Fig. 6. Position of the right mental foramen
Fig. 5. Position of the left mental foramen
Fig. 4. Left (l) and right (r) mandibular bone thickness (bt) in the four age groups (group 1, 0–20 years old; group 2, 21–40 years old; group 3, 41–60 years old; group 4, 61 and older) in men (0) and women [1]
Fig. 3. Left (l) and right (r) mandibular bone thickness in all patients
Fig. 2. Definition of the position of the mental foramen
Fig. 1. Measurement of mandibular bone thickness, defined as the distance between the lateral wall of the mandibular canal and the lateral mandibular compact bone (solid turquoise line)
Age groupTotal1234SexMale41363930146Female44513538168Total 85877468314Table 1 Number of men and women in each age group (group 1, 0–20 years old; group 2, 21–40 years old; group 3, 41–60 years old; group 4, 61 and older)
Valdec, S., Borm, J.M., Casparis, S. et al. Vestibular bone thickness of the mandible in relation to the mandibular canal—a retrospective CBCT-based study.
Int J Implant Dent 5, 37 (2019). https://doi.org/10.1186/s40729-019-0189-z
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Published: 15 November 2019
DOI: https://doi.org/10.1186/s40729-019-0189...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
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Silvio Valdec and Jan Borm are equally contributing first authors.
The study was approved by the cantonal ethics committee of the canton of Zurich (KEK 2018-01691).
Not applicable.
Silvio Valdec, Jan Borm, Stephanie Casparis, Georg Damerau, Michael Locher and Bernd Stadlinger declare that they have no competing interests.
Silvio Valdec and Jan M. Borm contributed equally to this work.
Clinic of Cranio-Maxillofacial and Oral Surgery, Centre for Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
Silvio Valdec, Jan M. Borm, Stephanie Casparis, Georg Damerau, Michael Locher & Bernd Stadlinger
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This study was conducted without external funding.
The authors thank Jacquie Klesing, Board-Certified Editor in the Life Sciences (ELS), for editing assistance with the manuscript. Further, we thank Malgorzata Roos for supporting the statistical analysis.
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Pyun JH, Lim YJ, Kim MJ, Ahn SJ, Kim J. Position of the mental foramen on panoramic radiographs and its relation to the...
Nucera R, Lo Giudice A, Bellocchio AM, Spinuzza P, Caprioglio A, Perillo L, et al. Bone and cortical bone thickness of mandibular buccal shelf for mini-screw insertion in adults. Angle Orthod. 2017;87(5):745–51.
Scomparin L, Soares MQ, Rubira CM, Yaedu RY, Imada TS, Centurion BS, et al. CBCT location of the fusion between the buccal and lingual cortical in the mandibular ramus: importance to sa...
Benninger B, Miller D, Maharathi A, Carter W. Dental implant placement investigation: is the anterior loop of the mental nerve clinically relevant? J Craniomaxillofac Surg. 2011;69(1):182–5.
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Kuribayashi A, Watanabe...
Ozturk A, Potluri A, Vieira AR. Position and course of the mandibular canal in skulls. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;113(4):453–8.
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Zahedi S, Mostafavi M, Lotfirikan N. Anatomic stud...
Bone thickness
Cone-beam computed tomography
Digital Imaging and Communications in Medicine
Inferior alveolar nerve
The original datasets supporting the findings are available.
The results of this study support the relevance of a preoperative CBCT to allow detailed planning of a surgical intervention that may potentially touch the area of the mandibular canal. This applies to surgical procedures like wisdom tooth removal, root resection, implant placement and bone block harvesting. A CBCT allows the exact determination of the horizontal bone thickness vestibular to the I...
In a study comparing measurements between cadavers and CT images, the distance between the upper edge of the mandibular canal and the alveolar ridge showed possible over- and underestimations. The quantification showed a possible overestimation of up to 1.05 mm and a possible underestimation of up to 1.36 mm [34]. This discrepancy is of relevance in preoperative planning. Intraoperatively, a r...
The IAN is an important anatomical structure whose course affects the preoperative planning of a bone graft or implant insertion in the mandible. Knowledge on the bone thickness between the lateral wall of the mandibular canal and the lateral mandibular compact bone as well as of the position of the mental foramen facilitates decision-making [24]. Furthermore, for many other surgical procedures, t...
The median age of the patients was 40.2 years (range 12.6–84.4 years). Patients were distributed almost evenly across the age groups (see Table 1).
Figure 3 clearly shows the median vestibular bone thicknesses (bt) at 2-mm intervals throughout the anterior to posterior course of the canal on both the right (bt2 r to bt66 r) and left (bt2 l to bt66 l) side of the mandible. The maximum di...
In addition, the position of the mental foramen was determined relative to the roots of the neighbouring teeth. This was assessed by defining regions of interest in the area of the first premolar, second premolar and first molar by extending the respective mesial and distal points of the cement-enamel junction caudally along the tooth axis. The position of the midpoint of the mental foramen was th...
Three hundred fourteen cone-beam computed tomograms (CBCTs) from 168 (53.5%) females and 146 (46.5%) males from the database of the Department of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Switzerland, from the years 2008 to 2013 were analysed. Patients were divided into 4 age groups: group 1 = 0–20 years, group 2 = 21–40 years, group 3...
The mandibular canal is a bilateral, intraosseous opening through which the IAN runs from the mandibular foramen to the mental foramen. The nerve innervates the teeth, the mucous membranes in the area of the mental foramen and the skin around the chin [14, 15]. Anatomical variations of the mandibular canal, such as bifid canals and an anterior loop of the mental nerve, are common [16, 17] and have...
When performing any kind of surgical procedure, a surgeon needs to be familiar with the possible variations in the anatomical configurations of both the mandibular canal and inferior alveolar nerve (IAN) [1,2,3]. This is particularly the case when performing root resections, removing wisdom teeth or harvesting autologous bone grafts.
Different techniques are described for reconstruction of missin...
Fig. 3. Quantification of type I collagen via ELISA. Data representative of the experiment run in triplicate. Values are expressed as mean (± SD). The asterisk symbol indicates a significant difference between groups (p < 0.05)
Fig. 2. a Cell proliferation in gingival fibroblasts at 24 h, 48 h, and 72 h. The line chart represents the means and standard deviations from three separate experiments. b Cell viability assay in gingival fibroblast at 24 h, 48 h, and 72 h. The line chart represents the means and standard deviations from three separate experiments. The values are expressed in means (± SD). The as...
Fig. 1. Scanning electron microscopy and laser interferometry. a, d Machined surface. b, e 20-min acid treatment. c, f 60-min acid treatment. Original magnification, × 15,000
de Souza, V.Z., Manfro, R., Joly, J.C. et al. Viability and collagen secretion by fibroblasts on titanium surfaces with different acid-etching protocols.
Int J Implant Dent 5, 41 (2019). https://doi.org/10.1186/s40729-019-0192-4
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Received: 09 August 2019
Accepted: 24 October 2019
Published: 21 November 2019
DOI: https://doi.org/10.1186/s40729-019-0192-4
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
This study was approved by the Research Ethics Committee of the São Leopoldo Mandic Research Institute, Campinas/SP (protocol No. 59866216.6.0000.5374).
Not applicable.
Vilton Zimmermann de Souza, Rafael Manfro, Júlio César Joly, Carlos Nelson Elias, Daiane Cristina Peruzzo, Marcelo Henrique Napimoga, and Elizabeth Ferreira Martinez state that they have no conflicts of interest.
VZS and EFM interpreted and analyzed the data collected, contributed to the drafting of the paper and revised it critically, and were major contributors in writing the manuscript. RM, JCJ, and CNE contributed to the concept/design of the study and the final manuscript. DCP and MHN critically revised and contributed to the final manuscript. All authors read and approved the final version to be publ...
Division of Implantology, Faculdade São Leopoldo Mandic, Campinas, SP, Brazil
Vilton Zimmermann de Souza, Júlio César Joly & Daiane Cristina Peruzzo
Division of Implantology, SOEBRÁS, Passo Fundo, RS, Brazil
Rafael Manfro
Materials Science Department, Instituto Militar de Engenharia, Rio de Janeiro, RJ, Brazil
Carlos Nelson Elias
Division of Immunology, Faculdade São Leopoldo Mandic,...
The funding received for this study was from the researcher himself.
The authors wish to thank Mrs. Pollyanna Tombini Montaldi for her excellent technical expertise and assistance.
Velasco-Ortega E, Alfonso-Rodríguez CA, Monsalve-Guil L, España-López A, Jiménez-Guerra A, Garzón I, Alaminos M, Gil FJ. Relevant aspects in the surface properties in titanium dental implants for the cellular viability. Mater Sci Eng C Mater Biol Appl. 2016;64:1–10.
Cao J, Wang T, Pu Y, Tang Z, Meng H. Influence on proliferation and adhesion of human gingival fibroblasts from different tit...
Martinez EF, Araújo VC. In vitro immunoexpression of extracellular matrix proteins in dental pulpal and gingival human fibroblasts. Int Endod J. 2004;37(11):749–55.
Lee HJ, Lee J, Lee JT, Hong JS, Lim BS, Park HJ, Kim YK, Kim TI. Microgrooves on titanium surface affect peri-implant cell adhesion and soft tissue sealing; an in vitro and in vivo study. J Periodontal Implant Sci. ...
Chai WL, Moharamzadeh K, Brook IM, Van Noort R. A review of histomorphometric analysis techniques for assessing implant-soft tissue interface. Biotech Histochem. 2011;86(4):242–54.
Buser D, Weber HP, Donath K, Fiorellini JP, Paquette DW, Williams RC. Soft tissue reactions to non-submerged unloaded titanium implants in beagle dogs. J Periodontol. 1992;63(3):225–35.
Schierano G, Ramieri G, Cor...
All data generated or analyzed during this study are included in this published article.
Therefore, the results of the present study indicate that the acid treatments used did not compromise cell growth nor collagen synthesis by gingival fibroblasts compared to machined titanium. The cost-benefit of manufacturing prosthetic abutments with treated surfaces should however be considered. In addition, in vitro studies using human keratinocytes and histological studies in vivo should be pe...
The connective tissue seal around the abutment is crucial for perimplant health. Several efforts have previously been made to optimize abutment surfaces, though without consensus on the ideal surface features. Blasquez et al. [11] have shown in their systematic review that different types of surface modifications for implant abutments may provide benefit to the surrounding connective tissue, which...
The results showed that, regardless of the treatment used, there was no difference in the values of cell proliferation in the different times of analysis. Similarly, cell viability values did not differ, especially after 24 h and 72 h. Corroborating the results of this study, Baltriukiene et al. [17] used grade 2 titanium disks with different surface treatments and demonstrated that the modifi...
Implant dentistry has for years focused on studying the interface between the bone and implant, searching for a suitable seal to prevent the advance of perimplant disease. Long-term prognosis of dental implants, however, depends not only on osseointegration, but also on the quality of the seal between the mucosa and the implant abutment [13].
The seal provided by the contact between mucosal tissu...
The results showed that acid treatment of the titanium surfaces for 20 or 60 min did not affect cell proliferation, either after 24 h (p = 0.484), 48 h (p = 0.698), or 72 h (p = 0.287) (Fig. 2a).
For the cell viability test, loss of viability was observed for the machined surface after 48 h of culture compared to the groups submitted to acid treatment for 20 or 60 min, which did not...
The experiments were repeated three times, under the same conditions, to ensure accuracy.
Quantification of secreted type I collagen by fibroblast cultures on to the different surfaces was evaluated by enzyme-linked immunosorbent assay (ELISA). The supernatant was collected and centrifuged at 336g for 10 min. Type I collagen quantification was carried out using the Human Type I Collagen kit (R&...
This study was approved by the Research Ethics Committee of the São Leopoldo Mandic Research Institute, Campinas/SP (protocol No. 59866216.6.0000.5374). Titanium disks were commercially pure, grade 4 (n = 108), measuring 6 mm in diameter by 2 mm in thickness, provided by the company Conexão Sistemas de Próteses (Arujá, São Paulo).
For the treatment of titanium disk surfaces, sulfuric, ni...
Consolidation of surface treatments for dental implants and knowledge on the cellular mechanisms of osseointegration has propelled research on the sealing capacity of bone to implant surfaces. Although osseointegration is extremely important for implant success, biological sealing of the perimplantar connective tissue is crucial to maintain success in the long-term because it acts as a first barri...
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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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...
Fig. 4. Implant placement surgery after 4 months of healing (a). Immediate loading of the new implants and the explanation of the implant at the left first molar (b). Panoramic radiograph showing the case finished with 12 months of follow-up (c). Clinical image showing the definitive screw-retained prostheses (d)
Fig. 4. Implant placement surgery after 4 months of healing (a). Immediate...
Fig. 3. Panoramic radiograph showing excessive marginal bone loss affecting all the dental implants in the mandible supporting fixed prostheses (a). Clinical image showing the advanced bone destruction around the implants at the incisors and left premolar regions (b). Clinical image showing the preservation of the pre-existing bone upon implant removal with the counter-torque regions (c). Panor...
Fig. 2. The cause of implant removal
Fig. 2. The cause of implant removal
Fig. 1. Frequency distribution of the location of the explanted dental implant
Fig. 1. Frequency distribution of the location of the explanted dental implant
Patient
Location
Manufacturer
Abutment connection
Type of fracture
Location of the fracture
Category of bone support around the implant (%)
Use of trephine bur
1
25
Unknown
Internal
Complete fracture
Implant body (apical third)
76–100
No
14
Unknown
Internal
Complete fracture
Implant body (apical third)
76–100
Yes
2
15
Nobel
Internal
Fissure line...
Anitua, E., Fernandez-de-Retana, S. & Alkhraisat, M.H. Performance of the counter-torque technique in the explantation of nonmobile dental implants. Int J Implant Dent 6, 1 (2020). https://doi.org/10.1186/s40729-019-0197-z
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Received: 30 July 2019
Accepted: 22 November 2019
Published: 09 January 2020
DOI: https://doi.org/10.1186/s40729-019-0197-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...
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
This study was performed following the Helsinki Declaration regarding the investigation with human subjects.
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Eduardo Anitua is the Scientific Director of BTI Biotechnology Institute (Vitoria, Spain). He is the head of the Foundation Eduardo Anitua, Vitoria, Spain. Sofia Fernandez-de-Retana and Mohammad H. Alkhraisat are researchers at BTI Biotechnology Institute (Vitoria, Spain).
Clínica Eduardo Anitua, Vitoria, Spain
Eduardo Anitua
BTI Biotechnology Institute, Vitoria, Spain
Eduardo Anitua, Sofia Fernandez-de-Retana & Mohammad H. Alkhraisat
Eduardo Anitua Foundation, C/Jose Maria Cagigal 19, 01007, Vitoria, Spain
Eduardo Anitua
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No funding was received for this study.
Howe M-S, Keys W, Richards D. Long-term (10-year) dental implant survival: a systematic review and sensitivity meta-analysis. J Dent. 2019. https://doi.org/10.1016/j.jdent.2019.03.008.
Buser D, Sennerby L, De Bruyn H. Modern implant dentistry based on osseointegration: 50 years of progress, current trends and open questions. Periodontol 2000. 2017;73(1):7–21. https://doi.org/10.1111/prd.12185.
...
Data will not be shared but are available upon request.
The good performance of the counter-torque method, as an atraumatic alternative for nonmobile implant removal, reinforces its use in the clinical practice. However, the technique is not exempt from complications (although at a very low rate).
To our knowledge, this is the study with the largest sample size reporting the performance, in the clinical practice, of the application of counter-torque technique for the removal of nonmobile dental implants. In this retrospective analysis, the counter-torque method demonstrated to be highly predictable, showing a high success rate. The fracture of the implant (0.65% at the implant apical third)...
Table 1 shows the relevant available information regarding the fractured dental implants. Ten dental implant fractures were observed in 7 patients. There were no differences regarding the location of the fractured implants, as 40% were located in the maxilla and 60% were located in posterior areas (Table 1). Postoperative recovery of the patients was uneventful and pain was successfully managed ...
In this report, 749 nonmobile dental implants were explanted in 355 patients. Figure 1 shows the anatomical location of the dental implants. The 50.6% of the removed implants were located in the maxilla and 48.2% of the cases were located in the anterior areas. Attending to the causes of explantation, the vast majority of the explantations occurred due to biological complications (86.2%), followe...
Patients of legal age treated for implant explantation of nonmobile dental implants between March 2010 and December 2018 were included in this retrospective study.
The treatment was performed using an implant removal kit (BTI Biotechnology Institute, Vitoria, Spain) that allowed the application of a counter-torque to the bone-implant interface [4]. The decision to raise a flap or not was made acc...
Although presenting high and acceptable survival rates [1, 2], dental implants fail as a consequence of infection (periimplantitis), excessive biomechanical stress, or improper positioning. Different techniques have been described to remove a failed dental implant that include block resection, buccal bone osteotomy, trephine osteotomy, and piezosurgery [3, 4]. The application of counter-torque to ...
The application of the counter-torque technique has been proposed as a conservative and atraumatic alternative for the explantation of nonmobile dental implants. The objective of this report is to assess the performance of this technique in a large number of patients.
Three hundred and fifty-five patients were treated for the explantation of 749 nonmobile dental implants. The explantations were p...
Figure 6. Control group. Some implant thread areas were not covered by bone layer (magnification × 25—toluidine blue)
Figure 6. Control group. Some implant thread areas were not covered by bone layer (magnification × 25—toluidine blue)
Figure 5. Control group. Implants belonging to the control group showed some small surface areas not contacted with bone (magnification × 25—toluidine blue)
Figure 5. Control group. Implants belonging to the control group showed some small surface areas not contacted with bone (magnification × 25—toluidine blue)
Figure 4. Control group. No bone condensation was possible with traditional burs and standard implant (magnification × 25—toluidine blue)
Figure 4. Control group. No bone condensation was possible with traditional burs and standard implant (magnification × 25—toluidine blue)
Figure 3. Test group. The present histological photo showed a continuous thin layer of newly formed bone along the neck area of the implant (magnification × 25—toluidine blue)
Figure 3. Test group. The present histological photo showed a continuous thin layer of newly formed bone along the neck area of the implant (magnification × 25—toluidine blue)
Figure 2. Test group. Implants in the test group showed an extremely high percentage of bone directly contacted to implant surface (magnification × 25—toluidine blue)
Figure 2. Test group. Implants in the test group showed an extremely high percentage of bone directly contacted to implant surface (magnification × 25—toluidine blue)
Figure 1. Test group. The implant achieved a high osseointegration degree. The newly formed bone appeared well interconnected with the pre-existing trabeculae. The “corticalization” phenomenon is evident: the bone appears densified around a titanium implant (magnification × 8—toluidine blue)
Figure 1. Test group. The implant achieved a high osseointegration degree. The newly formed b...
BIC%P < 0.05BV%P < 0.05VamP < 0.05Reverse torqueP > 0.05 NsISQP < 0.05Table 3 Statistical comparison (T test) of examined parameters between the test and control groups. The histomorphometric analysis demonstrated significant differences in BIC% and %BV values between the two implant groups
Implant typeBIC%BV%Vam (μm) ± SDReverse torque (N/cm) ± SDISQ value ± SDTest group70.91 ± 7.9541.83 ± 6.3082.6 ± 23.2798.2 ± 16.8163.5 ± 1.30Control group49.33 ± 10.7329.61 ± 5.0560.5 ± 16.5898.8 ± 24.4059.4 ± 1.39Table 2 Mean values of histomorphometric parameters (%BIC and %BV) and biomechanical values (VAM, reverse torque, and ISQ) of each implant group
Basal %BV 26.17 ± 2.35Test groupControl group 41.83 ± 6.30*29.61 ± 5.05Table 1 Basal bone volume percentage (basal %BV) was compared to %BV around implants after 2 months of healing in both groups. %BV in the test group was significantly higher than basal %BV (P < 0.05)
Trisi, P., Falco, A. & Berardini, M. Single-drill implant induces bone corticalization during submerged healing: an in vivo pilot study. Int J Implant Dent 6, 2 (2020). https://doi.org/10.1186/s40729-019-0198-y
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Received: 30 August 2019
Accepted: 04 December 2019
Published: 15 January 2020
DOI: https://doi.org/10.1186/s40729-019-0198-y
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
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The Ethics Committee for Animal Research of the Veterinary School of the University of Teramo (Teramo, Italy) approved the study protocol with the protocol number 8110.
The Ethics Committee for Animal Research of the Veterinary School of the University of Teramo (Teramo, Italy) approved the study protocol with the protocol number 8110.
The authors declare that they have no competing interests.
Biomaterial Clinical and Histological Research Association, Private Practice, Via Galilei 8, 65122, Pescara, Italy
Paolo Trisi, Antonello Falco & Marco Berardini
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PT contributed to the study design, animal s...
No grants were received for the present study.
The authors wish to thank Cortex® Dental Implants (Shlomi, Israel) and NoDrill® (Milano, Italy) for providing the implants used in the present study.
Gehrke SA, Bettach R, Aramburú Júnior JS, Prados-Frutos JC, Del Fabbro M, Shibli JA. Peri-Implant Bone Behavior after Single Drill versus Multiple Sequence for Osteotomy Drill. Biomed Res Int. 2018;11:2018.
Möhlhenrich SC, Abouridouane M, Heussen N, Hölzle F, Klocke F, Modabber A. Thermal evaluation by infrared measurement of implant site preparation between single and gradual drilling in art...
Summers RB. A new concept in maxillary implant surgery: the osteotome technique. Compendium. 1994;15:152–6.
Büchter A, Kleinheinz J, Wiesmann HP, et al. Biological and biomechanical evaluation of bone remodelling and implant stability after using an osteotome technique. Clin Oral Implants Res. 2005;16:1–8.
Stavropoulos A, Nyengaard JR, Lang NP, et al. Immediate loading of single SLA implant...
Albrektsson T, Brånemark PI, Hansson HA, et al. Osseointegrated titanium implants. Requirements for ensuring a long-lasting, direct bone-to-implant anchorage in man. Acta Orthop Scand. 1981;52(2):155–70.
Molly L. Bone density and primary stability in implant therapy. Clin Oral Implants Res. 2006;2:124–35.
Chong L, Khocht A, Suzuki JB, et al. Effect of implant design on initial stability of ...
All data and materials are available from the corresponding author in Pescara, Italy.
The hypothesis was accepted. Compressing implants with single-drill bone preparation demonstrated many clinical and histological advantages with respect with to standard implant drilling procedures and classical implant shape and design in low-density bone type. It is possible to summarize the advantages of this technique as follows: higher bone to implant contact percentage than the control group...
The comparison between the basal %BV and %BV in the test group revealed that these innovative implants were able to increase in a significant way the peri-implant bone density with respect to starting host bone density. This increased peri-implant bone density extended from about 0.5–0.7 mm beyond the implant perimeter causing an osseocorticalization around the fixture profile.
A recent study [...
Results from the present study clearly show that it is possible to insert an implant using a one-step concept for the surgical preparation of the bone bed in cancellous bone.
Guazzi et al. [24], comparing the clinical outcome of implants inserted in sites prepared with a simplified protocol consisting of one large single drill versus multiple conventional drilling steps, demonstrated less surgica...
No implant failure was observed after 2 months of healing. The clinical examination, done immediately after the bone block retrieval, showed no crestal bone resorption. No bone defects around implants, such as fenestration or dehiscence, were detected. The host bone density expressed in bone volume percentage (basal %BV) was 26.17 ± 2.35. This low value of BV% is common in soft bone, according to...
Specimens were immediately fixed in 10% neutral buffered formalin and processed for histologic analysis. After dehydration, samples were infiltrated with a methyl-methacrylate resin from a starting solution 50% ethanol/resin and subsequently 100% resin, with each step lasting 24 h. After polymerization, the blocks were sectioned and then ground down to about 40 μm. Toluidine blue staining was use...
After implant insertion, cover screws were secured and the surgical wounds were closed by a resorbable periosteal-muscular inner suture, followed by an external cutaneous 2-0 silk suture.
Each animal underwent systemic antibiotic therapy for 5 days with 8 ml long-acting Clamoxil (Pfizer Limited, Sandwich, USA). After surgery, animals received appropriate veterinary care and were allowed free acce...
The Ethics Committee for Animal Research of the Veterinary School of the University of Teramo (Teramo, Italy) approved the study protocol, which followed the guidelines established by the European Union Council Directive of February 2013 (R.D.53/2013).
Two female sheep, 4–5 years old, were included in the study. Clinical examination determined that all animals were in good general health. Exclu...
The aim of the present paper is to evaluate a reduced implant site preparation technique to preserve bone bulk and enhance primary stability using a new conical self-tapping implant in cancellous type IV bone. A histologic, histomorphometric, and biomechanical comparative analysis was conducted in low-density bone of the sheep’s iliac crest. The hypothesis to test is if undersized preparation an...
It is well documented that implant initial bone fixation, known as primary implant stability, represents the pre-requisite to achieve a successful long-term osseointegration [1].
Many studies demonstrated that the implant primary stability is strictly influenced by host bone density [2], fixture geometry [3, 4], and surgical technique used for preparing bone implant bed [5]. Other studies [6, 7] ...
The aim of the present paper is to evaluate a simplified implant site preparation technique to preserve bone bulk and enhance osseointegration using a new conical self-tapping implant in cancellous bone.
Ten Expander® 3.8 × 10 mm implants (NoDrill®, Milano, Italy) were inserted in the right side (test group) of sheep’s iliac crest using only the pilot drill 1.8 mm in diameter. Ten 3.8 × 10 ...
Fig. 8. Maximum von Mises stress value in implant bodies (MPa)
Fig. 8. Maximum von Mises stress value in implant bodies (MPa)
Fig. 7. Von Mises stress distribution in implant bodies. (right: buccal side, left: lingual side)
Fig. 7. Von Mises stress distribution in implant bodies. (right: buccal side, left: lingual side)
Fig. 6. Largest maximum principle stress value in cortical bone (MPa)
Fig. 6. Largest maximum principle stress value in cortical bone (MPa)
Fig. 5. Distribution of the maximum principle stress in the surrounding bone (occlusal view)
Fig. 5. Distribution of the maximum principle stress in the surrounding bone (occlusal view)
Fig. 4. Distribution of the maximum principle stress in the surrounding bone (right: buccal side, left: lingual side)
Fig. 4. Distribution of the maximum principle stress in the surrounding bone (right: buccal side, left: lingual side)
Fig. 3. Assembly of implant and bone models. A static load of 100 N was applied obliquely from the buccal side to the occlusal plane of the superstructure at 30 to the long axis of the implant
Fig. 3. Assembly of implant and bone models. A static load of 100 N was applied obliquely from the buccal side to the occlusal plane of the superstructure at 30 to the long axis of the implant
Fig. 2. Models of different implant body lengths
Fig. 2. Models of different implant body lengths
Fig. 1. Three-dimensional CAD model. (upper: a abutment screw, b superstructure, c implant body; Lower: bone model)
Fig. 1. Three-dimensional CAD model. (upper: a abutment screw, b superstructure, c implant body; Lower: bone model)
Young’s modulus (GPa)Poisson’s ratioReferenceAbutment screw (Ti-6Al-4V)1100.33[19]Superstructure (gold alloy)96.60.35[20]Cortical bone130.3[21]Cancellous bone1.370.3[21]Implant body (cpTi)1100.34 Implant body (TiZr)97.30.36 Table 1 Mechanical properties of each model component
Araki, H., Nakano, T., Ono, S. et al. Three-dimensional finite element analysis of extra short implants focusing on implant designs and materials. Int J Implant Dent 6, 5 (2020). https://doi.org/10.1186/s40729-019-0202-6
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Received: 20 August 2019
Accepted: 11 December 2019
Published: 29 January 2020
DOI: https://doi.org/10.1186/s40729-019-0202-6
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 m...
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Not applicable
The authors declare that they have no competing interests.
Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, Osaka, 565-0871, Japan
Haruka Araki, Tamaki Nakano, Shinji Ono & Hirofumi Yatani
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This research was supported by Grants-in-Aid for Scientific Research T15K204780 and T15K111560 from the Japan Society for the Promotion of Science.
Gottlow J, Dard M, Kjellson F, Obrecht M, Sennerby L. Evaluation of a new titanium-zirconium dental implant: a biomechanical and histological comparative study in the mini pig. Clin Implant Dent Relat Res. 2012;14:538–45.
Jimbo R, Naito Y, Galli S, Berner S, Dard M, Wennerberg A. Biomechanical and histomorphometrical evaluation of TiZr alloy implants: an in vivo study in the rabbit. Clin Implan...
Yamanishi Y, Yamaguchi S, Imazato S, Nakano T, Yatani H. Influences of implant neck design and implant–abutment joint type on peri-implant bone stress and abutment micromovement: three-dimensional finite element analysis. Dent Mater. 2012;28:1126–33.
Harel N, Eshkol-Yogev I, Piek D, Livne S, Lavi D, Ormianer Z. Bone microstrain values of 1-piece and 2-piece implants subjected to mechanical lo...
Lee TJ, Ueno T, Nomura N, Wakabayashi N, Hanawa T. Titanium-zirconium binary alloy as dental implant material: analysis of the influence of compositional change on mechanical properties and in vitro biologic response. Int J Oral Maxillofac Implants. 2015;31:547–54.
Al-Nawas B, Brägger U, Meijer HJA, Naert I, Persson R, Perucchi A. A double-blind randomized controlled trial (RCT) of titanium-13...
Renouard F, Nisand D. Impact of implant length and diameter on survival rates. Clin Oral Implants Res. 2006;17(Suppl 2):35–51.
Lee SA, Lee CT, Fu MM, Elmisalati W, Chuang SK. Systematic review and meta-analysis of randomized controlled trials for the management of limited vertical height in the posterior region: short implants (5 to 8 mm) vs longer implants (> 8 mm) in vertically augmented site...
Within the limitations of this study, the following conclusions were drawn.
The stress distribution in the cortical bone and implant body was smaller in the TL implant than in the BL implant.
The TiZr alloy had a lower elastic modulus than cpTi, and the stress distribution generated in the cortical bone and implant body was also lower.
The stress distribution generated in the cortical bone an...
Clinically, it is generally considered that the crown length increases proportionally when the length of the implant body decreases because of alveolar bone resorption. However, most previous studies performing FEA of short implants have analyzed them with a standard crown length [38]. In this study, the distance from the tip of the implant body to the occlusal plane was standardized to make the a...
The difference in the implant body structure between the submerged and non-submerged implants greatly affected the stress distribution. Since the TL implant body lies above the bone level rather than level with the crestal bone, it was found that the stress concentrates above the apex of the alveolar bone, regardless of the material type. As a result, the maximum stress value in the cortical bone ...
Overloading, which is one of the factors contributing to bone resorption around an implant body, can lead to complications because force is applied beyond the prosthodontic or biological tolerance [23]. It is believed that when stress of a certain magnitude is applied to the bone, microscopic bone destruction occurs resulting in bone resorption [24, 25]. Because implants do not have buffering mech...
The distribution of the maximum principal stress in the cortical bone concentrated on the neck of the implant body. In the TL implants, tensile stress was concentrated on the buccal side and compressive stress on the lingual side. In the BL implants, tensile stress concentration was observed on the lingual side. The distributions were similar between the cpTi and TiZr implants (Figs. 4 and 5). Th...
To validate the accuracy of the FEA model, microstrain of the surrounding bone were compared with the results of in vitro experiment measured with strain gauge [22]. In the literature, it was reported that microstrain of 59.3876 ± 24.7185 μe at the neck of implant and 17.3456 ± 12.9147 μe at the apical occurred in a bovine bone under an oblique load of 120 N. Under the same conditi...
TL and BL three-dimensional computer-aided design (CAD) implant models were created using the CAD function in computer-aided engineering software (SolidWorks 2014, Dassault Systèmes SolidWorks Corporation, MA, USA), and they were created with reference to conical connection implant used clinically. The connection part of superstructure has a tapered 15° conical shape without any special locking ...
Dental implants are widely used as a treatment option to replace a defective prosthesis. In recent years, treatment using short implants, which are ≤ 8 mm in length, has been increasing in cases with vertical bone resorption [1]. It is thought that this will become more popular as the number of patients who require minimally invasive treatment, such as older patients and those with chronic d...
When using short implants, fracture of the implant body and bone resorption are a concern because stress concentrates on and around a short implant. The purpose of this research is to investigate the differences in stress distribution between tissue level (TL) and bone level (BL) implant body designs, and between commercially pure titanium (cpTi) and the newer titanium–zirconium (TiZr) alloy in ...
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...
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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.
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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...
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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...
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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 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 ...
nMeanStandard deviationMinimumMaximumFD01301.2430.1520.7501.560FD11301.1130.2240.4051.510FD21301.1160.1960.4101.510FD3671.0920.2160.4301.500FD4671.0810.2470.4301.500Table 2 Mean fractal dimension (FD) values before and after implant insertion
Failure (n)Success (n)P valuePowerEffect sizeSexWomen3870.0240.680.21Men634FD190.82 ± 0.28 (mean)0.45 (min)–1.26 (max)1211.13 ± 0.25 (mean)0.41 (min)–1.51 (max)< 0.0010.991.45FD290.97 ± 0.24 (mean)0.61 (min)–1.36 (max)1211.13 ± 0.19 (mean)0.41 (min)–1.51 (max)0.0230.990.79Crown-implant Ratio26.51 ± 3.89 (mean)3.77 (min)–9.27 (max)654.61 ± 1.58 (mean)2.57 min)–10.67 (max)0.101...
Kış, H.C., Güleryüz Gürbulak, A. Evaluation of the peri-implant bone trabecular microstructure changes in short implants with fractal analysis. Int J Implant Dent 6, 13 (2020). https://doi.org/10.1186/s40729-020-00209-7
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Received: 12 September 2019
Accepted: 12 March 2020
Published: 01 April 2020
DOI: https://doi.org/10.1186/s40729-020-00209-7
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material...
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
Hatice Cansu Kış and Ayşegül Güleryüz Gür...
Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Nuh Naci Yazgan University, Kayseri, Turkey
Hatice Cansu Kış
Department of Prosthetic Dentistry, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
Ayşegül Güleryüz Gürbulak
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The work was supported by the Department of Oral & Maxillofacial Radiology, Nuh Naci Yazgan University in Kayseri, Turkey.
We would like to thank Editage (www.editage.com) for English language editing.
Mu T-J, Lee D-W, Park K-H, Moon I-S. Changes in the fractal dimension of peri-implant trabecular bone after loading: a retrospective study. Journal of periodontal & implant science. 2013;43(5):209–14.
Zeytinoğlu M, İlhan B, Dündar N, Boyacioğlu H. Fractal analysis for the assessment of trabecular peri-implant alveolar bone using panoramic radiographs. Clinical oral investigations. 2015;19(2...
Mandelbrot BB. The fractal geometry of nature: WH freeman New York; 1983.
Sánchez I, Uzcátegui G. Fractals in dentistry. Journal of dentistry. 2011;39(4):273–92.
Boutroy S, Bouxsein ML, Munoz F, Delmas PD. In vivo assessment of trabecular bone microarchitecture by high-resolution peripheral quantitative computed tomography. The Journal of Clinical Endocrinology & Metabolism. 2005;90(12):6508...
Dental panoramic radiographs
Fractal dimension 0 (preoperative)
Fractal dimension 1 (0–1 months of follow-up)
Fractal dimension 2 (1–3 months of follow-up)
Fractal dimension 3 (6–12 months of follow-up)
Fractal dimension 4 (12 + months of follow-up)
Cone beam computed tomography
Region of interest
Fractal analysis is a useful method to measure the trabecular microstructure of bone in nonstandardized dental radiographs. The present study has a low power to reject the null hypothesis because of the low number of cases of failed implants. Therefore, further studies with a large sample size are warranted. Assessing a series of studies can provide certain cut-off values; this can enable to routi...
Fractal analysis of bone microstructure on dental radiographs may be useful for diagnostic applications; however, the histological microstructures of the bone cannot be visualized by any clinical imaging modality. Corpas et al. [12] stated that minor changes in bone occurring over a short-term period can be followed up with digital intraoral radiography; however, the results of radiographic fracta...
This study aimed to evaluate the microstructural changes in the peri-implant bone in patients with short implants in terms of the implant survival status by using fractal analysis measurements.
In this study, a significant difference was found in the FD1 and FD2 values between the implant survival groups, and the mean FD1 and FD2 values of the success group were significantly higher than those of...
Descriptive statistics were performed. The data were not normally distributed (p < 0.05). The intra-observer correlation coefficients of repeated measurements were 0.927, 0.889, 0.913, 0.988, 0.961, and 0.936 for FD0 (fractal dimension), FD1, FD2, FD3, FD4, and crown-implant ratio, respectively. Descriptive data are shown in Figs. 5, 6, and 7. A significant difference was found for sex between the...
The crown-implant ratio was measured using the ImageJ version 1.38 software measuring tool in conjunction with a magnification tool. Each implant was measured from its bottom to the crown base and then from the crown base to its highest point (Fig. 4).
All measurements were performed by a dento-maxillofacial radiologist who was blinded to patient information. To evaluate the intra-observer correl...
This retrospective study was conducted in the dental clinic of Oral and Maxillofacial Radiology department and was approved by the local ethics committee (2013/203). The participants had approached the Prosthodontics Clinic between 2012 and 2019 for partial or complete tooth complaints. Among the data of 116 patients reviewed, panoramic radiographs of 67 patients were examined and included in this...
The quality of bone tissue at the site of implantation can be determined preoperatively with high accuracy, and changes in the trabecular structure, which is vital for the primary and secondary stability of the implant, can be observed during the follow-up after implantation.
Previous studies have evaluated fractal analysis of peri-implant bone before and after loading. However, no study has exam...
Mandelbrot introduced fractals to describe his observation of shapes in nature, such as curves, surfaces, disconnected “dust,” and odd shapes. The word fractal originates from the Latin word “fractus,” which means broken. By using fractal mathematics, several studies have analyzed various fractal patterns in the human body. Fractal analysis is a mathematical method of describing complex sh...
This study aimed to evaluate the microstructural changes in the peri-implant bone in patients with short implants in terms of implant survival status by using fractal analysis measurements.
Dental panoramic radiographs (DPRs) of 67 patients were examined and included in this study. Fractal analysis and measurement of the crown-implant ratio were performed with ImageJ. The fractal analysis measure...
Fig. 5. PROMs over 5 years: improvement of satisfaction from loading to study end
Fig. 5. PROMs over 5 years: improvement of satisfaction from loading to study end
Fig. 4. Soft tissue parameters at 5-year post-loading. a Plaque index: score 0, no plaque detected; score 1, plaque only recognized by running a probe across the smooth marginal surface of the implant; score 2, plaque seen by the naked eye; score 3, abundance of soft matter. b Sulcus bleeding index: score 0, no bleeding when a periodontal probe was passed along the gingival margin adjacent to th...
Fig. 3. Standardized peri-apical radiographs representing the bone level changes at the implant level: immediately post insertion (a), at loading (abutment/crown placement) (b), and at 5-year post-loading (c)
Fig. 3. Standardized peri-apical radiographs representing the bone level changes at the implant level: immediately post insertion (a), at loading (abutment/crown placement) (b), and at 5...
Fig. 2. Kaplan-Meier cumulative survival rate
Fig. 2. Kaplan-Meier cumulative survival rate
Fig. 1. Study flow-chart: assessments and reason for dropouts. Study visits were done according to standard procedures in the respective study centers. Blue, mandatory visits; gray, optional visits
Fig. 1. Study flow-chart: assessments and reason for dropouts. Study visits were done according to standard procedures in the respective study centers. Blue, mandatory visits; gray, optional visits
Bone level changenMeanSDInsertion-loading103− 0.520.55Loading-1-year follow-up93− 0.040.37Loading-3-year follow-up90− 0.040.40Loading-5-year follow-up86− 0.090.43Table 3 Mean crestal bone level changes in mm
CharacteristicsCategoryTotalTotal patients/implantsn94/130Center 19/17Center 218/26Center 320/26Center 414/16Center 518/26Center 615/19Gender, n (%)Male30 (31.9)Female64 (68.1)Age at surgery, yearsMean ± SD50.4 ± 13.7Range (min/max)19.1-75.6Age range distribution, n (%)< 30 years8 (8.5)30-45 years22 (23.4)45-60 years38 (40.4)60-75 years25 (26.6)> 75 years1 (1.1)Tobacco use, n (%)Non-sm...
Time periodPatientsImplantsBefore loading58Loading-1 year681-3 years673-5 years13Total1826Table 1 Dropouts over observation time
Ackermann, KL., Barth, T., Cacaci, C. et al. Clinical and patient-reported outcome of implant restorations with internal conical connection in daily dental practices: prospective observational multicenter trial with up to 7-year follow-up.
Int J Implant Dent 6, 14 (2020). https://doi.org/10.1186/s40729-020-00211-z
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Received: 16 December 2019
Accepted: 12 Ma...
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material...
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A written consent was given by all patients after being informed of the study. The study was performed following the declaration of Helsinki. Ethics committee approval was obtained from the international ethical committee of Freiburg (Germany, Ref. 010/1833).
Not applicable.
All authors declare that they have no conflicts of interest regarding this study. All authors have been lecturing for Caml...
Filderstadt, Germany
Karl-Ludwig Ackermann
Leipzig, Germany
Thomas Barth
Munich, Germany
Claudio Cacaci
Landsberg a. L., Germany
Steffen Kistler
Forchheim, Germany
Markus Schlee
Department of Maxillofacial Surgery, Goethe University Frankfurt, Frankfurt, Germany
Markus Schlee
Berlin, Germany
Michael Stiller
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This study was funded by an unrestricted grant (NISCAM01/10) of the Oral Reconstruction Foundation (previously CAMLOG Foundation).
The authors thank Lucius Keller of Touchpoint Communication AG (Luzern, Switzerland) for the medical writing support.
Chang M, Odman PA, Wennstrom JL, Andersson B. Esthetic outcome of implant-supported single-tooth replacements assessed by the patient and by prosthodontists. Int J Prosthodont. 1999;12(4):335–41.
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Cochran D, Oates T, Morton D, Jones A, Buser D, Peters F. Clinical field trial examining an implant with a sand-blasted, acid-etched surface...
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Adverse event
Bone level change
Distance implant shoulder to first visible bone contact
Orthopantomogram
Plaque index
Patient reported outcome measures
Platform switching
Sulcus bleeding index
The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
This prospective observational multicenter study demonstrated successful functional and esthetic outcomes of the study implant restorations (single tooth restoration, fixed partial dentures) with reliable peri-implant hard and soft tissue stability and high patients’ satisfaction. The results are comparable with the outcome of already published controlled randomized clinical studies and retrospe...
In recent years, patients’ needs have increased in terms of the esthetic and functional outcome of the dental restoration. PROMs have been reported in several studies and represent a well-described non-invasive method to measure patient’s satisfaction with these needs; however, they might present a lack of standardization [39, 40] due to the very subjective view on esthetics or functionality o...
Changes in crestal bone level are well-documented in the literature. Bone remodeling is reported to take place between surgery and loading. The reported changes are generally around 0.5 mm [17, 27, 30] but can reach more than 1 mm [31] in randomized or observational trials. The present study is well in accordance with these findings with its bone remodeling of − 0.52 ± 0.55 mm. Nearly 45%...
Endosseous dental implants are a commonly accepted treatment procedure and showed high survival and success rates as well as good functional performance in numerous clinical trials and retrospective analyses, also for Conelog implants as for their specific implant surface [17, 23, 26]. However, in general, one could argue that results of controlled clinical studies do not reflect the real situatio...
Table 3 shows the mean bone level changes of the implants with available radiographs from insertion to 5-year post-loading. Bone remodeling around the implant was noticeable from surgery to loading, presenting a mean value of − 0.52 ± 0.55 mm. From loading to the 5-year follow-up, the mean change in crestal bone remained clinically stable (−0.09 ± 0.43 mm) (Fig. 3).
Split into three g...
The study was started with 94 patients with 130 implants. At the end of the study (5-year post-loading), 76 patients with 104 implants were considered for analysis. Dropouts were distributed over the time of the study as described in Table 1. The majority of dropouts occurred early in the study phase. The reasons for the dropouts were variable as described in Fig. 1.
The demographic and clinica...
The study data, soft and hard tissue parameters as well as the PROMs were descriptively analyzed using IBM SPSS V25.0 (IBM Corp., Armonk, NY, USA): Categorical variables were shown with frequencies and mean values were used for continuous variables. Survival analysis was performed using Kaplan–Meier method. Time of loading was the study baseline as per protocol, and the statistical unit was the ...
Patients were scheduled to follow-ups at 6 months, 1-, 2-, 3-, 4-, and 5-year post-loading for the assessment of the study parameter (Fig. 1). Depending on the investigators’ standard post-operative protocol, follow-up appointments were scheduled slightly differently: One center skipped the control visits at 6 months. Additionally, due to the observational character of the study and the pati...
This is an observational multicenter clinical study, approved by the ethics committee of the Freiburg ethics commission international (feci 010/1833). The study was planned and conducted according to the German medical devices law, the Declaration of Helsinki, good clinical practice, and the reporting is aligned with the STROBE statement. A minimum of 90 to 100 patients were planned to be included...
Features of the chosen implant system for a study may also influence the outcome of the treatment: The degree of the manufacturer’s tolerances of implants with a conical implant-abutment connection heightens the risk of a mispositioning of the abutment, which cannot be corrected by repeated torqueing. Platform switching (PS) implants tend to have a protective effect on hard implant tissue outcom...
Many randomized controlled clinical trials have been published about dental implants. They have demonstrated long-term success in the rehabilitation of edentulous patients [1, 2] as well as patients with single or multiple teeth replacements [3, 4].
While this type of trials have an indispensable place in establishing a new product or a new operation technique regarding safety and efficacy, the r...
The interpretation of the results of randomized clinical trials is often questioned in relation with daily circumstances in practices. This prospective observational multicenter study was instigated to reflect the need for information in real-life situations with dental implants with internal conical implant-abutment connection (Conelog implant system). The implants were followed up at least 5-yea...
Fig. 6. Comparison of cleansability of each decontamination method on the different implant surfaces. Asterisk indicates p < 0.05
Fig. 6. Comparison of cleansability of each decontamination method on the different implant surfaces. Asterisk indicates p < 0.05
Fig. 5. Quantitative analysis of CFU counts on rough and machined surface implants after cleansing by each method. Asterisk represents vs Cont; a, vs G; b, vs US; c, vs Air; d, vs Rot; e, vs Las which indicates p < 0.05
Fig. 5. Quantitative analysis of CFU counts on rough and machined surface implants after cleansing by each method. Asterisk represents vs Cont; a, vs G; b, vs US; c, vs Air; d...
Fig. 4. SEM analysis of 4 areas. 1 Rough surface—microthread area. 2 Rough surface—macrothread area. 3 Machined surface—microthread area. 4 Machined surface—macrothread area
Fig. 4. SEM analysis of 4 areas. 1 Rough surface—microthread area. 2 Rough surface—macrothread area. 3 Machined surface—microthread area. 4 Machined surface—macrothread area
Fig. 3. Decontamination methods. a Gauze soaked in saline applied using a sawing motion. b Ultrasonic scaler (SUPRASSON P-MAX, Satelec-Acteon group, Bordeaux, France, power setting: P5, tip: Implant Protect IP3L/R). c Air abrasives (AIR-FLOW MASTER PIEZON®, EMS, Nyon, Switzerland, power setting: water flow 100%, air pressure 75%, powder: AIR-FLOW® PERIO POWDER, nozzle: PERIO-FLOW® nozzles, di...
Fig. 2. GC Aadva® implant; 3.3-mm diameter, 8-mm length
Fig. 2. GC Aadva® implant; 3.3-mm diameter, 8-mm length
Fig. 1. Hard resin splint model carrying 6 implants
Fig. 1. Hard resin splint model carrying 6 implants
Rough surfaceContGUSAirRotLasMedian137.53.446.513.04.816.3Min73.00.36.80.50.63.0Max785.027.0240.035.537.034.0Machine surfaceContGUSAirRotLasMedian84.50.98.53.23.325.3Min43.00.20.92.01.60.4Max295.04.236.014.05.661.5Table 3 Quantitative analysis of CFU counts (× 105) from rough and machined surface implants after cleansing by each method
Machined surface (microthread)No effectFairGoodExcellentG +US + Air + Rot +Las + Machined surface (macrothread)No effectFairGoodExcellentG +US + Air + Rot +Las + Table 2 Qualitative evaluation by SEM analysis of micro- and macrothread areas of machined surface implants
Rough surface (microthread)No effectFairGoodExcellentG + US + Air + Rot + Las+ Rough surface (macrothread)No effectFairGoodExcellentG + US + Air + Rot + Las+ Table 1 Qualitative evaluation by SEM analysis of micro- and macrothread areas of rough surface implants
Within the limitations of this study, the following conclusions were drawn.
The stress distribution in the cortical bone and implant body was smaller in the TL implant than in the BL implant.
The TiZr alloy had a lower elastic modulus than cpTi, and the stress distribution generated in the cortical bone and implant body was also lower.
The stress distribution generated in the cortical bone and ...
Clinically, it is generally considered that the crown length increases proportionally when the length of the implant body decreases because of alveolar bone resorption. However, most previous studies performing FEA of short implants have analyzed them with a standard crown length [38]. In this study, the distance from the tip of the implant body to the occlusal plane was standardized to make the a...
The difference in the implant body structure between the submerged and non-submerged implants greatly affected the stress distribution. Since the TL implant body lies above the bone level rather than level with the crestal bone, it was found that the stress concentrates above the apex of the alveolar bone, regardless of the material type. As a result, the maximum stress value in the cortical bone ...
Overloading, which is one of the factors contributing to bone resorption around an implant body, can lead to complications because force is applied beyond the prosthodontic or biological tolerance [23]. It is believed that when stress of a certain magnitude is applied to the bone, microscopic bone destruction occurs resulting in bone resorption [24, 25]. Because implants do not have buffering mech...
The distribution of the maximum principal stress in the cortical bone concentrated on the neck of the implant body. In the TL implants, tensile stress was concentrated on the buccal side and compressive stress on the lingual side. In the BL implants, tensile stress concentration was observed on the lingual side. The distributions were similar between the cpTi and TiZr implants (Figs. 4 and 5). Th...
To validate the accuracy of the FEA model, microstrain of the surrounding bone were compared with the results of in vitro experiment measured with strain gauge [22]. In the literature, it was reported that microstrain of 59.3876 ± 24.7185 μe at the neck of implant and 17.3456 ± 12.9147 μe at the apical occurred in a bovine bone under an oblique load of 120 N. Under the same conditi...
TL and BL three-dimensional computer-aided design (CAD) implant models were created using the CAD function in computer-aided engineering software (SolidWorks 2014, Dassault Systèmes SolidWorks Corporation, MA, USA), and they were created with reference to conical connection implant used clinically. The connection part of superstructure has a tapered 15° conical shape without any special locking ...
Dental implants are widely used as a treatment option to replace a defective prosthesis. In recent years, treatment using short implants, which are ≤ 8 mm in length, has been increasing in cases with vertical bone resorption [1]. It is thought that this will become more popular as the number of patients who require minimally invasive treatment, such as older patients and those with chronic d...
When using short implants, fracture of the implant body and bone resorption are a concern because stress concentrates on and around a short implant. The purpose of this research is to investigate the differences in stress distribution between tissue level (TL) and bone level (BL) implant body designs, and between commercially pure titanium (cpTi) and the newer titanium–zirconium (TiZr) alloy in ...
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
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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.
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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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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...
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
Hatice Cansu Kış and Ayşegül Güleryüz Gür...
Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Nuh Naci Yazgan University, Kayseri, Turkey
Hatice Cansu Kış
Department of Prosthetic Dentistry, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
Ayşegül Güleryüz Gürbulak
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The work was supported by the Department of Oral & Maxillofacial Radiology, Nuh Naci Yazgan University in Kayseri, Turkey.
We would like to thank Editage (www.editage.com) for English language editing.
Mu T-J, Lee D-W, Park K-H, Moon I-S. Changes in the fractal dimension of peri-implant trabecular bone after loading: a retrospective study. Journal of periodontal & implant science. 2013;43(5):209–14.
Zeytinoğlu M, İlhan B, Dündar N, Boyacioğlu H. Fractal analysis for the assessment of trabecular peri-implant alveolar bone using panoramic radiographs. Clinical oral investigations. 2015;19(2...
Mandelbrot BB. The fractal geometry of nature: WH freeman New York; 1983.
Sánchez I, Uzcátegui G. Fractals in dentistry. Journal of dentistry. 2011;39(4):273–92.
Boutroy S, Bouxsein ML, Munoz F, Delmas PD. In vivo assessment of trabecular bone microarchitecture by high-resolution peripheral quantitative computed tomography. The Journal of Clinical Endocrinology & Metabolism. 2005;90(12):6508...
Dental panoramic radiographs
Fractal dimension 0 (preoperative)
Fractal dimension 1 (0–1 months of follow-up)
Fractal dimension 2 (1–3 months of follow-up)
Fractal dimension 3 (6–12 months of follow-up)
Fractal dimension 4 (12 + months of follow-up)
Cone beam computed tomography
Region of interest
Fractal analysis is a useful method to measure the trabecular microstructure of bone in nonstandardized dental radiographs. The present study has a low power to reject the null hypothesis because of the low number of cases of failed implants. Therefore, further studies with a large sample size are warranted. Assessing a series of studies can provide certain cut-off values; this can enable to routi...
Fractal analysis of bone microstructure on dental radiographs may be useful for diagnostic applications; however, the histological microstructures of the bone cannot be visualized by any clinical imaging modality. Corpas et al. [12] stated that minor changes in bone occurring over a short-term period can be followed up with digital intraoral radiography; however, the results of radiographic fracta...
This study aimed to evaluate the microstructural changes in the peri-implant bone in patients with short implants in terms of the implant survival status by using fractal analysis measurements.
In this study, a significant difference was found in the FD1 and FD2 values between the implant survival groups, and the mean FD1 and FD2 values of the success group were significantly higher than those of...
Descriptive statistics were performed. The data were not normally distributed (p < 0.05). The intra-observer correlation coefficients of repeated measurements were 0.927, 0.889, 0.913, 0.988, 0.961, and 0.936 for FD0 (fractal dimension), FD1, FD2, FD3, FD4, and crown-implant ratio, respectively. Descriptive data are shown in Figs. 5, 6, and 7. A significant difference was found for sex between the...
The crown-implant ratio was measured using the ImageJ version 1.38 software measuring tool in conjunction with a magnification tool. Each implant was measured from its bottom to the crown base and then from the crown base to its highest point (Fig. 4).
All measurements were performed by a dento-maxillofacial radiologist who was blinded to patient information. To evaluate the intra-observer correl...
This retrospective study was conducted in the dental clinic of Oral and Maxillofacial Radiology department and was approved by the local ethics committee (2013/203). The participants had approached the Prosthodontics Clinic between 2012 and 2019 for partial or complete tooth complaints. Among the data of 116 patients reviewed, panoramic radiographs of 67 patients were examined and included in this...
The quality of bone tissue at the site of implantation can be determined preoperatively with high accuracy, and changes in the trabecular structure, which is vital for the primary and secondary stability of the implant, can be observed during the follow-up after implantation.
Previous studies have evaluated fractal analysis of peri-implant bone before and after loading. However, no study has exam...
Mandelbrot introduced fractals to describe his observation of shapes in nature, such as curves, surfaces, disconnected “dust,” and odd shapes. The word fractal originates from the Latin word “fractus,” which means broken. By using fractal mathematics, several studies have analyzed various fractal patterns in the human body. Fractal analysis is a mathematical method of describing complex sh...
This study aimed to evaluate the microstructural changes in the peri-implant bone in patients with short implants in terms of implant survival status by using fractal analysis measurements.
Dental panoramic radiographs (DPRs) of 67 patients were examined and included in this study. Fractal analysis and measurement of the crown-implant ratio were performed with ImageJ. The fractal analysis measure...
Fig. 5. PROMs over 5 years: improvement of satisfaction from loading to study end
Fig. 5. PROMs over 5 years: improvement of satisfaction from loading to study end
Fig. 4. Soft tissue parameters at 5-year post-loading. a Plaque index: score 0, no plaque detected; score 1, plaque only recognized by running a probe across the smooth marginal surface of the implant; score 2, plaque seen by the naked eye; score 3, abundance of soft matter. b Sulcus bleeding index: score 0, no bleeding when a periodontal probe was passed along the gingival margin adjacent to th...
Fig. 3. Standardized peri-apical radiographs representing the bone level changes at the implant level: immediately post insertion (a), at loading (abutment/crown placement) (b), and at 5-year post-loading (c)
Fig. 3. Standardized peri-apical radiographs representing the bone level changes at the implant level: immediately post insertion (a), at loading (abutment/crown placement) (b), and at 5...
Fig. 2. Kaplan-Meier cumulative survival rate
Fig. 2. Kaplan-Meier cumulative survival rate
Fig. 1. Study flow-chart: assessments and reason for dropouts. Study visits were done according to standard procedures in the respective study centers. Blue, mandatory visits; gray, optional visits
Fig. 1. Study flow-chart: assessments and reason for dropouts. Study visits were done according to standard procedures in the respective study centers. Blue, mandatory visits; gray, optional visits
Bone level changenMeanSDInsertion-loading103− 0.520.55Loading-1-year follow-up93− 0.040.37Loading-3-year follow-up90− 0.040.40Loading-5-year follow-up86− 0.090.43Table 3 Mean crestal bone level changes in mm
CharacteristicsCategoryTotalTotal patients/implantsn94/130Center 19/17Center 218/26Center 320/26Center 414/16Center 518/26Center 615/19Gender, n (%)Male30 (31.9)Female64 (68.1)Age at surgery, yearsMean ± SD50.4 ± 13.7Range (min/max)19.1-75.6Age range distribution, n (%)< 30 years8 (8.5)30-45 years22 (23.4)45-60 years38 (40.4)60-75 years25 (26.6)> 75 years1 (1.1)Tobacco use, n (%)Non-sm...
Time periodPatientsImplantsBefore loading58Loading-1 year681-3 years673-5 years13Total1826Table 1 Dropouts over observation time
Ackermann, KL., Barth, T., Cacaci, C. et al. Clinical and patient-reported outcome of implant restorations with internal conical connection in daily dental practices: prospective observational multicenter trial with up to 7-year follow-up.
Int J Implant Dent 6, 14 (2020). https://doi.org/10.1186/s40729-020-00211-z
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Received: 16 December 2019
Accepted: 12 Ma...
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material...
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A written consent was given by all patients after being informed of the study. The study was performed following the declaration of Helsinki. Ethics committee approval was obtained from the international ethical committee of Freiburg (Germany, Ref. 010/1833).
Not applicable.
All authors declare that they have no conflicts of interest regarding this study. All authors have been lecturing for Caml...
Filderstadt, Germany
Karl-Ludwig Ackermann
Leipzig, Germany
Thomas Barth
Munich, Germany
Claudio Cacaci
Landsberg a. L., Germany
Steffen Kistler
Forchheim, Germany
Markus Schlee
Department of Maxillofacial Surgery, Goethe University Frankfurt, Frankfurt, Germany
Markus Schlee
Berlin, Germany
Michael Stiller
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This study was funded by an unrestricted grant (NISCAM01/10) of the Oral Reconstruction Foundation (previously CAMLOG Foundation).
The authors thank Lucius Keller of Touchpoint Communication AG (Luzern, Switzerland) for the medical writing support.
Chang M, Odman PA, Wennstrom JL, Andersson B. Esthetic outcome of implant-supported single-tooth replacements assessed by the patient and by prosthodontists. Int J Prosthodont. 1999;12(4):335–41.
Kiltz U, Winter J, Schirmer M, Weber U, Hammel L, Baraliakos X, et al. German translation and cross-cultural adaptation of the ASAS health index: an ICF-based instrument for documentation of functional...
Ravald N, Dahlgren S, Teiwik A, Grondahl K. Long-term evaluation of Astra Tech and Branemark implants in patients treated with full-arch bridges. Results after 12-15 years. Clin Oral Implants Res. 2013;24(10):1144–51.
Schwarz F, Alcoforado G, Nelson K, Schaer A, Taylor T, Beuer F, et al. Impact of implant-abutment connection, positioning of the machined collar/microgap, and platform switching...
Gupta S, Sabharwal R, Nazeer J, Taneja L, Choudhury BK, Sahu S. Platform switching technique and crestal bone loss around the dental implants: a systematic review. Ann Afr Med. 2019;18(1):1–6.
Hsu YT, Lin GH, Wang HL. Effects of platform-switching on peri-implant soft and hard tissue outcomes: a systematic review and meta-analysis. Int J Oral Maxillofac Implants. 2017;32(1):e9–e24.
Nelson K,...
Cacaci C, Ackermann KL, Barth T, Kistler S, Stiller M, Schlee M. A non-interventional multicenter study to document the implants success and survival rates in daily dental practices of the CONELOG screw-line implant. Clin Oral Investig. 2019;23(6):2609–16.
Cochran D, Oates T, Morton D, Jones A, Buser D, Peters F. Clinical field trial examining an implant with a sand-blasted, acid-etched surface...
Krennmair G, Seemann R, Weinlander M, Piehslinger E. Comparison of ball and telescopic crown attachments in implant-retained mandibular overdentures: a 5-year prospective study. Int J Oral Maxillofac Implants. 2011;26(3):598–606.
Slot W, Raghoebar GM, Cune MS, Vissink A, Meijer HJA. Four or six implants in the maxillary posterior region to support an overdenture: 5-year results from a randomize...
Adverse event
Bone level change
Distance implant shoulder to first visible bone contact
Orthopantomogram
Plaque index
Patient reported outcome measures
Platform switching
Sulcus bleeding index
The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
This prospective observational multicenter study demonstrated successful functional and esthetic outcomes of the study implant restorations (single tooth restoration, fixed partial dentures) with reliable peri-implant hard and soft tissue stability and high patients’ satisfaction. The results are comparable with the outcome of already published controlled randomized clinical studies and retrospe...
In recent years, patients’ needs have increased in terms of the esthetic and functional outcome of the dental restoration. PROMs have been reported in several studies and represent a well-described non-invasive method to measure patient’s satisfaction with these needs; however, they might present a lack of standardization [39, 40] due to the very subjective view on esthetics or functionality o...
Changes in crestal bone level are well-documented in the literature. Bone remodeling is reported to take place between surgery and loading. The reported changes are generally around 0.5 mm [17, 27, 30] but can reach more than 1 mm [31] in randomized or observational trials. The present study is well in accordance with these findings with its bone remodeling of − 0.52 ± 0.55 mm. Nearly 45%...
Endosseous dental implants are a commonly accepted treatment procedure and showed high survival and success rates as well as good functional performance in numerous clinical trials and retrospective analyses, also for Conelog implants as for their specific implant surface [17, 23, 26]. However, in general, one could argue that results of controlled clinical studies do not reflect the real situatio...
Table 3 shows the mean bone level changes of the implants with available radiographs from insertion to 5-year post-loading. Bone remodeling around the implant was noticeable from surgery to loading, presenting a mean value of − 0.52 ± 0.55 mm. From loading to the 5-year follow-up, the mean change in crestal bone remained clinically stable (−0.09 ± 0.43 mm) (Fig. 3).
Split into three g...
The study was started with 94 patients with 130 implants. At the end of the study (5-year post-loading), 76 patients with 104 implants were considered for analysis. Dropouts were distributed over the time of the study as described in Table 1. The majority of dropouts occurred early in the study phase. The reasons for the dropouts were variable as described in Fig. 1.
The demographic and clinica...
The study data, soft and hard tissue parameters as well as the PROMs were descriptively analyzed using IBM SPSS V25.0 (IBM Corp., Armonk, NY, USA): Categorical variables were shown with frequencies and mean values were used for continuous variables. Survival analysis was performed using Kaplan–Meier method. Time of loading was the study baseline as per protocol, and the statistical unit was the ...
Patients were scheduled to follow-ups at 6 months, 1-, 2-, 3-, 4-, and 5-year post-loading for the assessment of the study parameter (Fig. 1). Depending on the investigators’ standard post-operative protocol, follow-up appointments were scheduled slightly differently: One center skipped the control visits at 6 months. Additionally, due to the observational character of the study and the pati...
This is an observational multicenter clinical study, approved by the ethics committee of the Freiburg ethics commission international (feci 010/1833). The study was planned and conducted according to the German medical devices law, the Declaration of Helsinki, good clinical practice, and the reporting is aligned with the STROBE statement. A minimum of 90 to 100 patients were planned to be included...
Features of the chosen implant system for a study may also influence the outcome of the treatment: The degree of the manufacturer’s tolerances of implants with a conical implant-abutment connection heightens the risk of a mispositioning of the abutment, which cannot be corrected by repeated torqueing. Platform switching (PS) implants tend to have a protective effect on hard implant tissue outcom...
Many randomized controlled clinical trials have been published about dental implants. They have demonstrated long-term success in the rehabilitation of edentulous patients [1, 2] as well as patients with single or multiple teeth replacements [3, 4].
While this type of trials have an indispensable place in establishing a new product or a new operation technique regarding safety and efficacy, the r...
The interpretation of the results of randomized clinical trials is often questioned in relation with daily circumstances in practices. This prospective observational multicenter study was instigated to reflect the need for information in real-life situations with dental implants with internal conical implant-abutment connection (Conelog implant system). The implants were followed up at least 5-yea...
Fig. 6. Comparison of cleansability of each decontamination method on the different implant surfaces. Asterisk indicates p < 0.05
Fig. 6. Comparison of cleansability of each decontamination method on the different implant surfaces. Asterisk indicates p < 0.05
Fig. 5. Quantitative analysis of CFU counts on rough and machined surface implants after cleansing by each method. Asterisk represents vs Cont; a, vs G; b, vs US; c, vs Air; d, vs Rot; e, vs Las which indicates p < 0.05
Fig. 5. Quantitative analysis of CFU counts on rough and machined surface implants after cleansing by each method. Asterisk represents vs Cont; a, vs G; b, vs US; c, vs Air; d...
Fig. 4. SEM analysis of 4 areas. 1 Rough surface—microthread area. 2 Rough surface—macrothread area. 3 Machined surface—microthread area. 4 Machined surface—macrothread area
Fig. 4. SEM analysis of 4 areas. 1 Rough surface—microthread area. 2 Rough surface—macrothread area. 3 Machined surface—microthread area. 4 Machined surface—macrothread area
Fig. 3. Decontamination methods. a Gauze soaked in saline applied using a sawing motion. b Ultrasonic scaler (SUPRASSON P-MAX, Satelec-Acteon group, Bordeaux, France, power setting: P5, tip: Implant Protect IP3L/R). c Air abrasives (AIR-FLOW MASTER PIEZON®, EMS, Nyon, Switzerland, power setting: water flow 100%, air pressure 75%, powder: AIR-FLOW® PERIO POWDER, nozzle: PERIO-FLOW® nozzles, di...
Fig. 2. GC Aadva® implant; 3.3-mm diameter, 8-mm length
Fig. 2. GC Aadva® implant; 3.3-mm diameter, 8-mm length
Fig. 1. Hard resin splint model carrying 6 implants
Fig. 1. Hard resin splint model carrying 6 implants
Rough surfaceContGUSAirRotLasMedian137.53.446.513.04.816.3Min73.00.36.80.50.63.0Max785.027.0240.035.537.034.0Machine surfaceContGUSAirRotLasMedian84.50.98.53.23.325.3Min43.00.20.92.01.60.4Max295.04.236.014.05.661.5Table 3 Quantitative analysis of CFU counts (× 105) from rough and machined surface implants after cleansing by each method
Machined surface (microthread)No effectFairGoodExcellentG +US + Air + Rot +Las + Machined surface (macrothread)No effectFairGoodExcellentG +US + Air + Rot +Las + Table 2 Qualitative evaluation by SEM analysis of micro- and macrothread areas of machined surface implants
Rough surface (microthread)No effectFairGoodExcellentG + US + Air + Rot + Las+ Rough surface (macrothread)No effectFairGoodExcellentG + US + Air + Rot + Las+ Table 1 Qualitative evaluation by SEM analysis of micro- and macrothread areas of rough surface implants
Otsuki, M., Wada, M., Yamaguchi, M. et al. Evaluation of decontamination methods of oral biofilms formed on screw-shaped, rough and machined surface implants: an ex vivo study.
Int J Implant Dent 6, 18 (2020). https://doi.org/10.1186/s40729-020-00212-y
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Received: 06 February 2020
Accepted: 17 March 2020
Published: 22 April 2020
DOI: https://doi.org/10.118...
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All participants provided informed consent verbally. Study information was disseminated to participants both verbally and in written form. This study protocol was approved by the ethical committee of Osaka University (H26.E-36).
All participants consented to the publication of their data through a written consent form obtained from the ethical committee of Osaka University.
Motohiro Otsuki, Masa...
Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
Motohiro Otsuki, Masahiro Wada, Yoshinobu Maeda & Kazunori Ikebe
Department of Oral and Molecular Microbiology, Osaka University Graduate School of Dentistry, Osaka, Japan
Masaya Yamaguchi & Shigetada Kawabata
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GC Corporation provided the implants to this research.
The authors thank Tomoaki Mameno for his work on data analysis.
Romeo E, Ghisolfi M, Murgolo N, Chiapasco M, Lops D, Vogel G. Therapy of peri-implantitis with resective surgery. A 3-year clinical trial on rough screw-shaped oral implants. Part I: clinical outcome. Clin Oral Implants Res. 2007;16(1):9–18.
Aoki A, Mizutani K, Schwarz F, Sculean A, Yukna RA, Takasaki AA, et al. Periodontal and peri-implant wound healing following laser therapy. Periodontol 200...
Berglundh T, Armitage G, Araujo MG, Avila-Ortiz G, Blanco J, Camargo PM, et al. Peri-implant diseases and conditions: consensus report of workgroup 4 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Periodontol. 2018;89(Suppl 1):S313–8.
Sousa V, Mardas N, Spratt D, Boniface D, Dard M, Donos N. Experimental models for contamination of ti...
Schwarz F, Ferrari D, Popovski K, Hartig B, Becker J. Influence of different air-abrasive powders on cell viability at biologically contaminated titanium dental implants surfaces. J Biomed Mater Res B Appl Biomater. 2009;88(1):83–91.
Widodo A, Spratt D, Sousa V, Petrie A, Donos N. An in vitro study on disinfection of titanium surfaces. Clin Oral Implants Res. 2016;27(10):1227–32.
Sahrmann P,...
Derks J, Schaller D, Hakansson J, Wennstrom JL, Tomasi C, Berglundh T. Effectiveness of implant therapy analyzed in a Swedish population: prevalence of peri-implantitis. J Dent Res. 2016;95(1):43–9.
Fransson C, Lekholm U, Jemt T, Berglundh T. Prevalence of subjects with progressive bone loss at implants. Clin Oral Implants Res. 2005;16(4):440–6.
Wada M, Mameno T, Onodera Y, Matsuda H, Daimon...
Control (no decontamination)
Gauze soaked in saline
Ultrasonic scaler (SUPRASSON P-MAX, Satelec-Acteon Group, Bordeaux, France; power setting: P5, tip: Implant Protect IP3L/R)
Air abrasive (AIR-FLOW MASTER PIEZON®, EMS, Nyon, Switzerland; power setting: water flow 100%, air pressure 75%, powder: AIR-FLOW® PERIO POWDER, nozzle: PERIO-FLOW® nozzles, distance from the nozzle to the implant 2 ...
The datasets used during the current study are available from the corresponding author on reasonable request.
In the present ex vivo experimental study, none of the tested decontamination methods thoroughly eliminated biofilms formed on rough/machined surface implants intraorally. Gauze soaked in saline and the rotary stainless steel instrument showed better cleansability than the ultrasonic scaler in qualitative and quantitative analyses and may be advantageous for cleansing contaminated implant surfaces...
Through SEM analysis and CFU counts, it was demonstrated that, except for the Er:YAG laser, decontamination of the machined surface implant was easier than that of the rough surface implant regardless of decontamination method. Gauze soaked in saline and the ultrasonic scaler demonstrated a statistically significant difference in CFU counts between the two surfaces. In this context, a machined sur...
Sahrmann et al. [15] tested three instruments (ultrasonic scaler, Gracey curette, and air abrasive device with glycine powder) on rough surface implants stained with indelible ink used as artificial plaque. There was a statistically significant difference in terms of stain removal rate. The air abrasive device showed the best result among the tested instruments. The result of this study is in line...
It has been previously stated that the alteration of the implant surface during cleansing may attenuate biocompatibility [29]. However, several clinical studies revealed the considerable treatment effect even though there was certain expected damage on the implant surface [7, 34]. Therefore, it is assumed that the most important consideration for treating peri-implantitis in the clinical setting s...
Regarding the air abrasives, the cleansing effect in the SEM analysis was also as considerable as that achieved by the ultrasonic scaler in the present study, in contrast to the results of the aforementioned study. Louropoulou et al. [29] also stated in their systematic review that an air-powder abrasive system with sodium bicarbonate powder could cleanse contaminated rough/smooth implant surfaces...
Based on the results of the SEM qualitative analysis, gauze soaked in saline and the rotary stainless steel instrument consistently showed good cleansability on rough and machined surface implants compared with the other methods. Conversely, the Er:YAG laser showed inferior cleansability to all other methods especially on rough surface implants. The ultrasonic scaler and air abrasive exhibited fai...
This study was performed following an ex vivo design to overcome the drawbacks of previous studies. One particular difference in this study was the use of a commercially available screw-shaped implant. As the implant shape and design have rather complicated macro- and microstructures compared with titanium disks or different forms of titanium commonly used in experimental studies, previous results...
During the experiment, three participants experienced small ulcers caused by the implants carried on the splints; however, it did not affect their daily life. Additionally, there were no signs of gingival inflammation in any participant.
G and Rot achieved relatively clean implant surfaces compared with Las in micro- and macrothread areas. US and Air demonstrated fair cleansability in microthread...
The SEM analysis was performed as previously described [16,17,18]. The decontaminated implant samples were fixed with 2% glutaraldehyde-RPMI 1640 immediately for 1 h at room temperature and washed with distilled water. Then, the samples were dehydrated with 100% t-butyl alcohol and freeze-dried. Finally, the samples were coated with platinum and examined using an emission-scanning electron micro...
Eleven participants, nine men and two women between 28 and 42 years of age (mean age 31.3 ± 4.6), were recruited as the study subjects. All participants provided informed consent verbally. Study information was disseminated to participants both verbally and in written form. The inclusion criteria were as follows:
Generally healthy subjects
Dentate subjects without ill-fitting restorations (...
Dental implants are now used broadly for recovering loss of masticatory function and esthetics. Although it has been revealed that dental implants can often survive long term, biological and mechanical complications may arise. Recent cross-sectional and retrospective studies noted a higher prevalence of peri-implantitis at the implant and subject level than previously considered [1,2,3,4]. Additio...
To evaluate the effect of several representative decontamination methods of oral biofilms on different implant surfaces.
Eleven participants wore a hard resin splint carrying 6 rough (GC Aadva® implant; 3.3-mm diameter, 8-mm length) or machined (not commercially available) surface implants for 4 days to accumulate dental plaque naturally on the titanium surfaces of the implants. Apart from sur...
Figure 2. poietic stem cells; MP, macrophages; OC, osteoclasts.
Figure 2. Summary of biological processes identified via gene expression during early peri-implant bone healing. CKs, cytokines; GFs, growth factors; EPC, endothelial progenitor cells; EC, endothelial cells; MSC, mesenchymal stem cells; OB, osteoblasts; ECM, extracellular matrix; HSC, haematopoietic stem cells; MP, macrophages; O...
Figure 1. Flowchart for study selection (
Figure 1. Flowchart for study selection ( n = number of studies).
Process
Upregulated genes
Category (gene code)
Inflammation/immune response
Pro-inflammatory cytokines
Tumor necrosis factor (TNF-a, TNFSF9)
Interleukin (IL-6, IL-2, IL-1 F9, IL-23A, ...
Study
Ivanovski et al. [
34
]
Donos et al. [
35
]
Bryington et al. [
36
]
Thalji et al. [
37
]
Design
9 patients; 9 implants placed
18 patients; 18 implants placed
10 patients;...
Category
Ivanovski et al. [ 34 ]
Donos et al. 2011 [ 35 ]
Bryington et al. [ 36 ]
Thalji et al. [ 37 ]
Study design
Comparison
None (only SLActive)
SLA vs. SLActive
TiOBlast vs. Osseospeed
TiOBlast vs. Osseospeed
Setting
University
University
University
University
Population, inclusion criteria
9 healthy volunteers with no mandibular thi...
Methodology
Ivanovski et al. [
34
]
Donos et al. [
35
]
Bryington et al. [
36
]
Thalji et al. [
37
]
Tissue harvesting
Tissue attached to implant carefully removed with a curette, preexisting hard tissue discarded
Tissue attached to ...
Shanbhag, S., Shanbhag, V. & Stavropoulos, A. Genomic analyses of early peri-implant bone healing in humans: a systematic review. Int J Implant Dent 1, 5 (2015). https://doi.org/10.1186/s40729-015-0006-2
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Received: 14 November 2014
Accepted: 27 January 2015
Published: 01 March 2015
DOI: https://doi.org/10.1186/s40729-015-0006-2
The authors declare that they have no competing interests.
SS conceived and carried out the study and drafted the manuscript. VS and AS participated in carrying out the study and drafting the manuscript. All authors read and approved the final manuscript.
Department of Periodontology, Faculty of Odontology, Malmö University, Carl Gustafs väg 34, 214 21, Malmö, Sweden
Siddharth Shanbhag & Andreas Stavropoulos
Centre for Oral Rehabilitation & Implant Dentistry, 1 Laxmi Niwas, 87 Bajaj Road, Vile Parle West, Mumbai, 400056, India
Siddharth Shanbhag & Vivek Shanbhag
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Donos N, Retzepi M, Wall I, Hamlet S, Ivanovski S. In vivo gene expression profile of guided bone regeneration associated with a microrough titanium surface. Clin Oral Implants Res. 2011;22(4):390–8. doi:10.1111/j.1600-0501.2010.02105.x.
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Ziebart T, Schnell A, Walter C, Kämmerer PW, Pabst A, Lehmann KM, et al. Interactions between endothelial progenitor cells (EPC) and titanium implant surfaces. Clin Oral Investig. 2013;17(1):301–...
Rocci M, Rocci A, Martignoni M, Albrektsson T, Barlattani A, Gargari M. Comparing the TiOblast and Osseospeed surfaces. Histomorphometric and histological analysis in humans. Oral Implantol (Rome). 2008;1(1):34–42.
Qin C, Baba O, Butler WT. Post-translational modifications of sibling proteins and their roles in osteogenesis and dentinogenesis. Crit Rev Oral Biol Med. 2004;15(3):126–36.
Vlaci...
Chehroudi B, Ghrebi S, Murakami H, Waterfield JD, Owen G, Brunette DM. Bone formation on rough, but not polished, subcutaneously implanted Ti surfaces is preceded by macrophage accumulation. J Biomed Mater Res A. 2010;93(2):724–37. doi:10.1002/jbm.a.32587.
Heng BC, Cao T, Stanton LW, Robson P, Olsen B. Strategies for directing the differentiation of stem cells into the osteogenic lineage in vit...
Nishimura I. Genetic networks in osseointegration. J Dent Res. 2013;92(12 Suppl):109S–18. doi:10.1177/0022034513504928.
Higgins JPT, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane-handbook.org; 2011.
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Lin Z, Rios HF, Volk SL, Sugai JV, Jin Q, Giannobile WV. Gene expression dynamics during bone healing and osseointegration. J Periodontol. 2011;82(7):1007–17. doi:10.1902/jop.2010.100577.
Ai-Aql ZS, Alagl AS, Graves DT, Gerstenfeld LC, Einhorn TA. Molecular mechanisms controlling bone formation during fracture healing and distraction osteogenesis. J Dent Res. 2008;87(2):107–18.
Albrektsson T...
Setzer FC, Kim S. Comparison of long-term survival of implants and endodontically treated teeth. J Dent Res. 2014;93(1):19–26. doi:10.1177/0022034513504782.
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.
Berglundh T, Abrahamsson ...
Based on limited evidence of gene expression data from four studies involving 43 patients, the following remarks can be made:
Early peri-implant healing (2 weeks) involves a sequence of biological events which are similar to those observed in other bone wound healing scenarios (fractures, extraction-sockets).
Osseointegration depends on osteogenesis at the implant interface, but other simultane...
It can be hypothesized that peri-implant neurogenesis is one of the underlying mechanisms governing the phenomenon of osseoperception, defined as the tactile sensibility of osseointegrated implants to occlusal forces induced via activation of nerve endings and/or receptors in the peri-implant environment [82,83]. Moreover, recent evidence suggests that implant surface properties may influence the ...
In the present review, a significant simultaneous upregulation of several angiogenesis-related genes was identified at day 7 in all included studies. Pro-angiogenic factors (ANXA2, EPAS-1) were upregulated at TiOBlast and Osseospeed surfaces at day 7 [37]. Genes associated with VEGF and P13K-AKT signaling pathways were upregulated at SLActive (but not SLA) surfaces on day 7 and continued to be upr...
Furthermore, genes associated with collagen fibril formation/organization (heat-shock protein-47 (HSP-47), pro-collagen C-endopeptidase enhancer (PCOLCE), small leucine-rich proteoglycans (SLRP)) and post-translational modification (pro-collagen lysyl-hydroxylases (PLOD1, PLOD2, PLOD3) and lysyl-oxidase (LOX)) were upregulated on Osseospeed and TiOBlast surfaces [37]. Collagen comprises approximat...
The key signaling pathways, via which GFs guide osteogenic cell differentiation, are the TGF-β/BMP- and Wnt-mediated pathways [19,47]. While the BMP pathway ensures differentiation of MSCs into osteo-chondro-progenitors (OCPs), the Wnt pathway is essential for subsequent osteoblastic commitment, i.e., Wnt acts ‘downstream’ of BMP to ensure that OCPs differentiate into osteoblasts and not chon...
Cells along the osteogenic differentiation pathway may be artificially categorized as (1) undifferentiated MSCs, (2) osteo-chondro-progenitor cells, (3) pre-osteoblasts, and (4) osteoblasts; although in reality, a developmental continuum without distinct boundaries may exist [43]. While pre-differentiated osteoblasts in the marrow compartment only play a minor role in bone wound healing, a more pr...
Thus, high risk of bias should be considered when interpreting the results, due to the above methodological limitations and the overall limited information (four studies) available.
Conventional implant surgery involves osteotomy preparation and insertion of the implant into the alveolar bone. The immediate local effects of this procedure, functionally relevant to subsequent healing processes, ar...
The included studies basically report on commercially available implants from two major manufacturers and involve comparisons of different implant surface technologies in regard with topography and/or chemistry modifications within each implant system. Various analyses were performed in the included studies; however, an attempt has been made to synthesize the various findings and discuss them here...
Both reviewers independently extracted data from the full texts of included articles using specially designed forms. Data on author(s), study design, implant type/surface, any additional procedures performed, number of patients (in each group), presence of a control group, procedure and time of implant retrieval, methods of gene expression analysis, and main results, were extracted. Descriptive su...
A study protocol for a systematic qualitative literature review was developed based on recommended methods [29]. The focused question was ‘what biological processes are reflected by gene expression analyses in peri-implant tissues of humans during the early stages (up to 4 weeks) of healing?’
All studies, controlled (using different implants) or uncontrolled, reporting gene expression analys...
Recent in vitro [24] and preclinical in vivo [25] studies have focused on the early molecular biological responses to various titanium implant surfaces. Understanding these early responses is essential for efforts aiming to accelerate and enhance the process of osseointegration [26]. Upregulation or downregulation of specific genes in peri-implant tissues identified by analyses of genetic material...
Osseointegrated oral implants are an integral part of modern reconstructive dentistry and are associated with favorable long-term therapeutic outcomes [1]. Osseointegration was originally defined as the direct contact between vital bone and a load-bearing implant observed at the light microscopic, i.e., histological, level [2]. Morphogenesis of implant osseointegration has been assessed in several...
The objective of the study was to systematically review the literature for studies reporting gene expression analyses (GEA) of the biological processes involved in early human peri-implant bone healing.
Electronic databases (MEDLINE, EMBASE) were searched in duplicate. Controlled and uncontrolled studies reporting GEA of human peri-implant tissues - including ≥5 patients and ≥2 time points - ...
SBP (mmHg)
DBP (mmHg)
PR (bpm)
RPP (bpm × mmHg)
Normotensive patients (N = 410)
On arrival at the office
133.0 ± 18.4
76.4 ± 12.5
79.2 ± 13...
SBP (>160 mmHg)
RPP (>12,000 bpm × mmHg)
Normotensive group (N = 410)
On arrival at the office
41 (10.0%)
111 (27.1%)
Prior to sedation
...
Normotensive group
Hypertensive group
p
value
Number (male: female)
410 (127: 283)
106 (37: 69)
0.170
Age (year mean ± SD)
...
Kimura, M., Takasugi, Y., Hanano, S. et al. Efficacy of intravenous sedation and oral nifedipine in dental implant patients with preoperative hypertension - a retrospective study of 516 cases. Int J Implant Dent 1, 6 (2015). https://doi.org/10.1186/s40729-015-0004-4
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Received: 08 October 2014
Accepted: 14 January 2015
Published: 18 March 2015
DOI: https://doi.org/10.1186/s407...
Motoshi Kimura, Yoshihiro Takasugi, Shigeyoshi Hanano, Katsuyuki Terabe and Yuko Kimura declare that they have no competing interests.
YT and MK designed the study; MK, SH, and KT performed the surgeries; YT performed the intravenous sedation. YT, MK, and YK collected and analyzed the data; MK wrote the manuscript. YT revised the manuscript. All authors read and approved the final manuscript.
Hanano Dental Clinic, 4-2-3 Yamanoue, Hirakata, Osaka, 573-0047, Japan
Motoshi Kimura & Shigeyoshi Hanano
Department of Anesthesiology, Kinki University Faculty of Medicine, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka, 589-8511, Japan
Yoshihiro Takasugi
Terabe Dental Clinic, 4-249 Sakae-cho, Tsu, Mie, 514-0004, Japan
Katsuyuki Terabe
First Department of Internal Medicine, Osaka Medical College...
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Little JW. The impact on dentistry of recent advances in the management of hypertension. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000;90:591–9.
Aubertin MA. The hypertensive patient in dental practice: updated recommendations for classification, prevention, monitoring, and dental management. Gen Dent. 2004;52:544–52.
Vaughan CJ, Delanty N. Hypertensive emergencies. Lancet. 2000;356...
Systolic blood pressure
Diastolic blood pressure
Pulse rate
Rate pressure product
Electrocardiogram
Percutaneous oxygen saturation
Analysis of variance
Immediate-release
In this study, we showed that the stable hemodynamic was obtained by performing intravenous sedation and oral administration of nifedipine for patients with hypertension. It is important not only to understand the systemic management of the patient but also to obtain stabled hemodynamic by performing intravenous sedation and oral administration of nifedipine for patients with hypertension in order...
Implant surgery is performed in patients with a wide age range, including elderly patients with hypertension. Dentists or oral surgeons often encounter hypertensive patients who are undiagnosed or noncompliant. Among Japanese over the age of 30, 60% of men and 44.6% of women suffer from high blood pressure, and 33.8% of men and 25.6% of women with a history of hypertension have not been managed me...
For patients with stage 2 hypertension before operation, it is difficult to maintain the recommended blood pressure during surgery using only intravenous sedation, and it is necessary to decrease blood pressure by antihypertensive drugs. In this study, the blood pressure of patients with sustained hypertension was reduced to stage I hypertension about 30 min after administration of oral nifedipin...
In 44 (8.5%) of the 516 implant surgery cases, oral nifedipine had to be administered, since preoperative SBP was higher than 160 mmHg in these patients. Within 30 min of administration of nifedipine, SBP of hypertensive patients decreased to a similar range as that of hypertensive patients who did not need administration of oral nifedipine. Intravenous sedation after nifedipine administration t...
In patients with oral nifedipine in the hypertensive group, the PR value slightly increased prior to initiation of intravenous sedation (p = 0.224) and then significantly decreased until completion of the operation (p 160 mmHg during and at completion of operation showed maximum SBP of 180 mmHg in the normotensive group, 190 mmHg on the hypertensive group without preoperative oral nifedip...
Patient demographics and clinical characteristics are summarized in Table 1. There were significant differences in age (p
This study protocol was approved by the ethics committee of Japanese Dental Society of Anesthesiology (No. 2015–4).
Following confirmation of a sufficient anesthetic effect, intravenous sedation with continuous infusion of propofol 1 to 2 mg/kg/h and midazolam 20 to 40 μg/kg bolus together with inhalation of oxygen 3 L/min via nasal cannula was initiated. After confirming Verrill sign, implant surgery was initiated. During operation, the propofol dose was adjusted to maintain the optimum conscious sedative ...
A retrospective review of the clinical records was conducted for 336 patients who received dental implant-related surgeries combined with intravenous sedation between January 2008 and February 2012 at our outpatient dental offices. Among the patients, 125 patients received multiple surgeries during the observation period: 4 patients underwent surgery five times, 7 patients four times, 29 patients ...
Osseointegrated dental implants were introduced in Japan in 1983, and the procedures are now performed very frequently. Dental implants are placed in a wide age range of patients, including elderly patients with hypertension. Patients with very high blood pressure are at great risk for acute medical problems when undergoing stressful dental procedures, such as oral surgery, periodontal surgery, an...
To examine the effects of intravenous sedation and oral nifedipine on blood pressure and pulse rate in patients with perioperative high blood pressure undergoing implant surgery, the clinical records of dental implant patients managed by intravenous sedation at our outpatient dental offices were retrospectively evaluated.
A total of 516 clinical charts were evaluated. The subjects were divided in...
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. Postoperative radiograph of the resected dental implant in the right anterior maxilla
Fig. 3. Postoperative radiograph of the resected dental implant in the right anterior maxilla
Fig. 2. On radiological examination, it was confirmed that the dental implant had perforated the cortical bone of the right nasal floor
Fig. 2. On radiological examination, it was confirmed that the dental implant had perforated the cortical bone of the right nasal floor
Fig. 1. On anterior rhinoscopy, the apical part of the titanium dental implant in the right anterior maxilla was seen in the nasal floor close to the nasal septum
Fig. 1. On anterior rhinoscopy, the apical part of the titanium dental implant in the right anterior maxilla was seen in the nasal floor close to the nasal septum
Wolff, J., Karagozoglu, K.H., Bretschneider, J.H. et al. Altered nasal airflow: an unusual complication following implant surgery in the anterior maxilla.
Int J Implant Dent 2, 6 (2016). https://doi.org/10.1186/s40729-016-0045-3
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Received: 24 August 2015
Accepted: 23 March 2016
Published: 29 March 2016
DOI: https://doi.org/10.1186/s40729-016-0045-3
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...
Jan Wolff, Hakki Karagozoglu, Jochen Bretschneider, Tymour Forouzanfar, and Engelbert Schulten declare that they have no competing interests.
JW gave substantial contributions to the conception or design of the work, drafted the work, and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately i...
Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center/Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
Jan Wolff, K. Hakki Karagozoglu, Tymour Forouzanfar & Engelbert A. J. M. Schulten
Department of Otorhinolaryngology-Head and Neck Surgery, VU University Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
Jochen H...
Esposito M, Grusovin MG, Kwan S, et al. Interventions for replacing missing teeth: bone augmentation techniques for dental implant treatment. Cochrane Database Syst Rev. 2008;16:CD003607.
Raghoebar GM, van Weissenbruch R, Vissink A. Rhino-sinusitis related to endosseous implants extending into the nasal cavity. A case report. Int J Oral Maxillofac Surg. 2004;33:312–4.
Zimbler MS, Lebowitz RA, ...
Since this is a case report, no approval of the Institutional Review Board was necessary.
Written informed consent was obtained from the patient for publication of this Case report and any accompanying images
In conclusion, dental implants protruding into the nasal cavity can cause alterations to the airflow. Dental implants partially residing in the nasal cavity can be minimal invasively treated by sectioning the apical part of the implant using a transnasal approach.
No complications were apparent during the surgical procedure. Postoperative clinical and radiological examinations demonstrated an intact nasal mucosa and an adequate resection of the dental implant to the level of the nasal floor (Fig. 3). The patient had an uneventful recovery and at 2-, 6-, and 12-month follow-up, she reported having no altered nasal airflow.
Insertion of endosseous dental im...
A 50-year-old female patient was referred to the Department of Oral and Maxillofacial Surgery of the VU University Medical Center in Amsterdam with complaints of a long ongoing unpleasant altered nasal airflow after the placement of eight dental implants in the maxilla. Four months prior to implant surgery, a bony augmentation of the atrophic edentulous alveolar crest and a bilateral maxillary sin...
Endosseous dental implants are commonly used to rehabilitate fully or partially edentulous patients [1]. The insertion of such implants can in some cases cause complications, especially in the edentulous atrophic maxilla [2–4]. In this paper, an unusual complication of altered nasal airflow after the placement of an endosseous dental implant in the maxilla is presented. Subsequent treatment of t...
Dental implants have been in routine clinical use for over three decades and are a predictable treatment modality. However, as with all other aspects of dentistry, complications occur. A 50-year-old female patient with complaints of a long ongoing unpleasant altered nasal airflow presented herself at the VU University Medical Center Amsterdam. Visual inspection of the right nasal cavity revealed t...
Implant
Author Year Reference
Study type
Patients
Primary disease in BP patients (n)
...
Topic
Identified (n)
Included (n)
Outcome osteonecrosis risk. ST (bisphosphonate OR denosumab) AND osteonecrosis jaw AND
...
Walter, C., Al-Nawas, B., Wolff, T. et al. Dental implants in patients treated with antiresorptive medication – a systematic literature review. Int J Implant Dent 2, 9 (2016). https://doi.org/10.1186/s40729-016-0041-7
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Received: 26 September 2015
Accepted: 23 March 2016
Published: 04 April 2016
DOI: https://doi.org/10.1186/s40729-016-0041-7
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...
The authors Christian Walter, Bilal Al-Nawas, Tim Wolff, Eik Schiegnitz, and Knut A. Grötz declare that they have no competing interests.
All authors designed the review. TW made the primary literature acquisition that was evaluated by the other others. All authors interpreted the data. CW drafted the manuscript that was revised by the other authors. All authors read and approved the final manus...
Department of Oral and Maxillofacial Surgery – Plastic Surgery of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131, Mainz, Germany
Christian Walter, Bilal Al-Nawas & Eik Schiegnitz
Department of Oral and Maxillofacial Surgery of the Dr. Horst Schmidt Clinic, Ludwig-Erhard-Str. 100, 65199, Wiesbaden, Germany
Tim Wolff & Knut A. Grötz
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Krimmel M, Ripperger J, Hairass M, Hoefert S, Kluba S, Reinert S. Does dental and oral health influence the development and course of bisphosphonate-related osteonecrosis of the jaws (BRONJ)? Oral Maxillofac Surg. 2014;18(2):213–8. doi:10.1007/s10006-013-0408-3.
Tsao C, Darby I, Ebeling PR, Walsh K, O'Brien-Simpson N, Reynolds E, et al. Oral health risk factors for bisphosphonate-associated jaw...
DeBaz C, Hahn J, Lang L, Palomo L. Dental Implant Supported Restorations Improve Quality of Life in Osteoporotic Women. Int J Dent. 2015;2015:451923. doi:10.1155/2015/451923.
Grötz KA, Al-Nawas B. Persisting alveolar sockets-a radiologic symptom of BP-ONJ? J Oral Maxillofac Surg. 2006;64(10):1571–2. doi:10.1016/j.joms.2006.05.041.
Hutchinson M, O'Ryan F, Chavez V, Lathon PV, Sanchez G, Hatche...
Carmagnola D, Celestino S, Abati S. Dental and periodontal history of oncologic patients on parenteral bisphosphonates with or without osteonecrosis of the jaws: a pilot study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;106(6):e10–5. doi:10.1016/j.tripleo.2008.07.011.
Jabbour Z, El-Hakim M, Mesbah-Ardakani P, Henderson JE, Albuquerque Jr R. The outcomes of conservative and surgical ...
Marx RE, Sawatari Y, Fortin M, Broumand V. Bisphosphonate-induced exposed bone (osteonecrosis/osteopetrosis) of the jaws: risk factors, recognition, prevention, and treatment. J Oral Maxillofac Surg. 2005;63(11):1567–75. doi:10.1016/j.joms.2005.07.010.
Al-Sabbagh M, Robinson FG, Romanos G, Thomas MV. Osteoporosis and bisphosphonate-related osteonecrosis in a dental school implant patient popula...
Javed F, Almas K. Osseointegration of dental implants in patients undergoing bisphosphonate treatment: a literature review. J Periodontol. 2010;81(4):479–84. doi:10.1902/jop.2009.090587.
Bedogni A, Bettini G, Totola A, Saia G, Nocini PF. Oral bisphosphonate-associated osteonecrosis of the jaw after implant surgery: a case report and literature review. J Oral Maxillofac Surg. 2010;68(7):1662–6...
Grötz KA, Piesold JU, Al-Nawas B. Bisphosphonat-assoziierte Kiefernekrose (BP-ONJ) und andere Medikamenten-assoziierte Kiefernekrosen. 2012. AWMF online.
Walter C, Al-Nawas B, Frickhofen N, Gamm H, Beck J, Reinsch L, et al. Prevalence of bisphosphonate associated osteonecrosis of the jaws in multiple myeloma patients. Head Face Med. 2010;6:11. doi:10.1186/1746-160X-6-11.
Walter C, Sagheb K, Bit...
bisphosphonate
bisphosphonate-associated osteonecrosis of the jaws
C-terminal telopeptide of the type I collagen
patients intervention control outcome
preferred reporting items for systematic reviews and meta-analyses protocols
quality of life
search term
temporomandibular joint
Successful implant therapy is feasible in patients receiving antiresorptive therapy. The risk of osteonecrosis development needs to be explained to the patient. An individual risk assessment is essential, taking the primary disease with the medication and further wound-healing-compromising diseases and medications into account. If possible, bone augmentations should be avoided, and a perioperative...
The use of bone markers is discussed controversially in the literature, and no clear recommendation can be given at the moment [1, 8]. In these cases, where an implant is planned, a perioperative antimicrobial prophylaxis should be administered, similar to the prophylaxis suggested in other surgical procedures performed in these patients, since this seems to be a tool to decrease BP-ONJ frequency ...
Dental implants can improve the Qol in patients with antiresorptive therapy (bisphosphonate/denosumab) [44] analogous to patients without antiresorptive therapy [48]. A recently performed systematic review on masticatory performance, bite force, nutritional state and patient’s satisfaction showed that implant-supported dentures were associated with high patient satisfaction regarding denture com...
Even latest guidelines and statements dealing with medication associated osteonecrosis of the jaws such as the American [7, 8], Scottish [47], Swiss [6] or German [1] do not address implant therapy in these patients in detail. Due to this lack of data a systematic literature review was performed to fill this gap. Unfortunately the literature dealing with this topic is very sparse and consists main...
No articles could be found regarding the prognosis of the remaining dentition depending on implant therapy, neither for patients with bisphosphonate nor denosumab treatment.
There are no reliable parameters indicating the success of implants in patients with anti-resorptive therapy. The risk of osteonecrosis development has already been described in the chapter referring to the osteonecrosis risk...
The literature dealing with this topic can be separated into two groups:
BP-ONJ case series for which varying amounts are caused by dentures in patients with malignant and benign diseases [2, 33–42] and
studies performed on BP patients with dentures analyzing the frequency of BP-ONJ [15, 43].
Here as well, no imbalance regarding the dignity of the primary disease could be found. Jabbour descr...
Out of 606 articles 556 articles were excluded because they were either duplicates, case reports, narrative reviews, case series with less than 5 cases or were not associated with the topic at all (Table 1 and Fig. 1). Some of the articles analyzed more than one outcome and are referred to several times. Since the available literature is very inhomogeneous with a low level of evidence a statisti...
A table was generated and used to collect the relevant information.
A systematic review was performed in accordance with the preferred reporting items for systematic reviews and meta-analyses protocols (PRISMA-P),
The review was performed using the PICO design.
Patients: For which subclientel of patients with antiresorptive therapy
Intervention: do dental implants have a benefit
Control: compared to forgoing dental implants
Outcome: in regards to oral rehabil...
A similar scenario is well known in patients with radiation of the jaws. Initially, radiation therapy was seen as a contraindication for implant insertion [14] because of osteoradionecrosis. In Germany meanwhile, implants are covered by the health insurance by law in some of these patients (§28 SGB V Sozialgesetzbuch). Due to xerostomia sufficient fixation of a denture is rather complicated, and ...
Bisphosphonate-associated osteonecrosis of the jaws (BP-ONJ) is a well-known side effect in patients receiving bisphosphonates (BP) due to e.g. osteoporosis, multiple myeloma or malignant diseases with metastases to the bone; prevalences range between 0.1% for patients with primary osteoporosis to 1% in patients with secondary osteoporosis and up to about 20% for special high risk subpopulations o...
Bisphosphonate-associated osteonecrosis of the jaws (BP-ONJ) is triggered by inflammatory processes. Typical trigger factors are periodontal disease, denture pressure sores, and surgical interventions such as tooth extractions. Unfortunately there is only little data on how to proceed with implant therapy in patients with bisphosphonate treatment. This topic is not addressed in the German guidelin...
Fig. 6. a Panoramic X-ray image 1 year after the surgery. b Intraoral photo 1 year after the surgery
Fig. 6. a Panoramic X-ray image 1 year after the surgery. b Intraoral photo 1 year after the surgery
Fig. 5. Histopathologic photo of the resected mandible (H-E staining)
Fig. 5. Histopathologic photo of the resected mandible (H-E staining)
gmentally resected. b Intraoperative photo. A vascularized fibula bone graft. c Resected mandible. d Panoramic X-ray image after the surgery
Fig. 4. a Intraoperative photo. The affected left mandible was segmentally resected. b Intraoperative photo. A vascularized fibula bone graft. c Resected mandible. d Panoramic X-ray image after the surgery
Fig. 3. CT images of the left mandible. a Axial view at the left first molar. b Coronal view at the left first molar
Fig. 3. CT images of the left mandible. a Axial view at the left first molar. b Coronal view at the left first molar
Fig. 2. Panoramic X-ray image at the first visit
Fig. 2. Panoramic X-ray image at the first visit
Fig. 1. Intraoral photo at the first visit
Fig. 1. Intraoral photo at the first visit
Teramoto, Y., Kurita, H., Kamata, T. et al. A case of peri-implantitis and osteoradionecrosis arising around dental implants placed before radiation therapy.
Int J Implant Dent 2, 11 (2016). https://doi.org/10.1186/s40729-016-0039-1
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Received: 01 August 2015
Accepted: 21 March 2016
Published: 05 April 2016
DOI: https://doi.org/10.1186/s40729-016-0039-1
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Yuji Teramoto, Hiroshi Kurita, Takahiro Kamata, Hitoshi Aizawa, Nobuhiko Yoshimura, Humihiro Nishimaki, Kazunobu Takamizawa declare that they have no competing interests.
All authors read and approved the final manuscript.
Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, 3-1-1, Asahi, Matsumoto, 390-8621, Japan
Yuji Teramoto, Hiroshi Kurita, Takahiro Kamata, Hitoshi Aizawa, Nobuhiko Yoshimura, Humihiro Nishimaki & Kazunobu Takamizawa
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O'Dell K, Sinha U. Osteoradionecrosis. Oral Maxillofac Surg Clin North Am. 2011;23(3):455–64.
Madrid C, Abarca M, Bouferrache K. Osteoradionecrosis: an update. Oral Oncol. 2010;46(6):471–4.
Jacobson AS, Buchbinder D, Hu K, Urken ML. Paradigm shifts in the management of osteoradionecrosis of the mandible. Oral Oncol. 2010;46(11):795–801.
Ozen J, Dirican B, Oysul K, Beyzadeoglu M, Ucok O, B...
Written informed consent was obtained from the patient for the publication of this report and any accompanying images.
Dental implants have become increasingly popular, and a considerable number of people have undergone dental restorations using dental implants. Therefore, there will be an increasing probability of patients with dental implants receiving irradiation around their implants. Further studies are required to analyze whether dental implants located in the radiation field cause adverse effects in the lon...
Secondarily, infection associated with dental implant may become a possible cause of ORN. In radiotherapy including the oral cavity, gingivitis is frequently observed adjacent to fixed metal dental restorations because they cause significant dose enhancement around them [12]. It is easy to speculate that the same occurs around dental implant prostheses (peri-implant mucositis). The presence of muc...
In this paper, we reported a case of ORN arising around dental implants placed before radiotherapy. This is the third such case report to be published. Granström et al. reported three cases of ORN developing around dental implants previously placed for skin-penetrating prosthesis [8]. Slama et al. reported a case of mandibular ORN in post-implant radiation [9]. In these cases, the presence of den...
A 66-year-old man was referred to our hospital for further treatment of ORN of the mandible. He had undergone dental implant treatments on both sides of the mandible (#35, #36, #45, and #47) 7 years previously. All of the implants were osseointegrated and charged. The patient had been followed up regularly by his dentist, and the clinical course had remained uneventful. He experienced left oropha...
Osteoradionecrosis (ORN) of the mandible is a severe complication that follows ionizing radiation therapy in patients undergoing treatment for head and neck cancer. The radiation dose, tumor location, dental trauma, premorbid state of dentition, and concomitant chemoradiotherapy are thought to be contributing factors for ORN [1–3]. Most patients with head and neck cancer are aged 50 years or mo...
A little is known about the effect of radiotherapy on the dental implants that have previously been osseointegrated and charged. Here, we reported a case of osteoradionecrosis which arose around dental implants placed before radiation therapy.
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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All authors have reviewed the article and agreed to the submission.
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. 6. Immunohistochemical staining of osteocalcin (a) and collagen I (c) in sections from mini pigs mandible from 9M and IR osteocalcin (b) and collagen I (d). There were statistically significant differences to osteocalcin in 9M samples and no statistically significant differences to collagen I samples. Magnification: ×40 (a, b) and ×100 (c, d)
Fig. 6. Immunohistochemical staining of ost...
Fig. 5. Representative photomicrographs of each third of the peri-implant bone of IR experimental condition (H&E, ×40). a First third (cervical third). b Intermediate third. c Apical third. Note the edges of bone grooving present rounded contour, mainly in the last third
Fig. 5. Representative photomicrographs of each third of the peri-implant bone of IR experimental condition (H&E, ×40). a...
Fig. 4. Representative photomicrographs of each third of the peri-implant bone of 9M experimental condition (H&E, ×40). a First third (cervical third). b Intermediate third. c Apical third. Bone grooving with no altered contour
Fig. 4. Representative photomicrographs of each third of the peri-implant bone of 9M experimental condition (H&E, ×40). a First third (cervical third). b Intermediat...
Fig. 3. Prothesis fixed installed on the three implants
Fig. 3. Prothesis fixed installed on the three implants
9M
IR
Third
Mean
Standard deviation
Mean
...
9M
IR
Third
Mean
Standard deviation
Mean
...
Animal
Mean
Standard deviation
Minimum
Maximum
1
150.1
30.2
122.7
184.4
2
163.3
35.1
132.4
205.3
3
175.2
15.2
153.2
204.6
4
163.6
15.4
157.3
185.1
5
153.3
15.2
146.2
174.2
6
150.3
26.4
129.2
174.6
Table 2 Removal torque value (Ncm) of three implants removed after 9 months (9M) per animal
Animal
Mean
Standard deviation
Minimum
Maximum
1
98.3
5.5
92.2
103.3
2
91.6
9.1
82.1
102.5
3
105.3
8.3
100.4
115.0
4
71.6
10.5
61.2
82.2
5
78.6
5.8
72.7
83.1
6
88.6
6.6
81
93.6
Table 1 Removal torque value (Ncm) of three implants immediate removed (IR) per animal
Silva, R.d., Passador, F. & Caria, P.H.F. Twist removal of healed vs. nonhealed implants—a mechanical and histological study in mini pigs. Int J Implant Dent 2, 23 (2016). https://doi.org/10.1186/s40729-016-0059-x
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Received: 27 April 2016
Accepted: 18 November 2016
Published: 25 November 2016
DOI: https://doi.org/10.1186/s40729-016-0059-x
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
FOP/UNICAMP, Piracicaba, SP, Brasil
Ricardo de Oliveira Silva & Paulo Henrique Ferreira Caria
CPG São Leopoldo Mandic, Campinas, SP, Brasil
Fabrício Passador
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You can also search for this author in PubMed Google Scholar
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Correspondence to Ricardo de Oliveira Silva.
We would like to thank Mario Perussi for supplying us with the customized system, implants, and prosthetic components, Dentifix®, FESB, veterinary professors Rafael Rodrigues and Alexander Correa Borghesan, and CAPES for the scholarship and financial support.
ROS conceived the study, held surgical procedures, and drafted the manuscript. FP did the preparation and helped in reading the histologic...
Yun H-M, Ahn S-J, Park K-R, Kim M-J, Kim J-J, Jin G-Z, et al. Magnetic nanocomposite scaffolds combined with static magnetic field in the stimulation of osteoblastic differentiation and bone formation. Biomaterials [Internet]. 2016;85:88–98. [cited 2016 Feb 10] Available from: http://www.sciencedirect.com/science/article/pii/S0142961216000491.
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Aubin JE, Liu F, Malaval L, Gupta AK. Osteoblast and chondroblast differentiation. Bone [Internet]. 1995;17(2):S77–83. [cited 2015 Dec 30] Available from: http://www.sciencedirect.com/science/article/pii/875632829500183E.
Mariano M. Minisuíno (minipig) na pesquisa biomédica experimental. O Minipig br1. Acta Cirúrgica Bras. 2003;18(5):387–91.
Herring SW. How can animal models answer clinic...
Piattelli A, Scarano A, Piattelli M. Microscopical aspects of failure in osseointegrated dental implants: a report of five cases. Biomaterials [Internet]. 1996;17(12):1235–41. [cited 2015 Oct 5] Available from: http://www.sciencedirect.com/science/article/pii/0142961296849441.
Stajčić Z, Stojčev Stajčić LJ, Kalanović M, Đinić A, Divekar N, Rodić M, et al. Removal of dental implants: re...
Assenza B, Scarano A, Perrotti V, Vozza I, Quaranta A, Quaranta M, et al. Peri-implant bone reactions around immediately loaded conical implants with different prosthetic suprastructures: Histological and histomorphometrical study on minipigs. Clin Oral Investig. 2010;14(3):285–90.
Sasaki H, Koyama S, Yokoyama M, Yamaguchi K, Itoh M SK. Bone metabolic activity around dental implants under loadi...
Glauser R, Sailer I, Wohlwend A, Studer S, Schibli M, Schärer P. Experimental zirconia abutments for implant-supported single-tooth restorations in esthetically demanding regions: 4-year results of a prospective clinical study. Int J Prosthodont [Internet]. 2004;17(3):285–90. [cited 2015 Oct 6] Available from: http://www.mendeley.com/catalog/experimental-zirconia-abutments-implantsupported-sing...
Brånemark PI. Osseointegration and its experimental background. J Prosthet Dent. 1983;50(3):399–410.
Chiapasco M, Gatti C. Immediate loading of dental implants placed in revascularized fibula free flaps: a clinical report on 2 consecutive patients. Int J Oral Maxillofac Implants. 2015;19(6):906–12.
Shemtov-Yona K, Rittel D. On the mechanical integrity of retrieved dental implants. J Mech Be...
Implant removal torque should be higher to remove implants with long-time installation than implants removed immediately after installation. Although, removal torque causes microscopical fractures and smooth on the peri-implant bone grooves, it does not compromised the bone healing.
According to Christenson R.H. [24], the bone structure, metabolism, and regulation are reflected by markers of resorption, formation, and/or turnover. Among the markers of bone resorption is the type 1 collagen degradation and maker of bone formation: Osteocalcin. Bone formation markers derive from the osteoblastic activity, formed during the different stages of osteoblasts proliferation, differen...
In order to better use a model which reproduce the natural conditions of dental implant in action, minipigs (BR-1) have been used in this study [44], the nonprimate animal model that is most appropriate for the study of human mastication [45] and commonly used in research because suine and human share important anatomic and physiologic characteristics [46, 47].
The osseointegration process is qui...
Dental implant revolutionized oral rehabilitation, becoming the natural teeth replacement by a titanium implant, a successful alternative to treat total or partial edentulism [14, 26, 27]. Nowadays, dental implants are definitely a current procedure in many dental offices [3, 28, 29]. Despite the long-term success shown by different studies [14, 30], implant failure is inevitable [31–33]. Since,...
Duplicate sections of peri-impant bone were obtained from each implant sample to evaluate the percentage of stained areas in order to differentiate markers of collagen I and osteocalcin within both experimental conditions (Fig. 6). The highest collagen I expression values were observed at the IR experimental condition, and osteocalcin expression was higher at the 9M.
There was a statistically si...
No remarkable complications were found during the healing period. At sacrifice, all 18 implants fixed after 9 months were considered successfully integrated at the time of the removal and none showed any mobility or signal of infection at sacrifice. There was no difference in the healing between animals who had the implants immediately removed after installation, and animal whose implants were re...
Hematoxylin-eosin-stained section images were digitized and analyzed in order to recognize the presence of native bone tissue by the presence of osteocyte lacunae-containing cells and the newly formed bone tissue recognized by the absence of lacunae. Also, the characteristics of peri-implant bone, presence or absence of bone fractures, and the shape and contour of bone grooving resultant of the tr...
The mandibles were sectioned into left and right segments, and each peri-implant bone was sectioned again to individualize them. Each peri-implant bone block was fixed in buffered formalin solution, pH 7.0, for 6 days, demineralized in 10% formic acid, and dehydrated through progressing alcohol concentrations and paraffin-embedded. Paraffin blocks were sectioned at 7-μm thick mounted on poly-l-...
This study was approved by the University Animal Ethics Committee-CEUA/UNICAMP-(Campinas, SP) (no.2730-1/12). Six adult male mini pigs (BR-1 mini pigs, São Paulo, Brazil) with ~36 months old and weighed ~55 kg were used in the experiment. The mini pigs were kept in the Experimental Center of the Veterinary Faculty (FESB-Bragança Paulista, SP) and were allowed to adapt to the environment 1 wee...
Many authors investigated bone reactions around dental implants [17–21]. What happens in the peri-implant bone implants removed is not reported in scientific articles. This study evaluated the peri-implant bone after his immediate removal and after 9 months of osseointegration. The aim of the present study was to evaluate the peri-implant bone after dental implant removal.
Since the discovery of osseointegration by Branemark in Sweden in 1960, where found that when titanium screws left undisturbed in bone, the osteocytes grow in close apposition to the titanium surfaces and provide firm anchorage. This discovery was successfully applied in dental and craniofacial reconstructive surgery in 1965 [1, 2]. Dental implants became a common procedure in the modern dental tr...
The objective of this study was to evaluate the effect of removal torque (reverse torque) of titanium implants in peri-implant bone.
The P1-M1 teeth were extracted bilaterally of 6 mini pigs (BR-1). Each animal received 6 titanium implants, three for each side of mandible. On the right side of mandible, 3 implants reminded 9 months (9M) under masticatory activity and on the left side, other 3 im...
Fig. 4. Kaplan-Meier implant survival curves for bone and bone substitutes
Fig. 4. Kaplan-Meier implant survival curves for bone and bone substitutes
Fig. 3. Kaplan-Meier survival curves for membrane types
Fig. 3. Kaplan-Meier survival curves for membrane types
Fig. 2. Kaplan-Meier implant survival curves for augmentation procedures
Fig. 2. Kaplan-Meier implant survival curves for augmentation procedures
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. 7. Orthopantomograph 2 years after implant placement
Fig. 6. Clinical picture 2 years after implant placement
Fig. 6. Clinical picture 2 years after implant placement
Fig. 5. Occlusal view of implants after vertical repositioning of the dental alveolus segment showing proper mesiodistal space and buccolingual spacing
Fig. 5. Occlusal view of implants after vertical repositioning of the dental alveolus segment showing proper mesiodistal space and buccolingual spacing
Fig. 4. Vertical repositioning of dental alveolus segment with placement of dental implants
Fig. 4. Vertical repositioning of dental alveolus segment with placement of dental implants
Fig. 3. Direct sinus lift with implant osteotomy preparation
Fig. 3. Direct sinus lift with implant osteotomy preparation
Fig. 2. Marked incision site for surgical access
Fig. 2. Marked incision site for surgical access
Fig. 1. Edentulous site with supra-eruption of opposing dentition
Fig. 1. Edentulous site with supra-eruption of opposing dentition
Tsegga, T., Wright, T. Maxillary segmental osteoperiosteal flap with simultaneous placement of dental implants: case report of a novel technique. Int J Implant Dent 3, 2 (2017). https://doi.org/10.1186/s40729-017-0067-5
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Received: 06 December 2016
Accepted: 13 January 2017
Published: 19 January 2017
DOI: https://doi.org/10.1186/s40729-017-0067-5
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 m...
Department of Oral & Maxillofacial Surgery, San Antonio Military Medical Center, 3551 Roger Brooke Dr., Ft. Sam Houston, 78234, TX, USA
Tibebu Tsegga & Thomas Wright
Department of Oral & Maxilofacial Surgery, Wilford Hall Ambulatory Surgical Center, 2200 Bergquist Dr, Suite 1, Lackland AFB, TX, 78236, USA
Tibebu Tsegga & Thomas Wright
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Irinakis T. Efficacy of injectable demineralized bone matrix as graft material during sinus elevation surgery with simultaneous implant placement in the posterior maxilla: clinical evaluation of 49 sinuses. J Oral and Maxillofac Surg. 2011;69:134–41.
Chiapasoo M, Casentini P, Zaniboni M. Bone augmentation procedures in implant dentistry. Int J Oral Maxillofac Implants. 2009;24:237–69.
Jenson...
This case highlights the evolving variations in dentoalveolar augmentation with an emphasis on concomitant implant placement. In the most traditional sense, a vertical osteoperiosteal flap technique would be bound with a stable basal bone that can be used to anchor simultaneous dental implant placement. Further refinement should consider minimizing crestal reflection and overall labial bone resorp...
A critical appraisal of the gingival architecture in the final end point of this case demonstrates some radiolucency through the soft tissue outlining the platform of the Nobel Biocare TiUnite implant. This would lead us to believe that either the transmucosal bone level placement attempt was inaccurate or excessive reflection of the labial tissue has caused some degree of resorption. This is anot...
A suitable alternative surgical management of this particular case might have been to simply perform an alveoloplasty to produce the desired inter-occlusal clearance and proceed with placement of implant and simultaneous direct sinus lift. That would have left more of the apical portion of the implant within the grafted sinus and possibly modified the location of keratinized band of tissue. The lo...
A 35-year-old female with a 10-year history of partial acquired edentulism at site numbers 3 and 4 presented to our clinic for dental implant evaluation. Preoperative clinical examination revealed a reproducible intercuspation, well-delineated band of keratinized tissue, and decreased inter-occlusal clearance to allow for optimal dimension of prosthetic crowns (Fig. 1). Radiographs demonstrated e...
Obtaining proper occlusal clearance to allow for a single unit crown restoration is a fundamental prerequisite for dental implant restoration. Long-standing edentulous sites are often fraught with disuse atrophy and unopposed supra-eruption of the opposing dentition. In the posterior maxillae/mandible, there are vital structures that have to be mobilized in order to allow space for either bone tra...
Dental restorative space from the opposing dentition requires adequate distance for restorative material for an acceptable restoration. Typically, long-standing edentulous alveolar ridges will have vertical and or horizontal defects that require alveolar ridge augmentation for ideal dental implant restorations. Along with these defects, one will see the opposing dentition supra erupt which can obl...
Fig. 3. ISQ values of MDIs and Ankylos® after euthanasia
Fig. 3. ISQ values of MDIs and Ankylos® after euthanasia
Fig. 2. ISQ values of MDIs and Ankylos® immediately upon insertion
Fig. 2. ISQ values of MDIs and Ankylos® immediately upon insertion
Fig. 1. Customized SmartPeg diagrams
Fig. 1. Customized SmartPeg diagrams
Dhaliwal, J.S., Albuquerque, R.F., Fakhry, A. et al. Customized SmartPeg for measurement of resonance frequency of mini dental implants. Int J Implant Dent 3, 4 (2017). https://doi.org/10.1186/s40729-017-0066-6
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Received: 09 November 2016
Accepted: 13 January 2017
Published: 01 February 2017
DOI: https://doi.org/10.1186/s40729-017-0066-6
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...
Faculty of Dentistry, McGill University, 2001 McGill College Avenue, Suite 500, Montreal, Quebec, H3A 1G1, Canada
Jagjit Singh Dhaliwal, Ali Fakhry & Jocelyne S. Feine
Faculty of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
Rubens F. Albuquerque Jr
Department of Zoology, Panjab University, Chandigarh, India
Sukhbir Kaur
PAPRSB Institute of Health Sci...
Dhaliwal J, Albuquerque R, Murshed, M, Tamimi, F, Feine, JS. A histomorphometric comparison of osseointegration with MDIs and standard implants. IADR/AADR/CADR 91st General Session, Seattle, Washington, USA, March 20–23, 2013
Zix J, Hug S, Kessler-Liechti G, Mericske-Stern R. Measurement of dental implant stability by resonance frequency analysis and damping capacity assessment: comparison of b...
Barros RR, Novaes Jr AB, Muglia VA, Iezzi G, Piattelli A. Influence of interimplant distances and placement depth on peri-implant bone remodeling of adjacent and immediately loaded Morse cone connection implants: a histomorphometric study in dogs. Clin Oral Implants Res. 2010;21(4):371–8. Epub 2010/02/05.
Marin C, Bonfante EA, Granato R, Suzuki M, Granjeiro JM, Coelho PG. The effect of alterati...
Meredith N, Book K, Friberg B, Jemt T, Sennerby L. Resonance frequency measurements of implant stability in vivo. A cross-sectional and longitudinal study of resonance frequency measurements on implants in the edentulous and partially dentate maxilla. Clin Oral Implants Res. 1997;8(3):226–33. Epub 1997/06/01.
Meredith N, Alleyne D, Cawley P. Quantitative determination of the stability of the im...
Ersanli S, Karabuda C, Beck F, Leblebicioglu B. Resonance frequency analysis of one-stage dental implant stability during the osseointegration period. J Periodontol. 2005;76(7):1066–71. Epub 2005/07/16.
Bornstein MM, Chappuis V, von Arx T, Buser D. Performance of dental implants after staged sinus floor elevation procedures: 5-year results of a prospective study in partially edentulous patients...
Shatkin TE, Oppenheimer BD, Oppenheimer AJ. Mini dental implants for long-term fixed and removable prosthetics: a retrospective analysis of 2514 implants placed over a five-year period. Compend Contin Educ Dent. 2007;28(2):92–9. quiz 100-1. Epub 2007/02/27.
Griffitts TM, Collins CP, Collins PC. Mini dental implants: an adjunct for retention, stability, and comfort for the edentulous patient. Or...
Branemark PI, Adell R, Breine U, Hansson BO, Lindstrom J, Ohlsson A. Intra-osseous anchorage of dental prostheses. I. Experimental studies. Scand J Plast Reconstr Surg. 1969;3(2):81–100. Epub 1969/01/01.
Meredith N. Assessment of implant stability as a prognostic determinant. Int J Prosthodont. 1998;11(5):491–501. Epub 1999/01/29.
Lioubavina-Hack N, Lang NP, Karring T. Significance of primar...
The results of this animal study indicate that ISQ measurement of these single-piece MDIs is possible with the help of a custom-made SmartPeg and that 3M™ESPE™MDIs attain primary and secondary stability at the same levels as standard implants in the rabbit tibia.
As there are no studies that provide data based on resonance frequency measurements for single-piece MDIs, the exact RFA threshold values for MDIs may have to be identified with more studies conducted in vivo.
The resonance frequency assessment with a customized SmartPeg would be a useful tool to provide clinically useful information about the condition of the bone-implant interface of 3M™ ESPE...
If the initial ISQ value is high, a small drop in stability normally levels out with time. A big drop in stability or decrease should be taken as a warning sign. Lower values are expected to be higher after the healing period. The opposite could be a sign of an unsuccessful implant, and actions should be taken accordingly.
Studies have shown that the resonance frequency value is greatly associate...
It is important to measure the Implant Stability Quotient (ISQ) of single-piece mini dental implants as they are becoming increasingly popular, with the concomitant increase in publications demonstrating their high survival and success rates. Although the clinical use of Osstell devices is also increasing, there is lack of studies on its use with single-piece implants, which do not have internal t...
The ISQ values obtained while calibrating the customized SmartPeg were similar to in vivo results. Median ISQ values at insertion and at 6 postoperative weeks were 53.3 (IQR 8.3) and 60.5 (5.5) for the 3M™ESPE™MDIs, and 58.5 (4.75) and 65.5 (9.3) for the Ankylos® implants, respectively, with no statistical difference (Figs. 2 and 3). The ISQ values of both 3M™ESPE™ MDI and Ankylos® (Fig...
ISQ values were averaged and compared between implant types and times using Wilcoxon’s matched pairs signed-rank tests at a significance level of p
For the MDIs, a small longitudinal skin incision was made just distal to the tibia/femur joint. The tibia/femur head was exposed subperiosteally, and an osteotomy was performed with the pilot drill under copious irrigation with saline solution, transposing the cortical bone to the depth of 0.5 mm. The implants were aseptically transferred to the bone site and manually rotated clockwise while exer...
Single use Osstell SmartPegs for standard implants are made from a soft metal with a zinc-coated magnet mounted on top of it and attached to the implants or abutments’ internal threads. As the company does not provide SmartPegs for one-piece implants, we developed a customized SmartPeg for mini dental implants (3M™ESPE™ MDIs), which do not have internal threads (Fig. 1). After confirming th...
The aim of the study is to test the feasibility of a customized SmartPeg for ISQ measurement of single-piece mini dental implants and to compare the primary stability of a standard and the mini dental implant (3M™ESPE™MDI) in a rabbit model after 6 weeks of healing.
There are no published studies on the ISQ measurement of mini dental implants, as SmartPegs for these implants are not available till date. Since these are one-piece implants and do not have an internal thread for the SmartPeg’s attachment, a custom-made SmartPeg needs to be fabricated for ISQ measurement. Therefore, we developed and tested a customized SmartPeg for 3M™ESPE™ MDIs to measure ...
Mechanical testing methods like reverse torque, or “pullout test,” have been used to study and measure the mechanical interface between implant and bone in various ways [22, 23]. The Branemark group has evaluated the mechanical properties of osseointegrated implants using torsion and pullout tests and lateral loading tests [24, 25]. Presence or absence of mobility and the bone level around the...
Osseointegration refers to the phenomenon for close apposition of the bone to the surface of an implant with no interposing tissue that can be clinically demonstrated by absence of mobility [1, 2]. Obtaining primary stability seems to be a precondition for a successful osseointegration [3]. Dental implants have a success rate of over 90% and are available in various sizes with different surfaces [...
The new custom-made SmartPeg is suitable for measuring the Implant Stability Quotient of 3M™ESPE™MDIs. The primary stability of 3M™ESPE™MDIs is similar to the primary stability attained by standard implants in the rabbit tibia.
One-piece narrow diameter implants (NDIs) have been recommended as “Single-tooth replacements in the anterior zones, single posterior, multiple-unit fixed dental prosthesis (FDP), edentulous jaws to be rehabilitated with FDP, and edentulous jaws rehabilitation with overdentures in situations with reduced mesiodistal space or reduced ridge width.” (ITI consensus 2013). Since NDIs can be immedia...
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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You can also search for this author in PubMed Google Scholar
You can also search for this author in PubMed Google Scholar
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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...
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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. 5. Total score for physical and psychological disabilities before (gray) and after (hatched) sinus augmentation according to indications
Fig. 5. Total score for physical and psychological disabilities before (gray) and after (hatched) sinus augmentation according to indications
Fig. 4. Total score for functional limitations before (gray) and after (hatched) sinus augmentation according to indications
Fig. 4. Total score for functional limitations before (gray) and after (hatched) sinus augmentation according to indications
Fig. 3. Total score for complaints due to surgical procedure pre-operative, post-operative, and recently
Fig. 3. Total score for complaints due to surgical procedure pre-operative, post-operative, and recently
Fig. 2. Cumulative survival rate according to Kaplan–Meier and sinus augmentation procedure
Fig. 2. Cumulative survival rate according to Kaplan–Meier and sinus augmentation procedure
Fig. 1. Flow chart of patients included in the study
Fig. 1. Flow chart of patients included in the study
Item
Mean ± SD pre-operative
Mean ± SD post-operative
Mean ± SD in the last time
Have you felt pain in your mouth?
...
Item
Mean ± SD before sinus lift
Mean ± SD after sinus lift
p value
Have you felt tense because of problems with your teeth, mouth or dentures?
...
Item
Mean ± SD before sinus lift
Mean ± SD after sinus lift
p value
Have you had difficulty chewing any foods?
...
Schiegnitz, E., Kämmerer, P.W., Sagheb, K. et al. Impact of maxillary sinus augmentation on oral health-related quality of life. Int J Implant Dent 3, 10 (2017). https://doi.org/10.1186/s40729-017-0072-8
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Received: 20 November 2016
Accepted: 12 March 2017
Published: 28 March 2017
DOI: https://doi.org/10.1186/s40729-017-0072-8
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...
Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University, Augustusplatz 2, 55131, Mainz, Germany
E. Schiegnitz, K. Sagheb, A. Pabst, B. Al-Nawas & M. O. Klein
Department of Oral and Maxillofacial Surgery, Plastic Surgery, University of Rostock, Rostock, Germany
P. W. Kämmerer
Department of Prosthodontics, University of ...
Stellingsma K, Bouma J, Stegenga B, Meijer HJ, Raghoebar GM. Satisfaction and psychosocial aspects of patients with an extremely resorbed mandible treated with implant-retained overdentures. A prospective, comparative study. Clin Oral Implants Res. 2003;14(2):166–72.
Heydecke G, Locker D, Awad MA, Lund JP, Feine JS. Oral and general health-related quality of life with conventional and implant d...
Locker D. Self-esteem and socioeconomic disparities in self-perceived oral health. J Public Health Dent. 2009 Winter;69(1):1-8.
Allen PF, McMillan AS, Walshaw D. A patient-based assessment of implant-stabilized and conventional complete dentures. J Prosthet Dent. 2001;85(2):141–7.
Ohrn K, Jonsson B. A comparison of two questionnaires measuring oral health-related quality of life before and aft...
Al-Nawas B, Schiegnitz E. Augmentation procedures using bone substitute materials or autogenous bone—a systematic review and meta-analysis. Eur J Oral Implantol. 2014 Summer;7 Suppl 2:S219-34.
Derks J, Hakansson J, Wennstrom 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...
Within the limitations of this study, the results demonstrated a high long-term survival for sinus augmentation procedures and significant improvement of OHRQoL after this procedure. Therefore, sinus augmentation procedures are highly valuable treatment options in implant dentistry.
In order to measure OHRQoL in the present study, a specific and shortened questionnaire based on the validated and reliable OHIP score was developed to consider representative impairments of maxillary sinus augmentation like sinusitis and to relieve the clinical application. In a cross sectional study, Allen et McMillan proofed that a shortened OHIP-14 version showed a similar ability to assess OH...
The clinical and radiological outcomes of sinus augmentation procedures have been published in several studies [1, 3, 6, 7]. However, little data on the physical and psychological impact of this procedure on the patient is available yet. The present study evaluated pre-operative and post-treatment OHRQoL self-assessment scores of patients treated with dental implants after sinus augmentation proce...
Concerning functional limitations, all posed questions showed significant better values for OHRQoL after sinus augmentation procedure than before the treatment (p
After an average time in situ of 41.2 ± 27 months (3.4 years; range 0–96 months), 40 of the 863 implants were lost. These results indicated an in situ rate of 95.4%. One-year and five-year survival rate according to Kaplan–Meier were 95.4 and 94.4%. In patients receiving an external sinus lift an in situ rate of 95.1% and in patients with an internal sinus lift an in situ rate of 96.4%...
The Kaplan–Meier survival function was applied for the description of survival rates. To examine the statistical difference between survival rates, a log-rank test was used. Implant-related data were calculated. For statistical comparison of the paired questions and the total scores, a Wilcoxon test was applied. The intention of this study was descriptive, exploratory without a primary hypothesi...
This retrospective study addresses the oral health-related quality of life after maxillary sinus augmentation. Therefore, all patients that received an implantation after maxillary sinus augmentation in the Department of Oral and Maxillofacial Surgery of the University Medical Centre Mainz, Germany, between July 2002 and December 2007 were included in this study. There were no specific exclusion c...
In conclusion, little information is available about patient’s perception of sinus augmentation procedures. The aim of the present study was to assess whether sinus augmentation procedures together with implant placement and prosthetic rehabilitation improve quality of life in dental patients using a modified German OHIP and to examine the survival rates after this procedure.
Rehabilitation of completely and partial edentulous patients with dental implants has proved to be a safe and predictable procedure [1–3]. However, reduced bone height and the proximity of the maxillary sinus are challenging limitations for dental implant placement in the posterior maxilla [3]. Besides the use of short and tilted implants [4], one of the most frequently used surgical techniques ...
The aim of this study was to measure the oral health-related quality of life (OHRQoL) after maxillary sinus augmentation to determine the physical and psychological impact of this procedure for the patient.
Three hundred sixteen patients treated with an external or internal maxillary sinus augmentation and a total of 863 implants in the Department of Oral and Maxillofacial Surgery, Johannes Guten...
Fig. 6. a Panoramic radiograph 16 months after the sequestrectomy. b Sagittal CT view. c Coronal CT view. d 3D CT view
Fig. 5. tograph 5 months after the sequestrectomy.
Fig. 5. a Extraoral photograph 5 months after the sequestrectomy. b Intraoral photograph 5 months after the sequestrectomy.
Fig. 4. y. c Removal of the dental implant with a specimen of the necrotic bone
Fig. 4. a Preoperative intraoral photograph. b Intraoperative photograph of the sequestrectomy. c Removal of the dental implant with a specimen of the necrotic bone
Fig. 3.
Fig. 3. a Panoramic radiograph showing the sequestrum separation after 5 months of teriparatide therapy (arrows). b Sagittal CT view. c Coronal CT view
molar (arrow). b Sagittal CT view. c Coronal CT view
Fig. 2. a Panoramic radiograph showing marked alveolar bone resorption surrounding the dental implant replacing the right mandibular first molar (arrow). b Sagittal CT view. c Coronal CT view
Fig. 1. al implants associated with mucosal inflammation and a purulent discharge
Fig. 1. a Extraoral photograph showing an extraoral fistula in the right mandibular region. b Intraoral photograph showing an intraoral fistula on the lingual side of the distal dental implants associated with mucosal inflammation and a purulent discharge
Zushi, Y., Takaoka, K., Tamaoka, J. et al. Treatment with teriparatide for advanced bisphosphonate-related osteonecrosis of the jaw around dental implants: a case report. Int J Implant Dent 3, 11 (2017). https://doi.org/10.1186/s40729-017-0074-6
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Received: 06 December 2016
Accepted: 12 February 2017
Published: 30 March 2017
DOI: https://doi.org/10.1186/s40729-017-0074-6
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 m...
Department of Oral and Maxillofacial Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
Yusuke Zushi, Kazuki Takaoka, Joji Tamaoka, Miho Ueta, Kazuma Noguchi & Hiromitsu Kishimoto
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Stanton DC, Balasanian E. Outcome of surgical management of bisphosphonate-related osteonecrosis of the jaws: review of 33 surgical cases. J Oral Maxillofac Surg. 2009;67:943–50.
Carlson ER, Basile JD. The role of surgical resection in the management of bisphosphonate-related osteonecrosis of the jaws. J Oral Maxillofac Surg. 2009;67:85–95.
Wilde F, Heufelder M, Winter K, et al. The role of ...
Grant BT, Amenedo C, Freeman K, Kraut RA. Outcomes of placing dental implants in patients taking oral bisphosphonates: a review of 115 cases. J Oral Maxillofac Surg. 2008;66:223–30.
Goss A, Bartold M, Sambrook P, Hawker P. The nature and frequency of bisphosphonate-associated osteonecrosis of the jaws in dental implant patients: a South Australian case series. J Oral Maxillofac Surg. 2010;68:33...
Marx RE. Pamidronate (Aredia) and zoledronate (Zometa) induced avascular necrosis of the jaws: a growing epidemic. J Oral Maxillofac Surg. 2003;61:1115–7.
Marx RE, Sawatari J, Fortin M, et al. Bisphosphonate-induced exposed bone (osteonecrosis/osteopetrosis) of the jaws; risk factors, recognition, prevention, and treatment. J Oral Maxillofac Surg. 2005;63:1567.
Harper RP, Fung E. Resolution of...
We have reported a case of a severely osteoporotic elderly woman with BRONJ around her dental implants, who was treated successfully with teriparatide. Teriparatide therapy appeared to exert beneficial effects in this patient.
It is therefore important that all patients treated with oral BPs must be given a full explanation of the potential risks of implant failure and BRONJ development in the short and long term. Because the potential role of infection in implant failure and BRONJ occurrence is still debated, great attention should be paid to the long-term oral hygiene and plaque control of implant-prosthetic restorati...
We describe a case of a patient with a 6-year history of alendronate therapy, in which BRONJ developed around her dental implants. In this patient, the dental implants achieved successful osseointegration, and BRONJ occurred after the second surgery. Several factors could have played a role in the development of BRONJ in this patient. Glucocorticoid therapy is associated with an increased risk of ...
In November 2011, after a consultation with an osteoporosis expert at the Orthopedic Medicine Clinic of our hospital, alendronate therapy was stopped and subcutaneous teriparatide therapy at a dose of 20 μg per day was started. During the course of the teriparatide therapy, the patient continued to use 0.02% benzalkonium chloride solution for local irrigation.
In April 2012, after 5 months of ...
A 66-year-old woman was referred to the Oral and Maxillofacial Surgery Clinic at Hyogo College of Medicine Hospital, Japan, in September 2011, for an extraoral fistula and refractory pain of the right mandible associated with a purulent discharge and soft tissue swelling. The patient’s osteoporosis was diagnosed in 2005 and treated with 35 mg of alendronate weekly by the family doctor. The pati...
Oral bisphosphonates (BPs) are used to treat osteoporosis, Paget’s disease, and osteogenesis imperfecta. They are most widely used for treatment of osteoporosis. BP-related osteonecrosis of the jaw (BRONJ) was first reported by Marx in 2003 [1]. The risk of BRONJ in osteoporotic patients treated with BPs remains low compared with that of oncology patients [2]. Recent studies have indicated that ...
We report a case of a 66-year-old severely osteoporotic woman with bisphosphonate-related osteonecrosis of the jaw (BRONJ) around her dental implants, who was treated successfully with teriparatide and sequestrectomy of the mandible. After 5 months of teriparatide therapy, the sequestrum separation had progressed and a sequestrectomy was performed under general anesthesia. Five months after the o...
Fig. 6. Micro CT scan images of the MDIs and Ankylos® embedded in rabbit bone 6 weeks post implantation
Fig. 6. Micro CT scan images of the MDIs and Ankylos® embedded in rabbit bone 6 weeks post implantation
Fig. 5. Histological section of standard implant in rabbit tibia stained with methylene blue and basic fuchsin
Fig. 5. Histological section of standard implant in rabbit tibia stained with methylene blue and basic fuchsin
Fig. 4. Histological section of mini dental implant in rabbit tibia stained with methylene blue and basic fuchsin
Fig. 4. Histological section of mini dental implant in rabbit tibia stained with methylene blue and basic fuchsin
Fig. 3. Histological sections being obtained with Leica SP 1600 saw microtome
Fig. 3. Histological sections being obtained with Leica SP 1600 saw microtome
Fig. 2. Leica SP 1600 saw microtome
Fig. 2. Leica SP 1600 saw microtome
Fig. 1. Radiograph showing implants in the rabbit tibia
Fig. 1. Radiograph showing implants in the rabbit tibia
BIC
3M™ ESPE™ MDIs
Ankylos® Friadent (Dentsply)
Median
58.5
57
Mean
57
56.5
Interquartile range
8
5.5
First quartile
53.25
53.75
Third quartile
61.25
59.25
Table 2 Descriptive statistics of the experimental and control group
Sample
3M™ESPE™ MDIs
Ankylos®
1.
67
54
2.
59
67
3.
54
45
4.
51
58
5.
47
57
6.
64
49
7.
50
54
8.
60
56
9.
56
60
10.
61
53
11.
62
59
12.
61
55
13.
59
59
14.
45
51
15.
58
59
16.
54
62
17.
66
62
18.
56
57
Table 1 Comparison of % BIC in both groups
Dhaliwal, J.S., Albuquerque, R.F., Murshed, M. et al. Osseointegration of standard and mini dental implants: a histomorphometric comparison. Int J Implant Dent 3, 15 (2017). https://doi.org/10.1186/s40729-017-0079-1
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Received: 22 February 2017
Accepted: 26 April 2017
Published: 01 May 2017
DOI: https://doi.org/10.1186/s40729-017-0079-1
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
This article was ammended to correct discrpencies in the Abstract. An erratum has also been published for this manuscript.
An erratum to this article is available at http://dx.doi.org/10.1186/s40729-017-0088-0.
Faculty of Dentistry, McGill University, 2001 McGill College Avenue, Suite 500, Montreal, Quebec, H3A 1G1, Canada
Jagjit S. Dhaliwal, Monzur Murshed & Jocelyne S. Feine
Faculty of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
Rubens F. Albuquerque Jr
Department of Medicine, McGill University, Montreal, Quebec, Canada
Monzur Murshed
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Gotfredsen K, Wennerberg A, Johansson C, Skovgaard LT, Hjorting-Hansen E. Anchorage of TiO2-blasted, HA-coated, and machined implants: an experimental study with rabbi...
Trisi P, Lazzara R, Rao W, Rebaudi A. Bone-implant contact and bone quality: evaluation of expected and actual bone contact on machined and osseotite implant surfaces. Int J Periodontics Restorative Dent. 2002;22(6):535–45.
Froum SJ, Simon H, Cho SC, Elian N, Rohrer MD, Tarnow DP. Histologic evaluation of bone-implant contact of immediately loaded transitional implants after 6 to 27 months. In...
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Siddiqui AA, Sosovicka M, Go...
Branemark PI, Adell R, Breine U, Hansson BO, Lindstrom J, Ohlsson A. Intra-osseous anchorage of dental prostheses. I. Experimental studies. Scand J Plast Reconstr Surg. 1969;3(2):81–100.
Boerrigter EM, Stegenga B, Raghoebar GM, Boering G. Patient satisfaction and chewing ability with implant-retained mandibular overdentures: a comparison with new complete dentures with or without preprosthetic ...
The results of this study show that MDIs as well as regular implants osseointegrate in rabbits.
Our study is also in concordance with the results of a removal torque study by Simon et al. [63] in immediately loaded “transitional endosseous implants” in humans. The percentage BIC for MDIs was similar to standard implants.
The surface topography also affects the BIC, Wennerberg et al. [32] measured and compared removal torque values on screw-shaped titanium implants with three surface typ...
The osseointegration potential of 3M™ESPE™ MDIs has not been studied. The MDI is a one-piece implant that simplifies the restorative phase resulting in a reduced cost for the patient. Titanium-aluminum-vanadium alloy (Ti 6Al-4V-ELI) is used for increased strength. The success of these implants led to its use in long-term fixed and removable dental prostheses [51]. Conventional implant treatmen...
On the whole, postoperative wound healing in all the rabbits was good. None of them exhibited any signs of wound infection or exposure. A total of 36 specimens were retrieved for histological examination.
All of the implants in both groups showed osseointegration and displayed a good amount of bone contact length (Figs. 4 and 5). No discernible differences were noticed between both the groups. T...
The saw blade has a thickness of 280 μm and a feed of 310 μm was selected to obtain the final section thickness of 30 μm. The knurled screw was used for the setting of the section thickness. The prepared section was finally removed from the saw blade. The specimens were prepared for histology by the method as described by Donath and Breuner [49].
Subsequently, the sections were stained with...
The specimens were dehydrated in the ascending graded ethanol solution and kept in a pre-filtration solution for 3 h at room temperature and then in the filtration solution at 4 °C for 17 h. The specimens were then embedded in a light curing resin Technovit 9100 NEW (Kulzer & Co., Wehrheim, Germany) polymerization system based on methyl methacrylate, specially developed for embedding mineraliz...
Expected length of the procedure was approximately 1 h. Following placement of the implants, the wound was sutured in layers. The underlying muscle, fascia, and dermal layers were sutured with the help of Vicryl (Polyglactin 910) suture with 3/8 circle reverse cutting needle. The skin was sutured to a primary closer with the same suture material.
Plain X-ray images of all the rabbit tibia were t...
A small longitudinal skin incision just distal to the tibia-femur joint was made. The tibia/femur head was exposed subperiosteally and an osteotomy performed with the delicately placed pilot drill over the entry point and lightly pumped up and down under copius saline irrigation just to enter the cortical bone for the MDIs. This was used for initial bone drilling to depth of 0.5 mm. The 3M™ESPE...
Nine clinically healthy New Zealand white rabbits weighing 3.5 kg and more were used for the study, and the animals were housed in the central animal house facility. The head of tibia/femur of the animals were used for the implantation of samples. Rabbits’ tibiae and femur have been widely used as an animal model by various other authors to study osseointegration of dental implants [36–45].
...
Despite the advantages of the mini dental implants, evidence on their efficacy and long-term success is lacking. The success of these implants will depend on their union with the surrounding bone. New implant systems entering into the market have to be studied with the help of animal models first, to demonstrate the osseointegration potential for their probable success in humans. There is a limite...
The term “osseointegration” was first introduced to explain the phenomenon for stable fixation of titanium to bone by Brånemark et al. in the 1960s [1]. Osseointegrated implants were introduced, a new era in oral rehabilitation began, and many studies were conducted [2, 3]. A success rate of over 90% has been reported [4, 5]. Further, a success rate of 81% in the maxillary bone and 91% in the...
Mini dental implants (MDIs) are becoming increasingly popular for rehabilitation of edentulous patients because of their several advantages. However, there is a lack of evidence on the osseointegration potential of the MDIs. The objective of the study was to histomorphometrically evaluate and compare bone apposition on the surface of MDIs and standard implants in a rabbit model.
Nine New Zealand ...
Fig. 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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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
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. face, 2: M4M surface) Units of the axis are in μm
Fig. 7. a, b (The marginal discrepancy pattern for group CR and M4M). a Group CR (1: Ceramic surface, 2: CR surface) Units of the axis are in μm. b Group M4M (1: Ceramic surface, 2: M4M surface) Units of the axis are in μm
Fig. 6. Access-hole filling surface areas measurement, average
Fig. 6. Access-hole filling surface areas measurement, average
Fig. 5. Depth and angle at the margin
Fig. 5. Depth and angle at the margin
Fig. 4. Margin depth measurement localization (example: TRA, T = 12 M)
Fig. 4. Margin depth measurement localization (example: TRA, T = 12 M)
Fig. 3. a–e (Filling surface changes): a (ROG, T = 0). b (ROG, T = 1 M). c (ROG, T = 3 M). d (ROG, T = 6 M). e (ROG, T = 12 M)
Fig. 3. a–e (Filling surface changes): a (ROG, T = 0). b (ROG, T = 1 M). c (ROG, T = 3 M). d (ROG, T = 6 M). e (ROG, T = 12 M)
Fig. 2. Occlusal contact point
Fig. 2. Occlusal contact point
Fig. 1. Brush-dip technique
Fig. 1. Brush-dip technique
T = 1 M
T = 3 M
T = 6 M
T = 12 M
No disappearance
CR
53.5% (15/28)
28.5% (8/28)
7.1% (2/28)
3.6% (1/28)
7.1% (2/28)
M4M
28.6% (8/28)
10.7% (3/28)
28.5% (8/28)
28.5% (8/28)
3.6% (1/28)
Table 4 Disappearance of the overfilling. Unit: %
T = 1 M
T = 3 M
T = 6 M
T = 12 M
CR
100
93.2
87.6
83.3
M4M
100
91.1
83.2
77.1
Table 3 Surface areas changes of access-hole filling. Unit: %
Patients
PositionCR
Patients
PositionM4M
T = 0
T = 12
T = 0
T = 12
AMB
13
10
7
AMB
23
10
7
14
6
5
24
8
3
16
8
8
26
8
5
17
10
10
27
8
5
ROG
24
10
7
ROG
14
10
6
26
10
10
16
10
7
27
10
10
17
10
7
NEU
11
4
3
NEU
21
6
5
13
8
7
23
6
5
16
8
7
25
10
10
...
Materials
Product names
Batch numbers
Manufacturer
Ceramic primer
Super-bond UCP
FX1
Sun Medical
Composite
Fantasista
GF11
Sun Medical
Bonding agent
Hybrid bond
FS1/GL1
Sun Medical
Adhesive composite
Bondfill SB
FT2/FS2/FS12
Sun Medical
Table 1 ᅟ
Tanimura, R., Suzuki, S. Comparison of access-hole filling materials for screw retained implant prostheses: 12-month in vivo study. Int J Implant Dent 3, 19 (2017). https://doi.org/10.1186/s40729-017-0076-4
Download citation
Received: 14 December 2016
Accepted: 22 April 2017
Published: 05 May 2017
DOI: https://doi.org/10.1186/s40729-017-0076-4
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
8, place du Général Catroux, 75017, Paris, France
Rémy Tanimura
Department of Clinical Community and Sciences, University of Alabama at Birmingham School of Dentistry, 1919 7th Avenue South, Birmingham, AL, 35294-0007, USA
Shiro Suzuki
You can also search for this author in PubMed Google Scholar
You can also search for this author in PubMed Google Scholar
Correspondence to Rémy Tanimur...
The authors thank Sun Medical Corporation for their material supply.
RT and SS carried out the clinical data and their analysis. RT and SS have been involved in drafting the manuscript and approved the final version to be published.
The authors, Rémy Tanimura and Shiro Suzuki, declare that they have no financial, commercial or any other competing interests.
Springer Nature remains neutral with...
de Pereira R P, Rocha CO, Reis JM, Arioli-Filho JN. Influence of sealing of the screw access hole on the fracture resistance of implant-supported restorations. Braz Dent J. 2016;27(2):148–52.
Mihali S, Canjau S, Bratu E, Wang HL. Utilization of ceramic inlays for sealing implant prostheses screw access holes: a case-control study. Int J Oral Maxillofac Implants. 2016;31(5):1142–9.
Download r...
Taira Y, Sakai M, Sawase T. Effects of primer containing silane and thiophosphate monomers on bonding resin to a leucite-reinforced ceramic. J Dent. 2012;40(5):353–8.
Kato H, Matsumura H, Tanaka T, Atsuta M. Bond strength and durability of porcelain bonding systems. J Prosthet Dent. 1996;75(2):163–8.
Queiroz JR, Souza RO, Nogueira Junior Jr L, Ozcan M, Bottino MA. Influence of acid-etching a...
Korsch M, Walther W. Peri-implantitis associated with type of cement: a retrospective analysis of different types of cement and their clinical correlation to the peri-implant tissue. Clin Implant Dent Relat Res. 2015;17(Suppl 2):e434–43.
Linkevicius T, Vindasiute E, Puisys A, Linkeviciene L, Maslova N, Puriene A. The influence of the cementation margin position on the amount of undetected cemen...
Millen C, Brägger U, Wittneben JG. Influence of prosthesis type and retention mechanism on complications with fixed implant-supported prostheses: a systematic review applying multivariate analyses. Int J Oral Maxillofac Implants. 2015;30(1):110–24.
Guichet DL, Caputo AA, Choi H, Sorensen JA. Passivity of fit and marginal opening in screw- or cement-retained implant fixed partial denture desig...
Within the limitation of the study, it was concluded that:
The null-hypothesis “superficial and marginal deterioration of M4M and CR would not be significantly different” was accepted.
The M4M (modified 4-META/MMA-TBB resin) and CR (composite resin) combined with a ceramic primer showed comparable characteristics (marginal integrity and wear behavior) in an access hole filling.
The esthetic...
The analysis for the ratio of access-hole with or without marginal staining at the time of T = 12 M showed that the results in group CR (12/16) and in group M4M (12/16) were the same. For this reason, the marginal discrepancy pattern, different in both groups did not influence the aesthetical result. The occlusal contact point (A, B, or C) was compared to the marginal staining rate. Among the...
Focusing on numbers of access-hole showing a disappearance of the overfilling in an early period (up to T = 3 M), groups CR and M4M exhibited 82% (23/28) and 39.3% (11/28), respectively (Table 4). This can be explained by the differences of mechanical properties of both materials. The elastic moduli of M4M and CR are 1.9 and 7.9 MPa, respectively. Flexural strength of M4M is 66 MPa which i...
The in vivo evaluation is quite different from that of the in vitro analysis. In the previous study, all the specimens were calibrated to a flat surface with 2.5 mm diameter. In present study, each access hole had a different dimension and configuration. The filling surfaces were often ø3 to 4 mm in diameter. Access-holes located in the occlusal groove area or in the inclined cusp surface induc...
Nowadays, implant screw-retained prosthesis becomes a popular mode of implant supra-structure restoration. Cement retained implant restoration has issues including irretrievability and difficulty of controlling the cement excess beyond the abutment joint. The cement excess can be a major cause of peri-implantitis [13,14,15]. Screw-retained implant restoration has also some disadvantages including ...
Among the 56 access holes, no filling was dislodged during 12 months, and no complaint was registered from the patients regarding functional and aesthetical aspects.
The results for surface areas changes of access-hole fillings at respective intervals were summarized in Table 3 and Fig. 6. The mean values of the change from T = 1 M to T = 12 M were 77.1 ± 13.1% for group M4M and...
The marginal depth of the access-hole filling at T = 0, T = 1 M, T = 3 M, and T = 6 M could not be defined successfully because of the overfilling phenomenon which disrupted the measurement of marginal gap depth and angle (Fig. 3a–e). Only the marginal depth and angle at T = 12 M could be measured with the same digital microscope, and the mean value for each group was ca...
Patients who received a metal framed ceramic screw retained implant crown or bridge were included in this study. These access holes were delimited only by ceramic. Those with metal surface exposure were excluded from this study. Patients with edentulous arch or section, full or partial denture as antagonists were excluded from the study. During the evaluation period, 2 patients (male) dropped out ...
A total of 60 access-holes in 14 patients (5 male and 9 female) aging from 34 to 69 were restored and observed during 12 months. All subjects were informed about the study, and their written consent to participate in the study was taken.
The materials used in this study are presented in Table 1. They include a phosphoric acid monomer ceramic primer (CP): UCP (Super-Bond Universal Ceramic Primer...
The retention of implant-supported prostheses is provided by the use of a screw or cement. Recently, it was demonstrated that cement-retained prostheses had a higher rate of technical and biological complications [1], despite a better passive fit than the screw-retained restorations [2]. The CAD/CAM development of the implant-supported prostheses allows a better passively fit with screw-retained p...
Screw retained implant prostheses seem to be an efficient restorative method to prevent peri-implantitis caused by cement excess around the abutment. The drawback of the screw-retained prostheses is the difficulty to realize an efficient access-hole filling functionally and aesthetically. Up to now, few in vitro and in vivo studies were reported in the literature. The aim of this study was to eval...
Fig. 5. Osteoblasts with an orientation tendency after 24 h of rotation (phallacidin fluorescence staining). On the left side with 200× and on the right side with 400× magnification. The yellow arrows show the orientation of the cells. The red arched arrow within the coloured circle shows the direction of rotation. The dashed white line oriented to the right stands for the resulting centrifug...
Fig. 4. Randomly orientated osteoblasts without influence of rotation (phallacidin fluorescence staining). On the left side with 200× and on the right side with 400× magnification. The white X on the coloured circle marks the location upon the plate where the osteoblasts were located. The red X marks the centre of the plate
Fig. 4. Randomly orientated osteoblasts without influence of rotati...
centrifugal force and the glass plates’ dimensions. For example, at a distance of 25 mm from the centre of the upper plate, the shear forces’ value is 8.33 dyn/cm2, together with an additional centrifugal force that has a value of 0.55 dyn/cm2
Fig. 3. Diagram for visualisation of the calculation of shear stress rates taking into account the centrifugal force and the glass plates’ dim...
earing gap and bottom plate are shown on the left side; rotation speed = 200 rpm; colour code bar (left edge) showing shear force values [Pa] [1 Pa = 10 dyn/cm2]; flow direction presented by arrows
Fig. 2. Side view of a computerized simulation, showing the flow chambers’ lower compartment and the flow profile in between the two plates; shearing gap and bottom plate are shown on ...
Fig. 1. Three-dimensional illustration (a–e) and photography (f) of the experimental setup with the components marked numerical. a as the lower plate); 2 Rotating glass panel [60 mm diameter (cell bearing)]; 3 Titanium axis. b4 Liquid medium (red). cGearwheel with set screw. eng ring with additional set screw
Fig. 1. Three-dimensional illustration (a–e) and photography (f) of the experim...
Culture medium/additives
Manufacturer
Order no.
Concentration
Dulbecco’s modified Eagle medium (DMEM) with l-glutamine, plus 4.5 g glucose,...
Component
Manufacturer
Order no.
Large petri dish
Becton Dickinson, Franklin Lakes, NJ, USA
...
Kämmerer, P.W., Thiem, D.G.E., Alshihri, A. et al. Cellular fluid shear stress on implant surfaces—establishment of a novel experimental set up.
Int J Implant Dent 3, 22 (2017). https://doi.org/10.1186/s40729-017-0085-3
Download citation
Received: 27 February 2017
Accepted: 22 May 2017
Published: 31 May 2017
DOI: https://doi.org/10.1186/s40729-017-0085-3
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...
Correspondence to
D. G. E. Thiem.
Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Centre Rostock, Schillingallee 35, 18057, Rostock, Germany
P. W. Kämmerer & D. G. E. Thiem
Department of Prosthetic and Biomaterial Sciences, King Saud University, Riyadh, Saudi Arabia
A. Alshihri
Harvard School of Dental Medicine, Boston, MA, USA
A. Alshihri
Department of Oral and Maxillofacial Surge...
The authors thank the Department of Hydraulic Machines, Faculty of Mechanical Engineering, Technical University of Munich, Germany, for helping with the computerised simulations.
Nothing to declare
The datasets supporting the conclusions of this article are available at the repository of the University Medical Centre Mainz, Germany, and can be provided on request.
PK had substantial contributio...
Papadaki M, Eskin SG. Effects of fluid shear stress on gene regulation of vascular cells. Biotechnol Prog. 1997;13(3):209–21.
James NL, Harrison DG, Nerem RM. Effects of shear on endothelial cell calcium in the presence and absence of ATP. FASEB J. 1995;9(10):968–73.
Kämmerer PW, Lehnert M, Al-Nawas B, Kumar VV, Hagmann S, Alshihri A, et al. Osseoconductivity of a specific streptavidin-biot...
Hughes-Fulford M. Signal transduction and mechanical stress. Sci STKE. 2004;2004(249):RE12.
Ruel J, Lemay J, Dumas G, Doillon C, Charara J. Development of a parallel plate flow chamber for studying cell behavior under pulsatile flow. ASAIO J. 1995;41(4):876–83.
Kazakidi A, Sherwin SJ, Weinberg PD. Effect of Reynolds number and flow division on patterns of haemodynamic wall shear stress near br...
Becker J, Kirsch A, Schwarz F, Chatzinikolaidou M, Rothamel D, Lekovic V, et al. Bone apposition to titanium implants biocoated with recombinant human bone morphogenetic protein-2 (rhBMP-2). A pilot study in dogs. Clin Oral Investig. 2006;10(3):217–24.
Hung CT, Allen FD, Pollack SR, Brighton CT. What is the role of the convective current density in the real-time calcium response of cultured bon...
Ehrlich PJ, Lanyon LE. Mechanical strain and bone cell function: a review. Osteoporos Int. 2002;13(9):688–700.
Vaughan TJ, Haugh MG, Mcnamara LM. A fluid-structure interaction model to characterize bone cell stimulation in parallel-plate flow chamber systems. J R Soc Interface. 2013;10(81):20120900.
Weinbaum S, Cowin SC, Zeng Y. A model for the excitation of osteocytes by mechanical loading-in...
To create fluid shear stress under in vitro conditions, several flow chambers have been developed in the past. The experimental setup of the flow chamber in the centre of this study offers advantages such as simplicity to assemble and ease of use as well as the creation of reproducible fluid shear forces on cells. Due to the new design, different cell types could be simultaneously analysed under r...
Besides, in the model reported in this study, microscopic examinations are possible after completing the experiment only. Nevertheless, an advantage of the new flow chamber is the possibility of testing different cell colonies simultaneously in one single experiment by placing cells in different radial locations on the spinning disc. Due to the current flow gradient from the centre to the peripher...
Due to the fact that constant flows were generated within the parallel flow chamber only, the situations of in vitro experiments differ from in vivo setting where dynamic flow profiles are particular [33]. As the constant laminar flow profile is not physiological in bones [34], vessels and other tissues [35], the informative value of the experimental setting is limited but it could be used for var...
The aim of this study was to establish a new FSS model that is easy to use as well as simple to assemble in order to create reproducible fluid shear forces on cells close to implant material surfaces. Todays’ commonly used commercial flow devices differ in geometry and function, which makes comparisons between experiments difficult [4, 10, 26, 27]. The benefits of this novel testing device are r...
in which ρ = density, h = height, ω = angular velocity and r = radius.
Figure 3 shows the respective physical force and its dependence on a bigger radius and higher rotational speed. The results of this study indicate that the centrifugal force represents only a little proportion of effective forces. Hence, the centrifugal forces’ impacts on the tested cells are considered to be insignifican...
Our analysis was focused on two main aspects:
Simulation of the fluid flow characteristics as well as quantification of the arising shear forces at the plate/plate flow chamber with reliable reproducibility
Assessment of the impact of fluid shear stress on osteoblast cells in terms of altered cell morphology and intracellular structural changes
The computational fluid dynamic analysis and the q...
For constant and fully developed laminar flow between the two parallel plates, the magnitude of the wall shear stress (τ) in between was calculated by formula 1:
in which η is the dynamic fluid viscosity (dyn/cm2), r is the radius of the plate (cm), ω stands for angular velocity and H for height (vertical distance in between the two plates).
To get information whether the flow is laminar or t...
A three-dimensional illustration and photography of the plate/plate flow chamber model is shown in Fig. 1. A detailed list of used parts can be found in Appendix 1.
The circulation within the flow chamber was generated by an externally attached electric motor, which rotates up to 500 rounds per minute (rpm). A commercial grade 4 pure medical titanium gear shaft (length = 40 mm, diameter =...
Therefore, the aim of the present study was to establish a new cell chamber model for FSS simulation and stimulation. In addition to its ease of use, the reported model in this study should meet the requirements of a simple design, generating reproducible flow characteristics next to laminar flows and clearly defined flow gradients on implant surfaces.
Cells can be influenced by different mechanostimuli, which lead to an activation of cellular and inter-cellular responses. These reactions may be caused by either a direct stimulation of the cell body (mechanoreception) or indirect cellular stimulation (response) [1,2,3]. Extracellular fluid movement induces fluid shear stress (FSS) that can result in different cellular processes including prolife...
Mechanostimuli of different cells can affect a wide array of cellular and inter-cellular biological processes responsible for dental implant healing. The purpose of this in vitro study was to establish a new test model to create a reproducible flow-induced fluid shear stress (FSS) of osteoblast cells on implant surfaces.
As FSS effects on osteoblasts are detectable at 10 dyn/cm2, a custom-made f...
Fig. 7. CR and M4M). a Group CR (1: Ceramic surface, 2: CR surface) Units of the axis are in μm. b Group M4M (1: Ceramic surface, 2: M4M surface) Units of the axis are in μm
Fig. 7. a, b (The marginal discrepancy pattern for group CR and M4M). a Group CR (1: Ceramic surface, 2: CR surface) Units of the axis are in μm. b Group M4M (1: Ceramic surface, 2: M4M surface) Units of the axis are i...
Fig. 6. Access-hole filling surface areas measurement, average
Fig. 6. Access-hole filling surface areas measurement, average
Fig. 5. Depth and angle at the margin
Fig. 5. Depth and angle at the margin
Fig. 4. Margin depth measurement localization (example: TRA, T = 12 M)
Fig. 4. Margin depth measurement localization (example: TRA, T = 12 M)
Fig. 3. ROG, T = 1 M). c (ROG, T = 3 M). d (ROG, T = 6 M). e (ROG, T = 12 M)
Fig. 3. a–e (Filling surface changes): a (ROG, T = 0). b (ROG, T = 1 M). c (ROG, T = 3 M). d (ROG, T = 6 M). e (ROG, T = 12 M)
Fig. 2. Occlusal contact point
Fig. 2. Occlusal contact point
Fig. 1. Brush-dip technique
Fig. 1. Brush-dip technique
T = 1 M
T = 3 M
T = 6 M
T = 12 M
No disappearance
CR
53.5% (15/28)
...
T = 1 M
T = 3 M
T = 6 M
T = 12 M
CR
100
93.2
87.6
...
Patients
Position
CR
Patients
Position
M4M
T = 0
T = 12
...
Materials
Product names
Batch numbers
Manufacturer
Ceramic primer
Super-bond UCP
...
Tanimura, R., Suzuki, S. Comparison of access-hole filling materials for screw retained implant prostheses: 12-month in vivo study.
Int J Implant Dent 3, 19 (2017). https://doi.org/10.1186/s40729-017-0076-4
Download citation
Received: 14 December 2016
Accepted: 22 April 2017
Published: 05 May 2017
DOI: https://doi.org/10.1186/s40729-017-0076-4
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
8, place du Général Catroux, 75017, Paris, France
Rémy Tanimura
Department of Clinical Community and Sciences, University of Alabama at Birmingham School of Dentistry, 1919 7th Avenue South, Birmingham, AL, 35294-0007, USA
Shiro Suzuki
You can also search for this author in
PubMed Google Scholar
You can also search for this author in
PubMe...
The authors thank Sun Medical Corporation for their material supply.
RT and SS carried out the clinical data and their analysis. RT and SS have been involved in drafting the manuscript and approved the final version to be published.
The authors, Rémy Tanimura and Shiro Suzuki, declare that they have no financial, commercial or any other competing interests.
Springer Nature remains neutral with...
de Pereira R P, Rocha CO, Reis JM, Arioli-Filho JN. Influence of sealing of the screw access hole on the fracture resistance of implant-supported restorations. Braz Dent J. 2016;27(2):148–52.
Mihali S, Canjau S, Bratu E, Wang HL. Utilization of ceramic inlays for sealing implant prostheses screw access holes: a case-control study. Int J Oral Maxillofac Implants. 2016;31(5):1142–9.
Download r...
Taira Y, Sakai M, Sawase T. Effects of primer containing silane and thiophosphate monomers on bonding resin to a leucite-reinforced ceramic. J Dent. 2012;40(5):353–8.
Kato H, Matsumura H, Tanaka T, Atsuta M. Bond strength and durability of porcelain bonding systems. J Prosthet Dent. 1996;75(2):163–8.
Queiroz JR, Souza RO, Nogueira Junior Jr L, Ozcan M, Bottino MA. Influence of acid-etching a...
Korsch M, Walther W. Peri-implantitis associated with type of cement: a retrospective analysis of different types of cement and their clinical correlation to the peri-implant tissue. Clin Implant Dent Relat Res. 2015;17(Suppl 2):e434–43.
Linkevicius T, Vindasiute E, Puisys A, Linkeviciene L, Maslova N, Puriene A. The influence of the cementation margin position on the amount of undetected cemen...
Millen C, Brägger U, Wittneben JG. Influence of prosthesis type and retention mechanism on complications with fixed implant-supported prostheses: a systematic review applying multivariate analyses. Int J Oral Maxillofac Implants. 2015;30(1):110–24.
Guichet DL, Caputo AA, Choi H, Sorensen JA. Passivity of fit and marginal opening in screw- or cement-retained implant fixed partial denture desig...
Within the limitation of the study, it was concluded that:
The null-hypothesis “superficial and marginal deterioration of M4M and CR would not be significantly different” was accepted.
The M4M (modified 4-META/MMA-TBB resin) and CR (composite resin) combined with a ceramic primer showed comparable characteristics (marginal integrity and wear behavior) in an access hole filling.
The esthetic...
The analysis for the ratio of access-hole with or without marginal staining at the time of T = 12 M showed that the results in group CR (12/16) and in group M4M (12/16) were the same. For this reason, the marginal discrepancy pattern, different in both groups did not influence the aesthetical result. The occlusal contact point (A, B, or C) was compared to the marginal staining rate. Among the...
Focusing on numbers of access-hole showing a disappearance of the overfilling in an early period (up to T = 3 M), groups CR and M4M exhibited 82% (23/28) and 39.3% (11/28), respectively (Table 4). This can be explained by the differences of mechanical properties of both materials. The elastic moduli of M4M and CR are 1.9 and 7.9 MPa, respectively. Flexural strength of M4M is 66 MPa which i...
The in vivo evaluation is quite different from that of the in vitro analysis. In the previous study, all the specimens were calibrated to a flat surface with 2.5 mm diameter. In present study, each access hole had a different dimension and configuration. The filling surfaces were often ø3 to 4 mm in diameter. Access-holes located in the occlusal groove area or in the inclined cusp surface induc...
Nowadays, implant screw-retained prosthesis becomes a popular mode of implant supra-structure restoration. Cement retained implant restoration has issues including irretrievability and difficulty of controlling the cement excess beyond the abutment joint. The cement excess can be a major cause of peri-implantitis [13,14,15]. Screw-retained implant restoration has also some disadvantages including ...
Among the 56 access holes, no filling was dislodged during 12 months, and no complaint was registered from the patients regarding functional and aesthetical aspects.
The results for surface areas changes of access-hole fillings at respective intervals were summarized in Table 3 and Fig. 6. The mean values of the change from T = 1 M to T = 12 M were 77.1 ± 13.1% for group M4M and...
The marginal depth of the access-hole filling at T = 0, T = 1 M, T = 3 M, and T = 6 M could not be defined successfully because of the overfilling phenomenon which disrupted the measurement of marginal gap depth and angle (Fig. 3a–e). Only the marginal depth and angle at T = 12 M could be measured with the same digital microscope, and the mean value for each group was ca...
Patients who received a metal framed ceramic screw retained implant crown or bridge were included in this study. These access holes were delimited only by ceramic. Those with metal surface exposure were excluded from this study. Patients with edentulous arch or section, full or partial denture as antagonists were excluded from the study. During the evaluation period, 2 patients (male) dropped out ...
A total of 60 access-holes in 14 patients (5 male and 9 female) aging from 34 to 69 were restored and observed during 12 months. All subjects were informed about the study, and their written consent to participate in the study was taken.
The materials used in this study are presented in Table 1. They include a phosphoric acid monomer ceramic primer (CP): UCP (Super-Bond Universal Ceramic Primer...
The retention of implant-supported prostheses is provided by the use of a screw or cement. Recently, it was demonstrated that cement-retained prostheses had a higher rate of technical and biological complications [1], despite a better passive fit than the screw-retained restorations [2]. The CAD/CAM development of the implant-supported prostheses allows a better passively fit with screw-retained p...
Screw retained implant prostheses seem to be an efficient restorative method to prevent peri-implantitis caused by cement excess around the abutment. The drawback of the screw-retained prostheses is the difficulty to realize an efficient access-hole filling functionally and aesthetically. Up to now, few in vitro and in vivo studies were reported in the literature. The aim of this study was to eval...
Fig. 5. Osteoblasts with an orientation tendency after 24 h of rotation (phallacidin fluorescence staining). On the left side with 200× and on the right side with 400× magnification. The yellow arrows show the orientation of the cells. The red arched arrow within the coloured circle shows the direction of rotation. The dashed white line oriented to the right stands for the resulting centrifug...
Fig. 4. Randomly orientated osteoblasts without influence of rotation (phallacidin fluorescence staining). On the left side with 200× and on the right side with 400× magnification. The white X on the coloured circle marks the location upon the plate where the osteoblasts were located. The red X marks the centre of the plate
Fig. 4. Randomly orientated osteoblasts without influence of rotati...
to account the centrifugal force and the glass plates’ dimensions. For example, at a distance of 25 mm from the centre of the upper plate, the shear forces’ value is 8.33 dyn/cm2, together with an additional centrifugal force that has a value of 0.55 dyn/cm2
Fig. 3. Diagram for visualisation of the calculation of shear stress rates taking into account the centrifugal force and the glas...
e in between the two plates; shearing gap and bottom plate are shown on the left side; rotation speed = 200 rpm; colour code bar (left edge) showing shear force values [Pa] [1 Pa = 10 dyn/cm2]; flow direction presented by arrows
Fig. 2. Side view of a computerized simulation, showing the flow chambers’ lower compartment and the flow profile in between the two plates; shearing gap...
Fig. 1. Three-dimensional illustration (a–e) and photography (f) of the experimental setup with the components marked numerical. a lower plate); 2 Rotating glass panel [60 mm diameter (cell bearing)]; 3 Titanium axis. b4 Liquid medium (red). cwheel with set screw. e ring with additional set screw
Fig. 1. Three-dimensional illustration (a–e) and photography (f) of the experimental setup w...
Culture medium/additives
Manufacturer
Order no.
Concentration
Dulbecco’s modified Eagle medium (DMEM) with l-glutamine, plus 4.5 g glucose,...
Component
Manufacturer
Order no.
Large petri dish
Becton Dickinson, Franklin Lakes, NJ, USA
...
Kämmerer, P.W., Thiem, D.G.E., Alshihri, A. et al. Cellular fluid shear stress on implant surfaces—establishment of a novel experimental set up.
Int J Implant Dent 3, 22 (2017). https://doi.org/10.1186/s40729-017-0085-3
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Received: 27 February 2017
Accepted: 22 May 2017
Published: 31 May 2017
DOI: https://doi.org/10.1186/s40729-017-0085-3
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...
Correspondence to
D. G. E. Thiem.
Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Centre Rostock, Schillingallee 35, 18057, Rostock, Germany
P. W. Kämmerer & D. G. E. Thiem
Department of Prosthetic and Biomaterial Sciences, King Saud University, Riyadh, Saudi Arabia
A. Alshihri
Harvard School of Dental Medicine, Boston, MA, USA
A. Alshihri
Department of Oral and Maxillofacial Surge...
The authors thank the Department of Hydraulic Machines, Faculty of Mechanical Engineering, Technical University of Munich, Germany, for helping with the computerised simulations.
Nothing to declare
The datasets supporting the conclusions of this article are available at the repository of the University Medical Centre Mainz, Germany, and can be provided on request.
PK had substantial contributio...
Papadaki M, Eskin SG. Effects of fluid shear stress on gene regulation of vascular cells. Biotechnol Prog. 1997;13(3):209–21.
James NL, Harrison DG, Nerem RM. Effects of shear on endothelial cell calcium in the presence and absence of ATP. FASEB J. 1995;9(10):968–73.
Kämmerer PW, Lehnert M, Al-Nawas B, Kumar VV, Hagmann S, Alshihri A, et al. Osseoconductivity of a specific streptavidin-biot...
Hughes-Fulford M. Signal transduction and mechanical stress. Sci STKE. 2004;2004(249):RE12.
Ruel J, Lemay J, Dumas G, Doillon C, Charara J. Development of a parallel plate flow chamber for studying cell behavior under pulsatile flow. ASAIO J. 1995;41(4):876–83.
Kazakidi A, Sherwin SJ, Weinberg PD. Effect of Reynolds number and flow division on patterns of haemodynamic wall shear stress near br...
Becker J, Kirsch A, Schwarz F, Chatzinikolaidou M, Rothamel D, Lekovic V, et al. Bone apposition to titanium implants biocoated with recombinant human bone morphogenetic protein-2 (rhBMP-2). A pilot study in dogs. Clin Oral Investig. 2006;10(3):217–24.
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Ehrlich PJ, Lanyon LE. Mechanical strain and bone cell function: a review. Osteoporos Int. 2002;13(9):688–700.
Vaughan TJ, Haugh MG, Mcnamara LM. A fluid-structure interaction model to characterize bone cell stimulation in parallel-plate flow chamber systems. J R Soc Interface. 2013;10(81):20120900.
Weinbaum S, Cowin SC, Zeng Y. A model for the excitation of osteocytes by mechanical loading-in...
To create fluid shear stress under in vitro conditions, several flow chambers have been developed in the past. The experimental setup of the flow chamber in the centre of this study offers advantages such as simplicity to assemble and ease of use as well as the creation of reproducible fluid shear forces on cells. Due to the new design, different cell types could be simultaneously analysed under r...
Besides, in the model reported in this study, microscopic examinations are possible after completing the experiment only. Nevertheless, an advantage of the new flow chamber is the possibility of testing different cell colonies simultaneously in one single experiment by placing cells in different radial locations on the spinning disc. Due to the current flow gradient from the centre to the peripher...
Due to the fact that constant flows were generated within the parallel flow chamber only, the situations of in vitro experiments differ from in vivo setting where dynamic flow profiles are particular [33]. As the constant laminar flow profile is not physiological in bones [34], vessels and other tissues [35], the informative value of the experimental setting is limited but it could be used for var...
The aim of this study was to establish a new FSS model that is easy to use as well as simple to assemble in order to create reproducible fluid shear forces on cells close to implant material surfaces. Todays’ commonly used commercial flow devices differ in geometry and function, which makes comparisons between experiments difficult [4, 10, 26, 27]. The benefits of this novel testing device are r...
in which ρ = density, h = height, ω = angular velocity and r = radius.
Figure 3 shows the respective physical force and its dependence on a bigger radius and higher rotational speed. The results of this study indicate that the centrifugal force represents only a little proportion of effective forces. Hence, the centrifugal forces’ impacts on the tested cells are considered to be insignifican...
Our analysis was focused on two main aspects:
Simulation of the fluid flow characteristics as well as quantification of the arising shear forces at the plate/plate flow chamber with reliable reproducibility
Assessment of the impact of fluid shear stress on osteoblast cells in terms of altered cell morphology and intracellular structural changes
The computational fluid dynamic analysis and the q...
For constant and fully developed laminar flow between the two parallel plates, the magnitude of the wall shear stress (τ) in between was calculated by formula 1:
in which η is the dynamic fluid viscosity (dyn/cm2), r is the radius of the plate (cm), ω stands for angular velocity and H for height (vertical distance in between the two plates).
To get information whether the flow is laminar or t...
A three-dimensional illustration and photography of the plate/plate flow chamber model is shown in Fig. 1. A detailed list of used parts can be found in Appendix 1.
The circulation within the flow chamber was generated by an externally attached electric motor, which rotates up to 500 rounds per minute (rpm). A commercial grade 4 pure medical titanium gear shaft (length = 40 mm, diameter =...
Therefore, the aim of the present study was to establish a new cell chamber model for FSS simulation and stimulation. In addition to its ease of use, the reported model in this study should meet the requirements of a simple design, generating reproducible flow characteristics next to laminar flows and clearly defined flow gradients on implant surfaces.
Cells can be influenced by different mechanostimuli, which lead to an activation of cellular and inter-cellular responses. These reactions may be caused by either a direct stimulation of the cell body (mechanoreception) or indirect cellular stimulation (response) [1,2,3]. Extracellular fluid movement induces fluid shear stress (FSS) that can result in different cellular processes including prolife...
Mechanostimuli of different cells can affect a wide array of cellular and inter-cellular biological processes responsible for dental implant healing. The purpose of this in vitro study was to establish a new test model to create a reproducible flow-induced fluid shear stress (FSS) of osteoblast cells on implant surfaces.
As FSS effects on osteoblasts are detectable at 10 dyn/cm2, a custom-made f...
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.
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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.
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Buser D, Dula K, Hirt HP, Schenk RK. Lateral ridge augmentation using autografts and barrier membranes: clinical study with 40 partially edentulous patients. J Oral Maxill...
The results of the clinical study proves the reliability and low comorbidity of autologous bone grafts in preprosthetic alveolar ridge reconstructions prior to implant insertion. The high graft success rate (95.6%) and the low early implant failure rate (0.38%) in a surveillance of all patients treated in three following years with this technique showing no exclusion and no dropout of any case for...
Data on risk factors based on the original examination and documentation are difficult to assess the adverse effects of variable factors on the surgical prognosis because of the multifactorial genesis of surgical complications [73]. Factors such as gender, age, or smoking habit could be associated with postoperative complications after two-stage dentoalveolar reconstruction with autologous bone gr...
The results of the present study have to take into account the absence of a control group with patients undergoing bone augmentation procedures with bone substitutes (allogen, alloplastic, exogen). Without a comparative group of grafting surgeries using alternative bone material, only limited statements can be made.
However, the excellent surgical outcome of autologous surgical methods providing ...
The use of autologous bone in this study has shown excellent graft survival and success rate (95.6%). This is equal to the results from the studies on implants inserted in reconstructed sites [6, 8, 24]. The early implant survival rate of 99.7% found in the present material is very high comparable to that in the previous systematic reviews after staged horizontal ridge augmentation [9, 10, 22, 62,...
Of the sinus floor elevations performed in this study, 84.8% were defined absolutely successful. Only two of our 72 patients having sinus lift operations could not finally be treated with dental implants. These results are comparable to other studies considering the sinus graft to be a safe treatment modality with few complications [6, 8, 51,52,53]. Raghoebar et al. reported incidences of sinus co...
Postoperative morbidity after mandibular bone harvesting procedures was reported to be mainly related to temporary or permanent neural disturbances involving the inferior alveolar nerve and its branches [19]. In this study, only the incidence of the temporary hypoesthesia of the mandibular and lingual nerve after harvesting from the retromolar area could be detected. It was 10.4 and 2.8%, respecti...
Systematic reviews have failed to find evidence that one particular grafting technique is superior to others [10]. Intraoral bone grafts from the mandibular symphysis, mandibular ramus, and maxillary tuberosity provide a good treatment modality for ridge augmentation, and the amount of bone available for harvesting is sufficient for defects up to the width of three teeth [42]. Harvesting of retrom...
Several grafting procedures have been described to create sufficient volume of bone for implant placement [8, 9]. Autologous bone grafts can be harvested by an intraoral approach (mandibular ramus, mandibular symphysis, zygomatic buttress) or from distant sites (iliac crest, calvaria, and etc.) [17, 36, 37]. However, bone harvesting potentially causes donor site morbidity which is a major issue fo...
The average healing period until implant placement after bone harvesting was 4.53 months. Initially, 546 implants in 279 patients were planned. After the healing period, it was possible to place 525 implants in 436 successfully augmented areas in 259 patients. Three hundred implants were inserted in the maxilla and 225 in the mandible. The remaining 21 implants planned for 20 patients could not b...
Regarding intraoperative complications, all sinus membrane perforations were covered with a resorbable collagen membrane (Bio-Gide®, Geistlich Biomaterials, Baden-Baden, Germany) which applied as sealant to overlap the site of perforation prior to insertion of the graft material. These patients were advised to avoid physical stress, blowing their noses, or sneezing for a period of 3 weeks, and n...
No permanent damage to any trigeminal nerves was evident in any of our entire cohort. All cases of postoperative hypoesthesia of the mental, lingual, or infraorbital nerve were just a temporary nature. At the time of implant surgery, none of these patients reported any persisting neural disturbances (Fig. 4).
In eleven patients, hypoesthesia of the mental area was mentioned, and three of them al...
Thirty-eight patients underwent a total of 116 augmentation procedures harvesting from the iliac crest. In 20 patients, a bone graft augmentation of the maxilla and the mandible in combination with bilateral sinus floor augmentations was performed. Eighteen patients had augmentations only in the maxilla, involving bone grafting and sinus lift elevations. Totally, 76 sinus lifts with bone material ...
In six patients, a partial graft resorption was detected at the time of implantation and an additional simultaneous augmentation with bone chips harvested with the Safescraper device (C.G.M. S.p.A., Divisione Medicale META, Italy) was then necessary in order to ensure the osseointegration of the implants. Two out of these six cases had grafts from the crista zygomatico-alveolaris, two from the ram...
A total of 112 sinus floor elevations were performed. In all of the cases, implants were inserted in a two-stage procedure. The donor site for harvesting the bone for the sinus elevations was in 76 procedures in the iliac crest area, and in 36 procedures, the bone was harvested with a bone scraper device from the lateral sinus wall at the site of sinus lifting.
The distribution and number of tran...
Two hundred seventy-nine patients—250 men and 29 women—underwent 456 augmentation procedures involving autologous bone grafts prior to implant placement. The patients ranged in age from 18.5 to 71.5 years (average 43.1 years) at the moment of augmentation surgery.
Of those patients, 162 (58.1%) were younger than 40 years of age and 117 (41.9%) were older than 40 years of age. Caries or pe...
Early and late implant loss was documented in this study, defining the clinical success of osseointegration. Early implant failures were assessed before the acquisition of osseointegration, i.e., before the placement of prosthodontic restorations. Early implant failure could occur from the time of placement, during the healing phase and before abutment connection. The implant inserted after re-aug...
Medical history of patient
Age of patient at the time of bone harvesting and augmentation
History of periodontal disease
Smoking habits
Donor site
Jaw area and dental situation of the recipient site
Intraoperative complications
Postoperative complications after augmentation
Management of complications
Bone graft stability and clinical resorption prior to implant placement
Complications a...
In addition to the bone already gained with the bone scraper device from the sinus wall during the antrostomy, bone was harvested with the same device from the maxillary buccal buttress, if more volume was needed. By taking this approach, the collection of enough bone for the augmentation of at least two implantation sites was feasible with a mean surgical time of 5 to 10 min for harvesting. In c...
Grafting from the iliac crest was always performed under general anesthesia in a two-team approach. The iliac crest was exposed and autogenous grafts from the anterosuperior inner edge of the iliac wing were harvested with an oscillating saw and/or a chisel, keeping a safe distance of around 2 cm from the anterosuperior iliac spine. After harvesting the bone grafts, the corticocancellous bone blo...
A standardized two-stage surgical protocol was used, and all sites were treated in a similar fashion. In the first intervention, a bone block harvested from the donor site was fixed with osteosynthesis titanium screws to the recipient site as an onlay graft to achieve a horizontal and/or vertical enlargement of the alveolar ridge. Placement of the bone graft was always guided by an augmentation te...
For this retrospective cohort study, we reviewed the records of all patients without exclusion criteria who were referred to the department of oral and plastic maxillofacial surgery at the military hospital of Ulm, Germany, between January 2009 and December 2011 for alveolar ridge augmentations prior to implant insertions using autologous bone grafts harvested from different donor sites and unilat...
In our military outpatient center exclusively, autologous bone transplantations harvested from different donor sites were used intraorally (crista zygomatico-alveolaris, ramus mandible, symphysis mandible, anterior sinus wall) and extraorally (iliac crest) to reconstruct severe horizontal and/or vertical alveolar ridge atrophy prior to implant placement. The aim of this study was to assess the cli...
Although the iliac crest is most often used in jaw reconstruction, a significant bone resorption has been mentioned [12]. This disadvantage, and the fact that dental implants do not always require a large amount of bone, has increased the use of autologous block bone grafts from intraoral sources [13]. Bone grafts from intraoral donor sites offer several benefits like surgical accessibility, proxi...
Oral implantation has a significant role in the rehabilitation of patients. Bone reconstruction techniques have been advanced in order to optimize the esthetic and functional outcome. However, the restoration of the oral function of atrophic alveolar crests still remains a challenge in oral implantology. Bone augmentation procedures are often indicated to allow implant placement in an optimal thre...
This review demonstrates the predictability of autologous bone material in alveolar ridge reconstructions prior to implant insertion, independent from donor and recipient site including even autologous bone chips for sinus elevation. Due to the low harvesting morbidity of autologous bone grafts, the clinical results of our study indicate that autologous bone grafts still remain the “gold standar...
This study assessed the clinical outcomes of graft success rate and early implant survival rate after preprosthetic alveolar ridge reconstruction with autologous bone grafts.
A consecutive retrospective study was conducted on all patients who were treated at the military outpatient clinic of the Department of Oral and Plastic Maxillofacial Surgery at the military hospital in Ulm (Germany) in the ...
ple. a Ground section stained with Levai-Laczkó. b Tissue identification of the ROI. c Closer view a bone and CCXBB. d Closer view of b
Fig. 5. Histomorphometric analysis of the same sample. a Ground section stained with Levai-Laczkó. b Tissue identification of the ROI. c Closer view a arrow pointing a cement line between new mineralized bone and CCXBB. d Closer view of b
Fig. 4. Histological samples. a CCXBB control without implantation. b Histologic samples with acute inflammatory infiltration. c Histologic sample with limited remaining CCXBB and large bone ingrowth
Fig. 4. Histological samples. a CCXBB control without implantation. b Histologic samples with acute inflammatory infiltration. c Histologic sample with limited remaining CCXBB and large bone ingr...
Fig. 3. Re-entry procedure of patient in Fig. 1. a Buccal aspect of the augmented region. b Horizontal bone augmentation. c Screws and pins removal and bone trephine sampling. d Implants placement and buccal bone width from the implant shoulder. e Primary flap closure. f Implants submerged healing
Fig. 3. Re-entry procedure of patient in Fig. 1. a Buccal aspect of the augmented region. b Ho...
Fig. 2. Lateral bone augmentation of the alveolar crest (a) atrophic ridge. b Perforations and adaptation of the cortical layer. c Shaping, pre-wetting and fixation of CCXBB with titanium screws. d Horizontal contour and peripheral gap between CCXBB and bone layer. e Outlying DBBM filling. f CM stabilized with pins
Fig. 2. Lateral bone augmentation of the alveolar crest (a) atrophic ridge. b ...
Fig. 1. Study chart and follow-up visits
Fig. 1. Study chart and follow-up visits
Differentiated tissues
Implant lost (Yes/no)
Mean
SD
Percentage
SD (%)
...
Patient
TRAP (%)
OPN (%)
ALP (%)
OSC (%)
1
...
Tissue type
Mean
Standard deviation
Median
CI 95%
Mineralized bone
...
Patient
Soft tissue dehiscence
Mineralized bone (%)
CCXBB (%)
Bone marrow (%)
Connect...
Ortiz-Vigón, A., Martinez-Villa, S., Suarez, I. et al. Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant placement.
Int J Implant Dent 3, 24 (2017). https://doi.org/10.1186/s40729-017-0087-1
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Received: 21 March 2017
Accepted: 12 June 2017
Published: 21 Ju...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
ETEP Research Group, Facultad de Odontología, Universidad Complutense de Madrid, Plaza Ramón y Cajal, 28040, Madrid, Spain
Alberto Ortiz-Vigón, Sergio Martinez-Villa, Iñaki Suarez, Fabio Vignoletti & Mariano Sanz
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We wish to acknowledge the dedication and scientific advise of Prof. Dr. Tord Berglundh on the histological analysis as well as the diligent work in processing the histological samples to Estela Maldonado for the immunohistochemistry and Asal Shikhan and Fernando Muñoz for the histomorphometry. The work of Esperanza Gross on the statistical analysis is highly acknowledged.
This study was partial...
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Nissan ...
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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
Z
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.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Private practice, Via Contrada 323, 41126, Modena, Italy
Tommaso Grandi & Luigi Svezia
Department of Obstetrics, Gynecology and Pediatrics, University of Modena and Reggio Emilia, Modena, Italy
Giovanni Grandi
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Esposito M, Grusovin MG, Maghaireh H, Worthington HV. Interventions for replacing missing teeth: different times for loading dental implants (Review). Cochrane Database Syst Rev. 2013;(3):CD003878. https://doi.org/10.1002/14651858.CD003878.pub5.
Esposito M, Grusovin MG, Felice P, Karatzopoulos G, Worthington HV, Coulthard P. The efficacy of horizontal and vertical bone augmentation procedures for...
Within the limits of this prospective cohort study, narrow-diameter implants (2.75 to 3.25 mm) can be successfully used as a minimally invasive alternative to horizontal bone augmentation in posterior mandible up to 1 year of function. This outcome could be related to the fact that these implants have been all splinted to other implants by a fixed prosthesis. These preliminary results must be co...
On the one hand, due to the small sample size of this study and moreover, the short follow-up (only 1 year after loading), it would be hazardous to conclude that the placement of NDIs to support fixed prostheses in posterior mandible is a predictable treatment modality. In order to draw more reliable conclusions, we need to wait for longer follow-ups, since it may be possible that after several y...
Dental implants with a reduced diameter are commonly used where bone width is narrow or in cases of restricted mesiodistal anatomy such as laterally maxillary and mandibular incisors. They could also be a viable alternative to bone augmentation especially in challenging situations such as the posterior regions of the mandible. While it has been shown that it is possible to horizontally augment bon...
The radiographic data are summarized in Tables 3 and 4. The group lost statistically significant marginal peri-implant bone at 6 months (−0.20; 95% C −0.14: −0.26, p
Forty-eight patients were screened for eligibility, but six subjects were not included for the following reasons: five patients (10.4%) were hesitant to receive implant treatment, and one patient (2.1%) was treated with intravenous amino-bisphosphonates. Forty-two patients were then considered eligible and were consecutively enrolled in the study. All patients were treated according to the allocat...
Primary outcome measures were as follows:
Implant failure: evaluated as implant mobility and removal of stable implants dictated by progressive marginal bone loss or infection. The stability of each implant was measured manually by tightening the abutment screw with a wrench delivering a torque of 20 Ncm. Implant stability assessment was performed at delivery of definitive crowns (3 months afte...
The present prospective study was conducted at a private practice (Tommaso Grandi, Modena) in Italy between October 2014 and January 2016.
Any patient with partial edentulism in posterior regions of mandible (premolar/molar areas), requiring one multiple tooth implant-supported restoration (2-, 3-, or 4-unit bridge), having a residual bone height of at least 8 mm and a thickness of at least 4 m...
The aim of this cohort study was to evaluate the outcome of narrow-diameter implants (2.75 and 3.25 mm diameter) used as definitive implants in patients with insufficient bone ridge thickness for placing standard-diameter implants in posterior regions of the mandible. The present study reports the clinical outcome up to 1 year after loading. It is planned to follow up this patients’ cohort to ...
Historically, implants have been used and documented mainly with diameters between 3.7 and 4.3 mm. Employing these diameters for numerous indications, scientifically substantiated treatment protocols with excellent long-term results have been established [1]. One disadvantage of a standard-diameter implant is the fact that, in clinical use, the available horizontal crestal dimensions of the alveo...
Can multiple splinted narrow-diameter implants be used as definitive implants in patients with insufficient bone ridge thickness in posterior regions of the mandible? With this aim, we evaluated their outcomes in this set up to 1 year after loading.
Forty-two patients with a mean age of 61.3 years old (range 49–73) in need of fixed prosthetic implant-supported rehabilitations in the posterior...
Parameters
H group correlation (R
s
)
HP group correlation (R
s
)
PPD-mPI
0.182 n.s.
...
Characteristics
H group correlation (R
s
)
HP group correlation (R
s
)
Age
0.040 n.s.
0.209*
Number of teeth (at the beginning o...
Clinical parameters
H group (n = 39) mean ± SD/median
HP group (n = 91) mean ± SD/median
Significance difference between H and HP group
...
Diagnosis in HP group
(37 patients, 91 implants)
Localized: ≤ 30% of site involved, generalized: > 30% of site involved
Numbers of peri-implantitis and prevalence in diagnosis n = 14, 15.4% of HP group
...
H group mean ± SD, or n (median)
HP group mean ± SD, or n (median)
Significant difference between H and HP group
Age
56.0 ± 11.8 (57.9)
...
Implant
Number
Replace select ™
44
Novel Replace ®
31
...
Seki, K., Nakabayashi, S., Tanabe, N. et al. Correlations between clinical parameters in implant maintenance patients: analysis among healthy and history-of-periodontitis groups.
Int J Implant Dent 3, 45 (2017). https://doi.org/10.1186/s40729-017-0108-0
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Received: 25 July 2017
Accepted: 19 October 2017
Published: 30 October 2017
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...
Patient recruitment and data collection for this study took place at Nihon University School of Dentistry Dental Hospital, Japan. The research was approved by the Nihon University School of Dentistry Ethics Committee (2013-15) and all activities were conducted in full accordance with ethical principles, including the World Medical Association Declaration of Helsinki. We described the purpose of th...
Implant Dentistry, Nihon University School of Dentistry Dental Hospital, Tokyo, 101-8310, Japan
Keisuke Seki, Shinya Nakabayashi, Atsushi Kamimoto & Yoshiyuki Hagiwara
Department of Comprehensive Dentistry and Clinical Education, Nihon University School of Dentistry, 1-8-13 Kanda-Surugadai, Chiyoda-ku, Tokyo, 101-8310, Japan
Keisuke Seki & Atsushi Kamimoto
Department of Applied Mathemati...
Karousis IK, Salvi GE, Heitz-Mayfield LJ, Brägger U, Hämmerle CH, Lang NP. Long-term implant prognosis in patients with and without a history of chronic periodontitis: a 10-year prospective cohort study of the ITI Dental Implant System. Clin Oral Implants Res. 2003;14:329–39.
Mengel R, Flores-de-Jacoby L. Implants in patients treated for generalized aggressive and chronic periodontitis: a 3-y...
Monjie A, Aranda L, Diaz KT, Alarcón MA, Bagramian RA, Wang HL, et al. Impact of maintenance therapy for the prevention of peri-implant diseases: a systematic review and meta-analysis. J Dent Res. 2016;95:372–9.
Armitage GC. Development of a classification system for periodontal diseases and conditions. Ann Periodontol. 1999;4:1–6.
Lang NP, Berglundh T; Working group 4 of Seventh European W...
Esposito M, Hirsch JM, Lekholm U, Thomsen P. Biological factors contributing to failures of osseointegrated oral implants. (I) Success criteria and epidemiology. Eur J Oral Sci. 1998;106:527–51.
Ogata Y, Nakayama Y, Tatsumi J, Kubota T, Sato S, Nishida T, et al. Prevalence and risk factors for peri-implant diseases in Japanese adult dental patients. J Oral Sci. 2017;59:1–11.
Heitz-Mayfield L...
Bleeding on probing
Modified plaque index
Probing pocket depth
We examined clinical parameters in patients receiving long-term implant maintenance. There were significant differences between the H and HP groups in age at the time of maintenance, number of natural teeth at the beginning of implant treatment, total number of extracted teeth, and maintenance. The prevalence of implant-based peri-implantitis was 10.8% of all the implants. All implants with peri-i...
A correlation between the PPD of the peri-implant tissue and lesion progression has been reported, similar to that seen with periodontitis [27]. Probing around the implant is useful for evaluating soft tissue inflammation and is considered reproducible [36]. Examination of peri-implant bleeding is reported to have higher diagnostic accuracy than probing around natural teeth [37]. However, because ...
BoP has been used to evaluate inflammatory conditions of periodontal tissue [33] and can also be an important evaluation item for peri-implant tissues. To avoid diagnosing bleeding resulting from strong probing as a false positive, we set the probing pressure to 0.15 N [34]. BoP values were low, with no significant difference between the groups (H group, 0.30; HP group, 0.28). This result was sim...
All the implants with peri-implantitis came from the HP group, not the H group, thus supporting the view that a history of periodontitis is a risk indicator for peri-implantitis. In the diagnosis of periodontitis within the HP group, it is notable that peri-implantitis increased as periodontitis become more severe. This supports the findings of a previous study that reported that the survival rate...
In this study, we reviewed the clinical parameters of 130 implants in 55 patients during ongoing long-term maintenance. We focused on the history of periodontitis and compared the parameters in two groups classified according to a history of periodontitis. A previous study on the prevalence of periodontitis revealed that moderate or severe periodontitis was observed in 64% of people over 65 years...
Because normality and homoscedasticity were not obtained for each clinical parameter between the two groups, a statistical study was conducted using the nonparametric test (Mann–Whitney U test) for the difference test between the two groups. PPD was recognized to be significantly greater (p
Of the 55 subjects, 25 were male and 30 were female (H group: 8/10, HP group: 17/20, respectively). A total of 130 implants (H group 39, HP group 91) were included in the analysis (Table 2). The mean maintenance period was 6 years and 6 months. The average number of natural teeth at the first visit and at the beginning of implant treatment were 25.3 ± 2.9 and 22.4 ± 4.5, respectively. Com...
At the time of optional maintenance, the following parameters were measured for each implant. Data collection and analysis were conducted by two operators who were blind to the research purpose and methods. One operator statistically analyzed the final data set.
Plaque adhesion (modified Plaque Index: mPI) on the superstructure of the implant was measured on a 4-point scale (0, no plaque; 1, plaq...
This study enrolled 55 patients (25 men, 30 women; mean age, 63.53 ± 10.51 years) who visited Nihon University School of Dentistry Dental Hospital for implant maintenance from April to September 2016. The inclusion criteria were treatment at the same hospital with two-stage implant placement before 2015, and ongoing maintenance at 3–6-month intervals after superstructure placement. Patients ...
Peri-implant diseases are the main biological complication of implant treatment and greatly influence treatment success [1]. Risk indicators for peri-implantitis include a history of periodontitis, poor oral hygiene, and smoking [2,3,4]. Peri-implantitis is often encountered clinically, occurring in 12 to 43% of implants and 28 to 47% of implant patients [5,6,7,8]. Similarities between the patholo...
The pathophysiology and pathology of peri-implantitis remain unclear; however, its similarity to periodontitis has been described. The evaluation of peri-implant tissue and the diagnostic criteria of peri-implant disease are not currently standardized as they are for periodontitis. In this study, we evaluated clinical parameters during the implant maintenance period to determine significant correl...
Fig. 6. Postoperative intraoral finding and radiograph
Fig. 6. Postoperative intraoral finding and radiograph
Fig. 5. High p53, p63, and Ki-67 reactivity are also observed in the basal cell layer (immunohistological staining, bar 400 μm)
Fig. 5. High p53, p63, and Ki-67 reactivity are also observed in the basal cell layer (immunohistological staining, bar 400 μm)
Fig. 4. Immunohistological findings show a negative staining mosaic pattern for keratin 13 (k13) and positive staining for keratin 17 (k17) (immunohistological staining, bar 400 μm)
Fig. 4. Immunohistological findings show a negative staining mosaic pattern for keratin 13 (k13) and positive staining for keratin 17 (k17) (immunohistological staining, bar 400 μm)
Fig. 3. Pathological microscopic examination reveals thickened squamous epithelia with slight nuclear atypism and disorders of the epithelial rete pegs accompanied by moderate grade inflammatory cell infiltration (HE staining, bar: 400 μm)
Fig. 3. Pathological microscopic examination reveals thickened squamous epithelia with slight nuclear atypism and disorders of the epithelial rete pegs a...
Fig. 2. Panoramic radiograph shows slight vertical bone resorption around the implants in the right side of the mandible
Fig. 2. Panoramic radiograph shows slight vertical bone resorption around the implants in the right side of the mandible
Fig. 1. Well-circumscribed gingival swelling on the lingual side of the right side of the mandible
Fig. 1. Well-circumscribed gingival swelling on the lingual side of the right side of the mandible
Antibody
Sorce
Clone
Staining
Keratin 13
DAKO
DE-K13
...
Noguchi, M., Tsuno, H., Ishizaka, R. et al. Primary peri-implant oral intra-epithelial neoplasia/carcinoma in situ: a case report considering risk factors for carcinogenesis.
Int J Implant Dent 3, 47 (2017). https://doi.org/10.1186/s40729-017-0109-z
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Received: 15 March 2017
Accepted: 25 October 2017
Published: 16 November 2017
DOI: https://doi.org/10.1186...
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...
Written informed consent was obtained from the patient for publication of this case report and any accompanying images.
Makoto Nogchi, Hiroaki Tsuno, Risa Ishizaka, Kumiko Fujiwara, Shuichi Imaue, and Kei Tomihara declare that they have no competing interests.
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Correspondence to
Makoto Noguchi.
Department of Oral and Maxillofacial Surgery, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, 2630 Sugitani Toyama city, Toyama, 9300194, Japan
Makoto Noguchi, Hiroaki Tsuno, Risa Ishizaka, Kumiko Fujiwara, Shuichi Imaue & Kei Tomihara
Department of Diagnosis Pathology, Graduate School of Medicine and Pharmaceutical Sciences for Research, Univers...
Vasilescu F, Ceauşu M, Tänsen C, et al. P53, p63 and ki-67 assessment in HPV-induced cervical neoplasia. RJME. 2009;50:357–61.
Ndiaye C, Mena M, Alemany L, et al. HPV DNA, E6/E7 mRNA, and p16INK4a detection in head and neck cancers: a systematic review and meta-analysis. Lancet Oncol. 2014;15:1319–31.
Nagy K, Sonkodi I, Szöke I, et al. The microflora associated with human oral carcinoma. ...
Sah JP, Johnson NW, Batsakis JG. Oral cancer. London: Informa Healthcare; 2011. p. 3–32.
Japan Society for Oral Tumors. General rules for clinical and pathological studies on oral cancer. 1st ed. Tokyo: Kanehara-shuppan Co; 2010. p. 44–7.
Laprise C, Shahl HP, Madathil SA, et al. Periodontal diseases and risk of oral cancer in Southern India: results from the HeNCe Life Study. Int J Cancer. 2...
Deoxyribonucleic acid
Human papilloma virus
Oral intra-epithelial neoplasia/carcinoma in situ
Squamous cell carcinoma
In our case, the persistence of peri-implant mucositis or peri-implantitis around the dental implant was implicated as being a plausible risk factor for carcinogenesis. Regular follow-up to ensure the maintenance of oral hygiene after dental implant therapy has again been shown to be important for preventing peri-implantitis, a plausible risk factor for carcinogenesis.
The latest evidence implies that the human papilloma virus (HPV) may be responsible for carcinogenesis in the oral cavity [12, 13]; however, its role is debatable. The interaction of the HPV’s E6 and E7 oncoproteins with cell cycle proteins disturbs the cell cycle mechanism and subsequent alteration in the expression of proteins such as p53, p63, and Ki-67 [14]. In our case, the immunohistochemi...
OIN/CIS can sometimes be difficult to distinguish pathologically from epithelial dysplasia on hematoxylin- and eosin-staining sections; this has proved challenging for oral pathologists [9]. Recently, it has been reported that combined immunohistochemistry for k13 and k17 was useful for the differential diagnosis [9, 10]. K13 is a marker for cellular differentiation toward prickle cells in normal ...
A 65-year-old woman was referred to our clinic with a tumor in the right lower gingiva. Her medical history included breast cancer without metastatic lesion, diabetes mellitus, hyperlipidemia, and hypertension. She had taken orally aspirin, amlodipine, pravastatin, and bepotastine for 2 years. She drank alcohol socially, but she had no history of tobacco smoking habit.
About 10 years prior to h...
Oral cancer ranks sixth among the malignancies in terms of worldwide prevalence, with more than 90% being pathologically squamous cell carcinoma (SCC) [1]. Oral SCC generally develops via multistep carcinogenesis. The squamous epithelium goes into irreversible change, including epithelial dysplasia and oral intra-epithelial neoplasia/carcinoma in-situ (OIN/CIS) [2], finally resulting in the develo...
In this case, prolonged peri-implant mucositis or peri-implantitis may have been a plausible risk factor for carcinogenesis.
Major risk factors for oral squamous cell carcinoma (SCC) are tobacco smoking, a betel quid chewing habit, and heavy alcohol consumption. However, around 15% of oral SCCs cannot be explained by these risk factors. Although oral SCC associated with dental implants is quite rare, there has been a recent gradual accumulation of reports about it. Here, we report a case of primary peri-implant oral int...
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
...
Years
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 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
Hist...
Patient
Anterior
(E1-floor of the sinus)
Middle
(C1-floor of the sinus)
Posterior
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...
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...
Tsegga, T., Wright, T. Maxillary segmental osteoperiosteal flap with simultaneous placement of dental implants: case report of a novel technique.
Int J Implant Dent 3, 2 (2017). https://doi.org/10.1186/s40729-017-0067-5
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Received: 06 December 2016
Accepted: 13 January 2017
Published: 19 January 2017
DOI: https://doi.org/10.1186/s40729-017-0067-5
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...
Department of Oral & Maxillofacial Surgery, San Antonio Military Medical Center, 3551 Roger Brooke Dr., Ft. Sam Houston, 78234, TX, USA
Tibebu Tsegga & Thomas Wright
Department of Oral & Maxilofacial Surgery, Wilford Hall Ambulatory Surgical Center, 2200 Bergquist Dr, Suite 1, Lackland AFB, TX, 78236, USA
Tibebu Tsegga & Thomas Wright
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Irinakis T. Efficacy of injectable demineralized bone matrix as graft material during sinus elevation surgery with simultaneous implant placement in the posterior maxilla: clinical evaluation of 49 sinuses. J Oral and Maxillofac Surg. 2011;69:134–41.
Chiapasoo M, Casentini P, Zaniboni M. Bone augmentation procedures in implant dentistry. Int J Oral Maxillofac Implants. 2009;24:237–69.
Jenson...
This case highlights the evolving variations in dentoalveolar augmentation with an emphasis on concomitant implant placement. In the most traditional sense, a vertical osteoperiosteal flap technique would be bound with a stable basal bone that can be used to anchor simultaneous dental implant placement. Further refinement should consider minimizing crestal reflection and overall labial bone resorp...
A critical appraisal of the gingival architecture in the final end point of this case demonstrates some radiolucency through the soft tissue outlining the platform of the Nobel Biocare TiUnite implant. This would lead us to believe that either the transmucosal bone level placement attempt was inaccurate or excessive reflection of the labial tissue has caused some degree of resorption. This is anot...
A suitable alternative surgical management of this particular case might have been to simply perform an alveoloplasty to produce the desired inter-occlusal clearance and proceed with placement of implant and simultaneous direct sinus lift. That would have left more of the apical portion of the implant within the grafted sinus and possibly modified the location of keratinized band of tissue. The lo...
A 35-year-old female with a 10-year history of partial acquired edentulism at site numbers 3 and 4 presented to our clinic for dental implant evaluation. Preoperative clinical examination revealed a reproducible intercuspation, well-delineated band of keratinized tissue, and decreased inter-occlusal clearance to allow for optimal dimension of prosthetic crowns (Fig. 1). Radiographs demonstrated e...
Obtaining proper occlusal clearance to allow for a single unit crown restoration is a fundamental prerequisite for dental implant restoration. Long-standing edentulous sites are often fraught with disuse atrophy and unopposed supra-eruption of the opposing dentition. In the posterior maxillae/mandible, there are vital structures that have to be mobilized in order to allow space for either bone tra...
Dental restorative space from the opposing dentition requires adequate distance for restorative material for an acceptable restoration. Typically, long-standing edentulous alveolar ridges will have vertical and or horizontal defects that require alveolar ridge augmentation for ideal dental implant restorations. Along with these defects, one will see the opposing dentition supra erupt which can obl...
Dhaliwal, J.S., Albuquerque, R.F., Fakhry, A. et al. Customized SmartPeg for measurement of resonance frequency of mini dental implants.
Int J Implant Dent 3, 4 (2017). https://doi.org/10.1186/s40729-017-0066-6
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Received: 09 November 2016
Accepted: 13 January 2017
Published: 01 February 2017
DOI: https://doi.org/10.1186/s40729-017-0066-6
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...
Faculty of Dentistry, McGill University, 2001 McGill College Avenue, Suite 500, Montreal, Quebec, H3A 1G1, Canada
Jagjit Singh Dhaliwal, Ali Fakhry & Jocelyne S. Feine
Faculty of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
Rubens F. Albuquerque Jr
Department of Zoology, Panjab University, Chandigarh, India
Sukhbir Kaur
PAPRSB Institute of Health Sci...
Dhaliwal J, Albuquerque R, Murshed, M, Tamimi, F, Feine, JS. A histomorphometric comparison of osseointegration with MDIs and standard implants. IADR/AADR/CADR 91st General Session, Seattle, Washington, USA, March 20–23, 2013
Zix J, Hug S, Kessler-Liechti G, Mericske-Stern R. Measurement of dental implant stability by resonance frequency analysis and damping capacity assessment: comparison of b...
Barros RR, Novaes Jr AB, Muglia VA, Iezzi G, Piattelli A. Influence of interimplant distances and placement depth on peri-implant bone remodeling of adjacent and immediately loaded Morse cone connection implants: a histomorphometric study in dogs. Clin Oral Implants Res. 2010;21(4):371–8. Epub 2010/02/05.
Marin C, Bonfante EA, Granato R, Suzuki M, Granjeiro JM, Coelho PG. The effect of alterati...
Meredith N, Book K, Friberg B, Jemt T, Sennerby L. Resonance frequency measurements of implant stability in vivo. A cross-sectional and longitudinal study of resonance frequency measurements on implants in the edentulous and partially dentate maxilla. Clin Oral Implants Res. 1997;8(3):226–33. Epub 1997/06/01.
Meredith N, Alleyne D, Cawley P. Quantitative determination of the stability of the im...
Ersanli S, Karabuda C, Beck F, Leblebicioglu B. Resonance frequency analysis of one-stage dental implant stability during the osseointegration period. J Periodontol. 2005;76(7):1066–71. Epub 2005/07/16.
Bornstein MM, Chappuis V, von Arx T, Buser D. Performance of dental implants after staged sinus floor elevation procedures: 5-year results of a prospective study in partially edentulous patients...
Shatkin TE, Oppenheimer BD, Oppenheimer AJ. Mini dental implants for long-term fixed and removable prosthetics: a retrospective analysis of 2514 implants placed over a five-year period. Compend Contin Educ Dent. 2007;28(2):92–9. quiz 100-1. Epub 2007/02/27.
Griffitts TM, Collins CP, Collins PC. Mini dental implants: an adjunct for retention, stability, and comfort for the edentulous patient. Or...
Branemark PI, Adell R, Breine U, Hansson BO, Lindstrom J, Ohlsson A. Intra-osseous anchorage of dental prostheses. I. Experimental studies. Scand J Plast Reconstr Surg. 1969;3(2):81–100. Epub 1969/01/01.
Meredith N. Assessment of implant stability as a prognostic determinant. Int J Prosthodont. 1998;11(5):491–501. Epub 1999/01/29.
Lioubavina-Hack N, Lang NP, Karring T. Significance of primar...
The results of this animal study indicate that ISQ measurement of these single-piece MDIs is possible with the help of a custom-made SmartPeg and that 3M™ESPE™MDIs attain primary and secondary stability at the same levels as standard implants in the rabbit tibia.
As there are no studies that provide data based on resonance frequency measurements for single-piece MDIs, the exact RFA threshold values for MDIs may have to be identified with more studies conducted in vivo.
The resonance frequency assessment with a customized SmartPeg would be a useful tool to provide clinically useful information about the condition of the bone-implant interface of 3M™ ESPE...
If the initial ISQ value is high, a small drop in stability normally levels out with time. A big drop in stability or decrease should be taken as a warning sign. Lower values are expected to be higher after the healing period. The opposite could be a sign of an unsuccessful implant, and actions should be taken accordingly.
Studies have shown that the resonance frequency value is greatly associate...
It is important to measure the Implant Stability Quotient (ISQ) of single-piece mini dental implants as they are becoming increasingly popular, with the concomitant increase in publications demonstrating their high survival and success rates. Although the clinical use of Osstell devices is also increasing, there is lack of studies on its use with single-piece implants, which do not have internal t...
The ISQ values obtained while calibrating the customized SmartPeg were similar to in vivo results. Median ISQ values at insertion and at 6 postoperative weeks were 53.3 (IQR 8.3) and 60.5 (5.5) for the 3M™ESPE™MDIs, and 58.5 (4.75) and 65.5 (9.3) for the Ankylos® implants, respectively, with no statistical difference (Figs. 2 and 3). The ISQ values of both 3M™ESPE™ MDI and Ankylos® (Fig...
ISQ values were averaged and compared between implant types and times using Wilcoxon’s matched pairs signed-rank tests at a significance level of p
For the MDIs, a small longitudinal skin incision was made just distal to the tibia/femur joint. The tibia/femur head was exposed subperiosteally, and an osteotomy was performed with the pilot drill under copious irrigation with saline solution, transposing the cortical bone to the depth of 0.5 mm. The implants were aseptically transferred to the bone site and manually rotated clockwise while exer...
Single use Osstell SmartPegs for standard implants are made from a soft metal with a zinc-coated magnet mounted on top of it and attached to the implants or abutments’ internal threads. As the company does not provide SmartPegs for one-piece implants, we developed a customized SmartPeg for mini dental implants (3M™ESPE™ MDIs), which do not have internal threads (Fig. 1). After confirming th...
The aim of the study is to test the feasibility of a customized SmartPeg for ISQ measurement of single-piece mini dental implants and to compare the primary stability of a standard and the mini dental implant (3M™ESPE™MDI) in a rabbit model after 6 weeks of healing.
There are no published studies on the ISQ measurement of mini dental implants, as SmartPegs for these implants are not available till date. Since these are one-piece implants and do not have an internal thread for the SmartPeg’s attachment, a custom-made SmartPeg needs to be fabricated for ISQ measurement. Therefore, we developed and tested a customized SmartPeg for 3M™ESPE™ MDIs to measure ...
Mechanical testing methods like reverse torque, or “pullout test,” have been used to study and measure the mechanical interface between implant and bone in various ways [22, 23]. The Branemark group has evaluated the mechanical properties of osseointegrated implants using torsion and pullout tests and lateral loading tests [24, 25]. Presence or absence of mobility and the bone level around the...
Osseointegration refers to the phenomenon for close apposition of the bone to the surface of an implant with no interposing tissue that can be clinically demonstrated by absence of mobility [1, 2]. Obtaining primary stability seems to be a precondition for a successful osseointegration [3]. Dental implants have a success rate of over 90% and are available in various sizes with different surfaces [...
The new custom-made SmartPeg is suitable for measuring the Implant Stability Quotient of 3M™ESPE™MDIs. The primary stability of 3M™ESPE™MDIs is similar to the primary stability attained by standard implants in the rabbit tibia.
One-piece narrow diameter implants (NDIs) have been recommended as “Single-tooth replacements in the anterior zones, single posterior, multiple-unit fixed dental prosthesis (FDP), edentulous jaws to be rehabilitated with FDP, and edentulous jaws rehabilitation with overdentures in situations with reduced mesiodistal space or reduced ridge width.” (ITI consensus 2013). Since NDIs can be immedia...
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...
Zushi, Y., Takaoka, K., Tamaoka, J. et al. Treatment with teriparatide for advanced bisphosphonate-related osteonecrosis of the jaw around dental implants: a case report.
Int J Implant Dent 3, 11 (2017). https://doi.org/10.1186/s40729-017-0074-6
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Received: 06 December 2016
Accepted: 12 February 2017
Published: 30 March 2017
DOI: https://doi.org/10.1186/s4...
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 Maxillofacial Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
Yusuke Zushi, Kazuki Takaoka, Joji Tamaoka, Miho Ueta, Kazuma Noguchi & Hiromitsu Kishimoto
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Stanton DC, Balasanian E. Outcome of surgical management of bisphosphonate-related osteonecrosis of the jaws: review of 33 surgical cases. J Oral Maxillofac Surg. 2009;67:943–50.Carlson ER, Basile JD. The role of surgical resection in the management of bisphosphonate-related osteonecrosis of the jaws. J Oral Maxillofac Surg. 2009;67:85–95.Wilde F, Heufelder M, Winter K, et al. The role of surg...
Stanton DC, Balasanian E. Outcome of surgical management of bisphosphonate-related osteonecrosis of the jaws: review of 33 surgical cases. J Oral Maxillofac Surg. 2009;67:943–50.
Carlson ER, Basile JD. The role of surgical resection in the management of bisphosphonate-related osteonecrosis of the jaws. J Oral Maxillofac Surg. 2009;67:85–95.
Wilde F, Heufelder M, Winter K, et al. The role of ...
Grant BT, Amenedo C, Freeman K, Kraut RA. Outcomes of placing dental implants in patients taking oral bisphosphonates: a review of 115 cases. J Oral Maxillofac Surg. 2008;66:223–30.
Goss A, Bartold M, Sambrook P, Hawker P. The nature and frequency of bisphosphonate-associated osteonecrosis of the jaws in dental implant patients: a South Australian case series. J Oral Maxillofac Surg. 2010;68:33...
Marx RE. Pamidronate (Aredia) and zoledronate (Zometa) induced avascular necrosis of the jaws: a growing epidemic. J Oral Maxillofac Surg. 2003;61:1115–7.
Marx RE, Sawatari J, Fortin M, et al. Bisphosphonate-induced exposed bone (osteonecrosis/osteopetrosis) of the jaws; risk factors, recognition, prevention, and treatment. J Oral Maxillofac Surg. 2005;63:1567.
Harper RP, Fung E. Resolution of...
We have reported a case of a severely osteoporotic elderly woman with BRONJ around her dental implants, who was treated successfully with teriparatide. Teriparatide therapy appeared to exert beneficial effects in this patient.
It is therefore important that all patients treated with oral BPs must be given a full explanation of the potential risks of implant failure and BRONJ development in the short and long term. Because the potential role of infection in implant failure and BRONJ occurrence is still debated, great attention should be paid to the long-term oral hygiene and plaque control of implant-prosthetic restorati...
We describe a case of a patient with a 6-year history of alendronate therapy, in which BRONJ developed around her dental implants. In this patient, the dental implants achieved successful osseointegration, and BRONJ occurred after the second surgery. Several factors could have played a role in the development of BRONJ in this patient. Glucocorticoid therapy is associated with an increased risk of ...
In November 2011, after a consultation with an osteoporosis expert at the Orthopedic Medicine Clinic of our hospital, alendronate therapy was stopped and subcutaneous teriparatide therapy at a dose of 20 μg per day was started. During the course of the teriparatide therapy, the patient continued to use 0.02% benzalkonium chloride solution for local irrigation.
In April 2012, after 5 months of ...
A 66-year-old woman was referred to the Oral and Maxillofacial Surgery Clinic at Hyogo College of Medicine Hospital, Japan, in September 2011, for an extraoral fistula and refractory pain of the right mandible associated with a purulent discharge and soft tissue swelling. The patient’s osteoporosis was diagnosed in 2005 and treated with 35 mg of alendronate weekly by the family doctor. The pati...
Oral bisphosphonates (BPs) are used to treat osteoporosis, Paget’s disease, and osteogenesis imperfecta. They are most widely used for treatment of osteoporosis. BP-related osteonecrosis of the jaw (BRONJ) was first reported by Marx in 2003 [1]. The risk of BRONJ in osteoporotic patients treated with BPs remains low compared with that of oncology patients [2]. Recent studies have indicated that ...
We report a case of a 66-year-old severely osteoporotic woman with bisphosphonate-related osteonecrosis of the jaw (BRONJ) around her dental implants, who was treated successfully with teriparatide and sequestrectomy of the mandible. After 5 months of teriparatide therapy, the sequestrum separation had progressed and a sequestrectomy was performed under general anesthesia. Five months after the o...
Fig. 6. Micro CT scan images of the MDIs and Ankylos® embedded in rabbit bone 6 weeks post implantation
Fig. 6. Micro CT scan images of the MDIs and Ankylos® embedded in rabbit bone 6 weeks post implantation
Fig. 5. Histological section of standard implant in rabbit tibia stained with methylene blue and basic fuchsin
Fig. 5. Histological section of standard implant in rabbit tibia stained with methylene blue and basic fuchsin
Fig. 4. Histological section of mini dental implant in rabbit tibia stained with methylene blue and basic fuchsin
Fig. 4. Histological section of mini dental implant in rabbit tibia stained with methylene blue and basic fuchsin
Fig. 3. Histological sections being obtained with Leica SP 1600 saw microtome
Fig. 3. Histological sections being obtained with Leica SP 1600 saw microtome
Fig. 2. Leica SP 1600 saw microtome
Fig. 2. Leica SP 1600 saw microtome
Fig. 1. Radiograph showing implants in the rabbit tibia
Fig. 1. Radiograph showing implants in the rabbit tibia
BIC
3M™ ESPE™ MDIs
Ankylos® Friadent (Dentsply)
Median
58.5
57
...
Sample
3M™ESPE™ MDIs
Ankylos®
1.
67
54
2.
...
Dhaliwal, J.S., Albuquerque, R.F., Murshed, M. et al. Osseointegration of standard and mini dental implants: a histomorphometric comparison.
Int J Implant Dent 3, 15 (2017). https://doi.org/10.1186/s40729-017-0079-1Download citationReceived: 22 February 2017Accepted: 26 April 2017Published: 01 May 2017DOI: https://doi.org/10.1186/s40729-017-0079-1
Dhaliwal, J.S., Albuquerque, R.F., Murshed, M. et al. Osseointegration of standard and mini dental implants: a histomorphometric comparison.
Int J Implant Dent 3, 15 (2017). https://doi.org/10.1186/s40729-017-0079-1
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Received: 22 February 2017
Accepted: 26 April 2017
Published: 01 May 2017
DOI: https://doi.org/10.1186/s40729-017-0079-1
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
This article was ammended to correct discrpencies in the Abstract. An erratum has also been published for this manuscript.
An erratum to this article is available at http://dx.doi.org/10.1186/s40729-017-0088-0.
Faculty of Dentistry, McGill University, 2001 McGill College Avenue, Suite 500, Montreal, Quebec, H3A 1G1, Canada
Jagjit S. Dhaliwal, Monzur Murshed & Jocelyne S. Feine
Faculty of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
Rubens F. Albuquerque Jr
Department of Medicine, McGill University, Montreal, Quebec, Canada
Monzur Murshed
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Schwartz Z, Lohmann CH, Oefinger J, Bonewald LF, Dean DD, Boyan BD. Implant surface characteristics modulate differentiation behavior of cells in the osteoblastic lineage. Adv Dent Res. 1999;13:38–48.
Boyan BD, Lossdorfer S, Wang L, Zhao G, Lohmann CH, Cochran DL, et al. Osteoblasts generate an osteogenic microenvironment when grown on surfaces with rough microtopographies. Eur Cell Mater. 2003...
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Park JW, Kim HK, Kim YJ, An CH, Hanawa T. Enhanced osteoconductivity of micro-structured titanium implants (XiVE S CELLplus) by addition of surface calcium chemistry: a histomorphometric study in the rabbit femur. Clin Oral Implants Res. 2009;20(7):684–90.
Yang GL, He FM, Yang XF, Wang XX, Zhao SF. Bone responses to titanium implants surface-roughened by sandblasted and double etched treatments...
Buser D, Schenk RK, Steinemann S, Fiorellini JP, Fox CH, Stich H. Influence of surface characteristics on bone integration of titanium implants. A histomorphometric study in miniature pigs. J Biomed Mater Res. 1991;25(7):889–902.
Gotfredsen K, Wennerberg A, Johansson C, Skovgaard LT, Hjorting-Hansen E. Anchorage of TiO2-blasted, HA-coated, and machined implants: an experimental study with rabbi...
Trisi P, Lazzara R, Rao W, Rebaudi A. Bone-implant contact and bone quality: evaluation of expected and actual bone contact on machined and osseotite implant surfaces. Int J Periodontics Restorative Dent. 2002;22(6):535–45.
Froum SJ, Simon H, Cho SC, Elian N, Rohrer MD, Tarnow DP. Histologic evaluation of bone-implant contact of immediately loaded transitional implants after 6 to 27 months. In...
Hong RK, Heo JM, Ha YK. Lever-arm and mini-implant system for anterior torque control during retraction in lingual orthodontic treatment. Angle Orthod. 2005;75(1):129–41.
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Siddiqui AA, Sosovicka M, Go...
Branemark PI, Adell R, Breine U, Hansson BO, Lindstrom J, Ohlsson A. Intra-osseous anchorage of dental prostheses. I. Experimental studies. Scand J Plast Reconstr Surg. 1969;3(2):81–100.
Boerrigter EM, Stegenga B, Raghoebar GM, Boering G. Patient satisfaction and chewing ability with implant-retained mandibular overdentures: a comparison with new complete dentures with or without preprosthetic ...
The results of this study show that MDIs as well as regular implants osseointegrate in rabbits.
Our study is also in concordance with the results of a removal torque study by Simon et al. [63] in immediately loaded “transitional endosseous implants” in humans. The percentage BIC for MDIs was similar to standard implants.
The surface topography also affects the BIC, Wennerberg et al. [32] measured and compared removal torque values on screw-shaped titanium implants with three surface typ...
The osseointegration potential of 3M™ESPE™ MDIs has not been studied. The MDI is a one-piece implant that simplifies the restorative phase resulting in a reduced cost for the patient. Titanium-aluminum-vanadium alloy (Ti 6Al-4V-ELI) is used for increased strength. The success of these implants led to its use in long-term fixed and removable dental prostheses [51]. Conventional implant treatmen...
On the whole, postoperative wound healing in all the rabbits was good. None of them exhibited any signs of wound infection or exposure. A total of 36 specimens were retrieved for histological examination.
All of the implants in both groups showed osseointegration and displayed a good amount of bone contact length (Figs. 4 and 5). No discernible differences were noticed between both the groups. T...
The saw blade has a thickness of 280 μm and a feed of 310 μm was selected to obtain the final section thickness of 30 μm. The knurled screw was used for the setting of the section thickness. The prepared section was finally removed from the saw blade. The specimens were prepared for histology by the method as described by Donath and Breuner [49].
Subsequently, the sections were stained with...
The specimens were dehydrated in the ascending graded ethanol solution and kept in a pre-filtration solution for 3 h at room temperature and then in the filtration solution at 4 °C for 17 h. The specimens were then embedded in a light curing resin Technovit 9100 NEW (Kulzer & Co., Wehrheim, Germany) polymerization system based on methyl methacrylate, specially developed for embedding mineraliz...
Expected length of the procedure was approximately 1 h. Following placement of the implants, the wound was sutured in layers. The underlying muscle, fascia, and dermal layers were sutured with the help of Vicryl (Polyglactin 910) suture with 3/8 circle reverse cutting needle. The skin was sutured to a primary closer with the same suture material.
Plain X-ray images of all the rabbit tibia were t...
A small longitudinal skin incision just distal to the tibia-femur joint was made. The tibia/femur head was exposed subperiosteally and an osteotomy performed with the delicately placed pilot drill over the entry point and lightly pumped up and down under copius saline irrigation just to enter the cortical bone for the MDIs. This was used for initial bone drilling to depth of 0.5 mm. The 3M™ESPE...
Nine clinically healthy New Zealand white rabbits weighing 3.5 kg and more were used for the study, and the animals were housed in the central animal house facility. The head of tibia/femur of the animals were used for the implantation of samples. Rabbits’ tibiae and femur have been widely used as an animal model by various other authors to study osseointegration of dental implants [36–45].
...
Despite the advantages of the mini dental implants, evidence on their efficacy and long-term success is lacking. The success of these implants will depend on their union with the surrounding bone. New implant systems entering into the market have to be studied with the help of animal models first, to demonstrate the osseointegration potential for their probable success in humans. There is a limite...
The term “osseointegration” was first introduced to explain the phenomenon for stable fixation of titanium to bone by Brånemark et al. in the 1960s [1]. Osseointegrated implants were introduced, a new era in oral rehabilitation began, and many studies were conducted [2, 3]. A success rate of over 90% has been reported [4, 5]. Further, a success rate of 81% in the maxillary bone and 91% in the...
Mini dental implants (MDIs) are becoming increasingly popular for rehabilitation of edentulous patients because of their several advantages. However, there is a lack of evidence on the osseointegration potential of the MDIs. The objective of the study was to histomorphometrically evaluate and compare bone apposition on the surface of MDIs and standard implants in a rabbit model.
Nine New Zealand ...
Fig. 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...
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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. 7. and M4M). a Group CR (1: Ceramic surface, 2: CR surface) Units of the axis are in μm. b Group M4M (1: Ceramic surface, 2: M4M surface) Units of the axis are in μm
Fig. 7. a, b (The marginal discrepancy pattern for group CR and M4M). a Group CR (1: Ceramic surface, 2: CR surface) Units of the axis are in μm. b Group M4M (1: Ceramic surface, 2: M4M surface) Units of the axis are in ...
Fig. 6. Access-hole filling surface areas measurement, average
Fig. 6. Access-hole filling surface areas measurement, average
Fig. 5. Depth and angle at the margin
Fig. 5. Depth and angle at the margin
Fig. 4. Margin depth measurement localization (example: TRA, T = 12 M)
Fig. 4. Margin depth measurement localization (example: TRA, T = 12 M)
Fig. 3. 1 M). c (ROG, T = 3 M). d (ROG, T = 6 M). e (ROG, T = 12 M)
Fig. 3. a–e (Filling surface changes): a (ROG, T = 0). b (ROG, T = 1 M). c (ROG, T = 3 M). d (ROG, T = 6 M). e (ROG, T = 12 M)
Fig. 2. Occlusal contact point
Fig. 2. Occlusal contact point
Fig. 1. Brush-dip technique
Fig. 1. Brush-dip technique
T = 1 M
T = 3 M
T = 6 M
T = 12 M
No disappearance
CR
53.5% (15/28)
...
T = 1 M
T = 3 M
T = 6 M
T = 12 M
CR
100
93.2
87.6
...
Patients
Position
CR
Patients
Position
M4M
T = 0
T = 12
...
Materials
Product names
Batch numbers
Manufacturer
Ceramic primer
Super-bond UCP
...
Tanimura, R., Suzuki, S. Comparison of access-hole filling materials for screw retained implant prostheses: 12-month in vivo study.
Int J Implant Dent 3, 19 (2017). https://doi.org/10.1186/s40729-017-0076-4
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Received: 14 December 2016
Accepted: 22 April 2017
Published: 05 May 2017
DOI: https://doi.org/10.1186/s40729-017-0076-4
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
8, place du Général Catroux, 75017, Paris, France
Rémy Tanimura
Department of Clinical Community and Sciences, University of Alabama at Birmingham School of Dentistry, 1919 7th Avenue South, Birmingham, AL, 35294-0007, USA
Shiro Suzuki
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The authors thank Sun Medical Corporation for their material supply.
RT and SS carried out the clinical data and their analysis. RT and SS have been involved in drafting the manuscript and approved the final version to be published.
The authors, Rémy Tanimura and Shiro Suzuki, declare that they have no financial, commercial or any other competing interests.
Springer Nature remains neutral with...
The authors thank Sun Medical Corporation for their material supply.
RT and SS carried out the clinical data and their analysis. RT and SS have been involved in drafting the manuscript and approved the final version to be published.
The authors, Rémy Tanimura and Shiro Suzuki, declare that they have no financial, commercial or any other competing interests.
Springer Nature remains neutral with...
de Pereira R P, Rocha CO, Reis JM, Arioli-Filho JN. Influence of sealing of the screw access hole on the fracture resistance of implant-supported restorations. Braz Dent J. 2016;27(2):148–52.
Mihali S, Canjau S, Bratu E, Wang HL. Utilization of ceramic inlays for sealing implant prostheses screw access holes: a case-control study. Int J Oral Maxillofac Implants. 2016;31(5):1142–9.
Download r...
Taira Y, Sakai M, Sawase T. Effects of primer containing silane and thiophosphate monomers on bonding resin to a leucite-reinforced ceramic. J Dent. 2012;40(5):353–8.
Kato H, Matsumura H, Tanaka T, Atsuta M. Bond strength and durability of porcelain bonding systems. J Prosthet Dent. 1996;75(2):163–8.
Queiroz JR, Souza RO, Nogueira Junior Jr L, Ozcan M, Bottino MA. Influence of acid-etching a...
Korsch M, Walther W. Peri-implantitis associated with type of cement: a retrospective analysis of different types of cement and their clinical correlation to the peri-implant tissue. Clin Implant Dent Relat Res. 2015;17(Suppl 2):e434–43.
Linkevicius T, Vindasiute E, Puisys A, Linkeviciene L, Maslova N, Puriene A. The influence of the cementation margin position on the amount of undetected cemen...
Millen C, Brägger U, Wittneben JG. Influence of prosthesis type and retention mechanism on complications with fixed implant-supported prostheses: a systematic review applying multivariate analyses. Int J Oral Maxillofac Implants. 2015;30(1):110–24.
Guichet DL, Caputo AA, Choi H, Sorensen JA. Passivity of fit and marginal opening in screw- or cement-retained implant fixed partial denture desig...
Within the limitation of the study, it was concluded that:
The null-hypothesis “superficial and marginal deterioration of M4M and CR would not be significantly different” was accepted.
The M4M (modified 4-META/MMA-TBB resin) and CR (composite resin) combined with a ceramic primer showed comparable characteristics (marginal integrity and wear behavior) in an access hole filling.
The esthetic...
The analysis for the ratio of access-hole with or without marginal staining at the time of T = 12 M showed that the results in group CR (12/16) and in group M4M (12/16) were the same. For this reason, the marginal discrepancy pattern, different in both groups did not influence the aesthetical result. The occlusal contact point (A, B, or C) was compared to the marginal staining rate. Among the...
Focusing on numbers of access-hole showing a disappearance of the overfilling in an early period (up to T = 3 M), groups CR and M4M exhibited 82% (23/28) and 39.3% (11/28), respectively (Table 4). This can be explained by the differences of mechanical properties of both materials. The elastic moduli of M4M and CR are 1.9 and 7.9 MPa, respectively. Flexural strength of M4M is 66 MPa which i...
The in vivo evaluation is quite different from that of the in vitro analysis. In the previous study, all the specimens were calibrated to a flat surface with 2.5 mm diameter. In present study, each access hole had a different dimension and configuration. The filling surfaces were often ø3 to 4 mm in diameter. Access-holes located in the occlusal groove area or in the inclined cusp surface induc...
Nowadays, implant screw-retained prosthesis becomes a popular mode of implant supra-structure restoration. Cement retained implant restoration has issues including irretrievability and difficulty of controlling the cement excess beyond the abutment joint. The cement excess can be a major cause of peri-implantitis [13,14,15]. Screw-retained implant restoration has also some disadvantages including ...
Among the 56 access holes, no filling was dislodged during 12 months, and no complaint was registered from the patients regarding functional and aesthetical aspects.
The results for surface areas changes of access-hole fillings at respective intervals were summarized in Table 3 and Fig. 6. The mean values of the change from T = 1 M to T = 12 M were 77.1 ± 13.1% for group M4M and...
The marginal depth of the access-hole filling at T = 0, T = 1 M, T = 3 M, and T = 6 M could not be defined successfully because of the overfilling phenomenon which disrupted the measurement of marginal gap depth and angle (Fig. 3a–e). Only the marginal depth and angle at T = 12 M could be measured with the same digital microscope, and the mean value for each group was ca...
Patients who received a metal framed ceramic screw retained implant crown or bridge were included in this study. These access holes were delimited only by ceramic. Those with metal surface exposure were excluded from this study. Patients with edentulous arch or section, full or partial denture as antagonists were excluded from the study. During the evaluation period, 2 patients (male) dropped out ...
A total of 60 access-holes in 14 patients (5 male and 9 female) aging from 34 to 69 were restored and observed during 12 months. All subjects were informed about the study, and their written consent to participate in the study was taken.
The materials used in this study are presented in Table 1. They include a phosphoric acid monomer ceramic primer (CP): UCP (Super-Bond Universal Ceramic Primer...
The retention of implant-supported prostheses is provided by the use of a screw or cement. Recently, it was demonstrated that cement-retained prostheses had a higher rate of technical and biological complications [1], despite a better passive fit than the screw-retained restorations [2]. The CAD/CAM development of the implant-supported prostheses allows a better passively fit with screw-retained p...
Screw retained implant prostheses seem to be an efficient restorative method to prevent peri-implantitis caused by cement excess around the abutment. The drawback of the screw-retained prostheses is the difficulty to realize an efficient access-hole filling functionally and aesthetically. Up to now, few in vitro and in vivo studies were reported in the literature. The aim of this study was to eval...
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...
Parameters
H group correlation (R
s
)
HP group correlation (R
s
)
PPD-mPI
0.182 n.s.
...
Characteristics
H group correlation (R
s
)
HP group correlation (R
s
)
Age
0.040 n.s.
0.209*
Number of teeth (at the beginning o...
Clinical parameters
H group (n = 39) mean ± SD/median
HP group (n = 91) mean ± SD/median
Significance difference between H and HP group
...
Diagnosis in HP group
(37 patients, 91 implants)
Localized: ≤ 30% of site involved, generalized: > 30% of site involved
Numbers of peri-implantitis and prevalence in diagnosis n = 14, 15.4% of HP group
...
H group mean ± SD, or n (median)
HP group mean ± SD, or n (median)
Significant difference between H and HP group
Age
56.0 ± 11.8 (57.9)
...
Implant
Number
Replace select ™
44
Novel Replace ®
31
...
Seki, K., Nakabayashi, S., Tanabe, N. et al. Correlations between clinical parameters in implant maintenance patients: analysis among healthy and history-of-periodontitis groups.
Int J Implant Dent 3, 45 (2017). https://doi.org/10.1186/s40729-017-0108-0
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Received: 25 July 2017
Accepted: 19 October 2017
Published: 30 October 2017
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...
Patient recruitment and data collection for this study took place at Nihon University School of Dentistry Dental Hospital, Japan. The research was approved by the Nihon University School of Dentistry Ethics Committee (2013-15) and all activities were conducted in full accordance with ethical principles, including the World Medical Association Declaration of Helsinki. We described the purpose of th...
Implant Dentistry, Nihon University School of Dentistry Dental Hospital, Tokyo, 101-8310, Japan
Keisuke Seki, Shinya Nakabayashi, Atsushi Kamimoto & Yoshiyuki Hagiwara
Department of Comprehensive Dentistry and Clinical Education, Nihon University School of Dentistry, 1-8-13 Kanda-Surugadai, Chiyoda-ku, Tokyo, 101-8310, Japan
Keisuke Seki & Atsushi Kamimoto
Department of Applied Mathemati...
Karousis IK, Salvi GE, Heitz-Mayfield LJ, Brägger U, Hämmerle CH, Lang NP. Long-term implant prognosis in patients with and without a history of chronic periodontitis: a 10-year prospective cohort study of the ITI Dental Implant System. Clin Oral Implants Res. 2003;14:329–39.
Mengel R, Flores-de-Jacoby L. Implants in patients treated for generalized aggressive and chronic periodontitis: a 3-y...
Monjie A, Aranda L, Diaz KT, Alarcón MA, Bagramian RA, Wang HL, et al. Impact of maintenance therapy for the prevention of peri-implant diseases: a systematic review and meta-analysis. J Dent Res. 2016;95:372–9.
Armitage GC. Development of a classification system for periodontal diseases and conditions. Ann Periodontol. 1999;4:1–6.
Lang NP, Berglundh T; Working group 4 of Seventh European W...
Esposito M, Hirsch JM, Lekholm U, Thomsen P. Biological factors contributing to failures of osseointegrated oral implants. (I) Success criteria and epidemiology. Eur J Oral Sci. 1998;106:527–51.
Ogata Y, Nakayama Y, Tatsumi J, Kubota T, Sato S, Nishida T, et al. Prevalence and risk factors for peri-implant diseases in Japanese adult dental patients. J Oral Sci. 2017;59:1–11.
Heitz-Mayfield L...
Bleeding on probing
Modified plaque index
Probing pocket depth
We examined clinical parameters in patients receiving long-term implant maintenance. There were significant differences between the H and HP groups in age at the time of maintenance, number of natural teeth at the beginning of implant treatment, total number of extracted teeth, and maintenance. The prevalence of implant-based peri-implantitis was 10.8% of all the implants. All implants with peri-i...
A correlation between the PPD of the peri-implant tissue and lesion progression has been reported, similar to that seen with periodontitis [27]. Probing around the implant is useful for evaluating soft tissue inflammation and is considered reproducible [36]. Examination of peri-implant bleeding is reported to have higher diagnostic accuracy than probing around natural teeth [37]. However, because ...
BoP has been used to evaluate inflammatory conditions of periodontal tissue [33] and can also be an important evaluation item for peri-implant tissues. To avoid diagnosing bleeding resulting from strong probing as a false positive, we set the probing pressure to 0.15 N [34]. BoP values were low, with no significant difference between the groups (H group, 0.30; HP group, 0.28). This result was sim...
All the implants with peri-implantitis came from the HP group, not the H group, thus supporting the view that a history of periodontitis is a risk indicator for peri-implantitis. In the diagnosis of periodontitis within the HP group, it is notable that peri-implantitis increased as periodontitis become more severe. This supports the findings of a previous study that reported that the survival rate...
In this study, we reviewed the clinical parameters of 130 implants in 55 patients during ongoing long-term maintenance. We focused on the history of periodontitis and compared the parameters in two groups classified according to a history of periodontitis. A previous study on the prevalence of periodontitis revealed that moderate or severe periodontitis was observed in 64% of people over 65 years...
Because normality and homoscedasticity were not obtained for each clinical parameter between the two groups, a statistical study was conducted using the nonparametric test (Mann–Whitney U test) for the difference test between the two groups. PPD was recognized to be significantly greater (p
Of the 55 subjects, 25 were male and 30 were female (H group: 8/10, HP group: 17/20, respectively). A total of 130 implants (H group 39, HP group 91) were included in the analysis (Table 2). The mean maintenance period was 6 years and 6 months. The average number of natural teeth at the first visit and at the beginning of implant treatment were 25.3 ± 2.9 and 22.4 ± 4.5, respectively. Com...
At the time of optional maintenance, the following parameters were measured for each implant. Data collection and analysis were conducted by two operators who were blind to the research purpose and methods. One operator statistically analyzed the final data set.
Plaque adhesion (modified Plaque Index: mPI) on the superstructure of the implant was measured on a 4-point scale (0, no plaque; 1, plaq...
This study enrolled 55 patients (25 men, 30 women; mean age, 63.53 ± 10.51 years) who visited Nihon University School of Dentistry Dental Hospital for implant maintenance from April to September 2016. The inclusion criteria were treatment at the same hospital with two-stage implant placement before 2015, and ongoing maintenance at 3–6-month intervals after superstructure placement. Patients ...
Peri-implant diseases are the main biological complication of implant treatment and greatly influence treatment success [1]. Risk indicators for peri-implantitis include a history of periodontitis, poor oral hygiene, and smoking [2,3,4]. Peri-implantitis is often encountered clinically, occurring in 12 to 43% of implants and 28 to 47% of implant patients [5,6,7,8]. Similarities between the patholo...
The pathophysiology and pathology of peri-implantitis remain unclear; however, its similarity to periodontitis has been described. The evaluation of peri-implant tissue and the diagnostic criteria of peri-implant disease are not currently standardized as they are for periodontitis. In this study, we evaluated clinical parameters during the implant maintenance period to determine significant correl...
Fig. 6. Postoperative intraoral finding and radiograph
Fig. 6. Postoperative intraoral finding and radiograph
Fig. 5. High p53, p63, and Ki-67 reactivity are also observed in the basal cell layer (immunohistological staining, bar 400 μm)
Fig. 5. High p53, p63, and Ki-67 reactivity are also observed in the basal cell layer (immunohistological staining, bar 400 μm)
Fig. 4. Immunohistological findings show a negative staining mosaic pattern for keratin 13 (k13) and positive staining for keratin 17 (k17) (immunohistological staining, bar 400 μm)
Fig. 4. Immunohistological findings show a negative staining mosaic pattern for keratin 13 (k13) and positive staining for keratin 17 (k17) (immunohistological staining, bar 400 μm)
Fig. 3. Pathological microscopic examination reveals thickened squamous epithelia with slight nuclear atypism and disorders of the epithelial rete pegs accompanied by moderate grade inflammatory cell infiltration (HE staining, bar: 400 μm)
Fig. 3. Pathological microscopic examination reveals thickened squamous epithelia with slight nuclear atypism and disorders of the epithelial rete pegs a...
Fig. 2. Panoramic radiograph shows slight vertical bone resorption around the implants in the right side of the mandible
Fig. 2. Panoramic radiograph shows slight vertical bone resorption around the implants in the right side of the mandible
Fig. 1. Well-circumscribed gingival swelling on the lingual side of the right side of the mandible
Fig. 1. Well-circumscribed gingival swelling on the lingual side of the right side of the mandible
Antibody
Sorce
Clone
Staining
Keratin 13
DAKO
DE-K13
...
Noguchi, M., Tsuno, H., Ishizaka, R. et al. Primary peri-implant oral intra-epithelial neoplasia/carcinoma in situ: a case report considering risk factors for carcinogenesis.
Int J Implant Dent 3, 47 (2017). https://doi.org/10.1186/s40729-017-0109-z
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Received: 15 March 2017
Accepted: 25 October 2017
Published: 16 November 2017
DOI: https://doi.org/10.1186...
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...
Written informed consent was obtained from the patient for publication of this case report and any accompanying images.Makoto Nogchi, Hiroaki Tsuno, Risa Ishizaka, Kumiko Fujiwara, Shuichi Imaue, and Kei Tomihara declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Written informed consent was obtained from the patient for publication of this case report and any accompanying images.
Makoto Nogchi, Hiroaki Tsuno, Risa Ishizaka, Kumiko Fujiwara, Shuichi Imaue, and Kei Tomihara declare that they have no competing interests.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Correspondence to
Makoto Noguchi.
Department of Oral and Maxillofacial Surgery, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, 2630 Sugitani Toyama city, Toyama, 9300194, Japan
Makoto Noguchi, Hiroaki Tsuno, Risa Ishizaka, Kumiko Fujiwara, Shuichi Imaue & Kei Tomihara
Department of Diagnosis Pathology, Graduate School of Medicine and Pharmaceutical Sciences for Research, Univers...
Vasilescu F, Ceauşu M, Tänsen C, et al. P53, p63 and ki-67 assessment in HPV-induced cervical neoplasia. RJME. 2009;50:357–61.
Ndiaye C, Mena M, Alemany L, et al. HPV DNA, E6/E7 mRNA, and p16INK4a detection in head and neck cancers: a systematic review and meta-analysis. Lancet Oncol. 2014;15:1319–31.
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Laprise C, Shahl HP, Madathil SA, et al. Periodontal diseases and risk of oral cancer in Southern India: results from the HeNCe Life Study. Int J Cancer. 2...
Deoxyribonucleic acid
Human papilloma virus
Oral intra-epithelial neoplasia/carcinoma in situ
Squamous cell carcinoma
In our case, the persistence of peri-implant mucositis or peri-implantitis around the dental implant was implicated as being a plausible risk factor for carcinogenesis. Regular follow-up to ensure the maintenance of oral hygiene after dental implant therapy has again been shown to be important for preventing peri-implantitis, a plausible risk factor for carcinogenesis.
The latest evidence implies that the human papilloma virus (HPV) may be responsible for carcinogenesis in the oral cavity [12, 13]; however, its role is debatable. The interaction of the HPV’s E6 and E7 oncoproteins with cell cycle proteins disturbs the cell cycle mechanism and subsequent alteration in the expression of proteins such as p53, p63, and Ki-67 [14]. In our case, the immunohistochemi...
OIN/CIS can sometimes be difficult to distinguish pathologically from epithelial dysplasia on hematoxylin- and eosin-staining sections; this has proved challenging for oral pathologists [9]. Recently, it has been reported that combined immunohistochemistry for k13 and k17 was useful for the differential diagnosis [9, 10]. K13 is a marker for cellular differentiation toward prickle cells in normal ...
A 65-year-old woman was referred to our clinic with a tumor in the right lower gingiva. Her medical history included breast cancer without metastatic lesion, diabetes mellitus, hyperlipidemia, and hypertension. She had taken orally aspirin, amlodipine, pravastatin, and bepotastine for 2 years. She drank alcohol socially, but she had no history of tobacco smoking habit.
About 10 years prior to h...
Oral cancer ranks sixth among the malignancies in terms of worldwide prevalence, with more than 90% being pathologically squamous cell carcinoma (SCC) [1]. Oral SCC generally develops via multistep carcinogenesis. The squamous epithelium goes into irreversible change, including epithelial dysplasia and oral intra-epithelial neoplasia/carcinoma in-situ (OIN/CIS) [2], finally resulting in the develo...
In this case, prolonged peri-implant mucositis or peri-implantitis may have been a plausible risk factor for carcinogenesis.
Major risk factors for oral squamous cell carcinoma (SCC) are tobacco smoking, a betel quid chewing habit, and heavy alcohol consumption. However, around 15% of oral SCCs cannot be explained by these risk factors. Although oral SCC associated with dental implants is quite rare, there has been a recent gradual accumulation of reports about it. Here, we report a case of primary peri-implant oral int...
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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Not applicable.
All authors read and approved the final manuscript.
Anton Dank, Irene H.A. Aartman, Daniël Wismeijer, and Ali Tahmaseb declare that they have no competing interests (Additional files 1, 2, 3 and 4).
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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
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Multivariate analyses
OR
(95% CI)
P
OR
...
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GAP patients
Implants (total)
Implants maxilla
...
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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. 1. Anatomical location of the control and Ca2+-modified dental implants
Fig. 1. Anatomical location of the control and Ca2+-modified dental implants
Variable
Experimental
Control
P
Diameter (mm)
Total
4.25
5.00
5.50
6.00
6.25
...
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4.25
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6.25
...
Anitua, E., Piñas, L. & Alkhraisat, M.H. Early marginal bone stability of dental implants placed in a transalveolarly augmented maxillary sinus: a controlled retrospective study of surface modification with calcium ions.
Int J Implant Dent 3, 49 (2017). https://doi.org/10.1186/s40729-017-0111-5
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Received: 04 September 2017
Accepted: 15 November 2017
Publi...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
An exemption from IRB approval of the study protocol was granted by the author’s institution as it was a retrospective study, and the evaluated medical device had already been approved for clinical use. This study was performed following the Helsinki declaration regarding the investigation with human subjects.
Not applicable.
Eduardo Anitua is the Scientific Director of BTI Biotechnology Insti...
Private practice in oral implantology, Clínica Eduardo Anitua, Vitoria, Spain
Eduardo Anitua
University Institute for Regenerative Medicine and Oral Implantology - UIRMI (UPV/EHU-Fundación Eduardo Anitua), Vitoria, Spain
Eduardo Anitua & Mohammad Hamdan Alkhraisat
BTI Biotechnology Institute, Vitoria, Spain
Eduardo Anitua & Mohammad Hamdan Alkhraisat
Universidad Europea de Madrid, Madr...
Not applicable
No funding was received for this study.
The data will not be shared but are available upon request.
Schulze R, Krummenauer F, Schalldach F, d'Hoedt B. Precision and accuracy of measurements in digital panoramic radiography. Dentomaxillofac Radiol. 2000;29:52–6.
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Anitua E, Alkhraisat MH, Pinas L, Orive G. Efficacy of biologically guided implant site preparation to obtain adequate primary implant stability. Ann Anat. 2015;199:9–15.
Anitua E, Alkhraist MH, Piñas L, Orive G. Association of transalveolar sinus floor elevation, p...
Moraschini V, Poubel LA, Ferreira VF, Barboza Edos S. Evaluation of survival and success rates of dental implants reported in longitudinal studies with a follow-up period of at least 10 years: a systematic review. Int J Oral Maxillofac Surg. 2015;44:377–88.
Berglundh T, Abrahamsson I, Lang NP, Lindhe J. De novo alveolar bone formation adjacent to endosseous implants. Clin Oral Implants Res. 200...
Plasma rich in growth factors
Strengthening the Reporting of Observational studies in Epidemiology
The modification of an acid-etched surface with calcium ions (UnicCa®) seems to enhance the marginal bone stability of dental implants, placed after transalveolar sinus floor elevation.
Unlike Ca2+-modified dental implants, two early implant losses were observed for the same dental implants but without Ca2+. Moderately rough implant surface has enhanced implant osseointegration and has increased the implant secondary stability [2, 3, 19]. Hydrophilic moderately rough surfaces showed faster osseointegration compared to those with hydrophobic characteristics [20, 21]. Ca2+ ions hav...
In this study, 51 patients participated with 65 dental implants. The mean age of the patients was 58 ± 11 years (range 38 to 72 years) at the time of surgery, and 28 were females.
The experimental group had 34 Ca2+-modified dental implants, and the control group had 31 dental implants (without surface modification with calcium ions).
Tables 1 and 2 show the diameters and lengths of the p...
The plasma rich in growth factors (PRGF) was prepared using the Endoret® system following the manufacturer instructions (BTI Biotechnology Institute, Vitoria, Spain). The technique for transalveolar sinus floor elevation is explained elsewhere [15]. Briefly, conventional drills working at low speed (150 rpm) without irrigation was used to prepare the implant site. A frontal cutting drill was the...
The manuscript was written following STROBE (Strengthening the Reporting of Observational studies in Epidemiology) guidelines. All described data and treatments were obtained from a single dental clinic in Vitoria, Spain. The time period of the study was between December 2014 and April 2016. Patients’ records were retrospectively reviewed to identify patients that fulfilled the following inclusi...
Dental implants are nowadays the treatment of choice to replace missing teeth due to their high predictability and long-term success [1]. This success is the outcome of several cellular and molecular events that take place at the implant-bone interface. Although the process of osseointegration is not fully understood, research is ongoing to enhance and accelerate this process. Moderately rough imp...
Recently, components of the extracellular cellular matrix have been assessed to enhance the biological response to dental implants. This study aims to assess the effect of surface modification with calcium ions on the early marginal bone loss of dental implants placed in a transalveolarly augmented maxillary sinus.
A retrospective study of transalveolar sinus floor augmentation was conducted in a...
Kanazawa, M., Atsuta, I., Ayukawa, Y. et al. The influence of systemically or locally administered mesenchymal stem cells on tissue repair in a rat oral implantation model.
Int J Implant Dent 4, 2 (2018). https://doi.org/10.1186/s40729-017-0112-4
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Received: 19 September 2017
Accepted: 04 December 2017
Published: 13 January 2018
DOI: https://doi.org/10.118...
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...
Miya Kanazawa, Ikiru Atsuta, Yasunori Ayukawa, Takayoshi Yamaza, Ryosuke Kondo, Yuri Matsuura, and Kiyoshi Koyano declare that they have no competing interests.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Correspondence to
Ikiru Atsuta.
Section of Implant and Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
Miya Kanazawa, Ikiru Atsuta, Yasunori Ayukawa, Ryosuke Kondo, Yuri Matsuura & Kiyoshi Koyano
Department of Molecular Cell and Oral Anatomy, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
Takayoshi...
This work was supported by JSPS KAKENHI Grant Numbers JP 15H05029 and 15H02573 to Y. Ayukawa.
Bazhanov N, Ylostalo JH, Bartosh TJ, Tiblow A, Mohammadipoor A, Foskett A, Prockop DJ. Intraperitoneally infused human mesenchymal stem cells form aggregates with mouse immune cells and attach to peritoneal organs. Stem Cell Res Ther. 2016;7:27.
Goldmacher GV, Nasser R, Lee DY, Yigit S, Rosenwasser R, Iacovitti L. Tracking transplanted bone marrow stem cells and their effects in the rat MCAO stro...
Stepp MA, Spurr-Michaud S, Tisdale A, Elwell J, Gipson IK. Alpha 6 beta 4 integrin heterodimer is a component of hemidesmosomes. Proc Natl Acad Sci U S A. 1990;87:8970–4.
Schroeder A, van der Zypen E, Stich H, Sutter F. The reactions of bone, connective tissue, and epithelium to endosteal implants with titanium-sprayed surfaces. J Maxillofac Surg. 1981;9:15–25.
Schroeder HE, Listgarten MA. F...
Zhang L, Li K, Liu X, Li D, Luo C, Fu B, Cui S, Zhu F, Zhao RC, Chen X. Repeated systemic administration of human adipose-derived stem cells attenuates overt diabetic nephropathy in rats. Stem Cells Dev. 2013;22:3074–86.
Zheng B, von See MP, Yu E, Gunel B, Lu K, Vazin T, Schaffer DV, Goodwill PW, Conolly SM. Quantitative magnetic particle imaging monitors the transplantation, biodistribution, a...
Egusa H, Sonoyama W, Nishimura M, Atsuta I, Akiyama K. Stem cells in dentistry—part I: stem cell sources. J Prosthodont Res. 2012;56:151–65.
Lindhe J, Berglundh T. The interface between the mucosa and the implant. Periodontol. 1998;17:47–54.
Ikeda H, Shiraiwa M, Yamaza T, Yoshinari M, Kido MA, Ayukawa Y, Inoue T, Koyano K, Tanaka T. Difference in penetration of horseradish peroxidase trace...
Our study supports systemic administration of MSCs to enable accelerated soft tissue sealing of the Ti surface in our rat oral implantation model. Although local MSC administration had little positive effect in our model, the MSCs accumulated around the peri-implant oral mucosa and were identified in various organs, indicating a wide range of possible applications. This study highlights that clini...
Figure 7C and D showed the suitable amount of MSCs had much better positive effect for the migration and adhesion of OECs to titanium surface. MSC attachment within the upper Transwell chamber was determined 24 h after seeding by fluorescence microscopy, as shown in Fig. 7D (a). The majority of MSCs appeared flattened with numerous cytoplasmic extensions and lamellipodia. The majority of MSCs pass...
Due to the existence of muscles, connective tissue, dermal layer, and basement membrane, cells within the mass of the injected area encounter these barriers, inhibiting the distance of migration between the application region and inflammatory site, which has an estimated diameter of 20–30 μm (Fig. 6). High-density cell injection at the topical region is also an obstacle for homing, thus using a...
Subcutaneously administrated cells or drugs are reported to take a few days to be delivered into the body through vessel bloods [33, 34]. This may be owed to difficulty of the cells in securing vascular accesses to the target site because of a lack of blood vessels at the buccinators, while systemic MSC homing occurs more readily through the bloodstream [35].
The effects of MSC treatment on level...
As shown in Fig. 3b, expression of adhesion proteins on the interface between PIE-implant was significantly lower in the control and local groups compared with the systemic group.
Ln-332 is the major adhesive ligand for integrin α6β4, which interacts with the cytoskeletal elements, and is a component of the hemidesmosomes, epithelial adhesion plaques that tack the plasma membrane of the epithe...
Because MSC treatment is being introduced more widely as a clinically available therapy, the method of administration must be considered to better mitigate risk. Although for a number of other factors also need consideration, including cell source, cell donor condition, cell population, and timing of MSC administration, this study only focused on comparison between systemic and local injection of ...
OEC adhesion assays were conducted according to previously published methods [16, 20]. Non-adherent or weakly attached cells were removed by shaking (3 × 5 min at 75 rpm) using a rotary shaker (NX-20, Nissin, Tokyo, Japan). Adherent cells were then counted and calculated as a percentage of the initial count, which was used to define adhesive strength of the cells.
Scratch assays were perfo...
For apoptosis detection, the 10-μm bucco-palatal sections from around the experimental implant were incubated overnight with FITC-conjugated anti-rat GFP (1:100, Sigma-Aldrich) and 7-amino actinomycin D (7-AAD, Apoptosis Detection Kit; BD Biosciences, Franklin Lakes, NJ) at 4 °C. Apoptotic cells were then counted and calculated as a percentage of the total cells.
MSCs were cultured in osteogen...
Twenty-four hours after implantation, rats were lightly anesthetized with chloral hydrate and lidocaine hydrochloride, and ex vivo expanded P3 green fluorescent protein (GFP)-MSCs (1 × 106 cells) were administrated via one of the following modes: (1) systemic injection via the tail vein (systemic group), (2) local injection into the gingivobuccal fold around the dental implant (local group), ...
Bone marrow cells were flushed out of the femurs and tibias of 4-week-old green fluorescent protein-transgenic Wistar rats. Cells were treated with a 0.85% NH4Cl solution for 10 min to lyse the red blood cells and were passed through a 70-μm cell strainer to obtain a single cell suspension. Cells were seeded into 100-mm plastic culture dishes (1 × 106 cells/dish), washed with phosphate buff...
The purpose of this study was to verify the effects and mechanisms of bone marrow-derived MSCs following their local administration using an oral implantation rat model, to deepen our understanding of this approach for effective utilization of MSCs.
Mesenchymal stem cell (MSC)-based approaches can be broadly divided into two categories: cell therapy and regenerative medicine. Cell therapy is focused on the anti-inflammatory, immune-regulatory, and homeostasis-regulatory actions of MSCs to treat disorders like malignant lymphoma, angina pectoris, and atopic dermatitis. Conversely, regenerative medicine is focused on MSCs playing a tissue engin...
Multipotent mesenchymal stem cells (MSCs) are used clinically in regenerative medicine. Our previous report showed systemically injected MSCs improved peri-implant sealing and accelerated tissue healing. However, the risks of systemic MSC administration, including lung embolism, must be considered; therefore, their local application must be assessed for clinical safety and efficacy. We investigate...
Fig. 8. Distribution of occlusal force in models. a Im67, b Im6, c Im4567, d Im456, e MT67, and f MT7. R right TMJ, L left TMJ, 4 first premolar, 5 second premolar, 6 first molar, and 7 second molar. Numbers within circles indicate implant superstructure
Fig. 8. Distribution of occlusal force in models. a Im67, b Im6, c Im4567, d Im456, e MT67, and f MT7. R right TMJ, L left TMJ, 4 first prem...
Fig. 7. Initializing models altering the load displacement curves of springs
Fig. 7. Initializing models altering the load displacement curves of springs
Fig. 6. Springs for opposing teeth and TMJs and load directions. Arrows indicate loads, arrowheads indicate restricted nods, and spiral lines indicate springs
Fig. 6. Springs for opposing teeth and TMJs and load directions. Arrows indicate loads, arrowheads indicate restricted nods, and spiral lines indicate springs
Fig. 5. Distribution of occlusal force in the natural teeth model displayed in Fig.4
Fig. 5. Distribution of occlusal force in the natural teeth model displayed in Fig.4
Fig. 4. Three-dimensional finite element model with natural teeth and no defect
Fig. 4. Three-dimensional finite element model with natural teeth and no defect
Fig. 3. Load displacement curves of natural teeth in FE model
Fig. 3. Load displacement curves of natural teeth in FE model
Fig. 2. Load displacement curves of springs
Fig. 2. Load displacement curves of springs
Fig. 1. Three-dimensional finite element model. The tooth roots and implant bodies are displayed with permeability. a Im67, b Im6, c Im4567, d Im456, e MT67, and f MT7
Fig. 1. Three-dimensional finite element model. The tooth roots and implant bodies are displayed with permeability. a Im67, b Im6, c Im4567, d Im456, e MT67, and f MT7
Material
Modulus of elasticity (MPa)
Poisson ratio
References
Cortical bone
140,000
...
Yoshitani, M., Takayama, Y. & Yokoyama, A. Significance of mandibular molar replacement with a dental implant: a theoretical study with nonlinear finite element analysis.
Int J Implant Dent 4, 4 (2018). https://doi.org/10.1186/s40729-018-0117-7
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Received: 13 March 2017
Accepted: 08 January 2018
Published: 27 February 2018
DOI: https://doi.org/10.1186/s407...
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...
Author Masazumi Yoshitani, Yoshiyuki Takayama, and Atsuro Yokoyama state that there are no competing interests.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Division of Oral Functional Science, Department of Oral Functional Prosthodontics, Graduate School of Dental Medicine, Hokkaido University, Kita-13, Nishi-7, Kita-ku, Sapporo, 060-8648, Japan
Masazumi Yoshitani & Atsuro Yokoyama
Removable Prosthodontics, Hokkaido University Hospital, Hokkaido University, Kita-14, Nishi-5, Kita-Ku, Sapporo, 060-8648, Japan
Yoshiyuki Takayama
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Kasai K, Takayama Y, Yokoyama A. Distribution of occlusal forces during occlusal adjustment of dental implant prostheses: a nonlinear finite element analysis considering the ...
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Within the limitations of this theoretical study, we demonstrated that restoration with the same number of implants as missing teeth shows almost symmetric occlusal force distribution, and it produced less biomechanically stress for a unilateral defect of the mandible. However, if restoration of a missing second molar with an implant is impossible or difficult, then an SDA with implants may also b...
It should be noted that our results were obtained under conditions of vertical loading by bilaterally balanced muscle activity with tight intercuspation in the correct mandibular position because the horizontal displacement of the premolars and molars was restrained. The actual distribution of occlusal forces may differ due to individual differences in the material properties of the soft tissue. A...
Occlusal adjustment is usually performed to obtain symmetrical occlusal force distribution in natural dentition. However, occlusal force distribution among natural teeth and implants depends on occlusal force because of the difference of displaceability between a natural tooth and an implant [14, 15]. Therefore, we evaluated the result of the analysis from viewpoints of symmetry of occlusal force ...
FEA is useful for mechanical simulations of a living body and has been used in implant dentistry research under careful consideration of the analysis conditions [32, 33]. Although some reports have demonstrated that bone density varies according to bone type and location, the material properties of the mandible were homogenous and isotropic in this study. However, the effect of this difference was...
In model Im456 (Fig. 8d), under loads 100 and 200 N, the occlusal force at the premolars on the defect side was larger than that in model Im4567 (shown in Fig. 8c). The occlusal force was also larger than that in model MT7 (shown in Fig. 6f). However, the occlusal force at the second premolar under load 200 N was 34.5 N, which was slightly smaller than the occlusal force at the second molar ...
In model Im6 (Fig. 8b), the occlusal force at the second premolar under loads 100, 200, 400, and 800 N were 18.3, 37.0, 38.8, and 70.2 N, respectively. The occlusal force was larger than that in model Im67 (shown in Fig. 8a), while it was approximately equivalent to that in model MT7 (shown in Fig. 8f). Under loads 100 and 200 N, the occlusal force at the second premolar on the defect side w...
The distributions of occlusal force are shown in Fig. 8. In model MT67 (Fig. 8e), the occlusal force at the first premolar on the defect side was 10.0–86.5 N, which was 1.2–15.0-fold larger than that on the natural dentition side. The occlusal force at the second premolar on the defect side was 24.6–190.1 N, which was 2.6–8.3-fold larger than on the natural dentition side. The occlusal...
Analysis was performed according to the report by Kayumi et al. [15]. In linear finite element analysis (FEA), all teeth maintain perfect contact with antagonists with no stress on occlusal surfaces before loading. However, there must be some occlusal force on the occlusal surface when a mandible is in the intercuspal position. Since the displaceabilities of osseointegrated implants, natural teeth...
Nonlinear characteristics according to the load displacement curve of teeth [21,22,23,24] and cartilage [30] were given to the springs for the opposing teeth and TMJs, respectively (Fig. 2). The nonlinear elasticity of the springs on the teeth and implants simulated displaceability of opposing natural teeth at compression and separation of the occlusal surface from opposing teeth at tension.
The...
The 3D FEMs were constructed based on those reported by Kasai et al. [14], Kayumi et al. [15] and consisted of a mandible, natural teeth with the periodontal ligament (PDL), and titanium implant(s) with superstructures in the left premolar and molar regions.
The surface of the mandible was generated using measurements of a commercially available model (QS7, SOMSO) of the dentate mandible with a 3...
From the viewpoint of occlusal force distribution, when a second molar defect remains without prosthesis, the force might concentrate in the implant, residual teeth, or temporomandibular joints (TMJs). Therefore, the aim of this study was to investigate occlusal force distribution in SDA in the mandible with/without an implant using a three-dimensional (3D) finite element model (FEM).
Dental implant treatment has been frequently applied in dental practice as the most important prosthodontic procedure with long-term predictability to restore oral function, maintain occlusion, and improve the quality of life (QoL) of a patient [1]. Clinically, dental implants are mainly applied to correct mandibular distally extended edentulism [2]. However, implant placement in the molar region ...
Dental implants are frequently applied to unilateral defects in the mandible. However, implant placement in the molar region of the mandible can be difficult due to anatomical structure. The aim of this study was to evaluate the distribution of occlusal force in a mandibular shortened dental arch (SDA) with implants.
Three-dimensional finite element (FE) models of the mandible with varying number...
Fig. 3. Proportion of dental implant FEA articles with a validation. (Left) Among totally 522 FEA articles of dental implants which we were able to access English full text up to January 2017, there are only 47 articles with a validation. (Right) The articles with a validation were categorized according to their validation method as follows levels: A, in vivo (human bodies); B, performed in vivo...
Fig. 2. Hierarchy of validations based on their similarity to real biomechanical behaviors. The articles (n = 47) were categorized according to their validation method as follows: in vivo experiments in humans (n = 1) and other animals (n = 3), model experiments (n = 32), others’ clinical data and past literature (n = 9), and other software (n = 2)
Fig. 2. Hierarchy ...
Fig. 1. Flowchart of literature review. An electronic literature search of PubMed was conducted up to January 2017 using the Medical Subject Headings “dental implants” and “finite element analysis.” After accessing the full texts, the context of each article was searched using the words “valid” and “validation” and articles in which these words appeared were read to determine whe...
Ranking
Authors
Year
FE model
FEM geometry reference
Material properties of tissues a...
Chang, Y., Tambe, A.A., Maeda, Y. et al. Finite element analysis of dental implants with validation: to what extent can we expect the model to predict biological phenomena? A literature review and proposal for classification of a validation process.
Int J Implant Dent 4, 7 (2018). https://doi.org/10.1186/s40729-018-0119-5
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Received: 05 November 2017
Accepte...
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...
Yuanhan Chang, Abhijit Anil Tambe, Yoshinobu Maeda, Masahiro Wada, and Tomoya Gonda declare that they have no competing interests.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
Yuanhan Chang, Yoshinobu Maeda, Masahiro Wada & Tomoya Gonda
Mahatma Gandhi Vidyamandir’s Karmaveer Bhausaheb Hiray Dental College & Hospital, Mumbai Agra Road, Panchwati, Nashik, Maharashtra, India
Abhijit Anil Tambe
You can als...
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Van Staden RC, Guan H, Loo YC. Application of the finite element method in dental implant research. Comput Methods Biomech Biomed Engin. 2006;9:257–70.
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Gass SI. Decision-adding m...
High-level validation of FEA using in vivo experiments is still rare in the dental implant field.
It is necessary to clearly indicate the validation process of the model when a study using FEA is presented.
The hierarchy proposed in this study based on the evidence level of the validations can be applied to evaluate the clinical significance of studies using FEA.
To explain or analyze the mechanical properties involved in biological phenomena such as motor tasks (mastication, walking, or heart contraction), a time-dependent finite element model may provide a more realistic view. However, if time-dependent performance criteria are considered (the most common is to clarify the influence of musculoskeletal structure on function or the performance of a motor t...
Because of the limitations of computer technology, most FEA models [75,76,77,78,79] simplify the skeletal muscle architecture in terms of a uniform fiber length, pennation angle, and line of action and represent the architecture using a Hill-based muscle model. However, how well the modeling of skeletal muscles as one-dimensional strings represents the behavior of the full three-dimensional muscle...
Table 1 shows all studies in the literature that considered the need for validation of FEAs. According to these studies, we established a hierarchy based on the evidence level of the validations (A to G, i.e., high to low) (Fig. 2).
Level A: validation using living humans
Level B: validation using living heterogeneous animals
Levels C and D: validation using homogenous and heterogeneous bone
...
Level E: model experiment performed using artificial materials (n = 23) [14, 25, 26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46]
Artificial materials such as acrylic resin, polyurethane, or plastic bone models were commonly used as embedded “bone” implants in validation experiments. Level E includes the use of special materials and specific methods to measure the force di...
We classified all validation processes based on their similarity to real biomechanical behaviors into the following hierarchy (levels A to G) (Fig. 2):
Level A: performed in vivo (human bodies) (n = 1) [10]
The top level of the hierarchy, level A, includes in vivo methods of FEA validation conducted in humans. In 2006, Heckmann et al. [10] quantified the degree of stress that occurs in the...
In total, 601 articles were obtained from the PubMed electronic search using the Medical Subject Headings “dental implants” and “finite element analysis.” After excluding articles for which the full text could not be accessed (n = 69) and that were not written in English (n = 10), 522 articles remained. These articles were searched using the terms “validation,” “validity,” ...
FEA studies with validation have recently become more common in the biomechanical field. FEA validations can be divided into two types: (1) direct validation, which involves experiments on the quantities of interest (from basic material characterizations to hierarchical system analysis such as model experiments and in vitro experiments), and (2) indirect validation, which involves the use of liter...
Finite element analysis (FEA) has been applied to investigate dental implant designs, the structure and material of the superstructure, and the stability of the surrounding bone [1, 2]. According to PubMed, only 10 FEA studies of dental implants were published in 1990, while 102 papers were published in 2014.
FEA has become an increasingly useful tool in the past few decades. In the medical field...
A literature review of finite element analysis (FEA) studies of dental implants with their model validation process was performed to establish the criteria for evaluating validation methods with respect to their similarity to biological behavior. An electronic literature search of PubMed was conducted up to January 2017 using the Medical Subject Headings “dental implants” and “finite element...
Fig. 6. Roughness (Sa) box plot
Fig. 6. Roughness (Sa) box plot
Fig. 5. 3D profile
Fig. 5. 3D profile
Fig. 4. CLSM
Fig. 4. CLSM
Fig. 3. SEM for localization of EDX analysis
Fig. 3. SEM for localization of EDX analysis
Fig. 2. SEM. White arrow (→) exemplary mark the droplet like shape of surface as described in the text
Fig. 2. SEM. White arrow (→) exemplary mark the droplet like shape of surface as described in the text
Fig. 1. Diagram of different implant areas used for sampling. 1) Machined (untreated) area. 2) rough (treated) area
Fig. 1. Diagram of different implant areas used for sampling. 1) Machined (untreated) area. 2) rough (treated) area
Amplitude parameters
Group
Name
Sa (μm)
Machined area
WhiteSKY
...
Element composition/semi-quantitative evaluation
Location
Type
Zr at %min–at %max
Hf at %
Y at %min–at %max...
NoneTable 1 Five commercially available ceramic implants and surface characteristics
Beger, B., Goetz, H., Morlock, M. et al. In vitro surface characteristics and impurity analysis of five different commercially available dental zirconia implants.
Int J Implant Dent 4, 13 (2018). https://doi.org/10.1186/s40729-018-0124-8
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Received: 11 December 2017
Accepted: 08 February 2018
Published: 26 April 2018
DOI: https://doi.org/10.1186/s40729-018...
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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Beger B, Goetz H, Morlock M, Schiegnitz E, and Al-Nawas B declare that they have no competing interests.
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Department of Maxillofacial Surgery, University Medical Center of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131, Mainz, Germany
B. Beger, M. Morlock, E. Schiegnitz & B. Al-Nawas
Biomaterials in Medicine (BioAPP), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
H. Goetz
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Papanagiotou HP, Morgano SM, Giordano RA, Pober R. In vitro evaluation of low-temperature aging effects and finishing procedures on the flexural strength and structural stability of Y-TZP dental ceramics. J Prosthet Dent. 2006;96(3):154–64.
Ewais OH, Al Abbassy F, Ghoneim MM, Aboushelib MN. Novel zirconia surface treatments for enhanced osseointegration: laboratory characterization. Int J Dent....
Ong JL, Carnes DL, Cardenas HL, Cavin R. Surface roughness of titanium on bone morphogenetic protein-2 treated osteoblast cells in vitro. Implant Dent. 1997;6(1):19–24.
Schwartz Z, Kieswetter K, Dean DD, Boyan BD. Underlying mechanisms at the bone-surface interface during regeneration. J Periodontal Res. 1997;32(1 Pt 2):166–71.
Al-Nawas B, Gotz H. Three-dimensional topographic and metrologic...
Jacobi-Gresser E, Huesker K, Schutt S. Genetic and immunological markers predict titanium implant failure: a retrospective study. Int J Oral Maxillofac Surg. 2013;42(4):537–43.
Wenz HJ, Bartsch J, Wolfart S, Kern M. Osseointegration and clinical success of zirconia dental implants: a systematic review. Int J Prosthodont. 2008;21(1):27–36.
Shulte W. The intra-osseous Al2O3 (Frialit) Tuebingen...
Aluminum oxide
Ceramic injection molding
Confocal laser scanning microscopy
Energy-dispersive X-ray spectroscopy
Hot isostatic pressing
Implant
Kilovolt
Millibar
Megapascal
Nanometer
Area roughness parameter
Scanning electron microscopy
Sandblasted, Large-grit, Acid-etched
Yttrium-stabilized tetragonal zirconium polycrystalline
Micrometer
New ceramic implants are showing a variety of surface characteristics due to different manufacturing processes as shown by other groups [2, 28]. The surface structures of the investigated implants are close to titanium implants. If the surface characteristics really have a high influence on osseointegration, ceramic implants cannot yet compare to the long experience with titanium. However, there a...
The semi-quantitative energy-dispersive X-ray spectroscopy (EDX) can be used to further analyze the components of the implant surface. None of the implants showed any impurity or unexpected results. Implants 4 and 5 showed yttrium under the detection limit in the EDX analysis. This could be caused by the lower dosage of yttrium endowment in the stabilization processing in comparison to other impla...
The surface shape (droplet-like surface), which was observed in the SEM samples, can be caused due to the sintering process in which ceramic powder was melted and then formed. Different particle, immersion, and droplet sizes can also change due to possible reasons like usage of various types and dosages of acid for the etching process and change of exposure time to acid effect. A longer exposure t...
Implant surface characteristics are of ongoing scientific interest. Implants made from titanium are still the most common to be used. Titanium implants are made from alpha-beta alloy which consists of 6% aluminum and 4% vanadium (Ti-6Al-4V). These materials have low density, high strength, and resistance to fatigue and corrosion, and their modulus of elasticity is closer to the bone than any other...
Implant 2 (Sa 1.27 μm ± 0.24) and implant 5 (Sa 1.22 μm ± 0.36) show the highest roughness values (Sa) of all tested implants: Straumann’s pure ceramic implant was blasted and etched and shows the overall highest Sa value in the rough area. Implant 3 (vitaclinical) shows correspondingly lower Sa around 1.05 μm (± 0.17) (Table 3). The lowest Sa value could be found in implant ...
SEM micrographs presented in Fig. 2 demonstrate the dissimilarity of the sample surface microstructure. Implant 1 shows an overall smoother surface and a slaty-like surface without evidence of a typical etching process. The surface shows sparse roughness. Implants 2–4 show deep markings from their brand’s specific etching and sandblasting processes. In × 10,000 magnification, immersions ca...
Subsequently, the depth map images are imported in the SPIP™ 4.2.6 (Image Metrology) software for roughness and texture evaluation. According to the ISO 25178-2 reference, all surface roughness parameters implemented in SPIP™ are evaluated and classified as amplitude, hybrid, functional, and spatial parameters. Selected values are shown in Table 3.
Analysis of the element composition of the implant surfaces by means of energy-dispersive X-ray spectroscopy (EDX) was performed with an INCA Energy 350 system (Oxford Instruments, Wiesbaden, Germany) coupled with the SEM Quanta 200 FEG (Fig. 2). Similar to the micro-morphological presentation, each implant was divided into comparable sites of interest. Typical areas were selected and evaluated (...
The following five commercially available dental zirconia implants were used in this study (Table 1). Bredent whiteSKY™ implant (I1) is made from unground Brezirkon™, an yttrium oxide (Y2O3)-stabilized tetragonal polycrystalline zirconium oxide and is sandblasted. Zirconium oxide is endowed with 3 mol% yttrium oxide to gain a rectangle and room temperature stable structure [17]. Straumann® ...
Dental implants have become a well-established treatment method for oral rehabilitation after tooth loss. Pure titanium is still the material of choice when it comes to dental intraosseous implants and has been used for decades. However, titanium implants have esthetic limitations, especially in the front aspect of the maxillary jaw. The recession of the gingiva can lead to visible implant necks. ...
The aim of this study was to assess surface characteristics, element composition, and surface roughness of five different commercially available dental zirconia implants.
Five zirconia implants (Bredent whiteSKY™ (I1), Straumann® PURE Ceramic (I2), ceramic.implant vitaclinical (I3), Zeramex® (I4), Ceralog Monobloc M10 (I5)) were evaluated.
The evaluation was performed by means of scanning el...
Fig. 5. Mean and standard deviation of the biomechanical data at both observation periods (P > 0.05). a Removal torque. b Removal energy. c Connection stiffness
Fig. 5. Mean and standard deviation of the biomechanical data at both observation periods (P > 0.05). a Removal torque. b Removal energy. c Connection stiffness
Fig. 4. Comparison among secant and tangent methods to calculate the connection stiffness values, which reveals the absence of mathematical discrepancy
Fig. 4. Comparison among secant and tangent methods to calculate the connection stiffness values, which reveals the absence of mathematical discrepancy
Fig. 3. Representative curve of the torque test for implants. a Graph of torque versus angular displacement with linear regression curve, and equation, representing the connection stiffness. b Determination procedure of unscrewing implant work up to test’s maximum torque
Fig. 3. Representative curve of the torque test for implants. a Graph of torque versus angular displacement with linear r...
Fig. 2. Adaptation of Shimadzu universal testing machine for performing removal torque test of dental implants. a General view. b Assembly detail of connection between Allen keys socket and the implant placed in the tibia
Fig. 2. Adaptation of Shimadzu universal testing machine for performing removal torque test of dental implants. a General view. b Assembly detail of connection between Allen...
Fig. 1. Two pairs of implants (10 mm × 4 mm, L × Ø) from each of the experimental groups were placed in each tibia with an alternating fashion in terms of medio-distal positioning regarding the group, but with the first group chosen at random. Implants were placed with an inter-implant distance of 1 cm
Fig. 1. Two pairs of implants (10 mm × 4 mm, L × Ø) from each of...
Removal torque
Removal energy
Connection stiffness
Spearman’s rho
Removal torque
Coefficient
...
Sum of squares
df
Mean square
F
Sig. (P value)
Removal torque
Between groups
...
de Jesus, R.N.R., Carrilho, E., Antunes, P.V. et al. Interfacial biomechanical properties of a dual acid-etched versus a chemically modified hydrophilic dual acid-etched implant surface: an experimental study in Beagles.
Int J Implant Dent 4, 28 (2018). https://doi.org/10.1186/s40729-018-0139-1
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Received: 01 February 2018
Accepted: 29 May 2018
Published: 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...
The animal experimental protocol was approved by the Bioethics Committee for Animal Experimentation (CEUA, protocol no. 098/10) at the Federal University of Uberlândia.
Rainde Naiara Rezende de Jesus, Eunice Carrilho, Pedro V. Antunes, Amílcar Ramalho, Camilla Christian Gomes Moura, Andreas Stavropoulos, and Darceny Zanetta-Barbosa declare that they have no competing interests.
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RNRJ participated in the study concept and design and performed the animal operations, biomechanical test, and data analysis and interpretation. EC, PVA, and AR contributed to define the test protocol and performed the biomechanical test and data analysis. CCGM and DZ participated in the study concept and desig...
Department of Periodontology, Faculty of Odontology, Malmö University, Carl Gustafs väg 34, 205-06, Malmö, Sweden
Rainde Naiara Rezende de Jesus & Andreas Stavropoulos
IBILI, Faculty of Medicine, University of Coimbra, Av. Bissaya Barreto, Bloco de Celas, 3000-075, Coimbra, Portugal
Rainde Naiara Rezende de Jesus & Eunice Carrilho
CEMUC, Mechanical Engineering Department, University of ...
The assistance of fifth-year dental students of the Federal University of Uberlândia in surgeries, including auscultation, and other practicalities is highly appreciated.
The Brazilian Federal Agency for Support and Evaluation of Graduate Education (CAPES research fellow, Full PhD Program, process no. 0975-14.1) provided funding and Neodent® (Curitiba, PR, Brazil) produced the titanium implants...
Kim S, Lee S, Cho I, Kim S, Kim T. Rotational resistance of surface-treated mini-implants. Angle Orthod. 2009;79(5):899–907. https://doi.org/10.2319/090608-466.1.
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de Jesus RNR, Stavropoulos A, Oliveira MTF, Soares PBF, Moura CCG, Zanetta-Barbosa D. Histomorphometric evaluation of a dual acid-etched vs. a chemically modified hydrophilic dual acid-etched implant surface. An experimental study in dogs. Clin Oral Implants Res. 2017;28(5):551–7. https://doi.org/10.1111/clr.12833.
Frost HM. Skeletal structural adaptations to mechanical usage (SATMU): 1. Redefi...
Boyan BD, Cheng A, Olivares-Navarrete R, Schwartz Z. Implant surface design regulates mesenchymal stem cell differentiation and maturation. Adv Dent Res. 2016;28(1):10–7. https://doi.org/10.1177/0022034515624444.
Mamalis AA, Silvestros SS. Analysis of osteoblastic gene expression in the early human mesenchymal cell response to a chemically modified implant surface: an in vitro study. Clin Oral ...
Wall I, Donos N, Carlqvist K, Jones F, Brett P. Modified titanium surfaces promote accelerated osteogenic differentiation of mesenchymal stromal cells in vitro. Bone. 2009;45(1):17–26. https://doi.org/10.1016/j.bone.2009.03.662.
Mamalis AA, Markopoulou C, Vrotsos I, Koutsilirieris M. Chemical modification of an implant surface increases osteogenesis and simultaneously reduces osteoclastogenesis...
Cochran DL, Jackson JM, Jones AA, Jones JD, Kaiser DA, Taylor TD, et al. A 5-year prospective multicenter clinical trial of non-submerged dental implants with a titanium plasma-sprayed surface in 200 patients. J Periodontol. 2011;82(7):990–9. https://doi.org/10.1902/jop.2011.100464.
Wallkamm B, Ciocco M, Ettlin D, Syfrig B, Abbott W, Listrom R, et al. Three-year outcomes of Straumann Bone Level...
Chemically modified sandblasted, large grit, and acid-etched surfaces
Sandblasted, large grit, and acid-etched surfaces
Neodent, Rua Benjamin Lins, 742, Curitiba, PR 80420–100, Brazil
Shimadzu Corporation, Nishinokyo Kuwabara-cho, Nakagyo-ku, Kyoto 604–8511, Japan
IBM Corporation v.23, 1 New Orchard Road, Armonk, New York 10, 504–1722, USA
No significant differences were observed between the specific hydrophilic (SAE-HD) and hydrophobic (SAE) surfaces evaluated in this study, in terms of biomechanical properties during the early osseointegration period.
In fact, the observed lack of differences between the groups could be attributed to the relatively low number of specimens per group. According to the observed data herein, applying a high power (80%) with the present sample size would had revealed a relatively large difference in removal torque equivalent to 43% between the experimental groups. Regarding removal energy and connection stiffness, t...
On the other hand, lack of significant differences between the two groups in the present experiment could be due to the fact that the effect of hydrophilicity, in terms of accelerating bone healing and osseointegration, was unfolded before the first evaluation time-point of 2 weeks, i.e., during the very early healing period. Consistently, pre-clinical investigations show the potential of chemica...
Improving surface wettability aims to increase the implant surface area achieving most favorable protein adsorption and cellular adhesion and thereby to positively regulate the biological response at the initial osseointegration process. Thus, the superior potential of superhydrophilic surfaces in enhancing osseointegration at early stages of bone formation may also enhance their load-bearing capa...
No remarkable events were observed during the surgical procedures and the subsequent healing period. The relative biomechanical performance of both experimental implant surfaces is illustrated in a representative graph of removal torque versus angular displacement. The removal torque, removal energy, and connection stiffness values are described in terms of mean, standard deviation, and 95% confid...
To assess the biomechanical strength of the bone-implant interface, the following parameters were assessed: (a) maximum removal torque (N cm) (primary outcome measure), obtained during the unscrewing process (primary outcome measure); (b) connection stiffness (N cm/rad), corresponding to the ratio between removal torque and angular displacement (secondary outcome measure); and (c) removal energy...
Six male Beagle dogs (~ 1.5 years old), weighting between 13 and 15 kg, were used in the present study. All animals were acclimatized in the experimental animal care facility of Federal University of Uberlândia for 2 weeks previously to the experimental procedures and randomly pair-housed in standard shelters (1 × 1.5 m kennel) to allow environmental enrichment (i.e., variety of toys, ...
The present preclinical in vivo study is reported according to the Animal Research: Reporting of In Vivo Experiments (ARRIVE) guidelines, in regard with relevant items [33]. The animal experimental protocol was approved by the Bioethics Committee for Animal Experimentation (CEUA, protocol no. 098/10) at the Federal University of Uberlândia and followed the normative guidelines of the National Cou...
Evaluation of biological effects and biomechanical properties of innovative technologies in the field of implant dentistry in preclinical animal models, prior to translational research, complies with standard regulations [33]. Thus, the aim of this preclinical animal study was to evaluate the effect of surface microtopography and chemistry on the biomechanical properties of implants with a sandbla...
The progressive evolution of oral implant surface technology (i.e., micro to nanotopography and chemical composition) [1, 2], implant macrogeometry, surgical procedures [3,4,5], and loading protocols [6,7,8] has resulted in high survival and clinical success rates [9]. Accordingly, chemically active micro and nanostructured implant surfaces, presenting moderate surface roughness (Ra/Sa values betw...
In this study, no significant differences were observed between the specific hydrophilic (SAE-HD) and hydrophobic (SAE) surfaces evaluated, in terms of biomechanical properties during the early osseointegration period.
The high survival clinical success rates of osseointegration are requisites for establishing a long-term biomechanical fixation and load-bearing potential of endosseous oral implants. The objective of this preclinical animal study was to evaluate the effect of surface microtopography and chemistry on the early stages of biomechanical rigidity with a sandblasted, dual acid-etched surface, with or w...
Fig. 1. PRISMA flow diagram of literature search
Fig. 1. PRISMA flow diagram of literature search
Study (year)
Sample (size)
Treatment group (size)
Methodology
Parameter
...
Study (year)
Sample (size)
Treatment group (size)
Methodology
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Sample
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Methodology
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Ethical statement
6
Study design
...
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...
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Abstract: structured summary of trial design, methods, results, and conclusions
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Luo, J., Miller, C., Jirjis, T. et al. The effect of non-steroidal anti-inflammatory drugs on the osteogenic activity in osseointegration: a systematic review.
Int J Implant Dent 4, 30 (2018). https://doi.org/10.1186/s40729-018-0141-7
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Received: 22 May 2018
Accepted: 13 July 2018
Published: 09 October 2018
DOI: https://doi.org/10.1186/s40729-018-0141-7
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 m...
Not applicable
Not applicable
Jie Denny Luo, Catherine Miller, Tamara Jirjis, Masoud Nasir, and Dileep Sharma declare that they have no competing interests.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
College of Medicine & Dentistry, James Cook University, 14-88 McGregor Road, Smithfield, QLD, 4878, Australia
Jie Denny Luo, Tamara Jirjis, Masoud Nasir & Dileep Sharma
College of Public Health, Medical and Veterinary Sciences, James Cook University, 14-88 McGregor Road, Smithfield, QLD, 4878, Australia
Catherine Miller
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The authors acknowledge and are grateful for the help and preparation of manuscript by the supporting research supervisors: Dr. Ernest Jennings and Prof. Alan Nimmo.
The systematic review is funded by James Cook University College of Medicine and Dentistry as part of a Dentistry Honours Research Project.
A meta-analysis was not conducted for this systematic review. The critical analysis tables t...
Winnett B, Tenenbaum HC, Ganss B, Jokstad A. Perioperative use of non-steroidal anti-inflammatory drugs might impair dental implant osseointegration. Clin Oral Implants Res. 2016;27(2):E1–7.
Goodman SB, Ma T, Mitsunaga L, Miyanishi K, Genovese MC, Smith RL. Temporal effects of a COX-2-selective NSAID on bone ingrowth. J Biomed Mater Res A. 2005;72((3):279–87.
Ribeiro FV, Cesar-Neto JB, Nocit...
Marquez-Lara A, Hutchinson ID, Nuñez F, Smith TL, Miller AN. Nonsteroidal anti-inflammatory drugs and bone-healing: a systematic review of research quality. JBJS Rev. 2016;4(3). https://doi.org/10.2106/JBJS.RVW.O.00055.
Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JPA, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate...
Salari P, Abdollahi M. Controversial effects of non-steroidal anti-inflammatory drugs on bone: a review. Inflamm Allergy Drug Targets. 2009;8(3):169–75.
Boursinos LA, Karachalios T, Poultsides L, Malizos KN. Do steroids, conventional non-steroidal anti-inflammatory drugs and selective Cox-2 inhibitors adversely affect fracture healing? J Musculoskelet Neuronal Interact. 2009;9(1):44–52.
Kaly...
Cyclooxygenase
Non-steroidal anti-inflammatory drug/s
Prostaglandin
Prostaglandin E2
The analgesic and therapeutic effects of NSAIDs are achieved by COX-2 inhibition [4]. It is likely that COX inhibition by NSAIDs is detrimental to the bone healing process, given the favourable actions of PG on this process [4]. Osteoblasts have the capacity to produce PGs, where PGE2 is most abundant, through the COX pathway though the evidence asserting that PGs have a direct role in bone healin...
The majority of the included studies revealed a high risk of bias, and conclusions from studies that have a high risk of bias are sufficient to affect interpretation of data [16,17,18]. Publication and selection bias is apparent in several included studies, as the negative effects of NSAIDs on osseointegration can be expected in the studies that administered NSAID at a high concentration and/or fo...
The influence of NSAIDS on bone healing in animal models has been shown to be related to the duration of treatment and drug selectivity [5]. A total of seven studies were identified that investigated the effect of NSAIDs on the osseointegration of titanium implants in animals: mice, rabbits, and rats (Table 8).
The duration of treatment is a factor to consider when using NSAIDs, and a study cond...
The effects of NSAIDs on the osteogenic activity of osteoblasts have been extensively studied at the molecular pharmacological level [23]. However, only two studies have been identified that investigated the effect of NSAIDs on osteoblasts attached to titanium surfaces (Table 6). In the study conducted by Boyan et al., their results demonstrated that a non-selective COX inhibitor (indomethacin, 0...
The eligibility and study selection criteria as mentioned above were applied to the 79 full-text articles. A total of 66 studies were excluded after a full-text assessment for the following reasons:
The study did not explore the role of COX pathway in osseointegration (n = 26).
The effects of NSAIDs on osteoblasts were not investigated on titanium (n = 24).
The study was a systematic re...
The full-text manuscripts of included studies were catalogued into in vitro, clinical, and in vivo studies. The data from the included studies were independently extracted by the primary (JDL) and the second reviewer (TJ) according to the “Data items” section as listed below. Disagreements or uncertainties were discussed with the third reviewer (MN) until an agreement was reached.
The data co...
An electronic search into four databases: Ovid, Pubmed, Scopus, and Web of Science was performed to systematically identify the available literature. Articles published between January 1, 1999, and July 7, 2018, were considered.
The focus question, used to guide the search strategy, according to the PICO schema is “Will variables such as the dosage, duration of administration, and selectivity o...
Cyclooxygenases have an important role in the production of PGs where these enzymes in bone tissues show increased activity under the influence of hypoxia-inducible factors [6, 11]. Therefore, local activity of COX enzymes promotes bone formation and resorption through the production of PGs [12]. Non-selective NSAIDs are reported to inhibit the activity of COX-1 equally, if not more than COX-2 [2]...
Non-steroidal anti-inflammatory drugs (NSAIDs) are a group of drugs with anti-inflammatory, analgesic, and antipyretic effects. They are commonly used in dentistry for management of dental pain associated with inflammation. NSAIDs exert their effects through the inhibition of the cyclooxygenase (COX) enzyme, therefore interfering with the synthesis of prostaglandins (PG) and thromboxanes; PGs and ...
Non-steroidal anti-inflammatory drugs are commonly used in implant dentistry for management of post-operative pain. The objective of this systematic review was to analyse the effect of non-steroidal anti-inflammatory drugs on the osteogenic activity of osteoblasts with an emphasis on its effect on osseointegration. A systematic literature search for in vitro, animal models, and clinical trials was...
Fig. 8. PPD on natural teeth. No significant differences appreciable
Fig. 8. PPD on natural teeth. No significant differences appreciable
Fig. 7. PPD on dental implants. No significant differences appreciable
Fig. 7. PPD on dental implants. No significant differences appreciable
between 1 month and 3 months, the test group values decrease during all the duration of the study
Fig. 6. BoP on natural teeth. While the control group shows a mild increase between 1 month and 3 months, the test group values decrease during all the duration of the study
Fig. 5. BoP on dental implants. It can be observed how the values keep decreasing after 1 month only in the test group
Fig. 5. BoP on dental implants. It can be observed how the values keep decreasing after 1 month only in the test group
Fig. 4. PI on natural teeth. After 1 month, the test group showed mild reduction while control a light improvement
Fig. 4. PI on natural teeth. After 1 month, the test group showed mild reduction while control a light improvement
Fig. 3. PI on dental implants. Test values keep reducing after 1 month while control maintains the same level
Fig. 3. PI on dental implants. Test values keep reducing after 1 month while control maintains the same level
Fig. 2. Patients’ population flow chart
Fig. 2. Patients’ population flow chart
Fig. 1. Electric toothbrush heads: on the left is the one designed for natural teeth, and on the right is the one designed for dental implants
Fig. 1. Electric toothbrush heads: on the left is the one designed for natural teeth, and on the right is the one designed for dental implants
Baseline
1 month
3 months
T0
T1
T2
BoP implants, t...
Allocca, G., Pudylyk, D., Signorino, F. et al. Effectiveness and compliance of an oscillating-rotating toothbrush in patients with dental implants: a randomized clinical trial.
Int J Implant Dent 4, 38 (2018). https://doi.org/10.1186/s40729-018-0150-6
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Received: 12 April 2018
Accepted: 24 October 2018
Published: 10 December 2018
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...
Not applicable
This study was conducted in compliance with the principles of the Declaration of Helsinki, and the approval of the ethics committee required for the study was obtained from the Ethics Committee of the IRCCS Ospedale Maggiore Policlinico di Milano, Fondazione Ca’ Granda. The procedures to be performed were explained in detail, and the patients signed the consent form.
Not applica...
Center for Edentulism and Jaw Atrophies, Maxillofacial Surgery and Dentistry Unit, Fondazione IRCCS Cà Granda – Ospedale Maggiore Policlinico, University of Milan, Via Commenda 10, 20122, Milan, Italy
Giuseppe Allocca, Diana Pudylyk, Fabrizio Signorino & Carlo Maiorana
Oral Surgery, Maxillofacial Surgery and Dentistry Unit, Fondazione IRCCS Cà Granda – Ospedale Maggiore Policlinico, Un...
Not applicable
The authors declare no funds for the research.
Mean data of PI, BoP, and PPD collected from 80 periodontal charts are shown in Table 1.
Berglundh T, Lindhe J. Dimension of the periimplant mucosa. Biological width revisited. J Clin Periodontol. 1996;23(10):971–3 PubMed PMID: 8915028.
Berglundh T, Lindhe J, Ericsson I, Marinello CP, Liljenberg B, Thomsen P. The soft tissue barrier at implants and teeth. Clin Oral Implants Res. 1991;2(2):81–90 PubMed PMID: 1809403.
Berglundh T, Abrahamsson I, Welander M, Lang NP, Lindhe J. Morp...
Quirynen M, De Soete M, van Steenberghe D. Infectious risks for oral implants: a review of the literature. Clin Oral Implants Res. 2002;13(1):1–19 PubMed PMID: 12005139.
Roos-Jansåker AM, Renvert S, Egelberg J. Treatment of peri-implant infections: a literature review. J Clin Periodontol. 2003;30(6):467–85 PubMed PMID: 12795785.
Ho HP, Niederman R. Effectiveness of the Sonicare sonic toothb...
Pjetursson BE, Lang NP. Prosthetic treatment planning on the basis of scientific evidence. J Oral Rehabil. 2008;35(Suppl 1):72–9. https://doi.org/10.1111/j.1365-2842.2007.01824.x PubMed PMID: 18181936.
Jung RE, Pjetursson BE, Glauser R, Zembic A, Zwahlen M, Lang NP. A systematic review of the 5-year survival and complication rates of implant-supported single crowns. Clin Oral Implants Res. 2008...
Bleeding on probing
Plaque index
Pocket probing depth
The oscillating-rotating toothbrush can be used for the plaque and bleeding control around both natural teeth and dental implants. It has also been shown how the toothbrush head designed for dental implant can be effective in plaque removing of the peri-implant tissues.
At the end of the present study, electric toothbrush groups showed plaque and bleeding values lower (PI and BoP on teeth) or at least without significative differences (BoP on implants) than the control group. These data may suggest how the use of electric toothbrush, associated to the dedicate heads, can be an effective method for plaque and bleeding reduction.
This 3-month study aimed to demonstrate the efficacy of an electric toothbrush in reducing plaque and gingival inflammation around dental implants and natural teeth. To better understand the different data collected around two different anatomical structures, we decided to collect data separately. Analyzing our results, it is possible to observe how the mean values for probing, bleeding, and plaqu...
The difference between the BoP recorded on dental implant sites at baseline and the end of the study showed statistical significance for both the test and control groups (P
Seventy-eight patients successfully completed the study (45 women and 33 men aged from 31 to 76 years old) (Fig. 2). Two patients of test group did not show up both at the first and second controls. No patients were excluded or showed complications or adverse reaction. Results are shown in Table 1. The average number of implants per patients was 4.8 ± 3.4 in the control group and 4.4 ±...
Mean scores of all clinical indices for each subject were calculated separately for dental implants and natural teeth. The final data analysis was performed for those subjects who completed the study. The Student’s t test and the Mann-Whitney U test were used to evaluate whether any statistically significant differences were present between the two groups at each time point, and the Wilcoxon sig...
The study was conducted between September 2015 and June 2017 at Implantology Department of Policlinic Hospital, University of Milan, Milan. It was designed as a monocentric randomized clinical study according to the STROBE criteria. Eighty patients who underwent dental implant rehabilitation were selected for this study. At the screening visit, subjects were asked to read and sign a written inform...
Dental implants became one of the most accepted treatments for the rehabilitation of partial or complete edentulism [1]. However, inflammatory processes may still occur due to the presence of the implant itself [2]. It is well known that peri-mucositis and peri-implantitis are strictly related to the presence of plaque on the surface of the implant-prosthetic complex, which lead respectively to th...
The aim of this randomized clinical trial was to assess the efficacy of an oscillating-rotating toothbrush in reducing plaque and inflammation around dental implants.
Eighty patients presenting dental implants were enrolled in this study and assigned randomly to two different groups: 40 patients in the test group and 40 in the control one. Each patient in the test group received an oscillating-ro...
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
...
Number of patients
Percentage
Pink esthetic score
Poor (0–7)
2
10.5%
...
Implant site
Biotype
Smile line
Placement timing
PES
WES
...
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 ...
Fig. 4. Statistical analysis for different variables. a Weighted mean survival rate. b Implant survival rate according to degree of penetration. c Analysis of clinical complications. d Analysis of radiographic complications
Fig. 4. Statistical analysis for different variables. a Weighted mean survival rate. b Implant survival rate according to degree of penetration. c Analysis of clinical com...
Fig. 3. Graphic representation of group 1 ≤ 4 mm penetration and group 2 > 4 mm penetrations
Fig. 3. Graphic representation of group 1 ≤ 4 mm penetration and group 2 > 4 mm penetrations
Fig. 1. Graphic representation of implants intruding sinus perforating or not the Schneiderian membrane
Fig. 1. Graphic representation of implants intruding sinus perforating or not the Schneiderian membrane
Fig. 2. PRISMA flowchart of the screening process
Fig. 2. PRISMA flowchart of the screening process
Reason for exclusion
Investigations
Study design (case series or case report)
Kim et al. (2017), Hatano et al. (2007)
Different grafting techn...
Author (year)
Study design
Follow-up (months)
N of patients
N of implants
Smokers
Le...
Clinical complications
Radiographic complications
Sinusitis
Thickening of Schneiderian membrane
Nasal bleeding, nasal obstruction, nasal secre...
Ragucci, G.M., Elnayef, B., Suárez-López del Amo, F. et al. Influence of exposing dental implants into the sinus cavity on survival and complications rate: a systematic review.
Int J Implant Dent 5, 6 (2019). https://doi.org/10.1186/s40729-019-0157-7
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Received: 09 October 2018
Accepted: 06 January 2019
Published: 05 February 2019
DOI: https://doi.org/10...
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...
Not applicable
Not applicable
Gian Maria Ragucci, Basel Elnayef, Fernando Suárez López del Amo, Hom-Lay Wang, Federico Hernández-Alfaro, and Jordi Gargallo-Albiol declare that they have no competing interests.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Correspondence to
Basel Elnayef.
Department of Oral and Maxillofacial Surgery, International University of Catalonia, C/Josep Trueta Sn, Sant Cugat del Vallés, C.P 08195, Barcelona, Spain
Gian Maria Ragucci, Basel Elnayef, Federico Hernández-Alfaro & Jordi Gargallo-Albiol
Department of Periodontics, University of Oklahoma Health Sciences Center – College of Dentistry, Oklahoma City, OK, USA
Fernando Suárez-López del ...
The authors want to thank Mr Juan Luis Gómez Martínez for the support in the statistical analysis.
Not applicable
Not applicable
The authors do not have any financial interests, either directly or indirectly, in the products or information listed in the paper.
Schwarz L, Schiebel V, Hof M, Ulm C, Watzek G, Pommer B. Risk factors of membrane perforation and postoperative complications in sinus floor elevation surgery: review of 407 augmentation procedures. J Oral Maxillofac Surg. 2015;73:1275–82.
Jung JA, Choi BH, Zhu SJ, Lee SH, Huh JY, You TM, Lee HJ, Li J. The effects of exposing dental implants to the maxillary sinus cavity on sinus complications....
Ardekian L, Oved-Peleg E, Mactei EE, Peled M. The clinical significance of sinus membrane perforation during augmentation of the maxillary sinus. J Oral Maxillofac Surg. 2006 Feb;64(2):277–82.
Anavi Y, Allon DM, Avishai G, Calderon S. Complications of maxillary sinus augmentations in a selective series of patients. Oral Surg Oral Med Oral Patho Oral RadiolEndod. 2008;106(1):34–8.
Van den Ber...
Curi MM, Cardoso CL, de Ribeiro C. Retrospective study of pterygoid implants in the atrophic posterior maxilla: implant and prosthesis survival rates up to 3 years. Int J Oral Maxillofac Implants. 2015;30(2):378–83.
Boyne PJ, James RA. Grafting of the maxillary sinus floor with autogenous marrow and bone. J Oral Surg. 1980;38(8):613–6.
Tatum H.Jr. Maxillary and sinus implant reconstructions....
Roccuzzo M, Bonino L, Dalmasso P, Aglietta M. Long-term results of a three arms prospective cohort study on implants in periodontally compromised patients: 10-year data around sandblasted and acid-etched (SLA) surface. Clin Oral Implants Res. 2014;25(10):1105–12.
Esposito M, Grusovin MG, Rees J, Karasoulos D, Felice P, Alissa R, Worthington H, Coulthard P. Effectiveness of sinus lift procedures...
The current review showed that the exposure of dental implants in the sinus cavity without the augmentation procedure or graft materials shows a high survival rate of 95.6%, without statistically significant differences according to the level of penetration (lower or higher to 4 mm). Changes in maxillary sinuses in relation to protruding implants within the sinus cavity do not statically affect ...
Consequently, it seems that maxillary sinus changes in relation to protruded implants inside the sinus cavity and does not statically affect to implant survival rate neither to clinical nor radiographic complications.
Several limitations could be described for the present review. Firstly, there is a lack of a control group in the included studies, to compare outcomes and complications, with impla...
Pneumatization of the maxillary sinus and resorption of the residual alveolar ridge following tooth extraction can compromise the dental implant placement. Similarly, extension of the dental implants inside the maxillary sinus cavity is not rare. Some studies have observed some differences in relation to the depth of the implant extension inside the sinus cavity. When the implants penetrate inside...
Seven studies [27,28,29,30,31,32,33] provide information on clinical complications with a global sample of 232 patients. Clinical complications among the different authors range from 0 to 14.3%, being the weighted mean complication rate 3.4% with an IC 95% [0 7.5] (Fig. 4c) Clinical complications analyzed in the studies were sinusitis, nasal bleeding, nasal obstruction, nasal secretion, mucopurul...
An initial screening yielded a total of 3551 publications of which 26 potentially relevant articles were selected after an evaluation of their titles and abstracts. Full text of these articles was obtained and evaluated thoroughly. Of these, eight articles [26,27,28,29,30,31,32,33] (Table 2) fulfilled the inclusion criteria and subsequently were included in the qualitative analysis (Fig. 2). Rea...
Heterogeneity was assessed based on calculation of the I2 statistic (percentage variability of estimated effect that can be attributed to the heterogeneity of the effects) and the null statistic test. Galbraith graphs displayed the degree of heterogeneity. In studies where great heterogeneity was detected, a sensitivity analysis was performed to determine its source. Funnel plots and the Egger tes...
Articles were included in this systematic review if they met the following inclusion criteria: human prospective or retrospective studies, reporting outcomes of implant placed perforating the sinus floor with implant burs, and without regenerative procedure (lateral sinus lift or transalveolar technique) and graft material. The intrusion into the sinus cavity can occur during drilling or implant p...
This systematic review and subsequent meta-analysis follow the guidelines of the PRISMA statement.
The following focus question was developed: Is the intrusion of dental implants into the sinus cavity during implant drilling or implant placement, without regenerative procedure (lateral sinus lift or transalveolar technique) and graft material, has an effect on implant survival or increase clinica...
Intrusion of dental implants into the maxillary sinus perforating through the Schneiderian membrane is considered a cause of undesirable complications [24, 25]. However, this phenomenon has never been properly evaluated and systematically studied. For this reason, the aim of this systematic review was to assess the implant survival and complication rates of implants intruding into the sinus cavity...
The edentulous posterior maxillary region often presents with unique challenging conditions in implant dentistry [1]. Limited bone height secondary to pneumatization of the maxillary sinus and the resorption of the alveolar ridge preclude in many instances the installation of dental implants. To compensate for the lack of bone height, several treatment options have been proposed.
The most conserv...
The overall survival rate of the implants into the sinus cavity was 95.6%, without statistical differences according to the level of penetration. The clinical and radiological complications were 3.4% and 14.8% respectively. The most frequent clinical complication was the epistaxis, and the radiological complication was thickening of the Schneiderian membrane, without reaching statistical significa...
After tooth loss, the posterior maxilla is usually characterized by limited bone height secondary to pneumatization of the maxillary sinus and/or collapse of the alveolar ridge that preclude in many instances the installation of dental implants. In order to compensate for the lack of bone height, several treatment options have been proposed. These treatment alternatives aimed at the installation o...
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...
Figure 6. BIC percentage measured with ImageJ analysis software
Figure 5. Time arrow about the stages of the study
Figure 4. A 2-month period was allowed for plaque retention and peri-implantitis
Figure 3. Silk ligatures placed in a submarginal position around the implants
Figure 2. Edentulous posterior mandible of the dog at 3 months after tooth extraction
Figure 1. Flowchart of the research design employed in the study. *Three dogs were used in each group 1 and 2. Three implants were inserted right side of the mandibles. After peri-implantitis period, extracted implants were inserted into the left side of the mandibles. **Two dogs were used in each group 3 and 4. Six failed implants from human inserted into the one dog’s mandible bilaterall...
Table 3 Inter- and intra-group ISQ analysis and measurements on day of surgery and at 3-month follow-up
Mean ± SDISQ day 0
Mean ± SDISQ at 3 month
p
Group 1
69.33 ± 8.48
77.77 ± 1.78
.019
Group 2
68.88 ± 5.90
79.44 ± 2.55
.001*
Group 3
71.77 ± 5.71
75.11 ± 5.84
.366
Group 4
70.44 ± 5.15
79.12 ± 4...
Table 2 Comparison of BIC percentages of 3 mm crestal area of the implants at 3-month follow-up
Group 1[Mean ± SD]
Group 2[Mean ± SD]
Group3[Mean ± SD]
Group 4[Mean ± SD]
p
77.67 ± 5.03
75.28 ± 10.65
71.86 ± 8.34
80.63 ± 5.58
.144*
Group 1[Mean ± SD]
Group 2[Mean ± SD]
Group3[Mean ± SD]
Group 4[Mean± SD]
p
83.39 ± 6.37
79.93 ± 11.83
75.45 ± 9.09
80.53 ± 5.22
290*
Levin et al. conducted a similar study and investigated the success rate of retrieved dental implants that were re-implanted into dogs. The infected implants were re-implanted into dog jaws without any chemical or mechanical cleaning and the authors reported that there was no difference in terms of BIC percentage between the infected/reinserted and new dental implants after a...
Levin et al. conducted a similar study and investigated the success rate of retrieved dental implants that were re-implanted into dogs. The infected implants were re-implanted into dog jaws without any chemical or mechanical cleaning and the authors reported that there was no difference in terms of BIC percentage between the infected/reinserted and new dental implants after an appropriate he...
Discussion
Approximately two million new dental implants are inserted per year around the world and tens of millions of implants are still in use. Moreover, it is estimated that approximately 200,000–250,000 implants are removed every year. Peri-implantitis is the major cause of the implant retrieval and also the most common complication caused by implant surgery. Mombelli et al. reported...
Results
The experimental period and the laboratory workup of the study were unremarkable. Surgical operations were uneventful and the post-operative healing periods were completed with no complications. Histologic analysis and the ISQ values indicated that osseointegration was achieved in all the implants.
Histomorphometric analysis
Histomorphometric analysis demonstrated that adequate bone f...
Removal and preparation of the implant-bone specimens
The implants with a neighboring bone were removed en bloc, and the adhesive soft tissues were dissected to investigate the healing status and the bone-implant contact (BIC) percentage. The specimens were fixed in 10% neutral buffered formalin for 48 h and dehydrated in subsequent concentrations of 70–99.9% ethanol. After dehydration, the sp...
Subsequently, the implant surfaces were rinsed with sterile saline solution and then all the implants were inserted in the contralateral side of the mandible of the same dog. After a 3-month osseointegration period, the animals were sacrificed with a high dose of pentobarbital (i.v.).
In group 2, the same procedures were applied as in group 1. However, unlike the implants in group 1, the implants...
Infiltration anesthesia with 2% articaine (Ultracaine DS, Sanofi Aventis Drugs, Istanbul, Turkey) was applied to the premolar area for hemostasis and for post-operative pain control. A full-thickness vestibular flap was elevated gently, and surgical tooth extraction was performed using surgical burs with straight elevators. Surgical wounds were closed with 3/0 vicryl sutures and streptomycin 0.5 g...
Methods
Research design
This in vivo study had a comparative, randomized, prospective research design, and each group consisted of 10 male beagle dogs that were veterinarian-controlled, healthy, and of similar weight. Animal Research Reporting in Vivo Experiment (ARRIVE) guidelines were used, and surgical procedure was approved by the Local Animal Experiments Ethical Committee of Erciyes Unive...
Background
Branemark et al. conducted the first experimental trial with titanium dental implants and created a new vision by defining the term “osseointegration” in the 1960s. Despite the advances in implant technology and protocols and the accumulating evidence in the literature, implant failure/loss may still occur due to several reasons. On the other hand, although dental implant therapy...
Reusing dental implants: an experimental study for detecting the success rates of re-osseointegration
Abstract
Background
The aim of this study was to histomorphometrically compare the implant-host integration between retrieved implants and new implants.
Methods
Jaws in 10 male beagle dogs were divided into four groups, and 36 dental implants were inserted into the jaws. In groups 1 and...
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 ...
Figure 4. Kaplan-Meier implant survival curves for bone and bone substitutes
Figure 3. Kaplan-Meier survival curves for membrane types
Figure 2. Kaplan-Meier implant survival curves for augmentation procedures
Figure 1. a Kaplan-Meier survival curves for implants with or without augmentation. Dashed line 95% confidence interval. b Kaplan-Meier survival curves for single crown implants overall and with or without augmentation. Dashed line 95% confidence interval
Table 5 Implants lost and in function up to 20.2 years after implant insertion using different graft materials
Graft material
Implants (n)
Min/max observation time (years)
Lost implants % (n)
Absolute survival rate %
p value
No graft material
4609
0.0/20.2
5.51 (254)
94.49
Geistlich Bio-Oss
2939
0.0/15.6
2.76 (81)
97.24
0.0004
Autogenous bone particles
...
Table 3 Explantations of implants inserted using different augmentation procedures up to 20.2 years after implantation
Augmentation procedure
Implants(n)
Lost implants % (n)
Absolute survival rate %
p value
No augmentation
4242
5.72 (243)
94.28
Lateral augmentation
3210
4.02 (129)
95.98
0.0010
External sinus lift one-step
1101
4.09 (45)
95.91
0.032...
Table 2 Implant loss in augmented and non-augmented sites up to 20.2 years after implant insertion
Augmentation
Implants (n)
Lost implants % (n)
Early implant loss % (n)
Late implant loss % (n)
Absolute survival rate %
No augmentation
4242
5.73 (243)
0.38 (16)
5.35 (227)
94.27
With augmentation
5916
3.67 (217)
0.32 (19)
3.35 (198)
96.33
Total
10158
4.53 ...
Table 1 Distribution of implants according to the period of observation
Year
Number of implants
Relative number of implants (%)
References
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(Suppl):43–61.
Nkenke E, Neukam FW. Autogenous bone harvesting and grafting in advanced jaw resorption: morbidity, resorption and implant survival. Eur J Oral Implantol. 2014;7 Suppl 2:S203–17.
von ...
In addition, Buch et al. compared the different criteria proposed for implant success with regard to their clinical value. The authors demonstrated that the proposed criteria led to very different success rates 6 years after implant insertion (75–89%) and did not allow reliable comparison of the results with each other. Thus, during control visits in our practices, only prosthetic complica...
The most often used graft material in our evaluation was Geistlich Bio-Oss (53.0%) followed by autogenous bone (32.5%). When compared to no graft, the use of both grafts resulted in significantly higher implant survival rates. In various studies, the bone substitute was found to promote bone regeneration and to allow for long-term stability of the augmented volume. A recent meta-analysis com...
However, there are also a few clinical studies in which reduced survival rates for implants inserted in grafted areas were found. Differences in numbers of implants analysed, surgical techniques, indications and/or graft materials may account for these inconsistent results and further studies might be needed.
In the retrospective analysis shown here, the comparison of different augmentation...
Discussion
The retrospective analysis presented here evaluates implants inserted in three different private practices with or without augmentation procedures. Treatments were performed according to the standard protocols applied in the private practices. More than 10,000 implants were inserted in various indications and were followed up to 20.2 years from the day of implant insertion. The o...
When looking into the Kaplan-Meier implant survival curves of the augmentation procedures using the log-rank test, the highest implant survival was found for bone condensing followed by lateral augmentation, internal sinus lift, transplantation of bone blocks, bone splitting/spreading, titanium mesh, external sinus lift (one- and two-step) and finally, no augmentation. This sequence was statistica...
Results
Of the 10,158 implants, 58.2% (5916 implants) were inserted using an augmentation procedure. The minimal observation period until the last control visit or until explantation was 0 days (day of implantation); the maximum period was 20.2 years. Distribution of analysed implants according to the period of observation is shown in Table 1.
A total of 4.53% (460 implants) of all implants...
The membranes applied included the native collagen membrane Geistlich Bio-Gide (Geistlich Pharma AG, Wolhusen, Switzerland) either alone or combined with one of the following membranes: Vicryl (Johnson & Johnson Medical GmbH, Norderstedt, Germany), Biovin Membran (OT Medical, Bremen, Germany), Parasorb Vlies (Resorba, Nuremberg, Germany), Gore-Tex Resolut (W.L. Gore & Associates, F...
The membranes applied included the native collagen membrane Geistlich Bio-Gide (Geistlich Pharma AG, Wolhusen, Switzerland) either alone or combined with one of the following membranes: Vicryl (Johnson & Johnson Medical GmbH, Norderstedt, Germany), Biovin Membran (OT Medical, Bremen, Germany), Parasorb Vlies (Resorba, Nuremberg, Germany), Gore-Tex Resolut (W.L. Gore & Associates, Flagstaff, USA), ...
Methods
The retrospective analysis evaluates patients who underwent implant therapy with or without accompanying augmentation procedures between August 1991 and December 2011 in three private practices. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines were followed. To investigate the effect of the different techniques applied on implant survival without ...
Background
Replacing missing teeth with dental implants is a routine treatment in many dental practices. In order to achieve adequate functional and aesthetic results, an optimal three-dimensional implant position has to be assured. Various materials are available to build up missing bone. While autogenous bone is usually regarded to be the gold standard, harvesting may be associated with morbi...
Retrospective analysis of 10,000 implants from insertion up to 20 years—analysis of implantations using augmentative procedures
Abstract
Background
A sufficient amount of bone is essential to ensure long-term stability of dental implants. To support the bone regeneration process, different techniques and materials are available. It has been questioned whether these techniques and materials...
Item
Mean ± SD pre-operative
Mean ± SD post-operative
Mean ± SD in the last time
Have you felt pain in your mouth?
0.9 ± 1.1
1.2 ± 1.0
0.3 ± 0.6
Have you had difficulties with your mouth opening?
0.2 ± 0.6
0.5 ± 0.9
0.1 ± 1.0
Have you had painful gums?
0.9 ± 1.0
1.0 ± 1.1
0.5 ± 0.8
Have you had a ...
Item
Mean ± SD before sinus lift
Mean ± SD after sinus lift
p value
Have you felt tense because of problems with your teeth, mouth or dentures?
1.8 ± 1.1
0.8 ± 1.0
Item
Mean ± SD before sinus lift
Mean ± SD after sinus lift
p value
Have you had difficulty chewing any foods?
1.6 ± 1.2
0.4 ± 0.7
Figure 5. Total score for physical and psychological disabilities before (gray) and after (hatched) sinus augmentation according to indications
Figure 4. Total score for functional limitations before (gray) and after (hatched) sinus augmentation according to indications
Figure 3. Total score for complaints due to surgical procedure pre-operative, post-operative, and recently
Figure 2. Cumulative survival rate according to Kaplan–Meier and sinus augmentation procedure
Figure 1. Flow chart of patients included in the study
Figure 1. Flow chart of patients included in the study
References
Al-Nawas B, Schiegnitz E. Augmentation procedures using bone substitute materials or autogenous bone—a systematic review and meta-analysis. Eur J Oral Implantol. 2014 Summer;7 Suppl 2:S219-34.
Derks J, Hakansson J, Wennstrom 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(...
The authors concluded that in clinical decision-making regarding donor site for bone graft harvesting, patients and clinicians should consider expected decrease in HRQoL if deciding to use extra-oral donor sites. Therefore, the authors recommended to prefer intra-oral donor sites whenever possible. In a recent study of Nickenig et al., OHIP-G 21 was evaluated in 8689 patients with variou...
In this prospective study, health-related quality of life questionnaire was given to 76 patients evaluating patient perception of recovery in the four areas pain, oral function, general activity, and other symptoms. The results showed that average and maximal pain peaked on post-operative day 1 and improved on post-operative days 4 and 5. Difficulty in mouth opening was greatest on pos...
Discussion
The clinical and radiological outcomes of sinus augmentation procedures have been published in several studies. However, little data on the physical and psychological impact of this procedure on the patient is available yet. The present study evaluated pre-operative and post-treatment OHRQoL self-assessment scores of patients treated with dental implants after sinus augmentation ...
In the subcategory physical and psychological disabilities, all questions had significant better values after the sinus lift (p
Results
Survival analysis
After an average time in situ of 41.2 ± 27 months (3.4 years; range 0–96 months), 40 of the 863 implants were lost. These results indicated an in situ rate of 95.4%. One-year and five-year survival rate according to Kaplan–Meier were 95.4 and 94.4%. In patients receiving an external sinus lift an in situ rate of 95.1% and in patients with an internal sinus...
Methods
Study design and subjects
This retrospective study addresses the oral health-related quality of life after maxillary sinus augmentation. Therefore, all patients that received an implantation after maxillary sinus augmentation in the Department of Oral and Maxillofacial Surgery of the University Medical Centre Mainz, Germany, between July 2002 and December 2007 were included in this stu...
Background
Rehabilitation of completely and partial edentulous patients with dental implants has proved to be a safe and predictable procedure. However, reduced bone height and the proximity of the maxillary sinus are challenging limitations for dental implant placement in the posterior maxilla. Besides the use of short and tilted implants, one of the most frequently used surgical techniques fo...
Abstract
Background
The aim of this study was to measure the oral health-related quality of life (OHRQoL) after maxillary sinus augmentation to determine the physical and psychological impact of this procedure for the patient.
Methods
Three hundred sixteen patients treated with an external or internal maxillary sinus augmentation and a total of 863 implants in the Department of Oral and Maxi...
Figure 5. Osteoblasts with an orientation tendency after 24 h of rotation (phallacidin fluorescence staining). On the left side with 200× and on the right side with 400× magnification. The yellow arrows show the orientation of the cells. The red arched arrow within the coloured circle shows the direction of rotation. The dashed white line oriented to the right stands for the r...
Figure 4. Randomly orientated osteoblasts without influence of rotation (phallacidin fluorescence staining). On the left side with 200× and on the right side with 400× magnification. The white X on the coloured circle marks the location upon the plate where the osteoblasts were located. The red X marks the centre of the plate
Figure 3. Diagram for visualisation of the calculation of shear stress rates taking into account the centrifugal force and the glass plates’ dimensions. For example, at a distance of 25 mm from the centre of the upper plate, the shear forces’ value is 8.33 dyn/cm2, together with an additional centrifugal force that has a value of 0.55 dyn/cm2
Figure 2. Side view of a computerized simulation, showing the flow chambers’ lower compartment and the flow profile in between the two plates; shearing gap and bottom plate are shown on the left side; rotation speed = 200 rpm; colour code bar (left edge) showing shear force values [Pa] [1 Pa = 10 dyn/cm2]; flow direction presented by arrows
Figure 1. Three-dimensional illustration (a–e) and photography (f) of the experimental setup with the components marked numerical. a 1 Lower petri dish (s’ bottom serving as the lower plate); 2 Rotating glass panel [60 mm diameter (cell bearing)]; 3 Titanium axis. b 4 Liquid medium (red). c 5 Reversed upper petri dish. d 6 Gearwheel with set screw. e 7 Closing; 8 Electronic motor device and ...
References
Ehrlich PJ, Lanyon LE. Mechanical strain and bone cell function: a review. Osteoporos Int. 2002;13(9):688–700.
Vaughan TJ, Haugh MG, Mcnamara LM. A fluid-structure interaction model to characterize bone cell stimulation in parallel-plate flow chamber systems. J R Soc Interface. 2013;10(81):20120900.
Weinbaum S, Cowin SC, Zeng Y. A model for the excitation of osteocytes by mec...
Besides, in the model reported in this study, microscopic examinations are possible after completing the experiment only. Nevertheless, an advantage of the new flow chamber is the possibility of testing different cell colonies simultaneously in one single experiment by placing cells in different radial locations on the spinning disc. Due to the current flow gradient from the centre to the pe...
Due to the fact that constant flows were generated within the parallel flow chamber only, the situations of in vitro experiments differ from in vivo setting where dynamic flow profiles are particular. As the constant laminar flow profile is not physiological in bones, vessels and other tissues, the informative value of the experimental setting is limited but it could be used for various cell...
Further on, the simulations indicated that the flow profile in between the two plates was not influenced by peripheral turbulences alongside the peripheral regions. To verify a cellular realignment towards the shear direction, cells were microscopically examined prior and after exposure to shear forces for 24 h upon a spinning disc at a speed level of 200 rpm. Even if not sufficiently ...
Discussion
The aim of this study was to establish a new FSS model that is easy to use as well as simple to assemble in order to create reproducible fluid shear forces on cells close to implant material surfaces. Todays’ commonly used commercial flow devices differ in geometry and function, which makes comparisons between experiments difficult. The benefits of this novel testing device are...
Regarding the upper compartment, peripheral turbulent flow along the outer edges was similar to the fluid movements within the area in between the plates. At the top, the turbulent flow directed from the centre to the periphery whereas the turbulences at the bottom were orientated in reverse to that. Moreover, the effect of the shear forces on the osteoblast cells was also influenced by the centri...
Results
Our analysis was focused on two main aspects:
Simulation of the fluid flow characteristics as well as quantification of the arising shear forces at the plate/plate flow chamber with reliable reproducibility
Assessment of the impact of fluid shear stress on osteoblast cells in terms of altered cell morphology and intracellular structural changes
Evaluation of the f...
Test procedure
The experimental process involved three steps. First, a count of n = 50.000 commercially available osteoblasts (PromoCell, Heidelberg, Germany) per millilitre of culture medium were cultured on the bottom of the cell-bearing surface (glass panel). Therefore, cells were seeded in a culture medium (cf. Appendix 2 for a detailed composition) at 37 °C. Prior to the test proce...
Analytical formula for evaluating the flow characteristics
Frequently used flow chambers are characterised by an internal fluid flow along a stationary cell-bearing surface, whereas the osteoblast test cells of this newly developed model are circulating within a resting culture medium.
For constant and fully developed laminar flow between the two parallel plates, the magnitude of the wall sh...
Methods
Experimental setup
A three-dimensional illustration and photography of the plate/plate flow chamber model is shown in Fig. 1. A detailed list of used parts can be found in Appendix 1.
The circulation within the flow chamber was generated by an externally attached electric motor, which rotates up to 500 rounds per minute (rpm). A commercial grade 4 pure medical titanium gear shaft (len...
Abstract
Background
Mechanostimuli of different cells can affect a wide array of cellular and inter-cellular biological processes responsible for dental implant healing. The purpose of this in vitro study was to establish a new test model to create a reproducible flow-induced fluid shear stress (FSS) of osteoblast cells on implant surfaces.
Methods
As FSS effects on osteoblasts are detectabl...
Abbreviations
BP:
bisphosphonate
BP-ONJ:
bisphosphonate-associated osteonecrosis of the jaws
CTX:
C-terminal telopeptide of the type I collagen
PICO:
patients intervention control outcome
PRISMA-P:
preferred reporting items for systematic reviews and meta-analyses protocols
QoL:
quality of life
ST:
search term
TMJ:
temporomandibular joint
...
Next to this, the patients need to be compliant with an appropriate motivation for oral hygiene and the necessary skills to transfer this. Infectious foci should be treated before implant therapy to further reduce the risk of osteonecrosis development. The surgical sites should be followed up clinically (persisting sharp bone edges without any tendency to remodel) and radiologically (e...
Although there are only very few cases in the literature with augmentation of bone/sinus lift, these procedures are linked to a functioning vascular recipient site with working osteoclastic resorption and osteoblastic bone formation, and this is compromised in patients with antiresorptive therapy. Due to the denudation of the bone at the recipient site the vascular situation might be e...
Discussion
Even latest guidelines and statements dealing with medication associated osteonecrosis of the jaws such as the American, Scottish, Swiss or German do not address implant therapy in these patients in detail. Due to this lack of data a systematic literature review was performed to fill this gap. Unfortunately the literature dealing with this topic is very sparse and consists mainl...
Nibbe analyzed 128 patients with IV BP or denosumab separated into 3 groups. In the first group 5 out of 60 patients with no denture had an osteonecrosis (8%), in the 2nd group 5 out of 34 patients with a fixed partial denture had an osteonecrosis 15%, and in the 3rd group 11 out of 34 patients with a removable denture had an osteonecrosis (32%). Kyrgidis determined that dentures increase the ris...
Results
Out of 606 articles 556 articles were excluded because they were either duplicates, case reports, narrative reviews, case series with less than 5 cases or were not associated with the topic at all (Table 1 and Fig. 1). Some of the articles analyzed more than one outcome and are referred to several times. Since the available literature is very inhomogeneous with a low level of evidence a...
Introduction
Bisphosphonate-associated osteonecrosis of the jaws (BP-ONJ) is a well-known side effect in patients receiving bisphosphonates (BP) due to e.g. osteoporosis, multiple myeloma or malignant diseases with metastases to the bone; prevalences range between 0.1% for patients with primary osteoporosis to 1% in patients with secondary osteoporosis and up to about 20% for special high risk ...
Dental implants in patients treated with antiresorptive medication – a systematic literature review
Abstract
Objective
Bisphosphonate-associated osteonecrosis of the jaws (BP-ONJ) is triggered by inflammatory processes. Typical trigger factors are periodontal disease, denture pressure sores, and surgical interventions such as tooth extractions. Unfortunately there is only little data on how...
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...
Figure 3. Postoperative radiograph of the resected dental implant in the right anterior maxilla
Figure 2. On radiological examination, it was confirmed that the dental implant had perforated the cortical bone of the right nasal floor
Figure 1. On anterior rhinoscopy, the apical part of the titanium dental implant in the right anterior maxilla was seen in the nasal floor close to the nasal septum
Discussion
Insertion of endosseous dental implants is usually associated with a low incidence of complications and excellent prognosis. However, physiologic changes following tooth loss may complicate or even impede insertion of dental implants in the upper jaw. Furthermore dental implants can only be inserted if there is sufficient bone for adequate stabilization. Therefore, in severely at...
Background
Endosseous dental implants are commonly used to rehabilitate fully or partially edentulous patients. The insertion of such implants can in some cases cause complications, especially in the edentulous atrophic maxilla. In this paper, an unusual complication of altered nasal airflow after the placement of an endosseous dental implant in the maxilla is presented. Subsequent treatmen...
Altered nasal airflow: an unusual complication following implant surgery in the anterior maxilla
Abstract
Dental implants have been in routine clinical use for over three decades and are a predictable treatment modality. However, as with all other aspects of dentistry, complications occur. A 50-year-old female patient with complaints of a long ongoing unpleasant altered nasal airflow presented...
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...
BIC
3M™ ESPE™ MDIs
Ankylos® Friadent (Dentsply)
Median
58.5
57
Mean
57
56.5
Interquartile range
8
5.5
First quartile
53.25
53.75
Third quartile
61.25
59.25
Sample
3M™ESPE™ MDIs
Ankylos®
1.
67
54
2.
59
67
3.
54
45
4.
51
58
5.
47
57
6.
64
49
7.
50
54
8.
60
56
9.
56
60
10.
61
53
11.
62
59
12.
61
55
13.
59
59
14.
45
51
15.
58
59
16.
54
62
17.
66
62
18.
56
57
Figure 6. Micro CT scan images of the MDIs and Ankylos® embedded in rabbit bone 6 weeks post implantation
Figure 5. Histological section of standard implant in rabbit tibia stained with methylene blue and basic fuchsin
Figure 4. Histological section of mini dental implant in rabbit tibia stained with methylene blue and basic fuchsin
Figure 3. Histological sections being obtained with Leica SP 1600 saw microtome
Figure 2. Leica SP 1600 saw microtome
Figure 1. Radiograph showing implants in the rabbit tibia
Our study is also in concordance with the results of a removal torque study by Simon et al. in immediately loaded “transitional endosseous implants” in humans. The percentage BIC for MDIs was similar to standard implants.
The surface topography also affects the BIC, Wennerberg et al. measured and compared removal torque values on screw-shaped titanium implants with three surface types. ...
Discussion
The osseointegration potential of 3M™ESPE™ MDIs has not been studied. The MDI is a one-piece implant that simplifies the restorative phase resulting in a reduced cost for the patient. Titanium-aluminum-vanadium alloy (Ti 6Al-4V-ELI) is used for increased strength. The success of these implants led to its use in long-term fixed and removable dental prostheses. Conventional imp...
Results
Clinical findings
On the whole, postoperative wound healing in all the rabbits was good. None of them exhibited any signs of wound infection or exposure. A total of 36 specimens were retrieved for histological examination.
Histological observations
All of the implants in both groups showed osseointegration and displayed a good amount of bone contact length (Figs. 4 an...
The built-in water cooling device prevents overheating of the object and removes saw dust from the cutting edge and thus prolongs the lift time of the saw blade. The most favorable feed rate was determined (Fig. 3). After trimming, the first undefined slice was removed from the saw blade. The desired section thickness was selected, considering the thickness of the saw blade and added to the desire...
Sample preparation for embedding
The specimens were dehydrated in the ascending graded ethanol solution and kept in a pre-filtration solution for 3 h at room temperature and then in the filtration solution at 4 °C for 17 h. The specimens were then embedded in a light curing resin Technovit 9100 NEW (Kulzer & Co., Wehrheim, Germany) polymerization system based on methyl methacrylate, speci...
The skin was sutured to a primary closer with the same suture material.
Radiograph
Plain X-ray images of all the rabbit tibia were taken after suturing to confirm the position of implants and to detect any injury/fracture of the bone (Fig. 1).
Post surgical treatment
After the surgical procedure, the animals were housed in a cage under the supervision of a veterinary doctor until they came out...
After mobilizing the mucoperiosteal flap, the 3-mm center punch was used to register a guide for the twist drill. The twist drill was used to establish the axial alignment of the implant and to assist in the guidance of the depth drill. The depth drills were sequentially used to create osteotomy to the subcrestal axial depth of 0.5 mm. The conical reamer was used to develop the conical shape of t...
Antiseptic skin preparation was done starting at the center of the surgical site and moved to the outside of the prepared area in a circular manner. Three scrubs with 2% chlorhexidine solution and three alternating rinses with alcohol were performed. The animal was draped and fixed with clamps on a sterile, impermeable covering to isolate the disinfected area. This was performed by the gloved and ...
Methods
Animal model
Nine clinically healthy New Zealand white rabbits weighing 3.5 kg and more were used for the study, and the animals were housed in the central animal house facility. The head of tibia/femur of the animals were used for the implantation of samples. Rabbits’ tibiae and femur have been widely used as an animal model by various other authors to study osseointegration of dent...
Considerable confusion exists in the literature regarding the best method to monitor the status of a dental implant. Various methods have been used to demonstrate the osseointegration of dental implants. A common and time-tested method to evaluate biological responses to an implant is to measure the extent of bone implant contact (BIC), referred to as histomorphometry at the light microscopic leve...
Background
The term “osseointegration” was first introduced to explain the phenomenon for stable fixation of titanium to bone by Brånemark et al. in the 1960s. Osseointegrated implants were introduced, a new era in oral rehabilitation began, and many studies were conducted. A success rate of over 90% has been reported. Further, a success rate of 81% in the maxillary bone and 91% in the man...
Abstract
Background
Mini dental implants (MDIs) are becoming increasingly popular for rehabilitation of edentulous patients because of their several advantages. However, there is a lack of evidence on the osseointegration potential of the MDIs. The objective of the study was to histomorphometrically evaluate and compare bone apposition on the surface of MDIs and standard implants in a rabbit m...
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...
Figure 3. Erythroid, granulocytic, monocytic and lymphocytic series are illustrated, as well as megakaryocytes (hematoxylin and eosin, original magnification ×400)
Figure 2. Normal hematopoietic cells, fat cells and bone trabeculae (hematoxylin and eosin, original magnification ×200)
Figure 1. The periapical radiograph revealed the presence of an extensive and poorly circumscribed osteoporotic area around the proximal implant
Only few cases of the focal osteoporotic bone marrow defect associated with dental implants has been described in the English literature. Sençimen et al. (2011) reported a clinical case in which the focal osteoporotic bone marrow defect occurred 2 years postoperatively apical to a dental implant in posterior mandible region and the diagnosis was established based on the combination of clini...
Case presentation
An 84-year-old white woman was referred to private dental clinic for an implant rehabilitation treatment. Intraoral examination revealed healthy mucosa and there was not any sign of infection. Her past medical history was unremarkable. The radiography of the molar region showed with a quite ill-defined radiolucent area presenting irregular borders associated to dental impl...
Abstract
In oral implantology, the most serious complications occur intraoperatively or within a short period. We describe an unusual case of focal osteoporotic bone marrow defect involving dental implant in the posterior mandibular region of the adult woman. Despite the fact that this condition requires no treatment, it could lead to the displacement of the dental implant. Additionally, th...
Figure 4. Sublingual artery originating from an anastomotic branch of the lingual and submental arteries: h submental artery, i hypoglossal artery, j lingual artery, and k anastomosis of the lingual and submental arteries
Figure 3. Submental artery as the source of the sublingual artery entering the MMLF: e submental artery, f inferior border of the mandible, and g facial artery
Figure 2. Lingual artery as the origin of the sublingual artery entering the MMLF: a external carotid artery, b lingual artery, c hypoglossal nerve, d right and left sublingual arteries originating from the ipsilateral lingual arteries and e inferior border of the mandible
Figure 1. Distribution of cadavers according to source of artery entering the MMLF (n = 34)
Figure 1. Distribution of cadavers according to source of artery entering the MMLF (n = 34)
The sublingual and submental arteries normally anastomose through their muscular mylohyoid branches. Loukas et al. only identified anastomotic patterns between sublingual and submental arteries in 40 % of the dissected cadavers, with no case where the two terminate as a single sublingual artery. We found three (8.9 %) cases of an anastomotic branch of the submental and lingual artery formi...
The MMLF is a consistent structure through which the sublingual artery enters the mandible. Perforation of the lingual plate by an implant drill poses a high risk of trauma to this vessel especially when the sublingual fossa is very pronounced because this vessel courses closely to the gland and fossa. When this artery is of a significant size, it is possible for 420 mL of blood to escape in...
Results
A total of 34 human cadavers were dissected in this study of which 30 (88.2 %) were males and 4 (11.8 %) were females (male/female, 15:2) aged between 25 and 40 years. The linear distance between the MMLF and the inferior border of the mandible ranged from 11.03 to 19.62 mm (mean = 15.58 mm ± 2.12 SD). The mesio-buccal thickness of the mandible at the level of the MMLF ra...
Methods
This was a cadaveric dissection study involving 34 human adult cadavers of indigenous Kenyan descent carried out at the Department of Human Anatomy, University of Nairobi. Majority of these cadavers are unclaimed bodies in the city of Nairobi, whose demographics are hardly known. Approval to conduct the study was obtained from the Kenyatta National Hospital/University of Nairobi Ethics,...
Background
The inter-foraminal region of the human mandible is a common elective area for several dental surgery procedures due to its favourable anatomic conditions. Some of the procedures done in this region include insertion of endosseous dental implants, bone harvesting from the chin, genioplasty in orthognathic surgery and placement of screws during plating in management of facial fracture...
Abstract
Background
Inter-foraminal implant placement poses a risk to the sublingual artery as it enters the mandibular midline lingual foramen. Lack of consensus on the source of this artery poses a dilemma to surgeons during management of haemorrhagic episodes. Determination of the exact source of this artery is therefore pivotal.
Methods
This was a cross-sectional descriptive study involv...
Dental
Orthopedic
Medical
Environment
Basic
Titanium toxicity
82
102
150
252
643
Titanium alloy toxicity
42
30
35
5
37
Titanium implant toxicity
37
56
22
3
74
Titanium implant corrosion
145
63
22
7
220
Titanium allergy
22
26
20
2
15
Yellow nail syndrome
–
–
250
–
6
Total
328
277
499
269
995
1991–1995
1996–2000
2001–2005
2006–2010
2011–2015
2016–2018
Titanium toxicity
30
58
81
216
432
412
Titanium alloy toxicity
12
17
30
18
40
32
Titanium implant toxicity
8
20
30
26
53
55
Titanium implant corrosion
20
48
59
88
122
120
Titanium allergy
2
5
5
21
22
30
Yellow nail syndrome
22
30
31
39
61
73
...
Conclusion
Titanium is used in many fields in addition to being used in dental implants. As the use of titanium increases, concerns over safety are increasing as well. In recent years, studies with regard to titanium toxicity have been on the rise. Although they have mainly been focused on environmental and basic fields, studies are now expanding into the medical field. Thus, there is a need fo...
Alternative methods of implant materials are under investigation for the risk of titanium. Typically, these include zirconia and polyetheretherketone (PEEK) dental implants. These materials are considered to be alternatives to the hypersensitivity of titanium and are aimed at improving esthetics. Currently, zirconia is a clinically applied material for dental implants. There have been many s...
The next issue involves looking at the potential threats of titanium. Titanium is currently used in a wide range of fields. As such, there are many studies with regard to environment safety in the field and basic science. Such titanium is primarily used as titanium oxide nanoparticles. Animal experiments, especially in rodents, are being conducted to study the effects of titanium oxide nanop...
Titanium is known to yield fewer allergic reactions than other metals such as nickel and palladium. However, as mentioned in the "Results" section, titanium allergy symptoms have been reported in some cases. These symptoms can occur systemically with inflammation of the mouth, erythema, etc. Therefore, any history or suspicion of a titanium allergy would be considered prior to dental implan...
The absorbed titanium can accumulate in other organs in the body as shown in the animal and cultured cell experiments. In addition, Feng et al. reported that nanoparticles can pass through the blood-brain barrier (BBB) and may be toxic to the central nervous system (CNS). The testing methods still have limitation and further studies need to be performed, but the neurotoxic nanoparticles incl...
This is defined as a tribosystem which has three interrelated components: tribology (friction, wear, and lubrication), corrosion (material and environmental factors), and biochemistry (interactions between cells and protein). The wear and corrosion in the contacting surface of implant fixture and implant abutment can cause the failure of dental implant system, and the wear debris and metalli...
Discussion
Titanium is presently used in a variety of applications including dental implants, orthopedic prostheses, industrial cosmetics, drugs, confections, and paints. Due to its extensive usage, issues related to stability need to be discussed. Titanium dental implants possess many advantages and are now widely used with high rates of success. However, we need to look at the aforementio...
There are numerous reports showing the association between titanium and yellow nail syndrome in addition to the above reports. In 2015, Decker et al. reported a case of a 67-year-old female patient who had lost her claws 18 months prior and had changes in bronchitis, sinusitis, and nails within the last 5 years. Inhaled corticosteroids were used for initial continuous cough symptoms but were no...
At least 10 of 20 patients were reported to show an improvement in symptoms after 6 months of continuous vitamin E1 administration at 200 IU/day; however, there was a continuous debate regarding the medication details.
Efforts to elucidate the pathogenesis of yellow nail syndrome are currently underway. In 2001, D’Alessandro et al. reported that the protein content of pleural effusions was...
Titanium-related diseases
It has been reported that systemic disease can occur due to titanium. According to a study by Berglund and Carlmark in 2011, titanium can be attributed to the cause of “yellow nail syndrome.” In 30 patients with yellow nail syndrome, energy-dispersive X-ray fluorescence (EDXRF) was used to measure the titanium content in the nails of patients; the titanium content w...
All metal prostheses except the implant screw and abutment were removed, and the eczema reaction was reduced to 30%; the symptoms still remained. The removal of the titanium implant screw and abutment in 2014 led to a full recovery. In Korea, allergy condition has also been reported after the installation of titanium implants. In 2012, a 70-year-old woman exhibited a stomatitis that appeared to be...
They are the releasing due to the friction between implant and bone surface during installation, the wear during debridement at maintenance visits, and the corrosion. Fretwurst et al. reported the metal particle in peri-implant soft tissue along with M1 macrophages and the increasing in titanium concentration with lymphocytes detection. In association with the metal particle releasing, the damage ...
Recently, there are more studies working on the linking of titanium implants and implant complication or failure. Wachi et al. reported that Ti ions may be involved in the deteriorating effects of peri-implant mucositis, which can develop into peri-implantitis accompanied by alveolar bone resorption. Olmedo et al. reported two cases of reactive lesions of peri-implant mucosa associated with titani...
Maritini et al. compared implantation of titanium powder plasma-spray-coated titanium screws (TPS-Ti) and fluorohydroxyapatite-coated titanium screws (FHA-Ti). Authors reported the evidence of titanium dispersion inside the medullary spaces when TPS-Ti was implanted, which was the result of friction occurring at the implant surface-host bone interface, leading to loss of integration in the coating...
In the presence of both H2O2 and albumin, there was a very much higher rate of metal release from Ti6Al4V compared to the presence of albumin and H2O2 alone. Furthermore, in a recent study, Zhang et al. continuously worked on the synergistic effect of albumin and H2O2 on corrosion of Ti6Al4V in physiological saline with electrochemical method and showed the time-dependent dissolution of Ti6Al4V. ...
In 1993, Haynes et al. performed experiments using titanium-aluminum-vanadium (Ti-Al-V) and cobalt-chromium (Co-Cr) particles of similar size range and concentration similar to those found in failed hip prostheses. In the abdominal macrophage experiments of rats, Co-Cr yielded a high toxic response while Ti-Al-V increased the release of inflammation-inducing mediators such as prostaglandin E2, int...
The interaction between TiO2-NP and inflammatory cytokines, including CXCL8, a clinically relevant pro-inflammatory chemokine, was also investigated by Batt et al.. The authors found that the TiO2-NP could preferentially adsorb CXCL8 (and IFN-γ), which leads to the disruption of neutrophil chemotaxis and modifies local inflammatory mediator concentration and might result in hampered inflammatory ...
Recently, Kim et al. reported an in vitro experiment regarding the expression of mucin genes in human airway epithelial cells. The authors confirmed that TiO2-NP initiated the TLR4-dependent pathway, leading to the MUC5B overproduction, which relates to the inflammatory response in human airway. In Suarez-Lopez del Amo et al. experiment, the TiO2 particles derived following implantation were colle...
Valentini et al. investigated the toxicity of TiO2-NP to the cortical neuron cultures and in the brain of rats, reported the clear impact of TiO2-NP on the neuronal cells and rat brain, and indicated the new evidences of TiO2-NP toxicity in CNS.
While there have been reports of titanium toxicity in animal models, Fabian et al. and Warheit et al. reported that the risk of titanium toxicity was no...
The toxicity of TiO2 (titanium dioxide) nanoparticles (TiO2-NP) in rodents has been reported. Many authors studied the serum biochemical parameters, pathology changes, and the biodistribution of TiO2-NP in the liver, kidneys, lung, spleen, and brain tissue by facilitating a variety of methods including blood biomarker assays, histopathological examination, etc. The dependence of experiment results...
Results
Extensive data was searched as mentioned in the research methods. According to the data analysis, the number of papers from 2011 to 2015 was the highest at 730; the research shows a trend of rapid increase in recent years with the large number of papers from 2016 to 2018. In the author’s field of specialization, 995 fields of basic science were the most studied; fields within environm...
Methods
Focus question
“What is the general overview of the risks and stability associated with titanium materials?”
Literature search
This review was prepared using data collected from until November 2018 through a keyword online search using MEDLINE (PubMed), Embase, Cochrane Library, and Google Scholar. Additional data were gathered for the necessary detailed parts using keywords incl...
Background
Titanium is one of the most widely used materials for dental implants due to its mechanical strength, biocompatibility, and a long history of use. Current titanium dental implants possess a high success rate; however, failures are still being reported. Cause of these implant failures can be poor oral hygiene, uncontrolled deposition of plaque, and calculus around the implant which ca...
Abstract
Background
Titanium is a commonly used inert bio-implant material within the medical and dental fields. Although the use of titanium is thought to be safe with a high success rate, in some cases, there are rare reports of problems caused by titanium. In most of these problematic reports, only individual reports are dominant and comprehensive reporting has not been performed. This comp...
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...
Reason for exclusion
Investigations
Study design (case series or case report)
Kim et al. (2017), Hatano et al. (2007)
Different grafting technique (lateral sinus lift or transalveolar technique)
Jensen et al. (1994), Winter et al. (2002), Toffler et al. (2004), Chappuis et al. (2009), Soltan et al. (2011), Xiao et al. (2011), Cricchio et al. (2011), Scala et al. (2012), Brus...
Author (year)
Study design
Follow-up (months)
N of patients
N of implants
Smokers
Length and diameter (mm)
Implant system
Shihab 2017
Retrospective
60
35
70
NA
5–12 × 3.0–5.7
IDI FMD Nucleoss
Ghanem 2014
Retrospective
72
10
10
NA
NA
NA
Nooh 2013
Prospective
12
56
63
0
4 × 8 4.3 × 10 5 × 8 5 × 10
Nobel Biocare
...
Clinical complications
Radiographic complications
Sinusitis
Thickening of Schneiderian membrane
Nasal bleeding, nasal obstruction, nasal secretion
Bone reaction to the implants
Headache and pain or tenderness in the region of the sinus
Sinus pathology
Decreased sense of smell
Figure 4. Statistical analysis for different variables. a Weighted mean survival rate. b Implant survival rate according to degree of penetration. c Analysis of clinical complications. d Analysis of radiographic complications
Figure 3. Graphic representation of group 1 ≤ 4 mm penetration and group 2 > 4 mm penetrations
Figure 2. PRISMA flowchart of the screening process
The secondary outcome of this review was the analysis of the clinical and radiological complications related to the penetration of implants in the maxillary sinus. Clinical complication among the different authors ranges from 0 to 14.3%, with a weighted mean complication rate of 3.4%, without finding statistical difference according to the level of implant penetration. The most common clinic...
Figure 1. Graphic representation of implants intruding sinus perforating or not the Schneiderian membrane
Analysis of clinical complications
Seven studies provide information on clinical complications with a global sample of 232 patients. Clinical complications among the different authors range from 0 to 14.3%, being the weighted mean complication rate 3.4% with an IC 95% [0 7.5] (Fig. 4c) Clinical complications analyzed in the studies were sinusitis, nasal bleeding, nasal obstruction, nasal sec...
Results
Study screening
An initial screening yielded a total of 3551 publications of which 26 potentially relevant articles were selected after an evaluation of their titles and abstracts. Full text of these articles was obtained and evaluated thoroughly. Of these, eight articles (Table 2) fulfilled the inclusion criteria and subsequently were included in the qualitative analysis (Fig. 2). Re...
Eligibility criteria
Articles were included in this systematic review if they met the following inclusion criteria: human prospective or retrospective studies, reporting outcomes of implant placed perforating the sinus floor with implant burs, and without regenerative procedure (lateral sinus lift or transalveolar technique) and graft material. The intrusion into the sinus cavity can occur du...
Materials and methods
This systematic review and subsequent meta-analysis follow the guidelines of the PRISMA statement.
Focus question
The following focus question was developed: Is the intrusion of dental implants into the sinus cavity during implant drilling or implant placement, without regenerative procedure (lateral sinus lift or transalveolar technique) and graft material, has an effec...
Introduction
The edentulous posterior maxillary region often presents with unique challenging conditions in implant dentistry. Limited bone height secondary to pneumatization of the maxillary sinus and the resorption of the alveolar ridge preclude in many instances the installation of dental implants. To compensate for the lack of bone height, several treatment options have been proposed.
The ...
Influence of exposing dental implants into the sinus cavity on survival and complications rate: a systematic review
Abstract
Background
After tooth loss, the posterior maxilla is usually characterized by limited bone height secondary to pneumatization of the maxillary sinus and/or collapse of the alveolar ridge that preclude in many instances the installation of dental implants. In order ...
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...
Table 3 Quantitative analysis of CFU counts (× 105) from rough and machined surface implants after cleansing by each method
Rough surface
Cont
G
US
Air
Rot
Las
Median
137.5
3.4
46.5
13.0
4.8
16.3
Min
73.0
0.3
6.8
0.5
0.6
3.0
Max
785.0
27.0
240.0
35.5
37.0
34.0
Machine surface
Cont
G
US
Air
Rot
Las
Median
84.5
0.9
8.5
3.2
3.3
...
Table 2 Qualitative evaluation by SEM analysis of micro- and macrothread areas of machined surface implants
Machined surface (microthread)
No effect
Fair
Good
Excellent
G
+
US
+
Air
+
Rot
+
Las
+
Machined surface (macrothread)
No effect
Fair
Good
Excellent
G
+
US...
Table 1 Qualitative evaluation by SEM analysis of micro- and macrothread areas of rough surface implants
Rough surface (microthread)
No effect
Fair
Good
Excellent
G
+
US
+
Air
+
Rot
+
Las
+
Rough surface (macrothread)
No effect
Fair
Good
Excellent
G
+
US
...
Figure 6. Comparison of cleansability of each decontamination method on the different implant surfaces. Asterisk indicates p < 0.05
Figure 5. Quantitative analysis of CFU counts on rough and machined surface implants after cleansing by each method. Asterisk represents vs Cont; a, vs G; b, vs US; c, vs Air; d, vs Rot; e, vs Las which indicates p < 0.05
Figure 4. SEM analysis of 4 areas. 1 Rough surface—microthread area. 2 Rough surface—macrothread area. 3 Machined surface—microthread area. 4 Machined surface—macrothread area
Figure 3. Decontamination methods. a Gauze soaked in saline applied using a sawing motion. b Ultrasonic scaler (SUPRASSON P-MAX, Satelec-Acteon group, Bordeaux, France, power setting: P5, tip: Implant Protect IP3L/R). c Air abrasives (AIR-FLOW MASTER PIEZON®, EMS, Nyon, Switzerland, power setting: water flow 100%, air pressure 75%, powder: AIR-FLOW® PERIO POWDER, nozzle: PERIO-FLOW®...
Figure 2. GC Aadva® implant; 3.3-mm diameter, 8-mm length
Surface characteristics
Through SEM analysis and CFU counts, it was demonstrated that, except for the Er:YAG laser, decontamination of the machined surface implant was easier than that of the rough surface implant regardless of decontamination method. Gauze soaked in saline and the ultrasonic scaler demonstrated a statistically significant difference in CFU counts between the two surfaces. ...
Our results are also in accordance with their results in terms of the high cleansability of the rotary metal instrument. In addition, the cotton pellet showed moderate cleansability among the tested methods, but the cleansing time for the cotton pellet (60 s) was shorter than that of the titanium brush with (120 s + 60 s)/without (120 s) photodynamic therapy. If adjusting the d...
Charalampakis et al. examined the effectiveness of mechanical and chemical decontamination methods using titanium disks contaminated intraorally. They employed four decontamination methods: gauze in saline, chlorhexidine, delmopinol, and an essential oil mixture. The authors discovered there was no significant difference in CFU counts among the four methods. In the present study, our findin...
However, the rotary stainless steel instrument created numerous shallow scratches, especially on machined surface implants. John et al. compared the supragingival plaque cleansability of a rotary titanium instrument to that of a stainless metal curette on contaminated titanium disks. The residual biofilm area left on implant treated with the rotary titanium instrument was significantl...
However, the rotary stainless steel instrument created numerous shallow scratches, especially on machined surface implants. John et al. compared the supragingival plaque cleansability of a rotary titanium instrument to that of a stainless metal curette on contaminated titanium disks. The residual biofilm area left on implant treated with the rotary titanium instrument was significantl...
Regarding the air abrasives, the cleansing effect in the SEM analysis was also as considerable as that achieved by the ultrasonic scaler in the present study, in contrast to the results of the aforementioned study. Louropoulou et al. also stated in their systematic review that an air-powder abrasive system with sodium bicarbonate powder could cleanse contaminated rough/smooth implant surface...
The SEM analysis demonstrated that three different rough surface disks harbored complex and firmly attached biofilms after gauze scrubbing irrespective of which antiseptic or saline was used.
However, the disks with a turned surface hosted fewer biofilm clusters after scrubbing. This finding is in line with our result showing the better cleansability of gauze soaked in saline on the m...
Augthun et al. examined the cultivability of mouse fibroblasts after cleansing machined or plasma-splayed surface implants carried on acrylic plates that had been contaminated with supragingival plaque from individuals. A plastic hand scaler and an air-abrasive system with sodium bicarbonate powder were employed in their study. A similar number of viable fibroblasts were observed after clean...
Discussion
Study design
This study was performed following an ex vivo design to overcome the drawbacks of previous studies. One particular difference in this study was the use of a commercially available screw-shaped implant. As the implant shape and design have rather complicated macro- and microstructures compared with titanium disks or different forms of titanium commonly used in experi...
Results
Complications
During the experiment, three participants experienced small ulcers caused by the implants carried on the splints; however, it did not affect their daily life. Additionally, there were no signs of gingival inflammation in any participant.
SEM analysis (Fig 4, Tables 1 and 2)
Rough surface implants
G and Rot achieved relatively clean implant surfaces compared with Las in...
This study protocol was approved by the ethical committee of Osaka University (H26.E-36).
SEM analysis
The SEM analysis was performed as previously described. The decontaminated implant samples were fixed with 2% glutaraldehyde-RPMI 1640 immediately for 1 h at room temperature and washed with distilled water. Then, the samples were dehydrated with 100% t-butyl alcohol and freeze-dried. Finall...
At the end of the 4-day experimental period, the implants were carefully removed from the splints by breaking the resin caps that held them in place. Each implant was randomly assigned to a treatment method (Cont, control (no decontamination); G, gauze soaked in saline; US, ultrasonic scaler (SUPRASSON P-MAX, Satelec-Acteon Group, Bordeaux, France; power setting: P5, tip: Implant Protect IP3L/R); ...
Materials and methods
Study subjects
Eleven participants, nine men and two women between 28 and 42 years of age (mean age 31.3 ± 4.6), were recruited as the study subjects. All participants provided informed consent verbally. Study information was disseminated to participants both verbally and in written form. The inclusion criteria were as follows:
Generally healthy subjects
Dent...
Background
Dental implants are now used broadly for recovering loss of masticatory function and esthetics. Although it has been revealed that dental implants can often survive long term, biological and mechanical complications may arise. Recent cross-sectional and retrospective studies noted a higher prevalence of peri-implantitis at the implant and subject level than previously considered. Add...
Abstract
Background
To evaluate the effect of several representative decontamination methods of oral biofilms on different implant surfaces.
Material and methods
Eleven participants wore a hard resin splint carrying 6 rough (GC Aadva® implant; 3.3-mm diameter, 8-mm length) or machined (not commercially available) surface implants for 4 days to accumulate dental plaque naturally on the ti...
Figure 3. Comparison of standard and over-dimensioned protocol. The figure displayed shows the comparison between standard and over-dimensioned protocol. a Displays the measurements obtained by RFA. The unit is ISQ with a range of 0 to 100 (minimum to maximum stability). b Displays the results obtained by the torque in and c by the torque out test. Although, there was no statistically s...
Figure 2. Over-dimensioned protocol. The over-dimensioned protocol was conducted by a final drill of 1 mm narrower than the implant diameter. The final drill for implants of 3.3. mm was 3.2 mm and of implants measuring 3.75 mm, it was 3.65 mm. Within this study, an over-dimensioned protocol was defined as a final drill larger than recommended by the company, which is in this case 4 o...
Figure 1. Standard protocol. This figure shows the implant types and drilling protocol used within this study. Standard protocol was conducted by a final drill of 2.80 mm for 3.3 mm implants, 3.20 mm for 3.75 mm implants, and 3.65 mm for 4.2 mm implants. Permissions for reproducing the figures were received from HI-TEC IMPLANTS LTD. Source: Product Catalogue 12th Edition [40]
3.3 mm
3.75 mm
4.2 mm
Mean (SD)
CI
Mean (SD)
CI
Mean (SD)
CI
ISQ
66.33 (4.59)
63.79–68.88
69.00 (5.98)
64.72–73.28
69.87 (8.88)
64.94–74.78
IT (Ncm)
102.65 (28.42)
86.91–118.39
90.97 (27.54)
71.27–110.67
78.19 (33.28)
59.76–96.62
TO (Ncm)
94.54 (29.09)
78.43–110.65
81.28 (28.89)
60.67–101.88
100.86 (36....
8.0 mm
10.0 mm
11.5 mm
13.0 mm
16.0 mm
Mean (SD)
CI
Mean (SD)
CI
Mean (SD)
CI
Mean (SD)
CI
Mean (SD)
CI
ISQ
65.5 (8.40)
58.48–72.52
73.17 (3.60)
69.39–76.95
67.11 (6.09)
62.43–71.79
66.15 (8.15)
59.43–73.07
70.67 (4.97)
66.84–74.49
IT (Ncm)
98.23 (18.56)
82.71–113.74
99.49 (43.73)
53.60–145.48
101.02 (36.80)
72.74–...
Insertion mode — manual insertion
Insertion mode — machine-driven insertion
n
Mean (SD)
CI
n
Mean (SD)
CI
ISQ
45
68.33 (6.83)
66.14–70.51
45
70.25 (5.52)
68.38–72.12
IT (Ncm)
45
90.56 (31.27)
80.56–100.56
45
83.94 (31.81)
73.17–94.7
TO (Ncm)
45
93.59 (32.3)
83.27–103.92
45
89.80 (37.32)
77.18–102.43
ISQ impla...
Drilling sequence — standard protocol
Drilling sequence — over-dimensioned protocol
n
Mean (SD)
CI
n
Mean (SD)
CI
ISQ
45
68.33 (6.83)
66.14–70.51
30
68.5 (8.82)
65.08–71.92
IT (Ncm)
45
90.56 (31.27)
80.56–100.56
30
63.74 (48.61)
44.89–82.59
TO (Ncm)
45
93.59 (32.3)
83.27–103.92
30
58.35 (40.43)
42.67–74.02
ISQ im...
Contrary to the research hypothesis, there was no difference in primary stability between manually and machine-driven inserted implants. To date, little is known about the influence of the insertion mode on the dental implant primary stability. Novsak et al. assumed a better primary stability in implants inserted manually and suspected that this behavior was related to a higher tac...
However, caution is recommended when using under-dimensioned drilling protocols: although high insertion torques ensure a greater initial implant stability and prevent adverse micromotions under loading, the induced over-compression could jeopardize the healing process. In addition, high stress is known to alter angiogenesis and impair new vessel formations, to induce local hypoxia and n...
Discussion
This study was performed in order to investigate changes in primary stability within an experimental setup of different insertion protocols and insertion modes. In order to obtain a high level of diagnostic certainty, three different methods for measurement of primary stability were recorded. As a secondary outcome parameter, potential differences between implants of different le...
Results
Drilling protocol: standard versus over-dimensioned
No statistically significant difference in RFA could be measured (Cohen’s d = − 0.022, effect size r = 0.011, p = 0.260), whereas IT values were significantly higher in implants inserted via SP (90.56 ± 31.27 Ncm) in comparison with the ODP (63.74 ± 48.61 Ncm, p = 0.002; Cohen’s d = 0.656, effect size r = 0.312). T...
Preparation protocol for oversized osteotomies (ODP)
This protocol repeated the steps of the standard protocol but then added a larger final drill. For the 3.3-mm implants, the final drill size was 3.2 mm; for the 3.75-mm implants, the final drill size was 3.65 mm (Fig. 2).
RFA
To analyze the data, an Osstell® SmartPeg threaded transducer (implant diameter 3.3 and 3.75 mm: SmartPeg Type ...
Methods
Bone specimens
Twenty mandibles from fresh porcine cadavers were obtained from a local slaughterhouse. The animals did not show any macroscopic signs of any pathologic bone conditions. After removal of the surrounding soft tissue, the surfaces of the bone samples were thoroughly cleaned. Each sample was checked macroscopically for irregularities and a minimum thickness of 20 mm at th...
Analyzing those, a decrease in primary and an increase in secondary stability with a shorter healing period for implants became apparent. Kim et al. compared the effect of oversized drilling sockets regarding bone-to-implant contact and bone density after 4 and 8 weeks in an in vivo dog model. They used a final drill of 4.00 mm for implants with a diameter of 4 mm in the oversized group and a ...
With increasing stiffness of the bone-implant interface, the vibration frequency of the sensor increases. While RFA is expressed in hertz, implant stability quotient (ISQ) is the scale used to quantify RFA values (range 1–100).
Even though RFA has been reported to be a reliable, reproducible, and objective method to measure the stiffness of bone-implant-complex, it has also been reported that R...
Background
A reliable option for replacing teeth is the insertion of osseointegrated implants. Dental implant primary stability (DIS) has also been reported to be a fundamental prerequisite for long-term success of dental implants, even though osseointegration has also been achieved without a certain amount of primary stability. Primary stability has been defined as the ability to withstand axi...
Abstract
Background
Dental implant primary stability is thought to be a fundamental prerequisite for the long-term survival and success. The aim of this study was to analyze the influence of protocol and insertion mode on dental implant stability ex vivo. One hundred and twenty implants were inserted either manually or machine-driven into porcine mandibles by a standard or over-dimensioned pro...
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...
Figure 6. Sample images of misdetected implants. a Both implants could not be detected because of the shadow of the spina. b Left implant was detected correctly as MK III/IIIG, but the right implant was not detected because of an unclear image
Figure 5. Average precision (AP) of each implant system in all images. MK III/MK III Groovy: MK III/IIIG, MK IV/Speedy Groovy: MK IV/SG, bone level: BL and Genesio Plus ST: Genesio
Figure 4. Ratio of implant systems detected correctly to all detected systems (True Positive ratio). MK III/MK III Groovy: MK III/IIIG, MK IV/Speedy Groovy: MK IV/SG, bone level: BL and Genesio Plus ST: Genesio
Figure 3. The total number of implant systems detected correctly (TPs) and those detected as other prostheses (FPs). MK III/MK III Groovy: MK III/IIIG, MK IV/Speedy Groovy: MK IV/SG, bone level: BL and Genesio Plus ST: Genesio
Figure 2. Total number of objects of each implant systemin all images. MK III/MK III Groovy: MK III/IIIG, MK IV/Speedy Groovy: MK IV/SG, bone level: BL and Genesio Plus ST: Genesio
Figure 1. Sample image for calculating IoU (MK III implant). The light gray square indicates the ground-truth bounding box, and the dark gray square indicates the predicted bounding box. IoU value was calculated that the overlapped area of light gray and dark gray squares was divided by the united area of light gray and dark gray squares.
Conclusion
Though there are several issues that still need to be addressed, implant systems can be identified from panoramic radiographic images using deep learning-based object detection. To increase the learning performance and apply this system in clinical practice, a higher quality and larger number of implant images and images of other implants will be needed in subsequent studies.
...
To identify implant systems from radiographic images, dental radiography, panoramic radiography, and computed tomography were considered. In this system, it is thought that implant systems are identified by the shape of the collar, groove, and apex of the implant images, which are unique characteristics of each implant. Consequently, the quality of the training images is important so that these ...
The second system employs nine questions about implant characteristics. The database returns candidate matching implants based on the answers to these questions, and dentists must match them with those of the patient. Both of these systems require dentists to check whether two images of an implant are the same to identify the implant system. In contrast, the system in this study is based on de...
Results
At least 240 instances of each implant system were detected in the panoramic radiographic images: the most common type was MK III/IIIG (1919 instances) and the least common was Genesio (240 instances; Fig. 2). The number of implants detected correctly (True Positive: TP), and those detected as other systems (false positive: FP) are shown in Fig. 3. The number of both TP and FP were the ...
Methods
Data collection
Panoramic radiographs were obtained from patients who received implant treatment in the Department of Prosthodontics, Gerodontology and Oral Rehabilitation at Osaka University Dental Hospital after January 2000. Panoramic radiographs with unknown implants were excluded and totally 1282 images were used to annotate implants. All images were JPEG files that were resized t...
Background
Dental implants were developed in the 1980s, and they are now used for patients with missing teeth globally. Their effect on dental treatment is great, and various improvements in patients’ quality of life have been reported. Implant treatment is no longer unusual for either patients or dentists. However, because more than 30 years have passed since implants were introduced into cl...
Abstract
Background
In some cases, a dentist cannot solve the difficulties a patient has with an implant because the implant system is unknown. Therefore, there is a need for a system for identifying the implant system of a patient from limited data that does not depend on the dentist’s knowledge and experience. The purpose of this study was to identify dental implant systems using a deep le...
Figure 6. Figure 6. a–d Von Mises stress distribution on bone. From a to d: L-M, ZL-M, L-V, and ZL-V respectively. The stress concentration occurred in the cortical bone around the neck of the implant. Groups L-M and ZL-M were quite similar and reduced stress
Figure 5. a–d Von Mises stress distribution on abutment. From a to d: L-M, ZL-M, L-V, and ZL-V respectively. Von Mises stresses were relatively similar and concentrated at the coronal part of the abutment in all groups
Figure 5. a–d Von Mises stress distribution on abutment. From a to d: L-M, ZL-M, L-V, and ZL-V respectively. Von Mises stresses were relatively similar and concentrated ...
Figure 4. a–d Von Mises stress distribution on implant. From a to d: L-M, ZL-M, L-V, and ZL-V respectively
Figure 4. a–d Von Mises stress distribution on implant. From a to d: L-M, ZL-M, L-V, and ZL-V respectively
Figure 3. a–d Maximum principal stress distribution on crown restoration. From a to d: L-M, ZL-M, L-V, and ZL-V respectively
Figure 3. a–d Maximum principal stress distribution on crown restoration. From a to d: L-M, ZL-M, L-V, and ZL-V respectively
Figure 2. The graph of the interaction of the materials and restoration design
Group
N
Mean (N)
Standard deviation
Minimum
Maximum
L-M
12
2891.88a
410.12
2079.74
3486.96
L-V
12
2077.37bc
356.59
1220.96
2493.39
ZL-M
12
1750.28c
314.96
1084.36
2163.95
ZL-V
12
2202.55b
503.14
1292.20
2912.81
Material
Young’s modulus (GPa)
Poisson ratio
Reference
E.max CAD
95
0.20
[1]
Vita Suprinity
65
0.23
[2]
Vita VM 11
65
0.23
*
E.max Ceram
64
0.23
[4]
Implant and abutment
114
0.34
[5]
Cortical bone
13.7
0.3
[5]
Spongious bone
1
0.3
[5]
Figure 1. Crown restoration design
Groups
N
Materials
L-M
12
IPS e-max CADIPS e.max CAD glaze
L-V
12
IPS e-max CADe.max Ceram DentinIPS e.max Ceram Glaze
ZL-M
12
Vita SuprinityVita Akzent Plus
ZL-V
12
Vita SuprinityVM-11Vita Akzent Plus
Material
Chemical composition (%)
Coefficient of thermal expansion (10−6 K−1)
Flexural strength (MPa)
Manufacturer
IPS e.max CAD; lithium disilicate glass ceramic (LDS)
SiO2 (57–80), Li2O (11–19), K2O (0–13), P2O5 (0–11), ZrO2 (0–8), ZnO (0–8), Al2O3 (0–5), MgO (0–5), coloring oxides (0–8)
10.2
360
Ivoclar Vivadent
IPS e.max Ceram; low-fusing nan...
Conclusions
Within the limitation of the present study, it can be concluded that the restoration design affected the failure load of ceramics. Monolithic design had a statistically significant effect on the failure load of two different ceramics (LDS > ZLS). Veneer application had opposite effects on two different ceramics which increased the failure load of ZLS and reduced it for LDS witho...
Zheng et al. compared the stress distribution of the same veneering ceramic on different cores and concluded that the zirconia core was clearly different from other materials with higher tensile stresses at the veneer core interface because the increasing differences between the elasticity modulus of the core and the veneer transmitted higher stress concentrations to the cores. Con...
Veneer application provided additional strength to the ZLS crowns in contrast to the LDS crowns. The higher failure load of the veneered ZLS crowns (2202.55 N; group L-V 2077.37 N) may be associated with the higher flexural strength of the veneering porcelain VM-11 (100 MPa; emax Ceram 90 MPa). These veneered groups had a statistically significant difference from the monoli...
Similar results were presented in a study of Traini et al. as it was concluded that ZLS was comparable to that of existing zirconia-based ceramics and was suitable for oral function even in the posterior regions. In the literature, there have been few studies on this ceramic and a limited number of them include the failure load of the material. In one of these studi...
In literature, it has been stated that the failure load of LDS crowns was higher than veneered zirconia and could be comparable with metal ceramic systems. Doğan et al. evaluated the fracture strength of different CAD/CAM-manufactured crowns and concluded that the monolithic LDS crowns had the highest fracture resistance. Present study confirmed as monolithic LDS crowns demonstrated so satisfying...
Discussion
Implant-supported restorations have been accepted as an alternative treatment for the rehabilitation of edentulous spaces. Despite the high success rates, implant failures are inevitable and classified as early or late implant failures. Late implant failures are observed after prosthetic restoration which is primarily related to biomechanical complications. Since occlusal loads are t...
Results
Descriptive analysis (mean, standard deviation (SD), minimum, maximum) of the groups is presented in Table 4.
Group L-M exhibited the highest failure load values (2891.88 N ± 410.12 N), and the lowest values were observed in group ZL-M (1750.28 N ± 314.96 N). Two-way ANOVA indicated a statistically significant difference between materials and veneering technique (p = 0.00 < ...
Statistical analysis
The statistical analysis was performed with SPSS 24.0 (SPSS Inc, Chicago, USA). The Kolmogorov–Smirnov normality test was used to evaluate whether the data distribution of the groups was normal. The homogeneity of the variances was analyzed by Levene’s test. Since test results indicated that data distribution of the groups was normal and the variances were homogenous,...
All crowns were subjected to a combination firing that included crystallization and glaze firing according to each manufacturer’s guidelines in the ceramic furnace (Vita Vacumat 6000 M, Vita Zahnfabrik, Bad Sackingen, Germany).
For veneered restorations, the design mode was changed to “split,” and the core was constructed in 0.6-mm thickness. In group L-V (n = 12), e.max ...
Methods
Preparation of test groups
This study tested the current glass ceramic ZLS by comparing LDS with monolithic and conventional veneering techniques in implant-supported crowns: group L-M: lithium disilicate ceramic (monolithic), group L-V: lithium disilicate ceramic (conventional veneering), group ZL-M: zirconia-reinforced lithium silicate ceramic (monolithic), group ZL-V: zirconia-reinf...
Background
Implants have been successfully used to replace missing teeth for many years. Notwithstanding the high success rates, complications such as screw loosening and/or fracture, prosthesis fracture, and even implant fracture are inevitable. The reasons of the complication may be related to decreased proprioception and low tactile sensitivity which makes implant-supported crowns more susc...
Abstract
Background
Present study compared the failure load of CAD/CAM-manufactured implant-supported crowns and the stress distribution on the prosthesis-implant-bone complex with different restoration techniques.
Methods
The materials were divided into four groups: group L-M: lithium disilicate ceramic (LDS, monolithic), group L-V: LDS ceramic (veneering), group ZL-M: zirconia-reinforced l...
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...
How do we define a case of peri‐implantitis in day‐to‐day clinical practice and teaching situations?
Diagnosis of peri‐implantitis requires:
Presence of bleeding and/or suppuration on gentle probing.
Increased probing depth compared to previous examinations.
Presence of bone loss beyond crestal bone level changes resulting from initial bone remodeling.
In the a...
The following case definitions and characteristics of peri‐implant health, peri‐implant mucositis, and peri‐implantitis should be viewed within context of several potential confounding factors.
It is known that there is no generic implant and that there are numerous implant designs with different surface characteristics, surgical and loading protocols. The degree of physiological remodeli...
What are the main factors associated with hard‐ and soft‐tissue deficiencies at potential implant sites?
The healing process following tooth loss leads to diminished dimensions of the alveolar process/ridge representing hard‐ and soft‐tissue deficiencies. Larger deficiencies may occur at sites exposed to the following factors: loss of periodontal support, endodontic in...
What is peri‐implantitis?
Peri‐implantitis is a plaque‐associated pathological condition occurring in tissues around dental implants, characterized by inflammation in the peri‐implant mucosa and subsequent progressive loss of supporting bone.
What is the evidence for plaque/biofilm as a principal etiological factor for peri‐implantitis?
There is evidence ...
What are the clinical characteristics of peri‐implant mucositis?
The main clinical characteristic of peri‐implant mucositis is bleeding on gentle probing. Erythema, swelling and/or suppuration may also be present.
Does peri‐implant mucositis exist in the absence of clinical signs of inflammation?
Clinical signs of inflammation are necessary for a diagnosis of peri...
What are the clinical characteristics of a healthy peri‐implant site?
In health, the peri‐implant site is characterized by absence of erythema, bleeding on probing, swelling and suppuration.
What are the main clinical differences between healthy peri‐implant and periodontal tissues?
In health, there are no visual differences between peri‐implant and periodontal t...
The objective of Workgroup 4 was to present a classification on peri‐implant diseases and conditions. Five position papers describing the characteristics of peri‐implant health, peri‐implant mucositis, peri‐implantitis, soft and hard tissue deficiencies and case definitions and diagnostic considerations were prepared prior to the workshop.
In preparing this consensus report regarding...
Consensus report of workgroup 4 of the 2017 World Workshop on the Classification of Periodontal and Peri‐Implant Diseases and Conditions
Abstract
A classification for peri‐implant diseases and conditions was presented. Focused questions on the characteristics of peri‐implant health, peri‐implant mucositis, peri‐implantitis, and soft‐ and hard‐tissue deficiencies were addressed.
...
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...
Table 2
Removal torque testing (RTQ) evaluation according to surface characteristic of implants
investigator
surface characteristics of implants
results of RTQ
Gahlert, 2007
Machined zirkonia
25.9 N/cm
Gahlert, 2007
Sandblasted zirconie
40.5 N/cm
Gahlert, 2007
SLA titanium
105.2 N/cm
Sennerby, 2005
Machined zirconia
Significantly lower RTQ values
...
Table 1
In vitro studies examining bone-implant contact of different implants
investigator
type of implant
follow-up period
bone-implant contact
Akagawa, 1993
Nonloaded zirconia
3 mo
81.9
Akagawa, 1993
Loaded zirconia
3 mo
69.8
Dubruille, 1999
Titanium
10 mo
54
Dubruille, 1999
Alumina
10 mo
68
Dubruille, 1999
Zirconia
10 mo
64.6
Scarano, ...
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...
4. Strength
Minamizato et al investigated the compressive strength of the blade type of zirconia dental implants with tunnels drilled by laser process, and found that specimens with tunnels showed lower compressive strength (237 kg/mm2) than specimens without tunnels (371.5 kg/mm2). They concluded that zirconia blades had adequate strength in occlusion.
Kohal et al evaluated the frac...
3. RTQ (removal torque testing)
Sennerby et al observed bone tissue responses to machined and surface-modified zirconia implants. To achieve a porous surface, the zirconia implants were coated with 2 different slurries containing zirconia powder and a pore-former, which gave different surface structures. Noncoated zirconia implants were used as controls. In addition, titanium i...
2. Surface analyses
Analisis permukaan dilakukan dalam 4 penelitian. Dalam penelitian pertama, Yang et al meneliti zirkonia dengan 4% CeO2 dan zirkonia dengan 3% lapisan Y2O3, yang diendapkan pada implant titanium dan implant CoCrMo menggunakan teknik semprotan plasma. Properti adesif, morfologis, dan struktur pada lapisan yang disemprot plasma dievaluasi. Rata-rata kekasaran permukaan zirkonia d...
2. Surface analyses
Surface analyses were performed in 4 studies. In the first study, Yang et al investigated zirconia with 4% CeO2 and zirconia with 3% Y2O3 coatings, which were deposited on titanium and CoCrMo implants using the plasma spraying technique. Adhesive, morphologic, and structural properties of the plasma-sprayed coatings were evaluated. The average surface roug...
1. Oseointegrasi, analisis histologis, dan BIC
Eighteen articles discussed osseous healing, histologic analyses, and BIC of zirconia dental implants. Seven of these articles evaluated zirconia as a coating material, evaluated zirconia dental implants.
Delapan belas artikel medhar penyembuhan osseus, analisis histologis, dan BIC dari implant gigi zirkonia. Tujuh di antara artikel ini mengevaluasi...
1. Osseointegration, histologic analyses, and BIC
Eighteen articles discussed osseous healing, histologic analyses, and BIC of zirconia dental implants. Seven of these articles evaluated zirconia as a coating material, evaluated zirconia dental implants.
Zirconia as a Coating Material
Cranin et al investigated the osseointegration of vitallium implants with the addit...