelet-rich plasma
Resonance frequency analysis
Transforming growth factor-β1
Transforming growth factor-β2
Vascular endothelial growth factor
Considering this data, it appears that application of CGF enhanced stability of implants and accelerated osseointegration in the early period. CGF has positive effects on the ISQ value at the first week and fourth week. Further laboratory studies are needed to demonstrate the positive effects of blood products on the osseointegration process at the histopathological level.
In a study by Monov et al. using PRP around the implant, a higher stability value was obtained in the study group during the early recovery period (6 weeks) although difference between the groups was not statistically significant [23]. Kim et al. reported in a study that there was a statistically significant increase in bone-implant contact with PRP administration in the vicinity of the implant [...
Introduced in 1998 by Marx, PRP is used in oral and maxillofacial surgeries to speed up the recovery of grafts in bone-grafted areas [14, 26–30]. Although many studies have shown that platelet-rich plasma affects bone healing positively, the results of some other studies suggest otherwise [31, 32].
In recent years, the platelet-rich fibrin (PRF) was described by Choukroun as a second-generation...
Implant stability is one of the important parameters that assess the loading time and dental implant success. Investigators have recommended that implants with ISQ
The study includes 12 patients (5 males, 7 females). Patients participating in the study are between 20–68 years of age and the mean age is 44 years. A total of 40 implants were placed, 20 of these were included in the study group (50%), and the other 20 were included in the control group (50%). Twenty-one implants were placed in type 2 bone, 19 implants in type 3 bone (Table 1). The distribu...
Independent sample t test was applied between the two groups by taking the differences between the data obtained in these periods. Two-way ANOVA and Fisher’s LSD test was used for evaluating the associations among group and insertion torque.
A value of p
All surgical procedures were performed under local anesthesia by the same surgeon. A full-thickness mucoperiosteal flap was removed by incision on the alveolar crest. Implant cavities were prepared according to the surgical protocol of the Bego Semados implant system (BEGO Implant Systems GmbH & Co. KG, Bremen, Germany). The final osteotomy diameters were the same as the placed implants. In the st...
This study was conducted in compliance with the principles of the Declaration of Helsinki, and approval of the ethics committee required for the study was obtained from the Ethics Committee of the Karadeniz Technical University (2015/21). The procedures to be performed were explained in detail and patients signed the consent forms. The study was carried out on individuals who applied to Karadeniz ...
That the implant has sufficient stability after placement is important for providing the necessary bone formation around the implant and for the optimal distribution of functional forces at the implant-bone interface during healing [15–17].
It can be said that resonance frequency analysis (RFA) is a very important tool for tracking the osseointegration process [18, 19]. RFA is a technique that ...
Osseointegration of dental implants is important for long-term success and stability. There is no standardization in terms of the time of osseointegration and the timing of prosthetic loading. This process varies between 0–6 months [1]. Various strategies are being explored to shorten this period. Changes in implant surface properties and design have increased primer stability and helped the pe...
Growth factor-containing products have been reported to increase implant stability and accelerate osseointegration. Concentrated growth factor (CGF) can be used for this purpose with the growth factors it contains. The aim of this study is to assess the effect of CGF on implant stability and osseointegration.
Twelve patients with maxillary anterior toothless were included in the study. Implant ca...
Fig. 3. Mean and standard deviation (SD) of percentage of correct answers regarding hardness at each of the four times. The horizontal label axis was the time stage, and the label to the vertical axis was percentage of correct answers regarding hardness (%)
Fig. 2. label axis was the time stage (1) before implant surgery with the complete denture in situ and (2) right after with provisional implant, (3) 1–2 weeks and (4) 3 months after insertion of the provisional screw-retained restoration, and the label to the vertical axis was contact area (mm2). The occlusal contact area was increased at 3 months after wearing implants (paired t test, p
Fig. 1. Correlation between measured Glucosensor value (mg/dl) (the vertical axis) and applied glucose density (mg/dl) (the horizontal axis) in the in vitro setup. A linear regression line could be applied to the data set, and we tested the accuracy of Glucosensor value
Fig. 1. Correlation between measured Glucosensor value (mg/dl) (the vertical axis) and applied glucose density (mg/dl) (the ...
Tanaka, M., Bruno, C., Jacobs, R. et al. Short-term follow-up of masticatory adaptation after rehabilitation with an immediately loaded implant-supported prosthesis: a pilot assessment. Int J Implant Dent 3, 8 (2017). https://doi.org/10.1186/s40729-017-0070-x
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Received: 24 October 2016
Accepted: 23 February 2017
Published: 07 March 2017
DOI: https://doi.org/10.1186/s40729-017...
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 Prosthetic Dentistry, Graduate School of Biomedical Science, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, 852-8588, Japan
Mihoko Tanaka, Tetsurou Torisu & Hiroshi Murata
Centre for Periodontology and Implantology Leuven, IJzerenmolenstraat 110, B-3001, Heverlee, Belgium
Mihoko Tanaka & Collaert Bruno
OMFS IMPATH, Department of Imaging & Pathology, University of Leuven, Kap...
The authors are grateful to the volunteers who participated in this study. This work was supported by JSPS Grant-in-Aid for Scientific Research (C), grant number 23592860.
MT, CB, and RJ conceived and designed the experiment. MT and CB performed the experiments and analyzed the data with R J. TT and HM helped to draft the manuscript. All authors read and approved the final manuscript.
Mihoko Tan...
Collaert B, Wijnen L, De Bruyn H. A 2-year prospective study on immediate loading with fluoride-modified implants in the edentulous mandible. Clin Oral Implants Res. 2011;22:1111–6.
Collaert B, De Bruyn H. Immediate functional loading of TiOblast dental implants in full-arch edentulous maxillae: a 3-year prospective study. Clin Oral Implants Res. 2008;19:1254–60.
Matsui Y, Ohno K, Michi K, S...
Bakke M, Holm B, Gotfredsen K. Masticatory function and patient satisfaction with implant-supported mandibular overdentures: a prospective 5-year study. Int J Prosthodont. 2002;15:575–81.
Miyaura K, Morita M, Matsuka Y, Yamashita A, Watanabe T. Rehabilitation of biting abilities in patients with different types of dental prostheses. J Oral Rehabil. 2000;27:1073–6.
Peyron MA, Blanc O, Lund JP...
Trulsson M, Johansson RS. Encoding of amplitude and rate of forces applied to the teeth by human periodontal mechanoreceptive afferents. J Neurophysiol. 1994;72:1734–44.
Hidaka O, Morimoto T, Masuda Y, Kato T, Matsuo R, Inoue T, et al. Regulation of masticatory force during cortically induced rhythmic jaw movements in the anesthetized rabbit. J Neurophysiol. 1997;77:3168–79.
Hidaka O, Morimo...
Klineberg IJ, Trulsson M, Murray GM. Occlusion on implants—is there a problem? J Oral Rehabil. 2012;39:522–37.
Feine J, Jacobs R, Lobbezoo F, Sessle BJ, Van Steenberghe D, Trulsson M, Fejerskov O, Svensson P. A functional perspective on oral implants—state-of-the-science and future recommendations. J Oral Rehabil. 2006;33:309–12.
Jacobs R, van Steenberghe D, Naert I. Masseter muscle fati...
The present pilot study could not confirm an immediate rise in bite force after implant rehabilitation. Instead, improvements were mainly noted up to 3 months after surgery and rehabilitation. Furthermore, it became evident that despite gradually improved bite force in all patients, masticatory efficiency and food hardness perception did not necessarily follow the same trend. The present findings...
Occlusal contact was significantly increased 3 months after implant rehabilitation when compared to stage one (prior to implant rehabilitation). We assumed the reason was that some participant’s occlusion was worn down because the material of provisional restoration was resin. To observe the adaptation of masticatory function after rehabilitation with an immediately loaded implant-supported pro...
Hardness perception became better after implant rehabilitation, with a reduction of the error rate by 16% (Fig. 3). While five out of eight participants performed better in this test after rehabilitation, the results in the others were less clear. More detailed analysis showed that, despite wearing dentures, four participants were 100% successful in recognition of hardness before implant surgery,...
Two participants were unavailable to attend the testing at 1–2 weeks after the provisional restoration had been inserted, which resulted in missing data.
Overall descriptive analyses yielded the following observations for the four tests.
Occlusal contact and approximate maximum bite force were significantly increased 3 months after implant rehabilitation because of the adjustment of provisio...
To assess the hardness differences, the examiner placed each test specimen on the tongue with chopsticks, and then the participants chewed on all sides and swallowed. They were asked to remember the hardness of the first specimen, which always had medium hardness and served as a control, and then to determine the level of hardness (hard, medium, or soft) of four consecutive and randomly administer...
To assess the masticatory efficiency, we used glucose extraction in the filtrate obtained after chewing the specimen. After rinsing the mouth with tap water, a gum-like specimen mixed with 5% glucose with a height of 10 mm (Glucosensor Gummy, GC, Tokyo, Japan) was placed on patient’s tongue with chopsticks. Patients were requested to chew on the cube for 20 s, after which, they expectorated al...
Six females and 2 males (average age 66.4 years, range 52–85 years) with upper (n = 7) or lower (n = 1) complete dentures participated in this study. Inclusion criteria were (1) an opposite jaw that included natural dentition at least to the second premolar on both sides, (2) a need for fixed rehabilitation, (3) no medical contraindication to the placement of implants, (4) no need for ...
The purpose of this pilot investigation was to use testing methodologies involving four aspects of masticatory adaptation after rehabilitation with an immediately loaded implant-supported prosthesis and to observe the recovery of each aspect respectively. Our hypothesis is that bite force may recover quickly, but other aspects will require monitoring and recording in order to form an overall judgm...
In addition, it also remains to be demonstrated how a potential compensatory mechanism might work, with one of the options being osseoperception [2, 18–23]. In this context, it is also important to consider the adaptation time needed after oral rehabilitation. Some studies have performed longitudinal evaluations of masticatory function for more than 3 years [24, 25]. However, there are limited ...
Tooth loss represents a major oral disability comparable to an amputation, with severe impairment of oral functions [1]. While denture wearers can rely on mucosal sensors, anchoring prosthetic teeth to the bone via osseointegrated implants has been assumed to create a (partial) sensory substitution for missing periodontal ligament receptors from stimuli transmitted via the bone [2]. The restoratio...
When teeth are extracted, sensory function is decreased by a loss of periodontal ligament receptions. When replacing teeth by oral implants, one hopes to restore the sensory feedback pathway as such to allow for physiological implant integration and optimized oral function with implant-supported prostheses. What remains to be investigated is how to adapt to different oral rehabilitations.
The pur...
Fig. 3. Mean bone loss at 6 months and 1 year. Mean bone loss distribution charts at 6 months and 1 year present no statistically significant difference. p value at 6 months was 0.2981 and at 1 year 0.6613
Fig. 3. Mean bone loss at 6 months and 1 year. Mean bone loss distribution charts at 6 months and 1 year present no statistically significant difference. p value at 6 months was ...
Fig. 2. ISQ values at placement, 6 weeks, 6 months, and 1 year. Mean and standard deviation of ISQ values taken at placement, 6 weeks, 6 months, and 1 year is presented. No statistical significant difference was determined between ISQ values at all time points. (p
Fig. 1. Implant design. The OSPTX and OSP implants are manufactured from high-grade commercially pure titanium with surface roughness produced via a fluoride treatment process. The OSP implant is a screw-shaped self-tapping implant. The diameter used in this study was 4.0 mm. The implant length used in this study was 8 mm. The OSPTX implant has the same features as the OSP except the apex of t...
Implant success
Clinically immobile when tested manually and/or with RFA (minimum ISQ = 65)
Absence of peri-implant radiolucency present on an undistorted radiograph
Absence of unresolved pain, discomfort, inf...
Inclusion
Male or female
At least 18 years old
Healthy enough to undergo routine implant surgery and subsequent dental treatment
Partially edentulous requiring...
Simmons, D.E., Maney, P., Teitelbaum, A.G. et al. Comparative evaluation of the stability of two different dental implant designs and surgical protocols—a pilot study.
Int J Implant Dent 3, 16 (2017). https://doi.org/10.1186/s40729-017-0078-2
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Received: 18 January 2017
Accepted: 22 April 2017
Published: 02 May 2017
DOI: https://doi.org/10.1186/s40729-01...
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 Periodontics, Louisiana State University Health Sciences Center School of Dentistry, 1100 Florida Avenue, New Orleans, LA, 70119, USA
David E. Simmons, Pooja Maney, Austin G. Teitelbaum, Susan Billiot & A. Archontia Palaiologou
Tulane University SPHTM, 1440 Canal St, Suite 2001, New Orleans, LA, 70130, USA
Lomesh J. Popat
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De Bruyn H, Raes F, Cooper LF, Reside G, Garriga JS, Tarrida LG, et al. Three-years clinical outcome of immediate provisionalization of single Osseospeed() implants in extraction sockets and healed ridges. Clin Oral Implants Res. 2013;24(2):217–23.
Ebler S, Ioannidis A, Jung RE, Hammerle CH, Thoma DS. Prospective randomized controlled clinical study comparing two types of two-piece dental impla...
O'Sullivan D, Sennerby L, Meredith N. Influence of implant taper on the primary and secondary stability of osseointegrated titanium implants. Clin Oral Implants Res. 2004;15(4):474–80.
Schwartz-Arad D, Herzberg R, Levin L. Evaluation of long-term implant success. J Periodontol. 2005;76(10):1623–8.
Alves CC, Neves M. Tapered implants: from indications to advantages. Int J Periodontics Restora...
Anitua E, Orive G. Short implants in maxillae and mandibles: a retrospective study with 1 to 8 years of follow-up. J Periodontol. 2010;81(6):819–26.
Feldman S, Boitel N, Weng D, Kohles SS, Stach RM. Five-year survival distributions of short-length (10 mm or less) machined-surfaced and Osseotite implants. Clin Implant Dent Relat Res. 2004;6(1):16–23.
Felice P, Cannizzaro G, Checchi V, March...
DENTSPLY International, Susquehanna Commerce Center, 221 West Philadelphia Street, York, PA 17401
I-CAT 17 19; Imaging Services International LLC, 1910 North Penn Rd., Hatfield, PA 19440
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Osstell USA, 6700 Alexander Bell Drive, Suite 200, Columbia, MD 21046
ImageJ 1.50i Wayne Rasband National Institutes of Heal...
Survival rates and stability of OSP and OSPTX implants was comparable.
Osteotomy preparation either by the standard or by the soft bone surgical protocol had no significant effect on implant survival, success, and stability.
Insertion torque presented a moderate to strong correlation with ISQ values at 6 weeks, 6 months, and 1 year.
Insertion torque presented a weak correlation to ISQ values...
Insertion torque presented a moderate to strong correlation with ISQ values at 6 weeks, 6 months, and 1 year but not at time of implant insertion. This finding is in agreement with Acil et al. who reported no statistically significant correlation between insertion torque and ISQ at time of implant placement [22].
Although a strong correlation was found between insertion torque and bone loss at...
Augmentation of the maxillary sinus prior to dental implant placement is routinely performed in order to help patients restore their maxillary posterior dentition. Unfortunately, not all patients are candidates for this procedure due to either health, personal, or financial concerns. An alternative treatment without the need for a sinus elevation procedure is the use of a shorter implant. Research...
Overall implant survival rate was 93.3%. Two implants failed, one implant in group A (OSPTXSoft) and one in group B (OSPTXStd). Both implant failures occurred at the time of uncovery (at 6 weeks) and prior to loading of the implants and were attributed to lack of integration. With the exception of these two failed implants, there was 100% success for all remaining implants using the parameters de...
ANOVA was used to compare the mean implant stabilities between the three groups. Post hoc testing was done via Tukey’s honestly significant differences test to calculate the differences between ISQ measurements at the time of implant placement, 6 weeks and 6 and 12 months (Fig. 2) as well as bone levels at 6 and 12 months (Fig. 3). The correlations of multiple parameters such as insertion t...
Following proper approval by the LSUHSC Institution Review Board (LSUNO IRB#7438), 27 (30 implant sites) systemically healthy patients at least 18 years old were enrolled in the study and randomly divided into three groups as follows (inclusion and exclusion criteria are described in detail in Table 1):
Group A received 10 OSPTX implants using the soft bone surgical protocol (OSPTXSoft).
Group...
A recent systematic review by Stocchero et al. concluded that an undersized drilling protocol in soft bone is an effective way to enhance insertion torque but recommended that further clinical studies are needed to confirm these data [18]. Our study was designed to address this question, as it compared the standard drilling protocol to a soft bone protocol.
Our study hypothesis is that the stabil...
Dental implants are now a widely accepted treatment option for the replacement of missing teeth. The therapeutic goal of dental implants is to support restorations that replace single or multiple missing teeth so as to provide patient comfort, function, and esthetics as well as assist in the ongoing maintenance of remaining intraoral and perioral structures. However, anatomic limitations such as t...
Survival and stability of OSPTX and OSP implants is comparable. Osteotomy preparation by either standard or soft bone surgical protocol presented no significant effect on implant survival and stability for the specific implant designs.
The purpose of this study was to compare a parallel wall design implant to a tapered apex design implant when placed in the posterior maxilla using two different surgical protocols.
Twenty-seven patients (30 implants) were divided into three groups. All implants were 4 mm wide in diameter and 8 mm long.
Group A received 10 tapered implants (OSPTX) (Astra Tech OsseoSpeed TX™) using the soft b...
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
...
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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. 10. Patient 1—post-operative evaluation of placement accuracy of the implants in the mandible. Green is the planned position; blue is the actual position
Fig. 10. Patient 1—post-operative evaluation of placement accuracy of the implants in the mandible. Green is the planned position; blue is the actual position
Fig. 9. Patient 1—prosthodontic end result 5 months after implant placement
Fig. 9. Patient 1—prosthodontic end result 5 months after implant placement
Fig. 8. Patient 2—intra-oral situation during orthodontic treatment at the age of 14. A temporary crown with bracket is fixed on the dental implant. Eight months after start of orthodontic treatment, the 34 is already close to the planned end position
Fig. 8. Patient 2—intra-oral situation during orthodontic treatment at the age of 14. A temporary crown with bracket is fixed on the dental...
Fig. 7. Patient 2—post-operative orthopantomogram (OPT) at age of 13. Situation 10 months after implant placement. Three months after starting the orthodontic treatment, the 34 is already erected
Fig. 7. Patient 2—post-operative orthopantomogram (OPT) at age of 13. Situation 10 months after implant placement. Three months after starting the orthodontic treatment, the 34 is already erect...
Fig. 6. Patient 1—post-operative orthopantomogram (OPT) at age of 18
Fig. 6. Patient 1—post-operative orthopantomogram (OPT) at age of 18
Fig. 5. he maxilla (left) and mandible (right) with drilling template and metal drilling inserts (Nobel biocare). b Drilling template for the mandible of patient 1. c Implant placement of patient 1. Dental implant placement in the mandible using the virtual developed tooth-supported templates and metal drilling inserts
Fig. 5. a Drilling templates of patient 1. Printed model of the maxilla (l...
Fig. 4. t goal. b Patient 2—virtual set-up of the ultimate implant position. One short dental implant was planned in region 35, based on the location of the mandibular nerve (orange), the impacted 34 (pink) and the bone quality and volume. c Patient 2—virtual set-up of the ultimate prosthetic treatment goal
Fig. 4. a Patient 1—virtual set-up of the ultimate treatment goal. b Patient 2...
Fig. 3. e CBCT and intra-oral scan at age of 18. b Patient 2—detailed 3D model of the combined data from the CBCT and intra-oral scan at age of 12
Fig. 3. a Patient 1—detailed 3D model of the combined data from the CBCT and intra-oral scan at age of 18. b Patient 2—detailed 3D model of the combined data from the CBCT and intra-oral scan at age of 12
Fig. 2. uation before start of orthodontic and implant treatment. Eleven permanent teeth (including 2 third molars) were congenitally missing and the 34 is impacted. To erect the 34, orthodontic treatment was desired. Due to the lack of stable anchorages in the third quadrant, it was decided to place one implant at tooth region 35 for orthodontic anchorage and future prosthetics. Due to very lim...
Fig. 1. osed deciduous teeth 55, 54, 65, 74, 75, 84, and 85 and start of orthodontic treatment. Eleven permanent teeth (including 4 third molars) were congenitally missing. b Patient 1—post-orthodontic situation at age of 16. The top of the mandibular processus alveolaris is small (upper). The interdental space at location of the second premolars in the maxilla is 7 and 14 mm at location of t...
Patient
Location implant (tooth nr)
Shoulder
Tip
Axis
X
Y
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ED (mm)
...
Filius, M.A.P., Kraeima, J., Vissink, A. et al. Three-dimensional computer-guided implant placement in oligodontia.
Int J Implant Dent 3, 30 (2017). https://doi.org/10.1186/s40729-017-0090-6
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Received: 27 March 2017
Accepted: 22 June 2017
Published: 08 July 2017
DOI: https://doi.org/10.1186/s40729-017-0090-6
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 is not applicable as this research was an evaluation of routine dental care.
Not applicable.
Author Marieke Filius, Joep Kraeima, Arjan Vissink, Krista Janssen, Gerry Raghoebar and Anita Visser state that there are no conflicts of interest.
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Correspondence to
Anita Visser.
Department of Oral and Maxillofacial Surgery, University of Groningen and University Medical Center Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands
Marieke A. P. Filius, Joep Kraeima, Arjan Vissink, Gerry M. Raghoebar & Anita Visser
Department of Orthodontics, University of Groningen and University Medical Center Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands
K...
The authors like to sincerely thank all co-workers from the Department of Orthodontics, University Center Groningen, The Netherlands, for the potent collaboration during the treatment process.
We also kindly thank native English speaker Jadzia Siemienski for critically reading our manuscript and making suggestions to improve the English.
This research did not receive any specific grant from fund...
Schalk-van der Weide Y, Beemer FA, Faber JA, Bosman F. Symptomatology of patients with oligodontia. J Oral Rehabil. 1994;21:247–61.
Filius MA, Cune MS, Raghoebar GM, Vissink A, Visser A. Prosthetic treatment outcome in patients with severe hypodontia: a systematic review. J Oral Rehabil. 2016;43:373–87.
Shen P, Zhao J, Fan L, et al. Accuracy evaluation of computer-designed surgical guide tem...
(Cone beam) computer tomography
Two-dimensional
Three-dimensional
Euclidian distances
Orthopantomogram
This technical advanced article introduces a fully digitalized workflow for implant planning in complex oligodontia cases. The application of computer-designed surgical templates enables predictable implant placement in oligodontia, where bone quantity and limited interdental spaces can be challenging for implant placement. The stepwise approach described in this technical advanced article provide...
This technical advanced article illustrated the benefit of a full three-dimensional virtual workflow to guide implant placement in oligodontia cases as well as that implants can be reliably placed at the planned positions with the technique proposed.
The described full three-dimensional virtual workflow has several advantages. First, the surgeon is pre-operatively better informed about the requir...
The surgical guides fitted well and facilitated implant placement. All implants were placed in the native bone. No dehiscences of the implant surface occurred.
Post-operative orthopantomograms (OPT) of patients 1 and 2 are shown in Figs. 6 and 7. In patient 1, six implants were placed (NobelParallel Conical Connection implants, Nobel Biocare Holding AG, Zürich-Flughafen, Switzerland; Length 8.5...
After raising a mucoperiostal flap, the dental implants were placed using the virtual developed tooth-supported drilling templates using metal inserts (Fig. 5c). It was checked whether no dehiscences of the implant surface were present.
A CBCT (ICat, Image Sciences International, Hatfield, UK; 576 slices, voxel size 0.3 mm, FOV: 11 × 16 cm) was made of two oligodontia patients (for patient details, see Figs. 1 and 2) for implant planning. Detailed patient information was obtained with regard to the nerve position and bone quality and quantity. In addition, a digital intra-oral scan was made to get a detailed 3D image of t...
Oligodontia is the congenital absence of six or more permanent teeth, excluding third molars [1]. The need for oral rehabilitation in patients with oligodontia is high as they often suffer from functional and aesthetic problems due to a high number of missing teeth. Implant-based prosthodontics seem to be favourable to improve oral function and aesthetics in oligodontia [2].
Implant treatment in ...
The aim of computer-designed surgical templates is to attain higher precision and accuracy of implant placement, particularly for compromised cases.
The purpose of this study is to show the benefit of a full three-dimensional virtual workflow to guide implant placement in oligodontia cases where treatment is challenging due compromised bone quantity and limited interdental spaces.
A full, digita...
Fig. 1. Flow diagram
Fig. 1. Flow diagram
Outcome variable
Crude modela
β (95% CI)
p value
Adjusted modelb
β (95% CI)
p-value
% Sites BoP
...
Control
Test
T0 (n = 22)
T3 (n = 20)
T0 (n = 31)
T3 (n = 30)
...
N = 47a
Total anaerobic bacterial load
Log-transformed mean (SD)
T0
T3
Difference
β (95% CI)b
p value
Control
...
N = 40a
Total anaerobic bacterial load
Log-transformed mean (SD)
Tpre
Tpost
Difference
β (95% CI)b
p value
...
Characteristics
Control
Test
Number of patients
14
14
...
Hentenaar, D.F.M., De Waal, Y.C.M., Strooker, H. et al. Implant decontamination with phosphoric acid during surgical peri-implantitis treatment: a RCT.
Int J Implant Dent 3, 33 (2017). https://doi.org/10.1186/s40729-017-0091-5
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Received: 28 March 2017
Accepted: 22 June 2017
Published: 17 July 2017
DOI: https://doi.org/10.1186/s40729-017-0091-5
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...
Diederik F. M. Hentenaar, Yvonne C. M. de Waal, Hans Strooker, Henny J. A. Meijer, Arie-Jan van Winkelhoff, and Gerry M. Raghoe declare that they have no competing interests.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Correspondence to
Gerry M. Raghoebar.
Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands
Diederik F. M. Hentenaar, Henny J. A. Meijer & Gerry M. Raghoebar
Center for Dentistry and Oral Hygiene, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
Yvonne C. M. De Waal, Hans Strooker, He...
Van Winkelhoff AJ, van Steenbergen TJ, Kippuw N, De Graaff J. Further characterization of Bacteroides endodontalis, an asaccharolytic black-pigmented Bacteroides species from the oral cavity. J Clin Microbiol. 1985;22:75–9.
Zambon JJ. Periodontal diseases: microbial factors. Ann Periodontol. 1996;1:879–925.
Héritier M. Effects of phosphoric acid on root dentin surface. A scanning and transm...
Htet M, Madi M, Zakaria O, Miyahara T, Xin W, Lin Z, Aoki K, Kasugai S. Decontamination of anodized implant surface with different modalities for peri-implantitis treatment: lasers and mechanical debridement with citric acid. J Periodontol. 2016;87:953–61.
Mouhyi J, Sennerby L, Van Reck J. The soft tissue response to contaminated and cleaned titanium surfaces using CO2 laser, citric acid and hy...
Esposito M, Grusovin MG, Worthington HV. Treatment of peri-implantitis: what interventions are effective? A Cochrane systematic review. Eur J Oral Implantol. 2012;5:21–41.
Louropoulou A, Slot DE, Van der Weijden F. The effects of mechanical instruments on contaminated titanium dental implant surfaces: a systematic review. Clin Oral Implants Res. 2014;25:1149–60.
Ramanauskaite A, Daugela P, F...
Lang NP, Berglundh T, Working Group 4 of Seventh European Workshop on Periodontology. Periimplant diseases: where are we now?—Consensus of the Seventh European Workshop on Periodontology. J Clin Periodontol. 2011;38(Suppl):11,178–181.
Derks J, Tomasi C. Peri-implant health and disease. A systematic review of current epidemiology. J Clin Periodontol. 2015;42:158–71.
Derks J, Schaller D, Hå...
Gerry Raghoebar
Diederik Hentenaar
Yvonne de Waal
Implant surface decontamination is considered a highly susceptible step in the treatment of peri-implantitis. The application of 35% phosphoric acid after mechanical debridement is superior to mechanical debridement combined with sterile saline rinsing for decontamination of the implant surface during surgical peri-implantitis treatment. However, phosphoric acid as implant surface decontaminant do...
Recent studies that zoom in on titanium surface physico-chemistry reveal interesting results [38, 39]. Kotsakis et al. [38] hypothesized that chemical residues alter the titanium surface physicochemistry and subsequently compromise cellular response to these decontaminated surfaces. However, they report on effective restoring of biocompatibility when sterile saline, citric acid, and EDTA/sodium hy...
Phosphoric acid gel as agent for implant surface decontamination has only been investigated in two other clinical studies [26, 27]. Strooker et al. [26] used phosphoric acid 35% for peri-implant supportive therapy and found greater reductions in bacterial load, but no significant clinical differences compared to conventional mechanical supportive therapy. They concluded that local application of 3...
This randomized controlled trial aimed to determine the effect of 35% phosphoric etching gel on decontamination of the implant surface during resective surgical treatment of peri-implantitis. Both decontamination procedures (mechanical debridement with curettes and gauzes combined with phosphoric acid 35% and mechanical debridement combined with sterile saline) resulted in a significant immediate ...
The progress of patients throughout the different phases of the study is illustrated in Fig. 1. Table 1 depicts the baseline demographic patient and implant characteristics. The included patients had a total of 128 implants of which 53 implants showed signs of peri-implantitis. Different implant brands and types with different implant surfaces were present, including Straumann (Straumann AG, Bas...
Angular bony defects were eliminated, and bone was recontoured using a rotating round bur under saline irrigation. Mucosal flaps were apically positioned and firmly sutured (Vicryl Plus® 3-0; Ethicon Inc., Somerville, NJ, USA), and suprastructures were re-positioned. For both control and test group, surgery was followed by 2 weeks of mouth rinsing with 0.12% CHX + 0.05% CPC without alcohol t...
Implant mobility;
Implants at which no position could be identified where proper probing measurements could be performed;
Previous surgical treatment of the peri-implantitis lesions.
The study protocol was based on the study protocols of two previous studies evaluating the decontaminating effect of chlorhexidine during surgical peri-implantitis treatment [10, 32] and is briefly described below....
The present study is a double-blind randomized controlled trial evaluating the effect of 35% phosphoric etching gel (test group) compared to the effect of saline (control group) for implant surface decontamination combined with mechanical debridement during surgical peri-implantitis treatment. Patients were randomly assigned to the test or control group using a one-to-one allocation ratio. The stu...
Thus far, the use of phosphoric acid etching gel as decontaminating agent has not been evaluated in a randomized controlled trial. The aim of the present randomized controlled trial is to evaluate the short-term microbiological and clinical effectiveness of 35% phosphoric etching gel as a decontaminating agent of the implant surface during resective surgical treatment of peri-implantitis.
Triggered host defense responses initiate inflammation of the peri-implant soft tissue (peri-implant mucositis), which can lead to loss of peri-implant supporting bone (peri-implantitis), and eventually, result in implant failure [1]. An increasing prevalence of peri-implantitis has been described in recent literature [2], with current incidence ranging from 1 to 47%. A non-linear, accelerating pa...
Peri-implantitis is known as an infectious disease that affects the peri-implant soft and hard tissue. Today, scientific literature provides very little evidence for an effective intervention protocol for treatment of peri-implantitis. The aim of the present randomized controlled trial is to evaluate the microbiological and clinical effectiveness of phosphoric acid as a decontaminating agent of th...
Fig. 5. Change in BoP values according to the percentage of sites with a score of 1, 2 or 3 by visit
Fig. 5. Change in BoP values according to the percentage of sites with a score of 1, 2 or 3 by visit
Fig. 4. Percentages of sites with PPD 1–3, 4–5 and ≥6 mm by visit (p
Fig. 3. Changes in BoP values between baseline and the various examination time points
Fig. 3. Changes in BoP values between baseline and the various examination time points
Fig. 2. Changes in PPD values between baseline and the various examination time points
Fig. 2. Changes in PPD values between baseline and the various examination time points
Fig. 1. A chitosan brush (LBC, BioClean®, LABRIDA AS) seated in an oscillating dental handpiece
Fig. 1. A chitosan brush (LBC, BioClean®, LABRIDA AS) seated in an oscillating dental handpiece
Baseline
n = 306
2 weeks
n = 272
4 weeks
n = 267
12 weeks
n = 282
24 weeks
n = 294
P
...
Center
Oslo
Jonkoping
Rome
Stavanger
Kristianstad
Tons...
Wohlfahrt, J.C., Evensen, B.J., Zeza, B. et al. A novel non-surgical method for mild peri-implantitis- a multicenter consecutive case series.
Int J Implant Dent 3, 38 (2017). https://doi.org/10.1186/s40729-017-0098-y
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Received: 08 April 2017
Accepted: 13 July 2017
Published: 03 August 2017
DOI: https://doi.org/10.1186/s40729-017-0098-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...
J.C. Wohlfahrt is the inventor and patent holder of BioClean and is a shareholder in LABRIDA AS. B.J. Evensen, B. Zeza, H. Jansson, A. Pilloni, A.M. Roos-Jansåker, G.L. Di Tanna, A.M. Aass, M. Klepp and O.C. Koldsland state that there were no conflicts of interests during the undertaking of the study.
Ethical approval was provided by the regional ethical review boards of each center (Norway: 201...
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JCW, BJE, BZ, HJ, AP, AMR-J, AMA, MK and OCK par...
Department of Periodontology, Institute of Clinical Dentistry, University of Oslo, Pb. 1109 Blindern, 0317, Oslo, Norway
J. C. Wohlfahrt, A. M. Aass & O. C. Koldsland
Private Practice, Tønsberg, Norway
B. J. Evensen
Department of Dental and Maxillofacial Sciences, Section of Periodontology, Sapienza, University of Rome, Rome, Italy
B. Zeza & A. Pilloni
Center for Oral Health, Departmen...
Salvi GE, et al. Reversibility of experimental peri-implant mucositis compared with experimental gingivitis in humans. Clin Oral Implants Res. 2012;23(2):182–90.
Korsch M, Obst U, Walther W. Cement-associated peri-implantitis: a retrospective clinical observational study of fixed implant-supported restorations using a methacrylate cement. Clin Oral Implants Res. 2014;25(7):797–802.
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Muthukuru M, et al. Non-surgical therapy for the management of peri-implantitis: a systematic review. Clin Oral Implants Res. 2012;23(Suppl 6):77–83.
Esposito M, Grusovin MG, Worthington HV. Treatment of peri-implantitis: what interventions are effective? A Cochrane systematic review. Eur J Oral Implantol. 2012;5(Suppl):S21–41.
Armitage GC, Xenoudi P. Post-treatment supportive care for the n...
Rokn A, et al. Prevalence of peri-implantitis in patients not participating in well-designed supportive periodontal treatments: a cross-sectional study. Clin Oral Implants Res. 2017;28(3):314–9.
Faggion CM Jr, et al. A systematic review and Bayesian network meta-analysis of randomized clinical trials on non-surgical treatments for peri-implantitis. J Clin Periodontol. 2014;41(10):1015–25.
Me...
Koldsland OC, Scheie AA, Aass AM. Prevalence of peri-implantitis related to severity of the disease with different degrees of bone loss. J Periodontol. 2010;81(2):231–8.
Roos-Jansaker AM, et al. Nine- to fourteen-year follow-up of implant treatment. Part II: presence of peri-implant lesions. J Clin Periodontol. 2006;33(4):290–5.
Derks J, et al. Effectiveness of implant therapy analyzed in a ...
In this multicenter case series of implants affected by mild peri-implantitis, significant reductions in the clinical parameters of inflammation were demonstrated at all time points after the initial treatment with a chitosan brush. The use of an oscillating chitosan device appears to be safe and has potential merits for the treatment of mild peri-implantitis and for the maintenance of dental impl...
The chitosan brush used in this study is made of a material that is soft with the aim to make a device optimized for removal of the biofilm within the implant threads. The soft bristles on the contrary make the device suboptimal for removal of hard deposits, such as calculus and cement remnants. It has been reported that such cement remnants are a common finding around dental implants [41], and in...
In the present study, significant reductions were observed in the clinical parameters of peri-implant inflammation at 2, 4, 12 and 24 weeks relative to baseline after debridement with the chitosan brush seated in an oscillating dental drill piece. No progression in radiographic bone loss was reported at any of the implants at the final evaluation, and the method was thus judged safe to use in cas...
Identifying peri-implant disease at an early stage and promptly treating the inflammatory condition is crucial to prevent the progression of peri-implant bone loss and ensure long-term implant survival [23,24,25]. After completion of active treatment and when the condition is controlled, supportive peri-implant therapy will reduce the risk of disease re-occurrence [9]. A number of scientific repor...
During this study, all 63 implants were reported to have stable radiographic levels of osseous support as validated by the six different local examiners. No adverse events were reported during the study.
In total, 63 implants in 63 patients were ultimately included in the analysis. Demographic information is presented in Tables 1 and 2.
Significant reductions in both PPD and mBoP were seen at all time points relative to the baseline clinical measurements (p
Mann-Whitney rank sum tests were used to compare changes in the clinical parameters between baseline and subsequent time points. To assess the hierarchical structure of the data (center > patient > site), a linear mixed model using the restricted maximum likelihood method (multilevel logistic models for binary outcomes) was constructed to analyse the PPD, mBoP and suppuration, adjusting for fac...
All patient-related information and clinical recordings were recorded in a web-based clinical research form (VieDoc version 3.24, PCG solutions, Uppsala, Sweden).
Patients under 18 years of age; current smokers; patients who had undergone radiotherapy in the head and neck region, chemotherapy or systemic long-term corticosteroid treatment; patients who were pregnant or nursing; patients receivin...
A 6-month multicenter prospective consecutive case series was performed in six different periodontal specialist clinics in Norway, Sweden and Italy.
Ethical approval was provided by the regional ethical review boards of each center (Norway: 2014/852/REK sør-øst; Italy: Sapienza 2011/15, 3547; and Sweden: EPN Lund 2014/695.) Fifteen patients at each center were planned to be included in the stud...
A number of other studies also report that leaving fragments of the instrument on the implant surface or scratching the surface may impede optimal peri-implant healing [17,18,19,20].
Chitosan is a marine biopolymer which is based on chitin derived from the shells of marine crustaceans. The material has been approved for use in surgical bandages, as a haemostatic agent and as a dietary supplement ...
Inflammation and loss of attachment around dental implants (i.e. peri-implantitis) has become a growing concern within the field of dental implantology [1,2,3,4,5,6,7]. Peri-implantitis is a microbial infection-driven soft tissue inflammation with loss of bony attachment around an implant. Peri-implant mucositis is the precursor of peri-implantitis, as gingivitis is for periodontitis [8]. It is cl...
The aim of the present study was to evaluate the effect on peri-implant mucosal inflammation from the use of a novel instrument made of chitosan in the non-surgical treatment of mild peri-implantitis across several clinical centers.
In this 6-month multicenter prospective consecutive case series performed in six different periodontal specialist clinics, 63 implants in 63 patients were finally inc...
Fig. 6. Cumulative survival rate of complication-free prostheses by a gender (p = 0.1220) and b type of prostheses (p
Fig. 5. Kaplan-Meier cumulative survival rate of complication-free prostheses at 10, 15, and 25 years after the prosthesis setting
Fig. 5. Kaplan-Meier cumulative survival rate of complication-free prostheses at 10, 15, and 25 years after the prosthesis setting
Fig. 4. Cumulative incidence of peri-implantitis by a gender (p = 0.0221), b implant type (p = 0.0128), c implant position (p = 0.2470), d presence of additional soft tissue management (p = 0.2488), and e width of keratinized mucosa around implant (p = 0.0045). Log rank test was used for assessing statistical significance
Fig. 4. Cumulative incidence of peri-implantitis by a gender ...
Fig. 3. Cumulative incidence of peri-implantitis
Fig. 3. Cumulative incidence of peri-implantitis
Fig. 2. Kaplan-Meier cumulative survival rates by a gender (p = 0.1049), b implant type (p = 0.6259), c implant position (p
Fig. 1. Kaplan-Meier cumulative survival rate at 10, 15, and 25 years after the prosthesis setting
Fig. 1. Kaplan-Meier cumulative survival rate at 10, 15, and 25 years after the prosthesis setting
Hazard ratio
95% confidence interval
p value
Gender (male)
1.82
0.946~3.487
...
Hazard ratio
95% confidence interval
p value
Gender (male)
2.38
1.138~5.362
...
Hazard ratio
95% confidence interval
p value
Gender (male)
1.99
0.538~8.201
...
Dia. (mm)
Maxilla anterior
Maxilla posterior
Mandible anterior
Mandible posterior
Tot...
Dia. (mm)
Maxilla anterior
Maxilla posterior
Mandible anterior
Mandible posterior
Tot...
Age/gender
Male
Female
Total
20–29
3
...
Horikawa, T., Odatsu, T., Itoh, T. et al. Retrospective cohort study of rough-surface titanium implants with at least 25 years’ function.
Int J Implant Dent 3, 42 (2017). https://doi.org/10.1186/s40729-017-0101-7
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Received: 26 April 2017
Accepted: 28 August 2017
Published: 05 September 2017
DOI: https://doi.org/10.1186/s40729-017-0101-7
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...
Tadashi Horikawa, Tetsurou Odatsu, Takatoshi Itoh, Yoshiki Soejima, Hutoshi Morinaga, Naruyoshi Abe, Naoyuki Tsuchiya, Toshikazu Iijima, and Takashi Sawase declare that they have no competing interests.
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TH, TO, and TS initiated and designed the retrospective study and drafted the manuscript including the preparation of figures and tables. TH, TAI, YS, HM, NA, NT, and TOI reviewed the medical records and collected the data. All authors revised the manuscript and approved the final manuscript.
Correspondence to...
Kyushu Implant Research Group, 4-14 Kokaihonmachi, Chuo-ku, Kumamoto, 860-0851, Japan
Tadashi Horikawa, Takatoshi Itoh, Yoshiki Soejima, Hutoshi Morinaga, Naruyoshi Abe, Naoyuki Tsuchiya, Toshikazu Iijima & Takashi Sawase
Department of Applied Prosthodontics, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, 852-8588, Japan
Tetsurou Odatsu & Takash...
Pjetursson BE, Thoma D, Jung R, Zwahlen M, Zembic A. A systematic review of the survival and complication rates of implant-supported fixed dental prostheses (FDPs) after a mean observation period of at least 5 years. Clin Oral Implants Res. 2012;23(Suppl 6):22–38.
Dorner S, Zeman F, Koller M, Lang R, Handel G, Behr M. Clinical performance of complete dentures: a retrospective study. Int J Prost...
Duda M, Matalon S, Lewinstein I, Harel N, Block J, Ormianer Z. One piece immediately loading implants versus 1 piece or 2 pieces delayed: 3 years outcome. Implant Dent. 2016;25:109–13.
Wennerberg A, Albrektsson T. Effects of titanium surface topography on bone integration: a systematic review. Clin Oral Implants Res. 2009;20(Suppl 4):172–84.
Teughels W, Van Assche N, Sliepen I, Quirynen M. E...
Dahlin C, Linde A, Gottlow J, Nyman S. Healing of bone defects by guided tissue regeneration. Plast Reconstr Surg. 1988;81:672–6.
Boyne PJ, James RA. Grafting of the maxillary sinus floor with autogenous marrow and bone. J Oral Surg. 1980;38:613–6.
Hellem S, Karlsson U, Almfeldt I, Brunell G, Hamp SE, Astrand P. Nonsubmerged implants in the treatment of the edentulous lower jaw: a 5-year pro...
Brånemark PI, Adell R, Breine U, Hansson BO, Lindström J, Ohlsson A. Intra-osseous anchorage of dental prostheses. I. Experimental studies. Scand J Plast Reconstr Surg. 1969;3:81–100.
Buser D, Sennerby L, De Bruyn H. Modern implant dentistry based on osseointegration: 50 years of progress, current trends and open questions. Periodontol. 2017;73:7–21.
Ekelund JA, Lindquist LW, Carlsson GE, ...
In conclusion, our analyses revealed a cumulative survival rate of 89.8% of TPS-surface implants with at least 25 years of functioning. The survival rate of maxillary positioned implants was significantly lower than that of mandibulary positioned implants. The patient gender, implant location, and width of keratinized mucosa affected the rate of peri-implantitis, resulting in late failure. Implan...
We also observed that the tooth-implant-supported prostheses had a lower complication-free rate than implant-supported fixed prostheses due to caries, periodontitis, or the root fracture of abutment teeth. Lang et al. reported that the survival rates of tooth implant-supported fixed partial dentures were 94.1% after 5 years and 77.8% after 10 years of functioning [31], and these results were alm...
Regarding the width of keratinized mucosa, many studies and a review have indicated that the presence of a sufficient width of keratinized mucosa is necessary for maintaining healthy peri-implants [26,27,28,29]. In the present study, when 2 mm of keratinized mucosa was used as the adequate width, the p value was 0.053 (data not shown). This also showed the tendency of the availability of keratini...
Peri-implantitis is the major reason for late failure [13, 14]. The consensus report of the Sixth European Workshop on Periodontology described peri-implant mucositis in approx. 80% of subjects restored with implant, and peri-implantitis in 28–56% of subjects [15]. In the present study, the cumulative incidence of peri-implantitis was 9.5, 15.3, 21.0, and 27.9% at 5, 10, 15, and 25 years after ...
Although all implants used in this study were withdrawn from the market about 20 years before, the longitudinal clinical outcomes over decades will help to better understand potential factors leading to implant failure or complications and assess the safe and predictable use of dental implant. Our analyses revealed a 25-year cumulative survival rate of 89.8% after the prosthesis setting, which se...
A total of 48 implants were eventually accompanied by a peri-implant infection: the cumulative incidence of peri-implantitis was 9.5, 15.3, 21.0, and 27.9% at 5, 10, 15, and 25 years after the prosthesis delivery, respectively (Fig. 3). After stepwise backward selection, the gender, implant type, and width of keratinized mucosa showed the significant difference in the cumulative survival rate (T...
A total of 92 patients (38 men, 54 women; mean age 54.3 years, range 20–78) received implant-supported prostheses (at the seven private practices) between 1984 and 1990. The distribution of patients by age and gender is presented in Table 1. Fifty-seven patients (140 implants) were considered dropouts due to the fact that no data were obtained at the endpoint, but 25 years had passed since th...
This retrospective observational study was approved by the ethical committee of Nagasaki University (No. 1512). The cases of all of the patients who underwent dental implant treatment with a TPS-surfaced solid-screw implant and whose prosthesis was set in the years 1984–1990 at seven private practices were analyzed. All inserted implants were either a TPS-type (TPS-type, Institute Straumann, Bas...
Dental implant treatment based on the concept of osseointegration [1] is now a widely accepted restorative treatment for fully and partially edentulous patients. In the earliest days of the use of osseointegrated implants, two different topographies were applied on the implant surfaces: a machined minimally rough titanium surface such as the Brånemark system and a rough microporous titanium plasm...
The longitudinal clinical outcomes over decades contribute to know potential factors leading to implant failure or complications and help in the decision of treatment alternatives.
The cases of all patients who received dental implants treated with titanium plasma-sprayed surfaces and whose prostheses were set in the period 1984–1990 at seven private practices were retrospectively analyzed. The...
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
...
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.
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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...
Failure rate
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...
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...
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...
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Implants maxilla
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Mengel, R., Heim, T. & Thöne-Mühling, M. Mucositis, peri-implantitis, and survival and success rates of oxide-coated implants in patients treated for periodontitis 3- to 6-year results of a case-series study.
Int J Implant Dent 3, 48 (2017). https://doi.org/10.1186/s40729-017-0110-6
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Received: 29 August 2017
Accepted: 26 October 2017
Published: 28 Novemb...
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...
RM is a professor at the Department of Prosthetic Dentistry, School of Dental Medicine, Philipps-University, Marburg/Lahn, Germany. TH is a private practicioner in Gruben, Brandenburg, Germany. MT is a researcher at the Department of Prosthetic Dentistry, School of Dental Medicine, Philipps-University, Marburg/Lahn, Germany.
This clinical study was conducted in accordance with the World Medical A...
Department of Prosthetic Dentistry, School of Dental Medicine, Philipps-University, Marburg/Lahn, Germany
Reiner Mengel & Miriam Thöne-Mühling
Gruben, Brandenburg, Germany
Theresa Heim
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Kim K-K, Sung H-M. Outcomes of dental implant treatment in patients with generalized aggressive periodontitis: a systematic review. J Adv Prosthodont. 2012;4:210–7.
Pettersson K, Mengel R. Comments on the statistical analysis of the paper by Albouy et al comparing four different types of implants with respect to ‘spontaneous’ progression of peri-implantitis. Eur J Oral Implantol. 2011;1:9...
Kinane DF, Radvar M. The effect of smoking on mechanical and antimicrobial periodontal therapy. J Periodontol. 1997;69:467–72.
Swierkot K, Lottholz P, Flores-de-Jacoby L, Mengel R. Mucositis, peri-implantitis, implant success, and survival of implants in patients with treated generalized aggressive periodontitis: 3- to 16-year results of a prospective long-term cohort study. J Periodontol. 2012...
Jungner M, Lundqvist P, Lundgren S. A retrospective comparison of oxidized and turned implants with respect to implant survival, marginal bone level and peri-implant soft tissue conditions after at least 5 years in function. Clin Implant Dent Relat Res. 2014;16:230–7.
Rocci A, Rocci M, Rocci C, Scoccia A, Gargari M, Martignoni M, Gottlow J, Sennerby L. Immediate loading of Brånemark system TiU...
Esposito M, Ardebili Y, Worthington HV. Interventions for replacing missing teeth: different types of dental implants. Cochrane Database Sys Rev. 2014;7:CD003815.
Salata LA, Burgos PM, Rasmusson L, Novaes AB, Papalexiou V, Dahlin C, Sennerby L. Osseointegration of oxidized and turned implants in circumferential bone defects with and without adjunctive therapies: an experimental study on BMP-2 and...
The results of the present case series study should be interpreted in a critical light because of the small study population. However, it can be concluded that periodontally diseased subjects treated in a supportive periodontal therapy can be successfully rehabilitated with oxide-coated dental implants for a follow-up period of 3 to 6 years. The results suggest that implants in the maxilla and in...
These results from long-term clinical studies indicate that oxide-coated implants achieve equivalent survival rates and prevalence of mucositis and peri-implantitis when compared to implants with other surface characteristics. They support the assumption that the implant surface has little influence on the development of mucositis or peri-implantitis. This was subsequently confirmed in a Cochrane ...
The present study examines the success rates of oxide-coated implants in subjects with treated periodontal disease. Several long-term clinical studies on periodontally healthy subjects have revealed survival rates of 97.1 to 99.2% for oxide-coated implants [10, 24, 25]. The results of the present study show a comparable implant survival rate (96.2% in GAP and 97.1% in GCP subjects) for subjects wi...
The present study examines the success rates of oxide-coated implants in subjects with treated periodontal disease. Several long-term clinical studies on periodontally healthy subjects have revealed survival rates of 97.1 to 99.2% for oxide-coated implants [10, 24, 25]. The results of the present study show a comparable implant survival rate (96.2% in GAP and 97.1% in GCP subjects) for subjects wi...
The univariate analyses showed a significantly higher risk for peri-implantitis in GAP subjects (OR = 3.294 with p = 0.027) and at implants with bone quality grade 3 (OR = 21.200 with p = 0.000). However, these differences were not significant in multivariate analyses.
Both the uni- and multivariate patient-related analyses were non-significant.
The implant success rate was 77.9% for GCP...
All 29 subjects were examined over the period of 3 to 6 years (Table 2). For the duration of the observation period, all the remaining teeth were periodontally healthy, with PDs ≤ 3 mm and negative BOP. All subjects were non-smokers, had excellent oral hygiene, attended the follow-up examinations on a regular basis, and had no systemic disease.
In total, four implants (3.1%) were lost du...
Peri-implant mucositis was defined as PDs ≥ 5 mm with BOP and no bone loss after the first year of loading. Peri-implantitis was defined as PDs > 5 mm with or without BOP and an annual bone loss of > 0.2 mm after the first year of loading.
All technical and surgical complications (e.g., fracture of the abutment screw or superstructure, compromised wound healing) were recorded.
T...
All patients received a supportive periodontal therapy at the Dental School of Medicine, Philipps-University, Marburg, in the course of the observation period. The first clinical examination was 2 to 4 weeks before the non-retainable teeth were extracted. The periodontally healthy residual dentition and the implants were evaluated immediately after the superstructure was inserted. Subsequently, t...
Second-stage surgery was performed in the maxilla after 6 months and in the mandible after 3 months. Implant placement and second-stage surgery were performed by a single periodontist (R.M.).
About 4 weeks after the final abutments were placed, GCP subjects were rehabilitated with single crowns, implant-supported bridges, or removable superstructures, according to the Marburg double crown syst...
A total of 29 partially edentulous subjects were consecutively recruited from the Dental School of Medicine, Philipps-University, Marburg, Germany between April 2010 and April 2013 (Table 1). Subjects were excluded for the following reasons: history of systemic disease (e.g., cardiovascular diseases, diabetes mellitus, osteoporosis), pregnancy, untreated caries, current orthodontic treatment, con...
The aim of this long-term clinical study on partially edentulous subjects treated for periodontal disease was to evaluate the prevalence of mucositis and peri-implantitis and to determine the survival and success rates of dental implants with oxide-coated surfaces.
In recent years, a great number of different implant systems varying in materials, surface structure, and macroscopic design have been introduced to the dental market [1]. In studies using implants with modified surfaces, it was concluded that rough surfaces induce a stronger initial bone response, achieve stability more rapidly, and integrate more fully with extant bone [2,3,4,5,6]. Dental implan...
The aim of this case-series study is to evaluate the prevalence of mucositis, peri-implantitis, and survival and success rates of oxide-coated implants in subjects treated for periodontitis.
Twenty-four subjects treated for generalized chronic periodontitis (GCP) and five treated for generalized aggressive periodontitis (GAP) were orally rehabilitated with a total of 130 dental implants. Subjects...
Fig. 2. Figure illustrating the proposed mucosal thickening index. A ≤1 mm, indicating no thickening; B >1 mm but ≤2 mm, indicating minimal thickening; C >2 mm but ≤5 mm, indicating moderate thickening; D >5 mm, indicating severe thickening
Fig. 2. Figure illustrating the proposed mucosal thickening index. A ≤1 mm, indicating no thickening; B >1 mm but ≤2 mm, indicating min...
Fig. 1. Figure illustrating the reference points of the CBCT measurements. A: most posterior point of the sinus wall; B: most anterior point of the sinus wall; C: mid-point between A and B; C1: measurement of mucosal thickening perpendicular to A–B line at point C; D: mid-point between A and C; D1: measurement of mucosal thickening perpendicular to A–B line at point D; E: mid-point between B...
Gender
Respiratory diseases
Cardio-vascular diseases
Diabetes mellitus
Smoking
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Patient
Anterior
(E1-floor of the sinus)
Middle
(C1-floor of the sinus)
Posterior
(D1-floor of the sinus)
...
Maska, B., Lin, GH., Othman, A. et al. Dental implants and grafting success remain high despite large variations in maxillary sinus mucosal thickening.
Int J Implant Dent 3, 1 (2017). https://doi.org/10.1186/s40729-017-0064-8
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Received: 18 October 2016
Accepted: 13 January 2017
Published: 18 January 2017
DOI: https://doi.org/10.1186/s40729-017-0064-8
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...
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Yvonne Kapila.
Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, 1011 N University Ave, Ann Arbor, MI, USA
Bartosz Maska, Guo-Hao Lin, Abdullah Othman, Shabnam Behdin, Suncica Travan, Erika Benavides & Yvonne Kapila
Department of Surgical Sciences, School of Dentistry, Marquette University, 1801 W Wisconsin Ave, Milwaukee, WI, USA
Guo-Hao Lin
Department of Peri...
The authors thank Ms. Victoria Zakrzewski for her help with the figure generation and preparation.
Co-primary author BM contributed to the CBCT measurement and preparation of the manuscript. Co-primary author G-HL contributed to the data analysis and preparation of the manuscript. Second author AO contributed to the protocol preparation, case review, case selection, and preparation of the manuscr...
Romanos GE, Froum S, Costa-Martins S, Meitner S, Tarnow DP. Implant periapical lesions: etiology and treatment options. J Oral Implantol. 2011;37:53–63.
Acharya A, Hao J, Mattheos N, Chau A, Shirke P, Lang NP. Residual ridge dimensions at edentulous maxillary first molar sites and periodontal bone loss among two ethnic cohorts seeking tooth replacement. Clin Oral Implants Res. 2014;25:1386–94...
Pazera P, Bornstein MM, Pazera A, Sendi P, Katsaros C. Incidental maxillary sinus findings in orthodontic patients: a radiographic analysis using cone-beam computed tomography (CBCT). Orthod Craniofac Res. 2011;14:17–24.
Ritter L, Lutz J, Neugebauer J, et al. Prevalence of pathologic findings in the maxillary sinus in cone-beam computerized tomography. Oral Surg Oral Med Oral Pathol Oral Radiol...
Gardner DG. Pseudocysts and retention cysts of the maxillary sinus. Oral Surg Oral Med Oral Pathol. 1984;58:561–7.
Chiapasco M, Palombo D. Sinus grafting and simultaneous removal of large antral pseudocysts of the maxillary sinus with a micro-invasive intraoral access. Int J Oral Maxillofac Surg. 2015;44:1499–505.
Cano J, Campo J, Alobera MA, Baca R. Surgical ciliated cyst of the maxilla. Cl...
Beretta M, Poli PP, Grossi GB, Pieroni S, Maiorana C. Long-term survival rate of implants placed in conjunction with 246 sinus floor elevation procedures: results of a 15-year retrospective study. J Dent. 2015;43:78–86.
Del Fabbro M, Corbella S, Weinstein T, Ceresoli V, Taschieri S. Implant survival rates after osteotome-mediated maxillary sinus augmentation: a systematic review. Clin Implant D...
Cone-beam computed tomographic
Protected Health Information
Sinus floor elevation
Our study found that the largest tissue thickening was present in the middle section of the maxillary sinus. This tissue thickening did not vary based on gender, age, or smoking status, nor did it relate to the underlying alveolar ridge height. However, patients with a history of periodontal diseases demonstrated a significant association with mucosal thickening. A mucosal thickening index was pro...
Although residual alveolar ridge height has been associated with sinus mucosal thickening [36], our study did not find a significant association between these two parameters. Acharya et al. [36] reported that lower available bone height in the subsinus region was related to thickened sinus membranes within an Asian-Indian and Hong Kong-based Chinese population. Differences in the ethnic compositio...
Based on the findings of the current study, a history of periodontal disease is the only identified parameter significantly associated with sinus mucosal thickening. This finding indicates that clinicians should expect some degree of mucosal thickening when performing sinus augmentation procedures in a previously periodontally involved site. This finding is consistent with several previously publi...
CBCT imaging has been recognized as a more sensitive imaging modality for identifying sinus thickening and pathoses in the posterior maxilla compared to panoramic radiography [21, 22]. This could explain why the current study identified a higher prevalence of mucosal thickening compared to earlier studies [23]. However, compared to other similar CBCT studies [21, 24, 25], the prevalence reported i...
Twenty-nine CBCT images (11 females and 18 males) were included in this study. All the implants placed in these included cases survived, representing a 100% implant survival rate. With regards to measurements of mucosal thickening, the intra-examiner reproducibility revealed an exact intra-examiner correlation of 99%, with a p value of 0.40 for a t test for independent samples, indicating a high r...
The sites that were measured are specified in the image below (Fig. 1). The most posterior and anterior aspects of the visible maxillary sinus were measured. The ½ point along with the ¼ and ¾ points were then selected, and the measurements of the mucosal thickening were then completed at these three sites. The thickest portion of the mucosa was also measured if it did not coincide with one of...
The study required access to University of Michigan Protected Health Information (PHI). PHI was necessary in order to track and coordinate the CBCT data and dental and medical history for each subject. Corresponding subject charts and electronic records were reviewed for retrieval of relevant implant placement and restorative history, medical history, and demographic information, including gender ...
Our study hypothesis was that mucosal thickening of more than 2 mm and up to 1/3 of the volume of the sinus would not alter the predictability for SFE and dental implant placement. The primary outcome was to determine the success rate of dental implant placement in augmented maxillary sinus areas with mucosal thickening. A secondary outcome was to evaluate the effect of gender, age, and smoking o...
Despite the high survival rate of dental implants inserted in maxillary sinuses that have undergone sinus floor elevation (SFE) with bone grafting, complications still occur [1–3]. Sinus membrane perforation is reported to be the most common complication [4, 5]. Postoperative maxillary sinusitis is less common (0–22%) [6, 7]; nevertheless, it could potentially compromise the outcome of SFE and...
Although mucosal thickening is the most common radiographic finding observed regarding sinus pathology, the knowledge regarding its clinical significance on the outcomes of dental implants and grafting in the maxillary sinuses is still limited. We hypothesized that mucosal thickening would not alter the predictability for sinus floor augmentation and dental implant placement. The purpose of this r...
Parmigiani-Izquierdo, J.M., Cabaña-Muñoz, M.E., Merino, J.J. et al. Zirconia implants and peek restorations for the replacement of upper molars.
Int J Implant Dent 3, 5 (2017). https://doi.org/10.1186/s40729-016-0062-2
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Received: 13 October 2016
Accepted: 22 December 2016
Published: 20 February 2017
DOI: https://doi.org/10.1186/s40729-016-0062-2
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...
Periodontics Unit, Faculty of Medicine and Dentistry, University of Murcia (Spain), Murcia, Spain
Arturo Sánchez-Pérez
Clínica CIROM, Murcia, 30001, Spain
José María Parmigiani-Izquierdo, María Eugenia Cabaña-Muñoz & José Joaquín Merino
Clínica Odontologíca Universitaria, Hospital Morales Meseguer, 2ª planta, C/ Marqués de los Vélez s/n, Murcia, 30008, Spain
Arturo Sánchez-...
Bormann K-H, Gellrich N-C, Kniha H, Dard M, Wieland M, Gahlert M. Biomechanical evaluation of a microstructured zirconia implant by a removal torque comparison with a standard Ti-SLA implant. Clin oral implants res. 2012;23:1210–6.
Oliva J, Oliva X, Oliva JD. One-year follow-up of first consecutive 100 zirconia dental implants in humans: a comparison of 2 different rough surfaces. Int j oral ma...
Brånemark PI, Hansson BO, Adell R, Breine U, Lindström J, Hallén O, et al. Osseointegrated implants in the treatment of the edentulous jaw. Experience from a 10-year period. Scand j plast reconstr surg suppl. 1977;16:1–132.
Parmigiani-Izquierdo JM. TécnicaAtraumática en Implantología. Rev esp odontoestomatológica implant. 11:30–5.
Parmigiani-Izquierdo JM, Sánchez-Pérez A, Cabaña-Mu...
Zirconia implants with PEEK restorations can be considered a good alternative for replacing natural teeth. Their biocompatibility and biostability make them a promising material for those patients who suffer from allergies and sensitivity to metal alloys.
PEEK restorations are a valid and alternative recommendation when using zirconia implants because of their cushioning effect and elastic modulu...
In addition to PEEK, new coatings based on PMMA or composite materials (Anaxblent®Anaxdent®, Nexco®Ivoclar®, Solidex®Shofu®, Novo.lign®Bredent®, etc.) which incorporate ceramic fillings have been developed. Due to their molecular structure, these materials have excellent density and homogeneity [24]. The micro filling integrated into the polymer matrix increases abrasion resistance, at the...
In terms of the load-cushioning capacity of the prosthetic elements, the use of PEEK as a prosthetic structure on implants has increased in recent years [14]. PEEK is a high-density thermoplastic polymer with a linear aromatic semi-crystalline structure that has exceptional physical and chemical properties as regards toughness, hardness and elasticity. Also, its low molecular weight, combined with...
Fifteen days after surgery, the appearance of the soft tissue was excellent, with no signs of inflammation in the mucosa. The patient mentioned the absence of bleeding and pain during the post-operation period. At the same time, we made a clinical and radiological evaluation. Three months after surgery, the stumps of the implants were carved to improve their parallelism with a special diamond dril...
A patient who is a 45-year-old woman and non-smoker has no medical record of interest. The patient complained of pain in the right second upper molar. She said that she felt intense pain while chewing. The pain was accentuated with occlusion and while chewing, making normal functioning impossible. The patient mentioned the absence of piece 16, which had been extracted 8 years previously.
Clinica...
In the field of implant dentistry, the most widely used implants over the past 40 years are those manufactured from titanium [1], which are still the most popular.
The recent demands for materials without metal alloys in dentistry, together with the increased sensitivity and allergies of some patients, have promoted the development of new materials.
An example of this is zirconia-based dental i...
One of the disadvantages of the zirconia implants is the lack of elasticity, which is increased with the use of ceramic or zirconia crowns. The consequences that could result from this lack of elasticity have led to the search for new materials with improved mechanical properties.
A patient who is a 45-year-old woman, non-smoker and has no medical record of interest with a longitudinal fracture i...
Fig. 4. Comparative illustration of mean ISQ values
Fig. 4. Comparative illustration of mean ISQ values
Fig. 3. Implants were placed after application of CGF membrane
Fig. 3. Implants were placed after application of CGF membrane
Fig. 2. CGF membrane was applied in study group implant sockets
Fig. 2. CGF membrane was applied in study group implant sockets
Fig. 1. CGF was obtained after centrifugation
Fig. 1. CGF was obtained after centrifugation
Control group
Study group
Immediate–1st week
−2.25 ± 1.713
1.40 ± 1.847
Immediate–4th wee...
Control group
Study group
Immediate
75.75 ± 5.552
78.00 ± 2.828
1st week
...
Case no.
Age
Sex
Group
Implant number
1
20
...
Pirpir, C., Yilmaz, O., Candirli, C. et al. Evaluation of effectiveness of concentrated growth factor on osseointegration.
Int J Implant Dent 3, 7 (2017). https://doi.org/10.1186/s40729-017-0069-3
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Received: 16 December 2016
Accepted: 16 February 2017
Published: 03 March 2017
DOI: https://doi.org/10.1186/s40729-017-0069-3
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...
Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Karadeniz Technical University, Trabzon, Turkey
Cagasan Pirpir, Onur Yilmaz, Celal Candirli & Emre Balaban
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Prakash S, Thakur A. Platelet concentrates: past, present and future. J Maxillofac Oral Surg. 2011;10(1):45–9.
Rodella LF, Favero G, Boninsegna R, Buffoli B, Labanca M, Scari G, et al. Growth factors, CD34 positive cells, and fibrin network analysis in concentrated growth factors fraction. Microsc Res Tech. 2011;74(8):772–7.
Ademokun JA, Chapman C, Dunn J, Lander D, Mair K, Proctor SJ, et al...
Huwiler MA, Pjetursson BE, Bosshardt DD, Salvi GE, Lang NP. Resonance frequency analysis in relation to jawbone characteristics and during early healing of implant installation. Clin Oral Implants Res. 2007;18(3):275–80.
Kroese-Deutman HC, Vehof JW, Spauwen PH, Stoelinga PJ, Jansen JA. Orthotopic bone formation in titanium fiber mesh loaded with platelet-rich plasma and placed in segmental defe...
Nurden AT, Nurden P, Sanchez M, Andia I, Anitua E. Platelets and wound healing. Front Biosci. 2008;13:3532–48.
Anitua E, Sanchez M, Zalduendo MM, de la Fuente M, Prado R, Orive G, et al. Fibroblastic response to treatment with different preparations rich in growth factors. Cell Prolif. 2009;42(2):162–70.
He L, Lin Y, Hu X, Zhang Y, Wu H. A comparative study of platelet-rich fibrin (PRF) and ...
Raghavendra S, Wood MC, Taylor TD. Early wound healing around endosseous implants: a review of the literature. Int J Oral Maxillofac Implants. 2005;20(3):425–31.
Oncu E, Bayram B, Kantarci A, Gulsever S, Alaaddinoglu EE. Positive effect of platelet rich fibrin on osseointegration. Med Oral Patol Oral Cir Bucal. 2016;21(5):e601–7.
Anitua E. Plasma rich in growth factors: preliminary results o...
Bone morphogenetic protein
Concentrated growth factor
Computed tomography
Insulin-like growth factor
Platelet-derived growth factor
Platelet-rich fibrin
Platelet-rich plasma
Resonance frequency analysis
Transforming growth factor-β1
Transforming growth factor-β2
Vascular endothelial growth factor
Considering this data, it appears that application of CGF enhanced stability of implants and accelerated osseointegration in the early period. CGF has positive effects on the ISQ value at the first week and fourth week. Further laboratory studies are needed to demonstrate the positive effects of blood products on the osseointegration process at the histopathological level.
In a study by Monov et al. using PRP around the implant, a higher stability value was obtained in the study group during the early recovery period (6 weeks) although difference between the groups was not statistically significant [23]. Kim et al. reported in a study that there was a statistically significant increase in bone-implant contact with PRP administration in the vicinity of the implant [...
Introduced in 1998 by Marx, PRP is used in oral and maxillofacial surgeries to speed up the recovery of grafts in bone-grafted areas [14, 26–30]. Although many studies have shown that platelet-rich plasma affects bone healing positively, the results of some other studies suggest otherwise [31, 32].
In recent years, the platelet-rich fibrin (PRF) was described by Choukroun as a second-generation...
Implant stability is one of the important parameters that assess the loading time and dental implant success. Investigators have recommended that implants with ISQ
The study includes 12 patients (5 males, 7 females). Patients participating in the study are between 20–68 years of age and the mean age is 44 years. A total of 40 implants were placed, 20 of these were included in the study group (50%), and the other 20 were included in the control group (50%). Twenty-one implants were placed in type 2 bone, 19 implants in type 3 bone (Table 1). The distribu...
Independent sample t test was applied between the two groups by taking the differences between the data obtained in these periods. Two-way ANOVA and Fisher’s LSD test was used for evaluating the associations among group and insertion torque.
A value of p
All surgical procedures were performed under local anesthesia by the same surgeon. A full-thickness mucoperiosteal flap was removed by incision on the alveolar crest. Implant cavities were prepared according to the surgical protocol of the Bego Semados implant system (BEGO Implant Systems GmbH & Co. KG, Bremen, Germany). The final osteotomy diameters were the same as the placed implants. In the st...
This study was conducted in compliance with the principles of the Declaration of Helsinki, and approval of the ethics committee required for the study was obtained from the Ethics Committee of the Karadeniz Technical University (2015/21). The procedures to be performed were explained in detail and patients signed the consent forms. The study was carried out on individuals who applied to Karadeniz ...
That the implant has sufficient stability after placement is important for providing the necessary bone formation around the implant and for the optimal distribution of functional forces at the implant-bone interface during healing [15–17].
It can be said that resonance frequency analysis (RFA) is a very important tool for tracking the osseointegration process [18, 19]. RFA is a technique that ...
Osseointegration of dental implants is important for long-term success and stability. There is no standardization in terms of the time of osseointegration and the timing of prosthetic loading. This process varies between 0–6 months [1]. Various strategies are being explored to shorten this period. Changes in implant surface properties and design have increased primer stability and helped the pe...
Growth factor-containing products have been reported to increase implant stability and accelerate osseointegration. Concentrated growth factor (CGF) can be used for this purpose with the growth factors it contains. The aim of this study is to assess the effect of CGF on implant stability and osseointegration.
Twelve patients with maxillary anterior toothless were included in the study. Implant ca...
Tanaka, M., Bruno, C., Jacobs, R. et al. Short-term follow-up of masticatory adaptation after rehabilitation with an immediately loaded implant-supported prosthesis: a pilot assessment.
Int J Implant Dent 3, 8 (2017). https://doi.org/10.1186/s40729-017-0070-x
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Received: 24 October 2016
Accepted: 23 February 2017
Published: 07 March 2017
DOI: https://doi.o...
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 Prosthetic Dentistry, Graduate School of Biomedical Science, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, 852-8588, Japan
Mihoko Tanaka, Tetsurou Torisu & Hiroshi Murata
Centre for Periodontology and Implantology Leuven, IJzerenmolenstraat 110, B-3001, Heverlee, Belgium
Mihoko Tanaka & Collaert Bruno
OMFS IMPATH, Department of Imaging & Pathology, University of Leuven, Kap...
The authors are grateful to the volunteers who participated in this study. This work was supported by JSPS Grant-in-Aid for Scientific Research (C), grant number 23592860.
MT, CB, and RJ conceived and designed the experiment. MT and CB performed the experiments and analyzed the data with R J. TT and HM helped to draft the manuscript. All authors read and approved the final manuscript.
Mihoko Tan...
Collaert B, Wijnen L, De Bruyn H. A 2-year prospective study on immediate loading with fluoride-modified implants in the edentulous mandible. Clin Oral Implants Res. 2011;22:1111–6.
Collaert B, De Bruyn H. Immediate functional loading of TiOblast dental implants in full-arch edentulous maxillae: a 3-year prospective study. Clin Oral Implants Res. 2008;19:1254–60.
Matsui Y, Ohno K, Michi K, S...
Bakke M, Holm B, Gotfredsen K. Masticatory function and patient satisfaction with implant-supported mandibular overdentures: a prospective 5-year study. Int J Prosthodont. 2002;15:575–81.
Miyaura K, Morita M, Matsuka Y, Yamashita A, Watanabe T. Rehabilitation of biting abilities in patients with different types of dental prostheses. J Oral Rehabil. 2000;27:1073–6.
Peyron MA, Blanc O, Lund JP...
Trulsson M, Johansson RS. Encoding of amplitude and rate of forces applied to the teeth by human periodontal mechanoreceptive afferents. J Neurophysiol. 1994;72:1734–44.
Hidaka O, Morimoto T, Masuda Y, Kato T, Matsuo R, Inoue T, et al. Regulation of masticatory force during cortically induced rhythmic jaw movements in the anesthetized rabbit. J Neurophysiol. 1997;77:3168–79.
Hidaka O, Morimo...
Klineberg IJ, Trulsson M, Murray GM. Occlusion on implants—is there a problem? J Oral Rehabil. 2012;39:522–37.
Feine J, Jacobs R, Lobbezoo F, Sessle BJ, Van Steenberghe D, Trulsson M, Fejerskov O, Svensson P. A functional perspective on oral implants—state-of-the-science and future recommendations. J Oral Rehabil. 2006;33:309–12.
Jacobs R, van Steenberghe D, Naert I. Masseter muscle fati...
The present pilot study could not confirm an immediate rise in bite force after implant rehabilitation. Instead, improvements were mainly noted up to 3 months after surgery and rehabilitation. Furthermore, it became evident that despite gradually improved bite force in all patients, masticatory efficiency and food hardness perception did not necessarily follow the same trend. The present findings...
Occlusal contact was significantly increased 3 months after implant rehabilitation when compared to stage one (prior to implant rehabilitation). We assumed the reason was that some participant’s occlusion was worn down because the material of provisional restoration was resin. To observe the adaptation of masticatory function after rehabilitation with an immediately loaded implant-supported pro...
Hardness perception became better after implant rehabilitation, with a reduction of the error rate by 16% (Fig. 3). While five out of eight participants performed better in this test after rehabilitation, the results in the others were less clear. More detailed analysis showed that, despite wearing dentures, four participants were 100% successful in recognition of hardness before implant surgery,...
Two participants were unavailable to attend the testing at 1–2 weeks after the provisional restoration had been inserted, which resulted in missing data.
Overall descriptive analyses yielded the following observations for the four tests.
Occlusal contact and approximate maximum bite force were significantly increased 3 months after implant rehabilitation because of the adjustment of provisio...
To assess the hardness differences, the examiner placed each test specimen on the tongue with chopsticks, and then the participants chewed on all sides and swallowed. They were asked to remember the hardness of the first specimen, which always had medium hardness and served as a control, and then to determine the level of hardness (hard, medium, or soft) of four consecutive and randomly administer...
To assess the masticatory efficiency, we used glucose extraction in the filtrate obtained after chewing the specimen. After rinsing the mouth with tap water, a gum-like specimen mixed with 5% glucose with a height of 10 mm (Glucosensor Gummy, GC, Tokyo, Japan) was placed on patient’s tongue with chopsticks. Patients were requested to chew on the cube for 20 s, after which, they expectorated al...
Six females and 2 males (average age 66.4 years, range 52–85 years) with upper (n = 7) or lower (n = 1) complete dentures participated in this study. Inclusion criteria were (1) an opposite jaw that included natural dentition at least to the second premolar on both sides, (2) a need for fixed rehabilitation, (3) no medical contraindication to the placement of implants, (4) no need for ...
The purpose of this pilot investigation was to use testing methodologies involving four aspects of masticatory adaptation after rehabilitation with an immediately loaded implant-supported prosthesis and to observe the recovery of each aspect respectively. Our hypothesis is that bite force may recover quickly, but other aspects will require monitoring and recording in order to form an overall judgm...
In addition, it also remains to be demonstrated how a potential compensatory mechanism might work, with one of the options being osseoperception [2, 18–23]. In this context, it is also important to consider the adaptation time needed after oral rehabilitation. Some studies have performed longitudinal evaluations of masticatory function for more than 3 years [24, 25]. However, there are limited ...
Tooth loss represents a major oral disability comparable to an amputation, with severe impairment of oral functions [1]. While denture wearers can rely on mucosal sensors, anchoring prosthetic teeth to the bone via osseointegrated implants has been assumed to create a (partial) sensory substitution for missing periodontal ligament receptors from stimuli transmitted via the bone [2]. The restoratio...
When teeth are extracted, sensory function is decreased by a loss of periodontal ligament receptions. When replacing teeth by oral implants, one hopes to restore the sensory feedback pathway as such to allow for physiological implant integration and optimized oral function with implant-supported prostheses. What remains to be investigated is how to adapt to different oral rehabilitations.
The pur...
Fig. 3. Mean bone loss at 6 months and 1 year. Mean bone loss distribution charts at 6 months and 1 year present no statistically significant difference. p value at 6 months was 0.2981 and at 1 year 0.6613
Fig. 3. Mean bone loss at 6 months and 1 year. Mean bone loss distribution charts at 6 months and 1 year present no statistically significant difference. p value at 6 months was ...
Fig. 2. ISQ values at placement, 6 weeks, 6 months, and 1 year. Mean and standard deviation of ISQ values taken at placement, 6 weeks, 6 months, and 1 year is presented. No statistical significant difference was determined between ISQ values at all time points. (p
Fig. 1. Implant design. The OSPTX and OSP implants are manufactured from high-grade commercially pure titanium with surface roughness produced via a fluoride treatment process. The OSP implant is a screw-shaped self-tapping implant. The diameter used in this study was 4.0 mm. The implant length used in this study was 8 mm. The OSPTX implant has the same features as the OSP except the apex of t...
Implant success
Clinically immobile when tested manually and/or with RFA (minimum ISQ = 65)
Absence of peri-implant radiolucency present on an undistorted radiograph
Absence of unresolved pain, discomfort, inf...
Inclusion
Male or female
At least 18 years old
Healthy enough to undergo routine implant surgery and subsequent dental treatment
Partially edentulous requiring...
Simmons, D.E., Maney, P., Teitelbaum, A.G. et al. Comparative evaluation of the stability of two different dental implant designs and surgical protocols—a pilot study.
Int J Implant Dent 3, 16 (2017). https://doi.org/10.1186/s40729-017-0078-2
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Received: 18 January 2017
Accepted: 22 April 2017
Published: 02 May 2017
DOI: https://doi.org/10.1186/s40729-01...
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 Periodontics, Louisiana State University Health Sciences Center School of Dentistry, 1100 Florida Avenue, New Orleans, LA, 70119, USA
David E. Simmons, Pooja Maney, Austin G. Teitelbaum, Susan Billiot & A. Archontia Palaiologou
Tulane University SPHTM, 1440 Canal St, Suite 2001, New Orleans, LA, 70130, USA
Lomesh J. Popat
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De Bruyn H, Raes F, Cooper LF, Reside G, Garriga JS, Tarrida LG, et al. Three-years clinical outcome of immediate provisionalization of single Osseospeed() implants in extraction sockets and healed ridges. Clin Oral Implants Res. 2013;24(2):217–23.
Ebler S, Ioannidis A, Jung RE, Hammerle CH, Thoma DS. Prospective randomized controlled clinical study comparing two types of two-piece dental impla...
O'Sullivan D, Sennerby L, Meredith N. Influence of implant taper on the primary and secondary stability of osseointegrated titanium implants. Clin Oral Implants Res. 2004;15(4):474–80.
Schwartz-Arad D, Herzberg R, Levin L. Evaluation of long-term implant success. J Periodontol. 2005;76(10):1623–8.
Alves CC, Neves M. Tapered implants: from indications to advantages. Int J Periodontics Restora...
Anitua E, Orive G. Short implants in maxillae and mandibles: a retrospective study with 1 to 8 years of follow-up. J Periodontol. 2010;81(6):819–26.
Feldman S, Boitel N, Weng D, Kohles SS, Stach RM. Five-year survival distributions of short-length (10 mm or less) machined-surfaced and Osseotite implants. Clin Implant Dent Relat Res. 2004;6(1):16–23.
Felice P, Cannizzaro G, Checchi V, March...
DENTSPLY International, Susquehanna Commerce Center, 221 West Philadelphia Street, York, PA 17401
I-CAT 17 19; Imaging Services International LLC, 1910 North Penn Rd., Hatfield, PA 19440
Intra-Lock International, 6560 S. West Rogers Circle, Suite 24, Boca Raton, FL 33487
Osstell USA, 6700 Alexander Bell Drive, Suite 200, Columbia, MD 21046
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Survival rates and stability of OSP and OSPTX implants was comparable.
Osteotomy preparation either by the standard or by the soft bone surgical protocol had no significant effect on implant survival, success, and stability.
Insertion torque presented a moderate to strong correlation with ISQ values at 6 weeks, 6 months, and 1 year.
Insertion torque presented a weak correlation to ISQ values...
Insertion torque presented a moderate to strong correlation with ISQ values at 6 weeks, 6 months, and 1 year but not at time of implant insertion. This finding is in agreement with Acil et al. who reported no statistically significant correlation between insertion torque and ISQ at time of implant placement [22].
Although a strong correlation was found between insertion torque and bone loss at...
Augmentation of the maxillary sinus prior to dental implant placement is routinely performed in order to help patients restore their maxillary posterior dentition. Unfortunately, not all patients are candidates for this procedure due to either health, personal, or financial concerns. An alternative treatment without the need for a sinus elevation procedure is the use of a shorter implant. Research...
Overall implant survival rate was 93.3%. Two implants failed, one implant in group A (OSPTXSoft) and one in group B (OSPTXStd). Both implant failures occurred at the time of uncovery (at 6 weeks) and prior to loading of the implants and were attributed to lack of integration. With the exception of these two failed implants, there was 100% success for all remaining implants using the parameters de...
ANOVA was used to compare the mean implant stabilities between the three groups. Post hoc testing was done via Tukey’s honestly significant differences test to calculate the differences between ISQ measurements at the time of implant placement, 6 weeks and 6 and 12 months (Fig. 2) as well as bone levels at 6 and 12 months (Fig. 3). The correlations of multiple parameters such as insertion t...
Following proper approval by the LSUHSC Institution Review Board (LSUNO IRB#7438), 27 (30 implant sites) systemically healthy patients at least 18 years old were enrolled in the study and randomly divided into three groups as follows (inclusion and exclusion criteria are described in detail in Table 1):
Group A received 10 OSPTX implants using the soft bone surgical protocol (OSPTXSoft).
G...
A recent systematic review by Stocchero et al. concluded that an undersized drilling protocol in soft bone is an effective way to enhance insertion torque but recommended that further clinical studies are needed to confirm these data [18]. Our study was designed to address this question, as it compared the standard drilling protocol to a soft bone protocol.
Our study hypothesis is that the stabil...
Dental implants are now a widely accepted treatment option for the replacement of missing teeth. The therapeutic goal of dental implants is to support restorations that replace single or multiple missing teeth so as to provide patient comfort, function, and esthetics as well as assist in the ongoing maintenance of remaining intraoral and perioral structures. However, anatomic limitations such as t...
Survival and stability of OSPTX and OSP implants is comparable. Osteotomy preparation by either standard or soft bone surgical protocol presented no significant effect on implant survival and stability for the specific implant designs.
The purpose of this study was to compare a parallel wall design implant to a tapered apex design implant when placed in the posterior maxilla using two different surgical protocols.
Twenty-seven patients (30 implants) were divided into three groups. All implants were 4 mm wide in diameter and 8 mm long.
Group A received 10 tapered implants (OSPTX) (Astra Tech OsseoSpeed TX™) using the soft b...
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
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. 5. Change in BoP values according to the percentage of sites with a score of 1, 2 or 3 by visit
Fig. 5. Change in BoP values according to the percentage of sites with a score of 1, 2 or 3 by visit
Fig. 4. Percentages of sites with PPD 1–3, 4–5 and ≥6 mm by visit (p
Fig. 3. Changes in BoP values between baseline and the various examination time points
Fig. 3. Changes in BoP values between baseline and the various examination time points
Fig. 2. Changes in PPD values between baseline and the various examination time points
Fig. 2. Changes in PPD values between baseline and the various examination time points
Fig. 1. A chitosan brush (LBC, BioClean®, LABRIDA AS) seated in an oscillating dental handpiece
Fig. 1. A chitosan brush (LBC, BioClean®, LABRIDA AS) seated in an oscillating dental handpiece
Baseline
n = 306
2 weeks
n = 272
4 weeks
n = 267
12 weeks
n = 282
24 weeks
n = 294
P
...
Center
Oslo
Jonkoping
Rome
Stavanger
Kristianstad
Tons...
Variable
Number (%)
SD
Range (min; max)
Gender (female/male)
45/18 (71.4/28.6)
...
Wohlfahrt, J.C., Evensen, B.J., Zeza, B. et al. A novel non-surgical method for mild peri-implantitis- a multicenter consecutive case series.
Int J Implant Dent 3, 38 (2017). https://doi.org/10.1186/s40729-017-0098-y
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Received: 08 April 2017
Accepted: 13 July 2017
Published: 03 August 2017
DOI: https://doi.org/10.1186/s40729-017-0098-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...
J.C. Wohlfahrt is the inventor and patent holder of BioClean and is a shareholder in LABRIDA AS. B.J. Evensen, B. Zeza, H. Jansson, A. Pilloni, A.M. Roos-Jansåker, G.L. Di Tanna, A.M. Aass, M. Klepp and O.C. Koldsland state that there were no conflicts of interests during the undertaking of the study.
Ethical approval was provided by the regional ethical review boards of each center (Norway: 201...
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JCW, BJE, BZ, HJ, AP, AMR-J, AMA, MK and OCK par...
Department of Periodontology, Institute of Clinical Dentistry, University of Oslo, Pb. 1109 Blindern, 0317, Oslo, Norway
J. C. Wohlfahrt, A. M. Aass & O. C. Koldsland
Private Practice, Tønsberg, Norway
B. J. Evensen
Department of Dental and Maxillofacial Sciences, Section of Periodontology, Sapienza, University of Rome, Rome, Italy
B. Zeza & A. Pilloni
Center for Oral Health, Departmen...
Salvi GE, et al. Reversibility of experimental peri-implant mucositis compared with experimental gingivitis in humans. Clin Oral Implants Res. 2012;23(2):182–90.
Korsch M, Obst U, Walther W. Cement-associated peri-implantitis: a retrospective clinical observational study of fixed implant-supported restorations using a methacrylate cement. Clin Oral Implants Res. 2014;25(7):797–802.
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Muthukuru M, et al. Non-surgical therapy for the management of peri-implantitis: a systematic review. Clin Oral Implants Res. 2012;23(Suppl 6):77–83.
Esposito M, Grusovin MG, Worthington HV. Treatment of peri-implantitis: what interventions are effective? A Cochrane systematic review. Eur J Oral Implantol. 2012;5(Suppl):S21–41.
Armitage GC, Xenoudi P. Post-treatment supportive care for the n...
Rokn A, et al. Prevalence of peri-implantitis in patients not participating in well-designed supportive periodontal treatments: a cross-sectional study. Clin Oral Implants Res. 2017;28(3):314–9.
Faggion CM Jr, et al. A systematic review and Bayesian network meta-analysis of randomized clinical trials on non-surgical treatments for peri-implantitis. J Clin Periodontol. 2014;41(10):1015–25.
Me...
Koldsland OC, Scheie AA, Aass AM. Prevalence of peri-implantitis related to severity of the disease with different degrees of bone loss. J Periodontol. 2010;81(2):231–8.
Roos-Jansaker AM, et al. Nine- to fourteen-year follow-up of implant treatment. Part II: presence of peri-implant lesions. J Clin Periodontol. 2006;33(4):290–5.
Derks J, et al. Effectiveness of implant therapy analyzed in a ...
In this multicenter case series of implants affected by mild peri-implantitis, significant reductions in the clinical parameters of inflammation were demonstrated at all time points after the initial treatment with a chitosan brush. The use of an oscillating chitosan device appears to be safe and has potential merits for the treatment of mild peri-implantitis and for the maintenance of dental impl...
In this multicenter case series of implants affected by mild peri-implantitis, significant reductions in the clinical parameters of inflammation were demonstrated at all time points after the initial treatment with a chitosan brush. The use of an oscillating chitosan device appears to be safe and has potential merits for the treatment of mild peri-implantitis and for the maintenance of dental impl...
The chitosan brush used in this study is made of a material that is soft with the aim to make a device optimized for removal of the biofilm within the implant threads. The soft bristles on the contrary make the device suboptimal for removal of hard deposits, such as calculus and cement remnants. It has been reported that such cement remnants are a common finding around dental implants [41], and in...
In the present study, significant reductions were observed in the clinical parameters of peri-implant inflammation at 2, 4, 12 and 24 weeks relative to baseline after debridement with the chitosan brush seated in an oscillating dental drill piece. No progression in radiographic bone loss was reported at any of the implants at the final evaluation, and the method was thus judged safe to use in cas...
Identifying peri-implant disease at an early stage and promptly treating the inflammatory condition is crucial to prevent the progression of peri-implant bone loss and ensure long-term implant survival [23,24,25]. After completion of active treatment and when the condition is controlled, supportive peri-implant therapy will reduce the risk of disease re-occurrence [9]. A number of scientific repor...
During this study, all 63 implants were reported to have stable radiographic levels of osseous support as validated by the six different local examiners. No adverse events were reported during the study.
In total, 63 implants in 63 patients were ultimately included in the analysis. Demographic information is presented in Tables 1 and 2.
Significant reductions in both PPD and mBoP were seen at all time points relative to the baseline clinical measurements (p
Mann-Whitney rank sum tests were used to compare changes in the clinical parameters between baseline and subsequent time points. To assess the hierarchical structure of the data (center > patient > site), a linear mixed model using the restricted maximum likelihood method (multilevel logistic models for binary outcomes) was constructed to analyse the PPD, mBoP and suppuration, adjusting for fac...
All patient-related information and clinical recordings were recorded in a web-based clinical research form (VieDoc version 3.24, PCG solutions, Uppsala, Sweden).
Patients under 18 years of age; current smokers; patients who had undergone radiotherapy in the head and neck region, chemotherapy or systemic long-term corticosteroid treatment; patients who were pregnant or nursing; patients receivin...
A 6-month multicenter prospective consecutive case series was performed in six different periodontal specialist clinics in Norway, Sweden and Italy.
Ethical approval was provided by the regional ethical review boards of each center (Norway: 2014/852/REK sør-øst; Italy: Sapienza 2011/15, 3547; and Sweden: EPN Lund 2014/695.) Fifteen patients at each center were planned to be included in the stud...
A number of other studies also report that leaving fragments of the instrument on the implant surface or scratching the surface may impede optimal peri-implant healing [17,18,19,20].
Chitosan is a marine biopolymer which is based on chitin derived from the shells of marine crustaceans. The material has been approved for use in surgical bandages, as a haemostatic agent and as a dietary supplement ...
Inflammation and loss of attachment around dental implants (i.e. peri-implantitis) has become a growing concern within the field of dental implantology [1,2,3,4,5,6,7]. Peri-implantitis is a microbial infection-driven soft tissue inflammation with loss of bony attachment around an implant. Peri-implant mucositis is the precursor of peri-implantitis, as gingivitis is for periodontitis [8]. It is cl...
The aim of the present study was to evaluate the effect on peri-implant mucosal inflammation from the use of a novel instrument made of chitosan in the non-surgical treatment of mild peri-implantitis across several clinical centers.
In this 6-month multicenter prospective consecutive case series performed in six different periodontal specialist clinics, 63 implants in 63 patients were finally inc...
Fig. 4. Cross-sectional images of areas 1–3 of a 39-year-old female. The visibility ratios for the superior wall in areas 1, 2, and 3 were 0.2, 0.9, and 0.9, respectively, whereas those of the inferior wall were 0.7, 0.9, and 1.0, respectively
Fig. 4. Cross-sectional images of areas 1–3 of a 39-year-old female. The visibility ratios for the superior wall in areas 1, 2, and 3 were 0.2, 0.9...
Fig. 3. Visibility ratios of the superior and inferior walls in three areas. The Friedman test and Scheffe’s test were used for the statistical analysis
Fig. 3. Visibility ratios of the superior and inferior walls in three areas. The Friedman test and Scheffe’s test were used for the statistical analysis
Fig. 2. Visibilities of the superior and inferior walls of the mandibular canal. a Both walls are visible. b Only the inferior wall is visible. c Neither of the walls is visible
Fig. 2. Visibilities of the superior and inferior walls of the mandibular canal. a Both walls are visible. b Only the inferior wall is visible. c Neither of the walls is visible
Fig. 1. Cross-sectional images in the range of 30 mm just distal to the mental foramen were used for evaluation. The range was divided into three areas, each of which was 10 mm in length, designated as area 1, area 2, and area 3, from anterior to posterior. (The mental foramen was identified on another section and was not visualized on this image)
Fig. 1. Cross-sectional images in the range...
Number of cases
Mandibular canal wall
Area 1
Area 2
Area 3
Superior wall
...
NoneTable 2 Mean visibility ratio ± SD
Mandibular canal wall
Area 1
Area 2
Area 3
Superior wall
0.7795
...
Ishii, H., Tetsumura, A., Nomura, Y. et al. Diagnostic ability of limited volume cone beam computed tomography with small voxel size in identifying the superior and inferior walls of the mandibular canal.
Int J Implant Dent 4, 18 (2018). https://doi.org/10.1186/s40729-018-0133-7
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Received: 20 December 2017
Accepted: 23 April 2018
Published: 26 July 2018
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 m...
All procedures followed were in accordance with the ethical standards of the responsible committees on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions. The study was approved by an institutional review board of our university (approval No. D2016-061). The requirement for informed consent from each patient was waived in this retrospect...
Correspondence to
Akemi Tetsumura.
Department of Oral and Maxillofacial Radiology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, Japan
Hiroko Ishii, Akemi Tetsumura, Yoshikazu Nomura, Shin Nakamura & Tohru Kurabayashi
URA, Research Administration Division, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, Japan
Masako Akiyama
Yo...
The datasets during and/or analyzed during the current study are available from the corresponding author on reasonable request.
Bertl K, Heimel P, Reich KM, Schwarze UY, Ulm C. A histomorphometric analysis of the nature of the mandibular canal in the anterior molar region. Clin Oral Investig. 2014;18:41–7.
Starkie C, Stewart D. The intra-mandibular course of the inferior dental nerve. J Anat. 1931;65:319–23.
Carter RB, Keen EN. The intramandibular course of the inferior alveolar nerve. J Anat. 1971;108:433–40.
Nai...
Faul F, Erdfelder E, Lang A-G, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39:175–91.
Kundel HL, Polansky M. Measurement of observer agreement. Radiology. 2003;228:303–8.
Alhassani AA, AlGhamdi AS. Inferior alveolar nerve injury in implant dentistry: diagnosis, causes, prevention, and managem...
Tyndall DA, Price JB, Tetradis S, Ganz SD, Hildebolt C, Scarfe WC. Position statement of the American Academy of Oral and Maxillofacial Radiology on selection criteria for the use of radiology in dental implantology with emphasis on cone beam computed tomography. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;113:817–26.
Weckx A, Agbaje JO, Sun Y, Jacobs R, Politis C. Visualization techniques...
Cone beam computed tomography
Field of view
In conclusion, we evaluated the visibility of the mandibular canal walls on limited volume CBCT images with a small voxel size. Evaluation was performed in the range of 30 mm in length just posterior to the mental foramen, which was divided into three equal areas (areas 1, 2, and 3, from anterior to posterior). The superior wall was significantly more poorly visualized than the inferior wall in a...
Our study had some limitations that should be addressed. First, in our study, antero-posterior location of the mandibular canal was defined by the distance from the mental foramen. Tooth positions could not be used as a reference, because premolars and molars were totally or partially missing in considerable number of the cases. Although areas 1–3 were considered mostly to correspond to the area...
Jung and Cho [6] reported that the mandibular canal was clearly visible in 50% of CBCT images in the first molar and in 58% in the second molar region. Similarly, Oliveira-Santos et al. [5] reported that it was visible in 63, 66, and 67% of second premolar, first molar, and second molar regions, respectively. As described above, these studies did not discriminate between the superior and the infer...
In this study, we only used CBCT images of the mandible obtained with the smallest FOV, 40 × 40 mm. On those images, the range of 30 mm in length in the mandible just posterior to the mental foramen was divided into three equal areas, each of which was 10 mm in length. They were designated as areas 1, 2, and 3, from anterior to posterior. After that, the visibilities of the superior and in...
It is very important to know the location of the mandibular canal prior to dental implant surgery to avoid surgical complications including vascular trauma or nerve damage.
CBCT is widely accepted to be the imaging method of choice for obtaining this information [1, 2]. However, it is well known that the mandibular canal cannot usually be identified over its entire course even when CBCT is used. ...
Interobserver agreement was substantial or almost perfect agreement (Table 1).
The mean values of the visibility ratio of the superior and inferior walls in each area are shown in Table 2 and Fig. 3. In all areas, the ratio of the superior wall was significantly lower than that of the inferior wall (p = 0.0000). As for variance among the three areas, the ratio was highest in the most poste...
The ratio ranged from 0 to 1.
Sample size was determined using the free software G* Power 3.1 [11]. We evaluated 30 patients, and the effect size was calculated from the mean, standard deviation, and correlation. Wilcoxon signed-rank sum test was chosen, and the significance level was set to 0.05. The result showed that a sample size of 26 to 75 patients would provide a power of at least 0.8 for ...
This study was approved by an institutional review board of our university (D2016-061).
Among the patients whose mandibles were examined by CBCT at our dental hospital between April 2012 and August 2016, 96 patients who fulfilled the following two conditions were selected.
On CBCT imaging:
The smallest field of view (FOV) of the device, 40 × 40 mm, was used.
The mental foramen and the ma...
The mandibular canal is an important anatomical structure that contains the neurovascular bundle, i.e., the inferior alveolar nerve and artery. The location of the mandibular canal must be correctly identified prior to dental implant surgery to avoid complications including intraoperative and postoperative hemorrhage and neurosensory loss. Cone beam computed tomography (CBCT) is considered the ima...
The aim of this study was to evaluate the visibility of the superior and inferior walls of the mandibular canal separately using limited volume cone beam computed tomography (CBCT) with small voxel size.
CBCT cross-sectional images of 86 patients obtained by 3D Accuitomo FPD and reconstructed with a voxel size of 0.08 mm were used for the evaluation. A 30-mm range of the mandible just distal to ...
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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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).
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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...
Failure rate
n
Univariate analyses
Multivariate analyses
OR
(95% CI)
P
OR
...
Peri-implantitis
n
Univariate analyses
Multivariate analyses
OR
(95% CI)
P
...
Mucositis
n
Univariate analyses
Multivariate analyses
OR
(95% CI)
P
OR
...
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Patients (total)
GCP patients
GAP patients
Implants (total)
Implants maxilla
...
GCP
GAP
Patient
24
5
Sex
...
Mengel, R., Heim, T. & Thöne-Mühling, M. Mucositis, peri-implantitis, and survival and success rates of oxide-coated implants in patients treated for periodontitis 3- to 6-year results of a case-series study.
Int J Implant Dent 3, 48 (2017). https://doi.org/10.1186/s40729-017-0110-6
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Received: 29 August 2017
Accepted: 26 October 2017
Published: 28 Novemb...
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...
RM is a professor at the Department of Prosthetic Dentistry, School of Dental Medicine, Philipps-University, Marburg/Lahn, Germany. TH is a private practicioner in Gruben, Brandenburg, Germany. MT is a researcher at the Department of Prosthetic Dentistry, School of Dental Medicine, Philipps-University, Marburg/Lahn, Germany.
This clinical study was conducted in accordance with the World Medical A...
Department of Prosthetic Dentistry, School of Dental Medicine, Philipps-University, Marburg/Lahn, Germany
Reiner Mengel & Miriam Thöne-Mühling
Gruben, Brandenburg, Germany
Theresa Heim
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Kim K-K, Sung H-M. Outcomes of dental implant treatment in patients with generalized aggressive periodontitis: a systematic review. J Adv Prosthodont. 2012;4:210–7.
Pettersson K, Mengel R. Comments on the statistical analysis of the paper by Albouy et al comparing four different types of implants with respect to ‘spontaneous’ progression of peri-implantitis. Eur J Oral Implantol. 2011;1:9...
Kinane DF, Radvar M. The effect of smoking on mechanical and antimicrobial periodontal therapy. J Periodontol. 1997;69:467–72.
Swierkot K, Lottholz P, Flores-de-Jacoby L, Mengel R. Mucositis, peri-implantitis, implant success, and survival of implants in patients with treated generalized aggressive periodontitis: 3- to 16-year results of a prospective long-term cohort study. J Periodontol. 2012...
Jungner M, Lundqvist P, Lundgren S. A retrospective comparison of oxidized and turned implants with respect to implant survival, marginal bone level and peri-implant soft tissue conditions after at least 5 years in function. Clin Implant Dent Relat Res. 2014;16:230–7.
Rocci A, Rocci M, Rocci C, Scoccia A, Gargari M, Martignoni M, Gottlow J, Sennerby L. Immediate loading of Brånemark system TiU...
Esposito M, Ardebili Y, Worthington HV. Interventions for replacing missing teeth: different types of dental implants. Cochrane Database Sys Rev. 2014;7:CD003815.
Salata LA, Burgos PM, Rasmusson L, Novaes AB, Papalexiou V, Dahlin C, Sennerby L. Osseointegration of oxidized and turned implants in circumferential bone defects with and without adjunctive therapies: an experimental study on BMP-2 and...
The results of the present case series study should be interpreted in a critical light because of the small study population. However, it can be concluded that periodontally diseased subjects treated in a supportive periodontal therapy can be successfully rehabilitated with oxide-coated dental implants for a follow-up period of 3 to 6 years. The results suggest that implants in the maxilla and in...
These results from long-term clinical studies indicate that oxide-coated implants achieve equivalent survival rates and prevalence of mucositis and peri-implantitis when compared to implants with other surface characteristics. They support the assumption that the implant surface has little influence on the development of mucositis or peri-implantitis. This was subsequently confirmed in a Cochrane ...
The present study examines the success rates of oxide-coated implants in subjects with treated periodontal disease. Several long-term clinical studies on periodontally healthy subjects have revealed survival rates of 97.1 to 99.2% for oxide-coated implants [10, 24, 25]. The results of the present study show a comparable implant survival rate (96.2% in GAP and 97.1% in GCP subjects) for subjects wi...
The univariate analyses showed a significantly higher risk for peri-implantitis in GAP subjects (OR = 3.294 with p = 0.027) and at implants with bone quality grade 3 (OR = 21.200 with p = 0.000). However, these differences were not significant in multivariate analyses.
Both the uni- and multivariate patient-related analyses were non-significant.
The implant success rate was 77.9% for GCP...
All 29 subjects were examined over the period of 3 to 6 years (Table 2). For the duration of the observation period, all the remaining teeth were periodontally healthy, with PDs ≤ 3 mm and negative BOP. All subjects were non-smokers, had excellent oral hygiene, attended the follow-up examinations on a regular basis, and had no systemic disease.
In total, four implants (3.1%) were lost du...
Peri-implant mucositis was defined as PDs ≥ 5 mm with BOP and no bone loss after the first year of loading. Peri-implantitis was defined as PDs > 5 mm with or without BOP and an annual bone loss of > 0.2 mm after the first year of loading.
All technical and surgical complications (e.g., fracture of the abutment screw or superstructure, compromised wound healing) were recorded.
T...
All patients received a supportive periodontal therapy at the Dental School of Medicine, Philipps-University, Marburg, in the course of the observation period. The first clinical examination was 2 to 4 weeks before the non-retainable teeth were extracted. The periodontally healthy residual dentition and the implants were evaluated immediately after the superstructure was inserted. Subsequently, t...
Second-stage surgery was performed in the maxilla after 6 months and in the mandible after 3 months. Implant placement and second-stage surgery were performed by a single periodontist (R.M.).
About 4 weeks after the final abutments were placed, GCP subjects were rehabilitated with single crowns, implant-supported bridges, or removable superstructures, according to the Marburg double crown syst...
A total of 29 partially edentulous subjects were consecutively recruited from the Dental School of Medicine, Philipps-University, Marburg, Germany between April 2010 and April 2013 (Table 1). Subjects were excluded for the following reasons: history of systemic disease (e.g., cardiovascular diseases, diabetes mellitus, osteoporosis), pregnancy, untreated caries, current orthodontic treatment, con...
The aim of this long-term clinical study on partially edentulous subjects treated for periodontal disease was to evaluate the prevalence of mucositis and peri-implantitis and to determine the survival and success rates of dental implants with oxide-coated surfaces.
In recent years, a great number of different implant systems varying in materials, surface structure, and macroscopic design have been introduced to the dental market [1]. In studies using implants with modified surfaces, it was concluded that rough surfaces induce a stronger initial bone response, achieve stability more rapidly, and integrate more fully with extant bone [2,3,4,5,6]. Dental implan...
The aim of this case-series study is to evaluate the prevalence of mucositis, peri-implantitis, and survival and success rates of oxide-coated implants in subjects treated for periodontitis.
Twenty-four subjects treated for generalized chronic periodontitis (GCP) and five treated for generalized aggressive periodontitis (GAP) were orally rehabilitated with a total of 130 dental implants. Subjects...
Fig. 4. Vestibular view of contralateral lateral incisor
Fig. 4. Vestibular view of contralateral lateral incisor
Fig. 3. Vestibular view of right lateral implant supported crown
Fig. 3. Vestibular view of right lateral implant supported crown
Fig. 2. Probing of the peri-implant sulcus
Fig. 2. Probing of the peri-implant sulcus
Fig. 1. a Pre-operative panoramic radiograph of the patient, (b) abutment in place, following the osseointegration period, (c) periapical radiograph at 1-year follow up, (d) final restoration at 1-year follow up, and (e) smile line
Fig. 1. a Pre-operative panoramic radiograph of the patient, (b) abutment in place, following the osseointegration period, (c) periapical radiograph at 1-year foll...
Smile line
VAS
Smile line
Correlation coefficient
1
− .699a
...
PES result
Smile line
Low (n = 4)
Medium (n = 10)
High (n = 5)
Poor (0–...
PES
WES
VAS
Spearman’s rho
VAS
Correlation coefficient
...
Esthetic score
0
1
2
PES
Mesial papilla
...
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Poor (0–7)
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10.5%
...
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...
Altay, M.A., Sindel, A., Tezerişener, H.A. et al. Esthetic evaluation of implant-supported single crowns: a comparison of objective and patient-reported outcomes.
Int J Implant Dent 5, 2 (2019). https://doi.org/10.1186/s40729-018-0153-3
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Received: 25 July 2018
Accepted: 09 December 2018
Published: 07 January 2019
DOI: https://doi.org/10.1186/s40729-018-0...
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 m...
This study was approved by the Akdeniz University Ethical Review Board.
All participants consented to publish their information details.
Dr. Altay has provided consultancy for Checkpoint Surgical LLC in 2014. All other authors declare that they have no competing interests.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Dumlupinar Boulevard, Campus, 07058, Antalya, Turkey
Mehmet Ali Altay, Alper Sindel, Hüseyin Alican Tezerişener & Nelli Yıldırımyan
Department of Prosthodontics, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
Mehmet Mustafa Özarslan
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Not applicable.
This study was conducted without external funding.
All data generated and analyzed during this study are included in this article.
Jivraj S, Chee W. Treatment planning of implants in the aesthetic zone. British Dental J. 2006;201(2):77–89.
Buser D, Martin W, Belser UC. Optimizing esthetics for implant restorations in the anterior maxilla: anatomic and surgical considerations. Int J Oral Maxillofac Implants. 2004;19:43–61.
Huynh-Ba G, Meister DJ, Hoders AB, Mealey BL, Mills MP, Oates TW, Cochran DL, Prihoda TJ, McMahan C...
Hof M, Umar N, Budas N, Seemann R, Pommer B, Zechner W. Evaluation of implant esthetics using eight objective indices-comparative analysis of reliability and validity. Clin Oral Implants Res. 2018;29(7):697–706.
Li X, Wu B, Cheng X, Li Y, Xie X, Deng F. Esthetic evaluation of implant-supported single crowns: the implant restoration esthetic index and patient perception. J Prosthodont. 2017. htt...
Rokn A, Bassir S, Ghahroudi AR, Kharazifard M, Manesheof R. Long-term stability of soft tissue esthetic outcomes following conventional single implant treatment in the anterior maxilla: 10-12 year results. Open Dent. 2016;10:602.
Angkaew C, Serichetaphongse P, Krisdapong S, Dart MM, Pimkhaokham A. Oral health-related quality of life and esthetic outcome in single anterior maxillary implants. Clin...
Pink esthetic score
Standard deviation
Statistical Package for the Social Sciences
Visual analogue scale
White esthetic score
Professionally reported esthetic outcomes (PES and WES results) may not significantly correlate with patient-reported outcomes, although they are helpful in monitorization of implants in the anterior zone during follow-ups. This study reveals that smile line is a significant factor in patient satisfaction, which should be evaluated thoroughly prior to implant placement in the anterior maxilla.
Only a limited number of studies compared esthetic outcomes of implants placed using different protocols [3, 25, 26]. A majority of these studies compared the results of immediate implant placement (type 1) with other protocols. Huynh-Ba et al. found no difference in terms of esthetics between type 1 and type 2 implant placement [25]. Similarly, Boardman et al. observed higher PES results followin...
In the present study, only two implants in patients with thin gingival biotypes failed to reach the clinically acceptable PES level. All other patients with both thick and thin biotypes achieved either acceptable or almost perfect scores for both PES and WES. According to the results of Angkaew et al., the PES/WES scores of patients with thick gingival biotype were significantly higher than those ...
Ever since the introduction of dental implants in the 1960s, they have been used worldwide with high success rates and accepted predictability [13]. Initial efforts of implant treatment mainly focused on osseointegration and function, whereas today, esthetics is also regarded as an essential component, which is commonly addressed together with functional goals of rehabilitation with dental implant...
All implants were loaded 3–6 months after implant surgery (conventional loading protocol); therefore, this parameter was not analyzed in this study.
The overall effect of gingival biotype and smile line on PES, WES, or VAS was studied using a general linear regression analysis for multivariate tests. Although both PES and WES were not affected (p = 0.580, p = 303; respectively), VAS wa...
Question4. “How do you feel about the color of the gum that is around your new implant tooth?” Mean patient rating was calculated as 8.4 (range 2–10, SD ± 2.0). Median score was 9. Fifteen patients responded with a score of ≥ 8 and 17 patients responded with a score of ≥ 6.
Question5. “What is your overall satisfaction with the new implant tooth?” Mean patient rating was ca...
A total of 19 (7 female and 12 male) patients, who were rehabilitated with a single implant in the anterior maxilla, were included in this study. Patients’ ages ranged between 19 and 42 with a mean of 31.8 years. None of the implants were associated with increased probing depth, bleeding, suppuration, foreign body sensation, pain, morbidity, or infection. Clinical features related to anterior s...
All patients were assessed according to the White Esthetic Score [8] which comprised the evaluation of five variables including general tooth form, tooth contour, tooth color (hue and value), surface texture, and translucence. Each variable was given a score of 0, 1, or 2. A score of 0 indicated the worst and a score of 2 indicated the best result for each variable. The implant-supported tooth was...
This study was conducted in accordance with the Declaration of Helsinki on medical protocol and was approved by the Akdeniz University Ethical Review Board.
The patients rehabilitated with a single implant-supported fixed prosthesis in the maxillary esthetic zone at the departments of Oral and Maxillofacial Surgery and Prosthetic Dentistry of Akdeniz University between June 2015 and April 2017 we...
Patient satisfaction, which indicates the success of the implant treatment from the patient’s perspective, is another important outcome measure and is commonly performed with questionnaires or a visual analog scale (VAS) [2, 8]. A current review of the literature, however, reveals only a limited number of studies reporting on patient-centered outcomes in addition to objective evaluations of impl...
Rehabilitation of missing teeth in the anterior maxilla with an implant-supported fixed prosthesis is a widely accepted treatment modality [1]. Dental implants have high rates of predictability in terms of osseointegration, particularly due to improvements in treatment techniques and surface topography [2]. However, rehabilitation with dental implants is not yet considered a perfect treatment moda...
This study investigated objective and patient-reported esthetic outcomes and their correlation for single-tooth implant restorations in the maxillary anterior region.
Nineteen patients were included. Gingival biotypes and smile lines were evaluated. Esthetic evaluation was performed according to the pink and white esthetic scores (PES and WES). Patients rated their satisfaction regarding the impl...
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 ...
Hazard ratio
95% confidence interval
p value
Gender (male)
1.82
0.946~3.487
...
Hazard ratio
95% confidence interval
p value
Gender (male)
2.38
1.138~5.362
...
Hazard ratio
95% confidence interval
p value
Gender (male)
1.99
0.538~8.201
...
Dia. (mm)
Maxilla anterior
Maxilla posterior
Mandible anterior
Mandible posterior
Tot...
Dia. (mm)
Maxilla anterior
Maxilla posterior
Mandible anterior
Mandible posterior
Tot...
Age/gender
Male
Female
Total
20–29
3
...
References
Brånemark PI, Adell R, Breine U, Hansson BO, Lindström J, Ohlsson A. Intra-osseous anchorage of dental prostheses. I. Experimental studies. Scand J Plast Reconstr Surg. 1969;3:81–100.
Buser D, Sennerby L, De Bruyn H. Modern implant dentistry based on osseointegration: 50 years of progress, current trends and open questions. Periodontol. 2017;73:7–...
Conclusions
In conclusion, our analyses revealed a cumulative survival rate of 89.8% of TPS-surface implants with at least 25 years of functioning. The survival rate of maxillary positioned implants was significantly lower than that of mandibulary positioned implants. The patient gender, implant location, and width of keratinized mucosa affected the rate of peri-implantitis, resulting in l...
A total of 48 implants were eventually accompanied by a peri-implant infection: the cumulative incidence of peri-implantitis was 9.5, 15.3, 21.0, and 27.9% at 5, 10, 15, and 25 years after the prosthesis delivery, respectively (Fig. 3). After stepwise backward selection, the gender, implant type, and width of keratinized mucosa showed the significant difference in the cumulative survival rate (T...
Results
Patient cohort
A total of 92 patients (38 men, 54 women; mean age 54.3 years, range 20–78) received implant-supported prostheses (at the seven private practices) between 1984 and 1990. The distribution of patients by age and gender is presented in Table 1. Fifty-seven patients (140 implants) were considered dropouts due to the fact that no data were obtained at the endpoint, bu...
Methods
Study design
This retrospective observational study was approved by the ethical committee of Nagasaki University (No. 1512). The cases of all of the patients who underwent dental implant treatment with a TPS-surfaced solid-screw implant and whose prosthesis was set in the years 1984–1990 at seven private practices were analyzed. All inserted implants were either a TPS-type (TPS-t...
Background
Dental implant treatment based on the concept of osseointegration [1] is now a widely accepted restorative treatment for fully and partially edentulous patients. In the earliest days of the use of osseointegrated implants, two different topographies were applied on the implant surfaces: a machined minimally rough titanium surface such as the Brånemark system and a rough micropor...
Abstract
Background
The longitudinal clinical outcomes over decades contribute to know potential factors leading to implant failure or complications and help in the decision of treatment alternatives.
Methods
The cases of all patients who received dental implants treated with titanium plasma-sprayed surfaces and whose prostheses were set in the period 1984–1990 at seven...
Figure 4. Patient satisfaction throughout the study
Figure 3. Bone level changes from loading to 5-year follow up
Figure 2. Clinical parameters and soft tissue parameters. a Modified plaque index. Error bars indicate standard deviation. * = p ≤ 0.05, *** = p ≤ 0.001. b Sulcus bleeding index. Error bars indicate standard deviation. * = p ≤ 0.05, *** = p ≤ 0.001. c Pocket probing depth. The asterisk represents statistically significant differences (* = p ≤ 0.05) observed between ...
Figure 1. Study flow diagram: follow up status and reasons for not completing the study; six-month, 2-year and 4-year follow up was optional
Figure 1. Study flow diagram: follow up status and reasons for not completing the study; six-month, 2-year and 4-year follow up was optional
Table 4 Life table analysis showing the cumulative success rate according to Albrektsson et al. and Buser et al.
Interval(months)
Implants in interval
According to Albrektsson et al.
According to Buser et al.
Implants withdrawn during interval
Failures during interval
Cumulative success rate (%)
Implants withdrawn during interval
Failures during interval
Cumulativ...
Table 3 Patient demographics with respect to implants
Overall
Subgroup*
Platform switching
Platform matching
Total Implants, n
285
203*
68*
Number of implants placed per patient, n (%)
1
125 (63.8)
97 (67.4)
20 (48.8)
2
56 (28.6)
37 (25.7)
16 (39.0)
3
12 (6.1)
7 (4.9)
5 (12.2)
4
3 (1.5)
3 (2.1)
0 (0.0)
Implant...
Table 2 Patient demographics
Overall
Subgroup*
Platform switching
Platform matching
Patients, n (%)
196 (100)
144
41
Sex, n (%)
Male
87 (44.4)
62 (43.1)
19 (46.3)
Female
109 (55.6)
82 (56.9)
22 (53.7)
Age, years
Mean (SD)
51.5 (14.2)
53.1 (14.4)
47.4 (12.9)
Range
17.9–82.1
17.9–82.1
19.3–78.5
Pr...
Investigator*
City/country
Number of patients included
Number of implants included
Dr. Helfried Hulla
Strass in Steiermark, Austria
10
15
Prof. DDr. Gerald Krennmair
Marchtrenk, Austria
10
20
Dr. S. Marcus Beschnidt (PI)
Baden-Baden, Germany
8
12
Dr. Karl-Ludwig Ackermann
Filderstadt, Germany
14
18
Dr. Thomas Barth
Leipzig, Germany
15
28
Dr...
Abbreviations
ASA:
American Society of Anesthesiologists
MPI:
Modified Plaque Index
PPD:
Pocket probing depth
RCT:
Randomized controlled clinical trial
SBI:
Sulcus Bleeding Index
SD:
Standard deviation
SLA:
Sand-blasted, large grit, acid-etched
References
Hjalmarsson L, Gheisarifar M, Jemt T. A systematic review of survival of s...
The appearance of poorer oral hygiene later in the study also appears to correspond with the drop in follow-up attendance, which again supports the importance of follow-up. All other complications could be resolved and were not persisting. Furthermore, patients selected for inclusion in this study were optimal candidates for dental implants. Though the inclusion criteria predestinate the patient s...
At 5-year follow-up, the overall SBI was 0.32 ± 0.49, reflective of no bleeding given that 0 equals no bleeding and 1 equals isolated bleeding spots visible [27]. The PPD initially decreased within the first 6 months from which point it significantly increased to 2.34 ± 1.18 mm at 5-year follow-up.
Nevertheless, the measured mean PPD still reflects the norm for conventionally placed i...
On the one hand, the variety of bone level changes in this study may be explained by different vertical soft tissue thicknesses, but cannot be validated due to these missing data. On the other hand, there are multiple confounding factors influencing the change in bone level, such as the size of the platform (mismatch), occlusal loading, and the microgap. Additional to the standard success criteria...
Over the 5-year study period, we report
At 3-year follow-up, bone loss was noted in one patient (reclassified as peri-implantitis at the 4-year follow-up) and an important bone loss (due to poor oral hygiene and bruxism; two implants) in a patient with psychosocial issues who could not be treated during the study. Such a patient would not have been included in an RCT.
Consequently, three implants were lost based on the bone loss criter...
Discussion and conclusions
This large, multicenter study provides real-life long-term data on 285 implants placed in 196 patients. The results show that the placement of CAMLOG SCREW-LINE implants with platform-matching or platform-switching abutments results in high survival and success in the long term. The overall success rate for implants was 97.1% at 5-year post-loading, and 97.4% and 96.2...
Jemt papilla score
At loading, the Jemt papilla score was 1.93 ± 1.01, significantly increasing to 2.14 ± 0.95 at 5-year follow-up (p = 0.023) (Fig. 2d). For the platform-switching subgroup, a significant difference was observed between baseline and 5-year follow-up (p
Implant survival
The cumulative survival rate was 100% at 1-year follow-up, 99.6% at 3-year follow-up, and 98.6% at 5-year follow-up. All three late failures were in the platform-switching subgroup.
Clinical parameters/soft tissue parameters
Plaque index
Mean modified plaque indices were very low at below 0.5 for all but one measurement throughout the course of the study (Fig. 2a). At loading...
Results
Patient demographics
In total, 196 patients from 17 centers met the inclusion criteria for this study and were included in the per-protocol analysis. In total, 285 implants were placed (Table 1). At the 5-year follow-up, data were available for the 137 patients who completed the study (Fig. 1). Patient demographic data is presented in Tables 2 and 3.
Implant success
Implant success...
The primary stability of the implant was assessed during surgery. Implant success and survival were evaluated in the group of implants restored with abutments [5, 29] at both placements of the provisional and definitive prostheses and at each follow-up visit thereafter. Implants were deemed successful in accordance with the criteria for implant success laid down by Albrektsson et al. [30]. Implan...
Assessments
Throughout the study, only radiographs consistent with standard implant procedures were taken. Bone level changes were assessed based on available and evaluable standardized periapical radiographs with a film-holder using parallel-technique or panoramic radiographs (depending on the standard in the study centers). Baseline was defined as the time of the first prosthetic installati...
The treatment indications were single or multiple tooth replacement in the maxilla or mandible without the use of simultaneous augmentation or membrane, of which the implants were to be restored with either fixed single crown or fixed partial denture restorations.
Treatment procedure
Patients were to be treated according to standard practice for implant procedures applicable in the countries par...
Methods
Study design
This was a prospective multicenter non- interventional study to assess implant success and survival rates in daily dental practices using the CAMLOG SCREW-LINE implants (CAMLOG Biotechnologies AG, Basel, Switzerland) used with or without platform-switching abutments. Patients were enrolled over a period of 2 years from October 2008 to September 2010 from 17 sites across f...
In the present study, CAMLOG SCREW-LINE implants with the Promote plus surface (sandblasted and acid-etched surface) were used. These implants in combination with platform-matching abutments have been shown to have high long-term success rates ranging from 97.8 to 100% at 5-year to 10-year follow-up [9,10,11,12,13]. They can be restored with either platform-matching or platform-switching abutments...
Background
Success and survival rates of endosseous implants are well-documented in a number of controlled clinical trials and systematic reviews [1,2,3]. Generally, controlled trials evaluate endosseous implants in specific clinical situations; thus, the patient population is subjected to rigorous inclusion criteria and follow-up. Accordingly, controlled clinical trials do not reflect th...
Implant success and survival rates in daily dental practice: 5-year results of a non-interventional study using CAMLOG SCREW-LINE implants with or without platform-switching abutments
Abstract
Background
The performance of dental implants in controlled clinical studies is often investigated in homogenous populations. Observational studies are necessary to evaluate the outcome of implant resto...
Table 1 Comparison of OHIP-14 and its domains in the pre-and postoperative periods
OHIP-14
Preoperative
Postoperative
P value
Median (min-max)
D1
6 (2–8)
0 (0–3)
0.002
D2
5 (1–8)
0 (0–3)
0.002
D3
7.5 (1–8)
0 (0–4)
0.002
D4
7.5 (2–8)
0 (0–1)
0.002
D5
8 (3–8)
0 (0–4)
0.002
D6
2 (0–8)
0 (0–0)
0.003
D7
4 ...
Figure 7. Panoramic radiography of the follow-up
Figure 6. Tomographic scan of the follow-up
Figure 5. a Mini-pillar guide. b Installation of the mini-pillars. c Protectors on the mini-pillars. d Relief of the prosthesis on the mini-pillars
Figure 4. Insertion of the implant. a Prototyped surgical guide installed and stabilized. b Long transmaxillary implants are placed on both sides of the maxilla. c Long transmaxillary implant placement with the final insertion using a ratchet or tufted wrench
Figure 3. Surgical guide. a Surgical guide in occlusal view. b Surgical guide in frontal view. c Prototyped model of the atrophic maxilla
Figure 2. Maxillary computed tomography. a Axial view. b Coronal view
Figure 1. Schematic drawing of the transmaxillary implant. Perforation is made using the 2.0 mm lance implant, for giving guidance and stability to the next drill, using the 3.0 mm implant
References
Alzarea BK. Assessment and evaluation of quality of life (OHRQoL) of patients with dental im-plants using the Oral Health Impact Profile (OHIP-14) - a clinical study. J Clin Diagn Res. 2016;10:57–60.
Aparicio C, Manresa C, Francisco K, Ouazzani W, Claros P, Potau JM, Aparicio A. The long-term use of zygomatic implants: a 10-year clinical and radiographic report. Clin Implant D...
Discussion
Considering the particularities of rehabilitation treatments with implants, such as patients with the atrophic edentulous maxilla, and particularly rehabilitation using long implants, this study aimed to assess the impact of using a modified long transmaxillary implant, placed horizontally on the OHRQoL of patients with the atrophic maxilla.
The missing teeth impair mastication ...
Results
The study consisted of 12 individuals, with 10 (83.3%) females and two (16.7%) males. The mean age of the sample was 55.83 ± 2.78 years.
A total of 12 maxillary atrophic patients were rehabilitated, 10 using the transmaxillary implants. Of these, two patients rehabilitated with the transmaxillary implant required postoperative adjustments because the implants were lost. In the first c...
Surgical procedures
External antisepsis was performed on the face using 2% Riorex chlorhexidine digluconate (Rioquímica, São José do Rio Preto, SP, Brazil) and intrabuccal (intraoral) antisepsis was performed using digluconate 0.12% chlorhexidine (Colgate, São Paulo, SP, Brazil). The entire maxilla was anesthetized using 4% articaine and 1:100,000 epinephrine (DFL, Rio de Janeiro, Brazil)...
The transmaxillary implant is more conservative than the zygomatic implant, because it is installed only in the lower third of the maxilla. The zygomatic implant can reach noble regions of the face and can cause serious risks of injury to support structures, including the face, eye socket, and infratemporal fossa. Long transmaxillary implants are positioned horizontally in the maxillary bone, unli...
Materials and methods
Ethical aspects
This retrospective case series was approved by the local Research Ethics Committee (CAAE 98088718.5.0000.0093). Patients were informed of the nature of the study and procedures, according to the Free and Informed Consent Term. Additionally, this study followed the Helsinki guidelines [19].
Study design
Twelve adult patients of both sexes were evaluated. ...
Background
The introduction of osseointegrated implants is considered one of the greatest breakthroughs in dentistry [4]. Dental implants have been used in edentulous jaws to improve the retention and stability of complete dentures. Attachment to implants, in addition to improving stability and functional aspects, increases patient satisfaction [7, 8]. In addition, implant connection improves ...
Long transmaxillary implants improve oral health-related quality of life of patients with atrophic jaws-a case series
Abstract
Background
The advancement of contemporary dentistry is related to the improvement of existing techniques, materials, and technology, consistently for improving people’s oral health, which can ultimately reflect better quality of life. This study aimed to evaluate 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 ...
Figure 10. Patient 1—post-operative evaluation of placement accuracy of the implants in the mandible. Green is the planned position; blue is the actual position
Figure 9. Patient 1—prosthodontic end result 5 months after implant placement
Figure 8. Patient 2—intra-oral situation during orthodontic treatment at the age of 14. A temporary crown with bracket is fixed on the dental implant. Eight months after start of orthodontic treatment, the 34 is already close to the planned end position
Figure 7. Patient 2—post-operative orthopantomogram (OPT) at age of 13. Situation 10 months after implant placement. Three months after starting the orthodontic treatment, the 34 is already erected
Figure 6. Patient 1—post-operative orthopantomogram (OPT) at age of 18
Figure 5. a Drilling templates of patient 1. Printed model of the maxilla (left) and mandible (right) with drilling template and metal drilling inserts (Nobel biocare). b Drilling template for the mandible of patient 1. c Implant placement of patient 1. Dental implant placement in the mandible using the virtual developed tooth-supported templates and metal drilling inserts
Figure 4. a Patient 1—virtual set-up of the ultimate treatment goal. b Patient 2—virtual set-up of the ultimate implant position. One short dental implant was planned in region 35, based on the location of the mandibular nerve (orange), the impacted 34 (pink) and the bone quality and volume. c Patient 2—virtual set-up of the ultimate prosthetic treatment goal
Figure 3. a Patient 1—detailed 3D model of the combined data from the CBCT and intra-oral scan at age of 18. b Patient 2—detailed 3D model of the combined data from the CBCT and intra-oral scan at age of 12
Figure 2 a Patient 2—pre-implant orthopantomogram (OPG) at the age of 12. Situation before start of orthodontic and implant treatment. Eleven permanent teeth (including 2 third molars) were congenitally missing and the 34 is impacted. To erect the 34, orthodontic treatment was desired. Due to the lack of stable anchorages in the third quadrant, it was decided to place one implant at tooth...
Figure 1. a Patient 1—orthopantomogram (OPT) at age of 13. Situation before extraction of the ankylosed deciduous teeth 55, 54, 65, 74, 75, 84, and 85 and start of orthodontic treatment. Eleven permanent teeth (including 4 third molars) were congenitally missing. b Patient 1—post-orthodontic situation at age of 16. The top of the mandibular processus alveolaris is small (upper). T...
Results
Clinical and radiographic assessments
The surgical guides fitted well and facilitated implant placement. All implants were placed in the native bone. No dehiscences of the implant surface occurred.
Post-operative orthopantomograms (OPT) of patients 1 and 2 are shown in Figs. 6 and 7. In patient 1, six implants were placed (NobelParallel Conical Connection implants, Nobel Biocare Ho...
Patient and methods
Implant planning and placement
Pre-implant procedure and 3D planning
A CBCT (ICat, Image Sciences International, Hatfield, UK; 576 slices, voxel size 0.3 mm, FOV: 11 × 16 cm) was made of two oligodontia patients (for patient details, see Figs. 1 and 2) for implant planning. Detailed patient information was obtained with regard to the nerve position and bone quality an...
Introduction
Oligodontia is the congenital absence of six or more permanent teeth, excluding third molars [1]. The need for oral rehabilitation in patients with oligodontia is high as they often suffer from functional and aesthetic problems due to a high number of missing teeth. Implant-based prosthodontics seem to be favourable to improve oral function and aesthetics in oligodontia [2].
Impla...
Three-dimensional computer-guided implant placement in oligodontia
Abstract
Background
The aim of computer-designed surgical templates is to attain higher precision and accuracy of implant placement, particularly for compromised cases.
Purpose
The purpose of this study is to show the benefit of a full three-dimensional virtual workflow to guide implant placement in oligodontia cases where t...
Figure 1. Flow diagram
Figure 1. Flow diagram
Table 5 Average differences in BoP, SoP, and PPD between the control and test group at 3-month follow-up
Outcome variable
Crude modelaβ (95% CI)
p value
Adjusted modelbβ (95% CI)
p-value
% Sites BoP% Sites SoPMean PPD
16.2 (−7.9 to 40.3)0.0 (−10.9 to 10.9)0.6 (−0.6 to 1.8)
0.7431.0000.205
7.9 (−16.4 to 32.3)0.7 (−10.1 to 11.4)0.2 (−1.0 to 1.3)
0.8210.882...
Table 4 Descriptive statistics of clinical parameters
Control
Test
T0 (n = 22)
T3 (n = 20)
T0 (n = 31)
T3 (n = 30)
Plaque
% of sites (SD)% of implants (n)
4.5 (12.5)13.6 (3)
10.0 (18.8)25.0 (5)
4.0 (9.3)16.1 (5)
2.5 (7.6)9.7 (3)
BoP
% of sites (SD)% of implants (n)
86.4 (18.5)100 (22)
28.8 (35.6)50 (10)
66.1 (29.3)96.8 (30)
39.2 (31.3...
Table 3 Log-transformed mean bacterial anaerobic counts (SD) for the control and test group before (T0) and 3 months after (T3) the surgical treatment (paperpoint samples)
N = 47a
Total anaerobic bacterial loadLog-transformed mean (SD)
T0
T3
Difference
β (95% CI)b
p value
Control
6.69 (1.32)
6.31 (1.30)
0.38 (1.36)
−0.26 (−0.84–0.33)
0.377
...
Table 2 Log-transformed mean bacterial anaerobic counts (SD) of culture-positive implants for the control and test group before (Tpre) and after (Tpost) debridement and decontamination of the implant surface (intra-operative microbrush samples)
N = 40a
Total anaerobic bacterial loadLog-transformed mean (SD)
Tpre
Tpost
Difference
β (95% CI)b
p value
Control
5.57 ...
Table 1 Characteristics of included patients/implants
Characteristics
Control
Test
Number of patients
14
14
Age (years; mean [SD])
57.0 (13.7)
60.9 (7.2)
Gender; M (male), F (female)
M5, F9
M7, F7
Smoking; n subjects (%)
1 (7%)
3 (21%)
History of periodontitis; n subjects (%)
4 (29%)
5 (36%)
Dental status; n subjects (%)
- Partially edentul...
References
Lang NP, Berglundh T, Working Group 4 of Seventh European Workshop on Periodontology. Periimplant diseases: where are we now?—Consensus of the Seventh European Workshop on Periodontology. J Clin Periodontol. 2011;38(Suppl):11,178–181.
Derks J, Tomasi C. Peri-implant health and disease. A systematic review of current epidemiology. J Clin Periodontol. 2015;42:158–71.
Derks ...
The residual biofilm area was significantly greater after treatment with phosphoric acid compared to air abrasive treatment with powder or even control treatment without powder. Apparently, only water and air might be effective in reducing the biofilm. Nonetheless, when the titanium surface was viewed under a scanning electron microscopy (SEM), no visible titanium surface change was seen aft...
A gel as application mode has the great advantage of being precisely applicable with minimal touching of the surrounding bone or connective tissue. A disadvantage of a gel might be the limited flow in deeper areas of the rough implant surface. To overcome this problem, it was decided to continuously rub the etching gel onto the implant surface with a small brush during the decontamination pe...
Discussion
This randomized controlled trial aimed to determine the effect of 35% phosphoric etching gel on decontamination of the implant surface during resective surgical treatment of peri-implantitis. Both decontamination procedures (mechanical debridement with curettes and gauzes combined with phosphoric acid 35% and mechanical debridement combined with sterile saline) resulted in a sign...
Clinical outcomes
Descriptive statistics of the clinical outcomes at baseline and follow-up are depicted in Table 4. At 3-month follow-up, 75% of the implants (66.7% of the patients) in the control group and 63.3% of the implants (53.8% of the patients) in the test group showed no clinical signs of inflammation (PPD ≤4 mm without bleeding and/or suppuration on probing) (Table 4). The results...
Results
The progress of patients throughout the different phases of the study is illustrated in Fig. 1. Table 1 depicts the baseline demographic patient and implant characteristics. The included patients had a total of 128 implants of which 53 implants showed signs of peri-implantitis. Different implant brands and types with different implant surfaces were present, including Straumann (Strauman...
Assuming a two-sided two sample t test with a significance level (α) of 0.05 and a power (β) of 80% required a sample size of 34 implants. A 20% compensation for dropouts was taken into account (34/0.8 = 42.5 implants). Based on a previous study [10], it was expected that not all baseline microbiological samples would yield a detectable number of cultivable bacteria ([10], 19 out of 79 =...
Peri-implant pocket depth was measured at four sites per implant (mesial, buccal, distal, and lingual) using a pressure sensitive probe (KerrHawe Click Probe®, Bioggo, Switzerland) (probe force of 0.25 N). Bleeding and suppuration were scored up to 30s after pocket probing. Microbiological peri-implant sulcus samples were collected from each implant with peri-implantitis using four sterile paper...
Angular bony defects were eliminated, and bone was recontoured using a rotating round bur under saline irrigation. Mucosal flaps were apically positioned and firmly sutured (Vicryl Plus® 3-0; Ethicon Inc., Somerville, NJ, USA), and suprastructures were re-positioned. For both control and test group, surgery was followed by 2 weeks of mouth rinsing with 0.12% CHX + 0.05% CPC without alcohol t...
Interventions
The study protocol was based on the study protocols of two previous studies evaluating the decontaminating effect of chlorhexidine during surgical peri-implantitis treatment [10, 32] and is briefly described below.
Within 1 month before surgical treatment, all patients received extensive oral hygiene instructions and mechanical non-surgical debridement of implants and remaining de...
Methods
Trial design
The present study is a double-blind randomized controlled trial evaluating the effect of 35% phosphoric etching gel (test group) compared to the effect of saline (control group) for implant surface decontamination combined with mechanical debridement during surgical peri-implantitis treatment. Patients were randomly assigned to the test or control group using a one-to-one al...
Background
Triggered host defense responses initiate inflammation of the peri-implant soft tissue (peri-implant mucositis), which can lead to loss of peri-implant supporting bone (peri-implantitis), and eventually, result in implant failure [1]. An increasing prevalence of peri-implantitis has been described in recent literature [2], with current incidence ranging from 1 to 47%. A non-linear, acc...
Implant decontamination with phosphoric acid during surgical peri-implantitis treatment: a RCT
Abstract
Background
Peri-implantitis is known as an infectious disease that affects the peri-implant soft and hard tissue. Today, scientific literature provides very little evidence for an effective intervention protocol for treatment of peri-implantitis. The aim of the present randomized controlled t...
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 ...
Author
Year
Study type
Selection bias (homogeneity and confounders)
Performance bias (fidelity to protocol)
Attrition bias (loss of participants)
Detection bias (reliable measures)
Reporting bias (selective reporting or conflict interests)
Summary assessment risk of bias
Alsaadi
2007
Retrospective
H
U
U
L
L
L
Aguilar-Salvatierra
2015
Prospective
H
L
L
L
L...
Table 1 List of the included studies and its main characteristics
Author
Year
Study type
Diabetes type
Control
Diabetes therapy
Glycemic control [HbA1c %]
Duration of diabetes (years)
Number of patients
Number of implants
Duration of study (years)
Implant survival [%]
Conclusion
Alsaadi
2007
Retrospective
Type II
Non-diabetes
n.d.
n.d.
n.d.
2004 (overall)
6...
Figure 1. Selection process of the included literature
References
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(3):377–88.
Khader YS, Dauod AS, El-Qaderi SS, Alkafajei A, Batayha WQ. Periodontal status of diabetics compared with nondiabetics...
Conclusions
The literature included to this review is very heterogeneous concerning the investigated objects, methods, and conclusions. Diabetes is a group of metabolic diseases in which there are high blood sugar levels over a prolonged period. When looking at the complications and side effects resulting from diabetes, it is important to know which type of diabetes the pati...
While four studies conclude better implant survival and less peri-implant complications in the well-controlled group, the three others see no difference in implant success even in the poorly controlled patients. The study of Khandelwal treated exclusively patients with poor glycemic control (HbA1c 7.5–11.4 %) and had 98 % implant survival, after 4 months; therefore, he concluded that impla...
Diabetes and bone augmentation
We identified two prospective studies that evaluated “advanced” implant surgery covering sinus lift procedure and guided bone regeneration.
The study of Erdogan consists of type II diabetics moderately and well-controlled (HbA1c 6–7.5 %) with a mean duration of disease of 7.5 years and a healthy control group. Augmentation of the maxilla was perform...
The bleeding on probing is more often in the poorly controlled population, but the probing depth is not increased.
Diabetes and implant survival
Implant survival is an easily defined and measured endpoint for dental implant therapy. Nearly every study reports its implant survival rate. Our literature search identified 18 publications with these data. We divided them into two groups: the ...
The results in the prospective study of Gomez-Moreno show that elevated HbA1c causes more bone resorption after 3 years, but this effect is not significant.
We identified two prospective studies investigating the influence of type II diabetes on osseointegration.
They are published by the same author but are independent studies from different years. In both studies, the patients included...
Results
Study selection
There are no guidelines existing to the topic of dental implants and diabetes mellitus. A total of 327 potentially relevant titles and abstracts were found by the electronic search and additional evaluation of reference lists. During the first screening, 230 publications were excluded based on the title and keywords. Additionally, 24 titles were excluded based on abstract...
Materials and methods
The substructure of the systematic review is based on the PRISMA statement. The focused question according to the PICO schema is: “Do diabetic patients with dental implants have a higher complication rate in comparison to healthy controls?”
Search strategies
The systematic literature search was performed by an independent scientist (Burkhard Kunzendorf). The following ...
Review
Introduction
Today, dental implants are one of the restorative methods to replace missing teeth. Improvements in implant design, surface characteristics, and surgical protocols made implants a secure and highly predictable procedure with a mean survival rate of 94.6 % and a mean success rate of 89.7 % after more than 10 years. Implant survival is initially dependent on successful osseoi...
Abstract
Dental implant surgery has developed to a widely used procedure for dental rehabilitation and is a secure and predictable procedure. Local and systemic risk factors can result in higher failure rates. Diabetes mellitus is a chronic disease that goes in with hyperglycemia and causes multifarious side effects. Diabetes as a relative contraindication for implant surgery is controversially...
Zygomatic implant group
Conventional implant group
Variable
N
Mean
PD
IC 95 %
N
Mean
PD
IC 95 %
p
Overall satisfaction
14
8.88
0.71
−1.17/−0.38
14
9.65
0.13
−1.19/−0.36
0.001
Stability
14
9.79
0.54
−0.50/0.09
14
10.00
0.00
−0.52/0.11
0.009
Ease of cleaning
14
5.82
1.99
−3.49/−1.14
14
8.15
0.78
−3....
Figure 8. Visual analog scale—evaluator version
Figure 7. Visual analog scale—patient version
Figure 6. Zygomatic implant probing using a WHO periodontal probe
Figure 5. Coronal slice from the CBCT showing small exteriorization of a zygomatic implant apex
Figure 4. Coronal slice from the CBCT showing implant apical third inside the zygomatic bone
Figure 3. Panoramic radiograph showing bone level maintenance around the conventional implants
Figure 2. Periapical radiographs using the parallelism technique. a Conventional implants—anterior. b Conventional implants—posterior
Figure 1. a Brånemark technique. b Sinus slot technique. c Extrasinus technique
References
Stievenart M, Malevez C. Rehabilitation of totally atrophied maxilla by means of four zygomatic implants and fixed prosthesis: a 6–40-month follow up. Int J Oral Maxillofac Surg. 2010;39:358–63.
Van der Mark EL, Bierenbroodspot F, Baas EM, De Lange J. Reconstruction of an atrophic maxilla: comparison of two methods. Br J Oral Maxillofac Surg. 2011;49:198–202.
Pelo S, Gasp...
The prostheses supported by zygomatic implants have a special design due to the location and a more palatal emergence profile of the implants in position when compared to conventional implants. This situation can hinder the tongue position and hygiene of the prosthesis and interfere with function. Some studies conducted an assessment of the level of patient satisfaction on the prosthesis sup...
Nakai et al. performed this exam 6 months following the placement of 15 zygomatic implants in nine patients and found an absence of signs and symptoms of sinusitis. Maló et al. evaluated the association between zygomatic implants and maxillary sinusitis using sinusoscopy on 14 patients and found no cases of infection or inflammation of the mucosa surrounding the implants, demonstrating that...
Becktor et al. report that patients with oral-sinus communication may develop suppuration with or without sinusitis. In such cases, treatment consists of the administration of antibiotics and/or the repositioning of the soft tissue and maintenance of a stable zygomatic implant, with no reports of the recurrence of sinusitis. Brånemark found fistula in five patients both before and aft...
Becktor et al. report that patients with oral-sinus communication may develop suppuration with or without sinusitis. In such cases, treatment consists of the administration of antibiotics and/or the repositioning of the soft tissue and maintenance of a stable zygomatic implant, with no reports of the recurrence of sinusitis. Brånemark found fistula in five patients both before and aft...
Other studies have reported the presence of problems with oral tissue in the region of the zygomatic implants, including infection and swelling, usually associated with loss of implant apical osseointegration. Hirsch et al. have reported the presence of hyperplasia, mucositis, and infection in eight patients in a total of ten throughout the monitoring period.
Although certain criteria to ev...
Our study demonstrated the absence of pain as well as of pus or bleeding on probing and palpation for both zygomatic and conventional implants, with good bone level for conventional implants. No periimplant radiolucency was noted around the conventional implants and in the apical portion of the zygomatic implants. These findings are similar to the studies of Stiévenart and Malevez, Peñarro...
As described by Hirsch et al., Aparicio et al., and Farzad et al., this criteria was assessed by periapical radiographs obtained by the parallelism technique combined with panoramic radiographs for conventional implants and CT scans for zygomatic implants. The bone loss was defined as a vertical change of bone level measured from the most inferior line of implant exposure. All previous studi...
Discussion
The morbidity caused by bone graft harvesting and the delay in the final treatment due to the time necessary for bone incorporation triggered the development of techniques without grafting as an option for the treatment of patients with edentulous jaws. Brånemark in 1998 developed a novel technique for placing implants in the zygomatic bone to treat severely atrophic maxilla wit...
Evaluation of the maxillary sinus health
Among the 14 patients submitted to zygomatic implants, only three reported having had nasal obstruction in the weeks preceding the evaluation. One of these patients had a cold, and the other two reported having self-medicated with antihistamines 1 week prior to the evaluation, with the subsequent disappearance of nasal obstruction. Only one patient re...
Results
Of the 17 operated patients, 14 were included in the study and 2 were excluded for not having enough data in the chart and 1 for refusing to return for evaluation of sinus health, totalizing 27 zygomatic implants and 55 conventional implants in group I, without losing any implant, representing 100 % survival of implants placed. The minimum follow-up was 15 and the maximum was 53 month...
For patients with signs indicating maxillary sinusitis, a quality of life questionnaire was administered and video-assisted nasal fibroscopy was performed.
The aim of the clinical exam was to investigate signs of sinusitis: (a) nasal obstruction, using a visual analog scale (VAS) ranging from 0 to 10 points, on which the patient marked his/her degree of obstruction, with the examiner’s subseque...
A ruler template with the respective magnifications was used, considering 25 to 0 % for panoramic and periapical radiographs, respectively. Additionally, the radiographic criteria recommended by Buser et al. were included to determine the success of the implants. These criteria consist of the absence of persistent radiolucency around the implant. The zygomatic implants were assessed only to verify...
All patients were rehabilitated with Conexão® implants system. The inclusion criteria for group I were patients with severe maxillary resorption, classified as classes IV and V of Cawood and Howell (1988), receiving zygomatic implants using Stella and Warner’s technique, performed by the Oral and Maxillofacial Surgery Department from the Rio Grande do Norte Federal University, and having full ...
The hypothesis of this study was to analyze if Stella and Warner’s technique have high survival rates and their rehabilitation have similar satisfaction when compared to total fixed prostheses with conventional implants.
Radiographic evaluation
Panoramic and periapical radiographs were obtained for conventional and zygomatic implants in group I (Figs. 2.a.b and 3). The purpose was to evaluate ...
Methods
This retrospective cohort study was submitted and approved by the Hospital Research Ethics Committee, receiving the registration number 137/201.
The sample consisted of 28 patients (21 females and 7 males), with age ranging from 46 to 63 years, and all of them have undergone either the placement of zygomatic implants using the Stella and Warner’s technique or conventional implants, ...
Background
The prosthodontic rehabilitation of patients with atrophic maxilla is a challenge for a clinician due to the severe compromise of masticatory function and speech with a significant quality of life impact. The poor bone volume found on these patients makes it difficult for conventional rehabilitation with fixed prosthesis and to insert dental implants.
Different surgical techniques w...
Abstract
Background
This study aimed to evaluate patients undergoing placement of zygomatic implants by Stella and Warner’s technique, considering the survival rate of conventional and zygomatic implants, and assess the health of the maxillary sinuses and the level of patient satisfaction.
Methods
In this retrospective cohort study, 28 patients had received a combination of conventional an...
Figure 2. Figure illustrating the proposed mucosal thickening index. A ≤1 mm, indicating no thickening; B >1 mm but ≤2 mm, indicating minimal thickening; C >2 mm but ≤5 mm, indicating moderate thickening; D >5 mm, indicating severe thickening
Table 2 Statistical results after inter-variable adjustment showing the association between recorded parameters and sinus mucosal thickening; p values that showed statistically significant differences are italicized
Gender
Respiratory diseases
Cardio-vascular diseases
Diabetes mellitus
Smoking
History of periodontal diseases
Endodontic treatment
History of orthodontic t...
Table 1 CBCT measurements of sinus mucosal thickening
Patient
Anterior(E1-floor of the sinus)
Middle(C1-floor of the sinus)
Posterior(D1-floor of the sinus)
Thickest(F-floor of the sinus)
1
3.06
0.32
0.76
4.59
2
0.34
0.21
0.20
0.34
3
0.39
0.54
1.38
1.66
4
4.15
3.79
0.61
6.36
5
5.64
1.33
3.73
8.42
6
7.34
0.77
0.86
7.66
7
1.9...
Figure 1. Figure illustrating the reference points of the CBCT measurements. A: most posterior point of the sinus wall; B: most anterior point of the sinus wall; C: mid-point between A and B; C1: measurement of mucosal thickening perpendicular to A–B line at point C; D: mid-point between A and C; D1: measurement of mucosal thickening perpendicular to A–B line at point D...
Shahbazian M, Vandewoude C, Wyatt J, Jacobs R. Comparative assessment of panoramic radiography and CBCT imaging for radiodiagnostics in the posterior maxilla. Clin Oral Investig. 2014;18:293–300.
Logan GM, Brocklebank LM. An audit of occipitomental radiographs. Dentomaxillofac Radiol. 1999;28:158–61.
Pazera P, Bornstein MM, Pazera A, Sendi P, Katsaros C. Incidental maxillary sinus findings...
Shanbhag S, Karnik P, Shirke P, Shanbhag V. Cone-beam computed tomographic analysis of sinus membrane thickness, ostium patency, and residual ridge heights in the posterior maxilla: implications for sinus floor elevation. Clin Oral Implants Res. 2014;25:755–60.
Gardner DG. Pseudocysts and retention cysts of the maxillary sinus. Oral Surg Oral Med Oral Pathol. 1984;58:561–7.
Chiapasco M, Pa...
References
Beretta M, Poli PP, Grossi GB, Pieroni S, Maiorana C. Long-term survival rate of implants placed in conjunction with 246 sinus floor elevation procedures: results of a 15-year retrospective study. J Dent. 2015;43:78–86.
Del Fabbro M, Corbella S, Weinstein T, Ceresoli V, Taschieri S. Implant survival rates after osteotome-mediated maxillary sinus augmentation: a systematic revi...
This study presents new data on maxillary sinus mucosal thickening derived from a carefully defined data set; however, there were some limitations in the study. One limitation was the limited sample size. However, as discussed, our stringent case selection criteria yielded a more uniform data set for analyses. Other limitations were related to the actual measurements of the maxillary sinus. ...
Our study did not find a significant association between endodontically treated teeth and mucosal thickening. Though this finding is consistent with some previously published studies, other studies did report an association. These discrepant findings could be the result of different inclusion criteria in the study design. Since our study did not include any patients with radiographic signs o...
The current study demonstrated that sinus mucosal thickening does not correlate with implant survival. This result is consistent with a previously published report by Jungner et al. In their study, the presence of sinus thickening was not significantly associated with implant failure. Similarly, our study found a 100% implant survival rate for both patients with and without sinus mucosal thi...
Discussion
CBCT imaging has been recognized as a more sensitive imaging modality for identifying sinus thickening and pathoses in the posterior maxilla compared to panoramic radiography. This could explain why the current study identified a higher prevalence of mucosal thickening compared to earlier studies. However, compared to other similar CBCT studies, the prevalence reporte...
Results
Twenty-nine CBCT images (11 females and 18 males) were included in this study. All the implants placed in these included cases survived, representing a 100% implant survival rate. With regards to measurements of mucosal thickening, the intra-examiner reproducibility revealed an exact intra-examiner correlation of 99%, with a p value of 0.40 for a t test for independen...
In order to standardize the measurements for each sinus, each scan was carefully oriented in the axial, coronal, and sagittal plane. In the axial plane, a horizontal line from the right and left zygoma was chosen as the standard. Orienting the hard palate horizontally was the standard in the coronal plane as well as in the sagittal plane. The specific teeth that were to be replaced by implants wer...
Given these specific inclusion and exclusion criteria and the specific purpose of this study, only 29 cases qualified for inclusion from an original screen of approximately 4000 cases. An initial search of our database resulted in a larger number of cases that would theoretically qualify; however, further investigation revealed the need to exclude a great number of cases. The reasons for exclusion...
Methods
Study design
Our study hypothesis was that mucosal thickening of more than 2 mm and up to 1/3 of the volume of the sinus would not alter the predictability for SFE and dental implant placement. The primary outcome was to determine the success rate of dental implant placement in augmented maxillary sinus areas with mucosal thickening. A secondary outcome was to evaluate the effect of g...
Background
Despite the high survival rate of dental implants inserted in maxillary sinuses that have undergone sinus floor elevation (SFE) with bone grafting, complications still occur. Sinus membrane perforation is reported to be the most common complication. Postoperative maxillary sinusitis is less common (0–22%); nevertheless, it could potentially compromise the outcome of...
Dental implants and grafting success remain high despite large variations in maxillary sinus mucosal thickening
Abstract
Background
Although mucosal thickening is the most common radiographic finding observed regarding sinus pathology, the knowledge regarding its clinical significance on the outcomes of dental implants and grafting in the maxillary sinuses is still limited. We hypothesized th...
Figure 5. Periapical X ray after 1 year of follow-up, the bone was stable and no sign of peri-implantitis was shown
Figure 4. Follow-up after 1 year, no radiographic sign was appreciating and the osseointegration was satisfactory
Figure 3. Final restaurations: The parallelism of the implants is achieved by carving the non-submerged part a occlusal view and b lingual view
Figure 2. Flapless surgical technique, atraumatic surgical procedure for zirconium implants using the circular scalpel (a)–sharp, clean cut without bleeding (b)
Figure 1. Diagnostic radiographic exploration previous to treatment
To avoid exceeding the adaptive limits of the bone and maintain the proper stimulation of mechanical stress that will keep the bone vital, PEEK components seem a viable alternative to obtaining a similar modulus to that of cortical bone. In this way, bone could be stimulated, favouring remodelling without overload. It would concentrate the load by absorbing and distributing the same. Its cap...
Discussion
Intraoral conditions (saliva pH, acidic drinks, bacterial plaque, etc.) interact with metals, increasing corrosion, a phenomenon that also affects titanium implants. Amongst other reasons, this is whereby patients increasingly request the use of materials free of metallic alloys. In response to this growing demand, zirconia implants are considered an alternative, due to their low...
Case presentation
A patient who is a 45-year-old woman and non-smoker has no medical record of interest. The patient complained of pain in the right second upper molar. She said that she felt intense pain while chewing. The pain was accentuated with occlusion and while chewing, making normal functioning impossible. The patient mentioned the absence of piece 16, which had been extracted 8 years...
Background
In the field of implant dentistry, the most widely used implants over the past 40 years are those manufactured from titanium, which are still the most popular.
The recent demands for materials without metal alloys in dentistry, together with the increased sensitivity and allergies of some patients, have promoted the development of new materials.
An example of this is zirconia-based...
Abstract
Background
One of the disadvantages of the zirconia implants is the lack of elasticity, which is increased with the use of ceramic or zirconia crowns. The consequences that could result from this lack of elasticity have led to the search for new materials with improved mechanical properties.
Case presentation
A patient who is a 45-year-old woman, non-smoker and has no medical record...
Implant success
Clinically immobile when tested manually and/or with RFA (minimum ISQ = 65)
Absence of peri-implant radiolucency present on an undistorted radiograph
Absence of unresolved pain, discomfort, infection or neuropathy, or peri-implant soft tissue complications attributable to the implant
Implant placement that does not preclude delivery of a prosthetic crown w...
Figure 3. Mean bone loss at 6 months and 1 year. Mean bone loss distribution charts at 6 months and 1 year present no statistically significant difference. p value at 6 months was 0.2981 and at 1 year 0.6613
Figure 3. Mean bone loss at 6 months and 1 year. Mean bone loss distribution charts at 6 months and 1 year present no statistically significant difference. p value at 6 month...
Figure 2. ISQ values at placement, 6 weeks, 6 months, and 1 year. Mean and standard deviation of ISQ values taken at placement, 6 weeks, 6 months, and 1 year is presented. No statistical significant difference was determined between ISQ values at all time points. (p
Inclusion
Male or female
At least 18 years old
Healthy enough to undergo routine implant surgery and subsequent dental treatment
Partially edentulous requiring single dental implants in the maxilla
Adequate volume of native or grafted bone to accommodate dental implants at least 8 mm long
No active infections
Physically, emotionally, and financially able to u...
Figure 1. Implant design. The OSPTX and OSP implants are manufactured from high-grade commercially pure titanium with surface roughness produced via a fluoride treatment process. The OSP implant is a screw-shaped self-tapping implant. The diameter used in this study was 4.0 mm. The implant length used in this study was 8 mm. The OSPTX implant has the same features as the OSP except the apex ...
Discussion
Augmentation of the maxillary sinus prior to dental implant placement is routinely performed in order to help patients restore their maxillary posterior dentition. Unfortunately, not all patients are candidates for this procedure due to either health, personal, or financial concerns. An alternative treatment without the need for a sinus elevation procedure is the use of a shorter...
Results
Overall implant survival rate was 93.3%. Two implants failed, one implant in group A (OSPTXSoft) and one in group B (OSPTXStd). Both implant failures occurred at the time of uncovery (at 6 weeks) and prior to loading of the implants and were attributed to lack of integration. With the exception of these two failed implants, there was 100% success for all remaining implants using the par...
Methods
Following proper approval by the LSUHSC Institution Review Board (LSUNO IRB#7438), 27 (30 implant sites) systemically healthy patients at least 18 years old were enrolled in the study and randomly divided into three groups as follows (inclusion and exclusion criteria are described in detail in Table 1):
Group A received 10 OSPTX implants using the soft bone surgical protocol (OSPT...
To avoid invasive sinus augmentation procedures, implants have been designed in shorter lengths such as 8 mm. To further enhance short implant primary stability, a tapered design has been developed which has been proven to provide greater initial stability. Implant stability can be evaluated by different measures such as torque at the time of implant placement, resistance to reverse torque, and re...
Background
Dental implants are now a widely accepted treatment option for the replacement of missing teeth. The therapeutic goal of dental implants is to support restorations that replace single or multiple missing teeth so as to provide patient comfort, function, and esthetics as well as assist in the ongoing maintenance of remaining intraoral and perioral structures. However, anatomic limitat...
Abstract
Background
The purpose of this study was to compare a parallel wall design implant to a tapered apex design implant when placed in the posterior maxilla using two different surgical protocols.
Methods
Twenty-seven patients (30 implants) were divided into three groups. All implants were 4 mm wide in diameter and 8 mm long.
Group A received 10 tapered implants (OSPTX) (Astra Tech O...
Figure 15. Intra-oral radiograph showing the implant 12 months after placement
Figure 14. Clinical view showing optimal esthetics around the screw-retained definitive all-ceramic crown
Figure 13. Situation after implant placement and repair of the bony defect with a 1:1 mixture of Bio-Oss® and autologous bone
Figure 12. The impacted canine has become visible after elevation of a full-thickness palatal flap and removing overlying bone
Figure 11. CBCT image showing the palatal location of the impacted secondary canine
Figure 10. Clinical view showing the failing right primary canine
Figure 9. Intra-oral radiograph showing the implant 12 months after placement
Figure 8. Clinical view showing optimal esthetics around the screw-retained definitive all-ceramic crown
Figure 7. Clinical view immediately after placement of the provisional implant crown
Figure 6. Situation after implant placement and restoration of the bony defect with a 1:1 mixture of Bio-Oss® and autologous bone
Figure 5. The implant is placed in the prepared socket
Figure 4. The prepared implant socket and osseous defect resulting from removal of the buccally impacted secondary canine and the primary canine. Note that the upper part of the alveolar crest is intact
Figure 3. The impacted canine has become visible after elevation of a full-thickness buccal mucoperiosteal flap and removing overlying bone
Figure 2. CBCT image showing the buccal location of the impacted secondary canine
Figure 1. Clinical view showing the failing right primary canine
Discussion
This case report describes two approaches for immediate replacement of a failing primary canine and an impacted secondary canine, viz. one for impacted cuspids located at the buccal side of the maxilla and one for impacted cuspids located at the palatal side of the maxilla, by an immediately placed and provisionalized single implant. With both approaches, esthetically satisfying ...
Case 2
A 45-year-old man consulted our department with an impacted right maxillary canine and a persistent primary canine with evident mobility and in need of removal (Fig. 10). The patient chose for a single implant treatment because he wanted to have a long lasting and fixed solution for the failing tooth. All general health prerequisites were met and intra-oral examination revealed a healthy, ...
Next, an open tray impression was made at implant level using a custom acrylic resin impression tray (Lightplast base plates; Dreve Dentamid GmbH, Unna, Germany) and a polyether impression material (Impregum Penta; 3 M ESPE, St. Paul, USA). Finally, a healing abutment (NobelReplace; Nobel Biocare AB) was placed, and any remaining residual space between the implant and the buccal bone wall was fill...
One day before surgery, the patient started taking antibiotics (amoxicillin 500 mg, three times daily for 7 days) and using a 0.2 % chlorhexidine mouthwash (Corsodyl; GlaxoSmithKline, Utrecht, the Netherlands) for oral disinfection. Following the administering of local anesthesia (Ultracaine D-S Forte; Aventis Pharma Deutschland GmbH, Frankfurt am Main, Germany), an incision was made on the palata...
Case presentation
Case 1
A 36-year-old woman consulted the Department of Oral and Maxillofacial Surgery of the University Medical Center Groningen, Groningen, the Netherlands, with a persisting upper right primary canine and impacted secondary canine (Fig. 1). The primary canine had to be removed because of fracture of the crown. The patient did not want to undergo orthodontic treatment, and a...
Background
Maxillary canines are the second most impacted teeth (20 % of all impacted teeth); the prevalence in general population is approximately 2 %. Most impacted cuspids are located palatally, with a palatal/buccal ratio of 8:1.
There are several known treatment options for impacted canines to align them into the dental arch. The most widely used option is orthodontic traction after surgi...
Immediate placement and provisionalization of an implant after removal of an impacted maxillary canine: two case reports
Abstract
Single immediate implant replacement is accompanied by excellent survival rates and a favorable esthetic outcome. The objective of this report was to describe a surgical approach for removal of a buccal or palatally located impacted secondary canine, com...
While four studies conclude better implant survival and less peri-implant complications in the well-controlled group, the three others see no difference in implant success even in the poorly controlled patients. The study of Khandelwal treated exclusively patients with poor glycemic control (HbA1c 7.5–11.4 %) and had 98 % implant survival, after 4 months; therefore, he concluded that implant the...
Diabetes and bone augmentation
We identified two prospective studies that evaluated “advanced” implant surgery covering sinus lift procedure and guided bone regeneration. The study of Erdogan consists of type II diabetics moderately and well-controlled (HbA1c 6–7.5 %) with a mean duration of disease of 7.5 years and a healthy control group. Augmentation of the maxilla was performed by g...
The bleeding on probing is more often in the poorly controlled population, but the probing depth is not increased.
Diabetes and implant survival
Implant survival is an easily defined and measured endpoint for dental implant therapy. Nearly every study reports its implant survival rate. Our literature search identified 18 publications with these data. We divided them into two groups: the first on...
We identified two prospective studies investigating the influence of type II diabetes on osseointegration. They are published by the same author but are independent studies from different years. In both studies, the patients included were stratified by HbA1c levels as well-controlled (HbA1c 6.1–8 %), moderately controlled (HbA1c 8.1–10 %), and poorly controlled (HbA1c ≥10 %).
The healthy...
Materials and methods
The substructure of the systematic review is based on the PRISMA statement. The focused question according to the PICO schema is: “Do diabetic patients with dental implants have a higher complication rate in comparison to healthy controls?”
Search strategies
The systematic literature search was performed by an independent scientist (Burkhard Kunzendorf). The follow...
Conclusions
The literature included to this review is very heterogeneous concerning the investigated objects, methods, and conclusions. Diabetes is a group of metabolic diseases in which there are high blood sugar levels over a prolonged period. When looking at the complications and side effects resulting from diabetes, it is important to know which type of diabetes the patient suffers from, if...
Results
Study selection
There are no guidelines existing to the topic of dental implants and diabetes mellitus. A total of 327 potentially relevant titles and abstracts were found by the electronic search and additional evaluation of reference lists. During the first screening, 230 publications were excluded based on the title and keywords. Additionally, 24 titles were excluded based on abstract...
Introduction
Today, dental implants are one of the restorative methods to replace missing teeth. Improvements in implant design, surface characteristics, and surgical protocols made implants a secure and highly predictable procedure with a mean survival rate of 94.6 % and a mean success rate of 89.7 % after more than 10 years. Implant survival is initially dependent on successful osseointegration...
Abstract
Dental implant surgery has developed to a widely used procedure for dental rehabilitation and is a secure and predictable procedure. Local and systemic risk factors can result in higher failure rates. Diabetes mellitus is a chronic disease that goes in with hyperglycemia and causes multifarious side effects. Diabetes as a relative contraindication for implant surgery is controversially...
Discussion
Treatment planning implant-prosthetic rehabilitation should be dependent on a biomechanical algorithm customized for each patient. Given the lack of a definitive load-bearing analysis for bone supporting implants, an empirical or intuitive dogma, based on a tooth model, has proliferated in the clinical amphitheater. This has led to a penchant for invasive and costly procedures ra...
With implants, the load is transferred directly from the implant to surrounding bone through the ankylosed root analog and adverse effects have not been found to be as pronounced during non-axial loading. However, there are thresholds of non-axial forces that have been shown to cause crestal bone loss around implants. Duyck et al. have shown that a transverse force of 14.7 N applied on a distan...
This has been explained by Frost. He has identified osteocytes as an important part of the cellular machinery of bone functional adaptation. When the strain stimulus surpasses the homeostatic regulatory mechanism threshold, but is below the bone fatigue failure, tissue level strains lead to fluid flow-mediated osteocyte and dendrite perturbation and release of anabolic factors. In turn, osteoblast...
Another reason is that without a periodontal ligament, implant occlusal loads are directly transferred to the bone leading to higher forces to the supporting structure surrounding implants and risk for bony microfracture (peri-implantitis), compared to natural teeth.
In order to measure bite forces, the most widely accepted recording device is the strain gauge bite force transduce...
Another reason is that without a periodontal ligament, implant occlusal loads are directly transferred to the bone leading to higher forces to the supporting structure surrounding implants and risk for bony microfracture (peri-implantitis), compared to natural teeth.
In order to measure bite forces, the most widely accepted recording device is the strain gauge bite force transduce...
Another reason is that without a periodontal ligament, implant occlusal loads are directly transferred to the bone leading to higher forces to the supporting structure surrounding implants and risk for bony microfracture (peri-implantitis), compared to natural teeth.
In order to measure bite forces, the most widely accepted recording device is the strain gauge bite force transduce...
Of note, statistical mediating factors are implant length, diameter, and surface as well as bone quantity D vs. A (Bone quantity relates to the bone volume present. Division A is the height of the bone more than 10 mm. Division B is more than 10 mm in height, but the width at the crest is 2.5–5 mm. Division C is less than 10 mm in height and width atrophied to less than 2...
Similar findings were reported by Kozlovsky et al., who performed a split-mouth design on Beagle dogs, placing prosthetic abutments on implants, either in supra-occlusion or infraocclusion. They found no loss of osseointegration or marginal bone loss with non-inflamed, occlusally overloaded prostheses on dental implants. In fact, the authors demonstrated, in the absence of in...
On the other hand, fatigue microdamage resulting in resorption of the bone may be the product of mechanical stress above this threshold. If this gradient could be defined for implant restorations, it would clarify a topic in implant dentistry that has been fueled more by dogma, expert opinion, and inferences from concepts used for natural teeth. The purpose of this study is to revi...
Abstract
Controversy persists as to the role of occlusal overload in peri-implantitis. Animal studies have not revealed the biological threshold for fatigue failure in the peri-implant bone. On the other hand, clinical studies have demonstrated a link between parafunction and implant failure, although variables such as intensity and frequency of loads, as well as bone density, have led to d...
Figure 5. The effect of grade 4 and grade 5 implant particles on human gingival fibroblast viability in vitro. Viability was determined using an MTT metabolic activity assay. Cells were exposed to either a dissolution products (ions and nanoparticles) or b culture medium containing suspended implant particles throughout the duration of the culture period. Cells were exposed to various con...
Figure 4. Titanium (Ti) and vanadium (V) content in Dulbecco’s Modified Eagle Medium (DMEM). a, b Dissolution products (media filtered through 0.2 μm PTFE membrane following initial soaking of the particles for 3 days) and c, d DMEM sampled during cell culture studies where cells were cultured with the particles over a period of 10 days (particles removed prior to ICP measurem...
Figure 3. Titanium (Ti) and vanadium (V) release from the particles in simulated body fluid (SBF). Experimental duration was 10 days. Results presented as mean ± standard deviation, n = 3
Figure 2. EDX spectra of particles produced by the mock implantoplasty procedure (SEM images in Fig. 1). a, b Particles from grade 4 commercially pure titanium implant, a angular microparticles and b small spheres. c, d particles from grade 5 titanium alloy, c angular microparticles and d small spheres (grade 5)
Figure 1. Representative photo of implants and SEM images of particles produced by mock implantoplasty procedure. a–c Straumann 021.4512, bone level, diameter 4.1 mm, regular CrossFit®, SLA® 12 mm Roxolid® (commercially pure grade 4 titanium). d–f Biohorizons PBR 50105, RBT 5.0 × 10.5 mm, 5.7 Platform (grade 5 titanium alloy). Arrows indicate titanium oxide spheres. Scale ba...
Further, the effect of implant particles on other cell types within the oral and systemic environments should not be overlooked. Although the health hazards of FPs and NPs are relatively less well established, literature in the fields of toxicology does indicate a glimpse of possible toxicity that should compel clinicians to carefully weigh the possible adverse human health effec...
This is due to the lack of vanadium and possibly larger particle size. Here, G5 particles are. Although a range of particle size of G5 was measured in this study, a portion of the particles generated from the mock implatoplasty process in the current study is comparable to that reported by Pioletti et al.. The internalisation of G5 particles, especially sub-micron particles, and the su...
There was no distinct difference in the amount of titanium ions released from G4 and G5 particles. Direct exposure to G5 implant particles in culture did result in significantly reduced cell viability at all-time points, from 3 to 10 days of culture, while G4 implant particles demonstrated no adverse effect on cell viability (Fig. 5b). The cytotoxic effects of vanadium are well docum...
Discussion
Unalloyed titanium, often referred to as commercially pure grade 4 titanium (CpTi), usually contains some trace elements of carbon, oxygen, nitrogen and iron (American Society for Testing and Materials international standards). These trace elements improve the mechanical properties of CpTi and are found in higher amounts from grade 1 to 4 CpTi. Many dental implants are made from ...
Results
Particles released from implants following the mock implantoplasty procedure were collected, and microparticle size of particles produced from the grade 4 (G4) and grade 5 (G5) implants was 77.4 ± 9.1 μm (modal number 66.3 μm) and 48.4 ± 6.4 μm respectively (modal number 43.1 μm). DLS analysis showed nano-sized particles were also present: hydrodynamic diameters were 125.4...
The media were filtered through 0.2 μm PTFE membrane syringe filters following incubation to remove the particles before use in cell culture. Group 2 (particle): Sterilised grade 4 and 5 Ti particles were suspended in DMEM at concentrations of 0.75, 1.5 and 3 mg ml−1 and used for cell culture without filtering. Basal DMEM and DMEM containing unprocessed grade 4 and 5 implants were used a...
Ion release from titanium particles
Simulated body fluid (SBF) was chosen as the dissolution test solution as we were interested in what happens when the particles become embedded in the soft/hard tissue rather than their interaction with saliva. SBF was prepared using the Kokubo method. Seven hundred millilitres of deionised (DI) water in a 1-L polypropylene beaker was warmed to 37 °C in a wa...
Materials and methods
Materials
Reagents and solvents were purchased from Sigma-Aldrich (Dorset UK). Commercially pure grade 4 titanium implants (n = 3) were purchased from Straumann (Sussex UK, Model number 021.4512, bone-level implant diameter 4.1 mm, Regular CrossFit®, SLA® 12 mm Roxolid®) (Fig. 1a). Grade 5 Ti-6Al-4 V titanium alloy implants were purchased from Biohorizons (Berk...
However, if previous records are available, then the diagnosis can be made with any increase in pocket depth with post remodelling bone loss of greater than 0.5 mm in the presence of bleeding and/or suppuration on gentle probing, A number of studies suggested this inflammatory disease is associated with anaerobic plaque bacteria. It has also been suggested peri-implantitis can also be related to...
Background
Dental implants offer a viable long-term treatment option for patients with missing teeth. The use of metallic dental implants has relatively high reliability and long-term success rates; however, it is not without complications and the need for ongoing maintenance persists. Particles are generated during the life span of an implant, and this can have significant physiological implic...
Abstract
Background
With increasing numbers of dental implants placed annually, complications such as peri-implantitis and the subsequent periprosthetic osteolysis are becoming a major concern. Implantoplasty, a commonly used treatment of peri-implantitis, aims to remove plaque from exposed implants and reduce future microbial adhesion and colonisation by mechanically modifying the implant sur...
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...
At 5 years of function
At 10 years of function
Patient level
Implant level
Patient level
Implant level
n
%
n
%
n
%
n
%
Failure
15
3.16%
31
1.56%
24
5.05%
47
2.36%
Δ 5‐ to 10‐year failure
1.89%
0.80%
Peri‐implantitis
40
8.42%
61
3.19%
76
16%
186
9.72%
Δ 5‐ to 10‐year peri‐impla...
Figure 1. Peri‐implantitis over the study period of 10 years at patient and implant level
Rehab. solution
Patient level
Implant level
Survival rate
Total
91.8%
96.1%
Fixed full‐arch bridge
90.5%
Implant‐supported overdenture
82.9%
Fixed partial denture
99.2%
Single‐tooth replacement
99.6%
Peri‐implantitis rate
Total
24.4%
12.9%
Fixed full‐arch bridge
14.3%
Implant‐...
Cumulative survival rate
Cumulative success rate
Time of functional loading (Years)
Patient level
Implant level
Patient level
Implant level
1 to 2
100%
100%
98.7%
99.5%
2 to 3
99.2%
99.7%
97.2%
98.8%
3 to 4
98.5%
99.4%
95.5%
97.9%
4 to 5
97.7%
98.9%
93.5%
96.7%
5 to 6
96.6%
98.4%
91.3%
95.3%
6 to 7
95.5%
97.9%
88.5%
93.6...
Demographic variables
Implants (%)
Age
≥61 years
315 (15.8)
≤60 years
1,676 (84.2)
Sex
Male
904 (45.4)
Female
1087 (54.6)
Systemic disorders11 under medical supervision.
With
173 (8.7)
Without
1,818 (91.3)
Smoking habits22 ≤20 cigarettes.
With
146 (7.3)
Without
1,845 (92.7)
Anatomic variables
...
Total
Patients
Implants
Clinical condition
Men
Women
n
%
Rehab. solution
n
%
n
%
Totally edentulous
40
50
90
19
Fixed full‐arch bridge
32
6.74
348
17.48
Implant‐supported overdenture
58
12.21
211
10.60
Partially edentulous
73
82
155
33
Fixed partial denture
155
32.63
732
36.77
Mono‐edentul...
CONCLUSIONS
Peri‐implantitis began to appear more frequently after the fifth year of functional loading, with a peak of incidence observed after the seventh year, especially between the seventh and eighth years. The incidence of peri‐implantitis increased when the data were analyzed from the fifth year to 10 years of function. Consequently, studies that consider a follow‐up period
The rate of peri‐implantitis observed in this study at 10 years, agreed with that described by Bragger et al. and Karoussis et al. in which peri‐implantitis occurred in 15.4% of the implants after a mean observation period of 10 years. Simonis et al. (2010) reported a prevalence of 16.9% of peri‐implantitis after an observation period of 10 to 16 years.
The study of de Waal et al. desc...
During the interval between the sixth and seventh year of functional loading, a slightly higher rate of failures than that in the previous years was observed.
The ratio between the rate of peri‐implant complications and the time of function was even more evident for peri‐implantitis, which showed a significant increase after the seventh year of functional loading, with a more evident increase...
The aim of this retrospective study was to assess the survival and success rates as well as the incidence of peri‐implantitis in patients with a history of periodontitis who followed an individual maintenance program and supportive periodontal and peri‐implant treatment (SPT), and with 1 to 10 years of implant functional loading.
The results obtained in the present study show that peri‐impl...
A total of 1,991 implants (475 patients) with 10 years of functional loading met the inclusion criteria and were included in this study: 90 patients were totally edentulous (559 implants), 155 patients were partially edentulous (732 implants), and 230 patients were mono‐edentulous (700 implants) (Tables 1 and 2).
Table 3 shows the life table analysis and cumulative survival and success rate and...
When a two‐stage technique was performed (i.e., sinus floor augmentation without implant insertion or staged‐approach GBR), a healing period of at least 6 months was observed before implant insertion. The implants were functionally loaded after 3 to 6 months of the implant placement.
2.3.3 Follow‐up
After surgery, for a maintenance program, all patients followed an individual SPT. The ...
Where a deficient posterior alveolar ridge and increased pneumatization of the maxillary sinus appeared, implants were inserted with simultaneous sinus floor augmentation (one‐step procedure) (osteotome technique, or lateral window technique) or after a previous sinus floor augmentation with bone grafting (two‐step procedure).
Sites that exhibited localized horizontal bone...
Successful tissue integration was examined using predefined criteria of success, as follows:
Absence of persistent subjective complaints, such as pain, foreign body sensation and/or dysesthesia.
Absence of implant mobility.
Absence of continuous radiolucency around the implant.
Implant prosthesis functional loading ≥1 year.
Absence of exude or suppuration at acupressure o...
2.2 Clinical parameters
Periodical clinical examinations assessed before treatment and during follow‐up were recorded. Clinical parameters at baseline and after prosthesis positioning were used as a reference of development of peri‐implant disease.
Based on the suggestion of Mombelli and Lang, and confirmed by the successive EWP consensus workshops published in 2008, 2011, and 2012, peri...
This is a retrospective cohort study started from the analysis of clinical records of patients referring to private dental practices in central Italy (AP) treated between February 1998 and December 2002 by three different operators, and then included into a follow‐up program. We followed the Strengthening the Reporting of OBservational studies in Epidemiology (STROBE) guidelines for an accurate ...
INTRODUCTION
Implant‐prosthetic rehabilitation is a clinical procedure used to solve cases of partial or total edentulism. A functioning implant may be subject to plaque‐associated biological complications, such as mucositis and peri‐implantitis.
Peri‐implant mucositis has been described as a reversible inflammatory lesion of the peri‐implant mucosa, whilst peri‐implantitis also desc...
A retrospective cohort study on peri‐implant complications in implants up to 10 years of functional loading in periodontally compromised patients
Abstract
Background
Prevalence of peri‐implantitis is directly proportional to the time of functional loading. The aim of this retrospective study was to assess the survival and success rates as well as the incidence of peri‐implantitis ...
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...
IMPLANT PLACEMENT
Prosthetic considerations for patients requiring implant placement should include evaluation of:
Number and location of missing teeth;
Interarch distance;
Number, type, and location of implants to be placed;
Existing and proposed occlusal scheme;
Design of planned restoration.
The surgical technique is based on the pretreatment evaluation and on the type of implant to ...
The American Academy of Periodontology has developed the following parameter on the placement and management of dental implants. Dental implants are a recognized form of tooth replacement and as such should be presented as an alternative for the replacement of missing teeth. A comprehensive treatment plan should be developed in consultation with all parties involved. Patients should be informed ab...
Weton
Pencarian metuken 5 artikel. Tiga di antaranya disertakan dalam tinjauan.11, 34, 35 Dua artikel dikecualikan karena tidak melaporkan tentang implant gigi PEEK.36, 37
Dari artikel yang disertakan, 2 artikel melaporkan penelitian pada sato34, 35 dan 1 artikel melaporkan tentang penelitian elemen terbatas in vitro.11
Tujuan dari penelitian elemen terbatas 3 dimensi ini adalah untuk membandin...
Conclusion
Literature reporting on dental implants made from PEEK demonstrate that PEEK is basically osseointegrated as biocompatible material in vivo. Further investigations are necessary to find ways to improve the biomechanical behavior to achieve a more homogenous stress distribution to the surrounding bone, which has not yet been experimentally proven. Long-term investigation...
Table 4. Differences in the mean insertion depths between submerged and nonsubmerged implants from Table 3
Nonsubmerged implants, mean insertion depths from Table 3, mm
Submerged implants, mean insertion depths from Table 3, mm
Differences in the Mean Insertion Depths, mm*
Zirconia
-2.15
-2.62
+0.47
Coated zirconia
-2.56
-2.25
-0.31
Titanium
...
Table 3. Mean values of bone-related and implant-related bone level (BL) (Koch et al) and the mean insertion depths
Mean bone-related BL, mm
Mean implant-related BL, mm
Mean insertion depth, mm
Nonsubmerged
Zirconia
-0.53
-1.62
-2.15
Coated zirconia
-0.59
-1.97
-2.56
Titanium
-0.37
-1.65
-2.02
PEEK
-1.3
-0.44
-1.74
Submerged
...
Discussion
Referring to a 3-dimensional finite element analysis of a CFR-PEEK and a titanium implant (Table 1), the authors concluded that due to its higher stress concentrations, the CFR-PEEK implant could not be recommended.11
This deformation rate could probably be diminished by an inner stiffening of the implant, for example, by an abutment connection bolt which extends to the apical region ...
Table 2. Overview of 2 in vivo animal investigations
Author
Cook and Rust-Dawicki
Year of publication
1995
Number of animals
4 (mongrel dogs)
Number of implants
40
Number of implants/ animal
10
Implantation site
Femur
Healing period
4 weeks (n = 2); 8 weeks (n = 2)
Implant design
Cylindrical
Healing method
Submerged/ unloaded
Implant mat...
Author
Sarot et al
Year of publication
2009
Implantation site
Virtual 3-dimensional model of a lower jawa of region 35, based on a randomly chosen computerized tomography scan with a total of 212 transversal slices wit 0.25 mm in length, consisting of medullar bone covered by a 1.0-mm thick layer of cortical bone, designed with the software Ansys DesignModeler v11 (ANSYS Inc...
Results
The search yielded 5 articles, of which 3 were included in the review.11, 34, 35 Two articles were excluded, because they did not report on dental implants of PEEK.36, 37
Of the included articles, 2 reported on animal investigations34, 35 and 1 on an in vitro finite element study.11
The aim of the 3-dimensional finite element study was to compare the stress distribution to the peri-impl...
Materials and Methods
Literature search
The articles for the current review were found using the PubMed search engine and searching for references cited within these articles. All articles published until December 2010 were reviewed. The following search terms were used together: “dental implant PEEK.”
Inclusion criteria
Only articles about dental implants from PEEK or modified PEEK publis...
Introduction
Dental implants increase the quality of life for many patients with tooth loss.1 The material of choice for oral endosseous implants is pure titanium, introduced at the end of the 1960s by Branemark.2 Although implants based on titanium and titanium alloys, such as Ti-6Al-7Nb and Ti- 6Al-4V,3, 4 are well evidence-based, it was demonstrated that their use can be correl...
Andreas Schwitalla, DDS ; Wolf-Dieter Müller, PhD
J Oral Implantol (2013) 39 (6): 743–749.
https://doi.org/10.1563/AAID-JOI-D-11-00002
Abstract
The insertion of dental implants containing titanium can be associated with various complications (eg, hypersensitivity to titanium). The aim of this article is to evaluate whether there are existing studies reporting on PEEK as an alternative m...
5. Stress analysis
One study evaluated stress analysis. Kohal et al observed the stress distribution patterns of zirconia implants (ReImplant), which were found to have low, well distributed, and similar stress distribution compared with titanium implants. These patterns could be characterized as favorable or nondestructive. Stress values were found to be similar for both models for all regi...