Fig. 2. Intraoral radiograph of an immediately placed post-extractive dental implant with a full contour zirconia restoration after 1 year (same patient as in Fig. 1)
Fig. 2. Intraoral radiograph of an immediately placed post-extractive dental implant with a full contour zirconia restoration after 1 year (same patient as in Fig. 1)
Fig. 1. Pre-operative panoramic radiograph of a failing molar in position 36
Fig. 1. Pre-operative panoramic radiograph of a failing molar in position 36
Agreement percentage (n = 11)
Presence of shame
0.0
Self-confidence has decreased
0.0
Evades eating with the implant
9.1
The ability to chew has decreased
0.0
Implant influences speech
0.0
Implant influences taste
0.0
Not satisfied with the colour of the crown
0.0
Not satisfied with the form of the crown
0.0
Not satisfied with ...
Bone change (mm)n = 11mean (SD)− 0.17 mm (0.73)> − 2.0 to − 1.51 (9.1)> − 1.5 to − 1.00 (0.0)> − 1.0 to − 0.52 (18.2)> − 0.5 to 0.04 (36.4)> 0.0 to 0.52 (18.2)> 0.5 to 1.02 (18.2)Table 4 Mean value, standard deviation, and frequency distribution (percentages) of marginal bone change between 1 month after restoration placement (T1) and 1 year in ...
Bone level (mm)n = 15Mean (SD)− 0.94 mm (0.54)> − 2.5 to − 2.01 (6.7)> − 2.0 to − 1.52 (13.3)> − 1.5 to − 1.04 (26.7)> − 1.0 to − 0.55 (33.3)> − 0.5 to 0.03 (20.0)Table 3 Mean value, standard deviation, and frequency distribution (percentages) of marginal bone level at 1 month after restoration placement (T1)
T1 (n = 15)T12 (n = 11)Plaque indexScore 0, 15 (100%)Score 0, 11 (100%)Calculus indexScore 0, 15 (100%)Score 0, 11 (100%)Gingival indexScore 0, 15 (100%)Score 0, 11 (100%)Bleeding indexScore 0, 15 (100%)Score 0, 10 (91%)Score 1, 1 (9%)Probing depth in mm (sd)2.0 (0.9)1.9 (0.8)Table 2 Frequencies and percentages of plaque index scores (possible score 0–3), calculus index scores (possibl...
Mean age in years (sd, minimum-maximum)
57 (6.6, 44–67)
Gender (number male/female)
6/9
Reason of failure (severe caries/crown fracture/root fracture)
3/6/6
Implant position (maxilla/mandible)
7/8
Implant position (in between teeth/no tooth distally)
11/4
Table 1 Baseline characteristics of the study group
Meijer, H.J.A., Raghoebar, G.M. Immediate implant placement in molar extraction sites: a 1-year prospective case series pilot study. Int J Implant Dent 6, 3 (2020). https://doi.org/10.1186/s40729-019-0201-7
Download citation
Received: 29 October 2019
Accepted: 11 December 2019
Published: 12 February 2020
DOI: https://doi.org/10.1186/s40729-019-0201-7
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...
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
This clinical study was conducted in accordance with the World Medical Association Declaration of Helsinki (version VI, 2002). The Medical Ethical Committee of the University Medical Center Groningen considered this case series study not subject to the Medical Research Involving Human Subjects Act (Number M15.184100). The study was registered at the Netherlands Trial Register (Number NL8117). Afte...
Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, PO Box 30.001, NL-9700 RB, Groningen, The Netherlands
Henny J. A. Meijer & Gerry M. Raghoebar
Department of Implant Dentistry, University Medical Center Groningen, Groningen, The Netherlands
Henny J. A. Meijer
You can also search for this author in PubMed Google Scholar
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An unrestricted grant from Nobel Biocare Services AG funded the 1-year clinical study; implant materials were provided (study code: 2015-1365).
Tallarico M, Xhanari E, Pisano M, Gatti F, Meloni SM. Molar replacement with 7 mm-wide diameter implants: to place the implant immediately or to wait 4 months after socket preservation? 1 year after loading results from a randomised controlled trial. Eur J Oral Implantol. 2017;10:169–78.
Checchi V, Felice P, Zucchelli G, Barausse C, Piattelli M, Pistilli R, Grandi G, Esposito M. Wide diameter i...
Hamouda NI, Mourad SI, El-Kenawy MH, Maria OM. Immediate implant placement into fresh extraction socket in the mandibular molar sites: a preliminary study of a modified insertion technique. Clin Implant Dent Relat Res. 2015;17(Suppl 1):e107–16. https://doi.org/10.1111/cid.12135.
Demircan S, Çankaya AB. Is immediate implant placement possible in the maxillary molar area? An anatomical study. Qu...
Gallucci GO, Hamilton A, Zhou W, Buser D, Chen S. Implant placement and loading protocols in partially edentulous patients: a systematic review. Clin Oral Implants Res. 2018;29(Suppl 16):106–34. https://doi.org/10.1111/clr.13276.
Slagter KW, Den Hartog L, Bakker NA, Vissink A, Meijer HJA, Raghoebar GM. Immediate placement of dental implants in the esthetic zone: a systematic review and pooled a...
The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.
Within the limitations of this study, it has been demonstrated that immediate placement of regular diameter implants in molar post-extraction sites of maxilla and mandible resulted in a high implant failure rate during a 1-year follow-up period.
In an attempt to incorporate the concept of patient engagement, this study investigated the patients’ satisfaction with the rehabilitated posterior region by assessing specific patient-centred outcomes. This was done by the patients filling out the established questionnaire 1 year after restoration placement [26, 27]. All the questioned outcome measures showed high patient satisfaction which is...
The mean marginal bone level was 0.94 mm below the neck of the implant at 1 month after restoration placement (T1). The optimal position of the peri-implant bone after a maturation period should be at the same level as the neck of the implant. This means that part of the biological width of the present study, which is acting as a barrier, was in contact with the implant surface roughness and w...
Immediate placement of regular diameter implants in molar post-extraction sites of the maxilla and mandible resulted in a high implant failure rate during a 1-year follow-up period.
The implant survival rate was 73.3% after 1 year in function. The performance of immediate placements in post-extraction sites was also analysed in the Cafiero et al., Atieh et al., Tallarico et al., and Checchi et a...
All 15 consecutive patients eligible to join the study on the basis of the inclusion and exclusion criteria agreed to participate in this study. The patient characteristics are depicted in Table 1. All implant-supported restorations had natural antagonistic teeth. Four of the 15 patients treated had a mobile implant, which had to be removed (in two patients 3 months after crown placement and in...
Radiographs were taken and evaluated 1 month and 12 months after restoration placement using a parallel technique, with an X-ray holder for periapical radiographs. They were analysed using a specially designed computer software to perform linear measurements on digital radiographs. The calibration was carried out in the vertical plane of each radiograph by using the known distance of the implan...
An impression was made at implant level 2 weeks after the second stage of the surgery in order to fabricate a single crown. A definitive full-zirconia crown (yttria-stabilized zirconium oxide) with an angulated screw channel (NobelProcera FCZ Implant Crown, NobelBiocare AB) was manufactured in the determined colour at a centralized milling facility (NobelProcera Service Center, Mahwah, NJ, USA) a...
All patients referred to the Department of Oral and Maxillofacial Surgery (University of Groningen, University Medical Hospital), from January 2016 to July 2017, for single-tooth implant therapy in the maxillary and mandibular posterior region were considered for inclusion. The following inclusion criteria were applied:
One failing first or second molar in the maxilla or mandible;
Sufficient bon...
Implant placement and loading protocols are changing [1]. There is a growing tendency to place single tooth implants immediately after the extraction of a failing tooth, especially in the maxillary aesthetic region, and preferably combined with immediate provisionalization [2,3,4,5,6]. This tendency is related to evolving society factors, including more demanding patients and a wish for direct tre...
There is a growing tendency to place single tooth implants immediately after extracting a failing tooth in the posterior region. The aim of this prospective case series pilot study was to evaluate immediate implant placement in molar post-extraction sites during a 1-year follow-up period.
Fifteen consecutive patients with a single failing molar in the maxilla or mandible, and presenting enough bo...
Fig. 2. Intraoral radiograph of an immediately placed post-extractive dental implant with a full contour zirconia restoration after 1 year (same patient as in Fig. 1)
Fig. 2. Intraoral radiograph of an immediately placed post-extractive dental implant with a full contour zirconia restoration after 1 year (same patient as in Fig. 1)
Fig. 1. Pre-operative panoramic radiograph of a failing molar in position 36
Fig. 1. Pre-operative panoramic radiograph of a failing molar in position 36
Agreement percentage (n = 11)Presence of shame0.0Self-confidence has decreased0.0Evades eating with the implant9.1The ability to chew has decreased0.0Implant influences speech0.0Implant influences taste0.0Not satisfied with the colour of the crown0.0Not satisfied with the form of the crown0.0Not satisfied with the colour of the mucosa around the crown0.0Not satisfied with the form of the muc...
Bone change (mm)n = 11mean (SD)− 0.17 mm (0.73)> − 2.0 to − 1.51 (9.1)> − 1.5 to − 1.00 (0.0)> − 1.0 to − 0.52 (18.2)> − 0.5 to 0.04 (36.4)> 0.0 to 0.52 (18.2)> 0.5 to 1.02 (18.2)Table 4 Mean value, standard deviation, and frequency distribution (percentages) of marginal bone change between 1 month after restoration placement (T1) and 1 year in ...
Bone level (mm)n = 15Mean (SD)− 0.94 mm (0.54)> − 2.5 to − 2.01 (6.7)> − 2.0 to − 1.52 (13.3)> − 1.5 to − 1.04 (26.7)> − 1.0 to − 0.55 (33.3)> − 0.5 to 0.03 (20.0)Table 3 Mean value, standard deviation, and frequency distribution (percentages) of marginal bone level at 1 month after restoration placement (T1)
T1 (n = 15)T12 (n = 11)Plaque indexScore 0, 15 (100%)Score 0, 11 (100%)Calculus indexScore 0, 15 (100%)Score 0, 11 (100%)Gingival indexScore 0, 15 (100%)Score 0, 11 (100%)Bleeding indexScore 0, 15 (100%)Score 0, 10 (91%)Score 1, 1 (9%)Probing depth in mm (sd)2.0 (0.9)1.9 (0.8)Table 2 Frequencies and percentages of plaque index scores (possible score 0–3), calculus index scores (possibl...
Mean age in years (sd, minimum-maximum)57 (6.6, 44–67)Gender (number male/female)6/9Reason of failure (severe caries/crown fracture/root fracture)3/6/6Implant position (maxilla/mandible)7/8Implant position (in between teeth/no tooth distally)11/4Table 1 Baseline characteristics of the study group
Meijer, H.J.A., Raghoebar, G.M. Immediate implant placement in molar extraction sites: a 1-year prospective case series pilot study. Int J Implant Dent 6, 3 (2020). https://doi.org/10.1186/s40729-019-0201-7
Download citation
Received: 29 October 2019
Accepted: 11 December 2019
Published: 12 February 2020
DOI: https://doi.org/10.1186/s40729-019-0201-7
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...
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
This clinical study was conducted in accordance with the World Medical Association Declaration of Helsinki (version VI, 2002). The Medical Ethical Committee of the University Medical Center Groningen considered this case series study not subject to the Medical Research Involving Human Subjects Act (Number M15.184100). The study was registered at the Netherlands Trial Register (Number NL8117). Afte...
Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, PO Box 30.001, NL-9700 RB, Groningen, The Netherlands
Henny J. A. Meijer & Gerry M. Raghoebar
Department of Implant Dentistry, University Medical Center Groningen, Groningen, The Netherlands
Henny J. A. Meijer
You can also search for this author in PubMed Google Scholar
You can also search for this author in...
An unrestricted grant from Nobel Biocare Services AG funded the 1-year clinical study; implant materials were provided (study code: 2015-1365).
Tallarico M, Xhanari E, Pisano M, Gatti F, Meloni SM. Molar replacement with 7 mm-wide diameter implants: to place the implant immediately or to wait 4 months after socket preservation? 1 year after loading results from a randomised controlled trial. Eur J Oral Implantol. 2017;10:169–78.
Checchi V, Felice P, Zucchelli G, Barausse C, Piattelli M, Pistilli R, Grandi G, Esposito M. Wide diameter i...
Hamouda NI, Mourad SI, El-Kenawy MH, Maria OM. Immediate implant placement into fresh extraction socket in the mandibular molar sites: a preliminary study of a modified insertion technique. Clin Implant Dent Relat Res. 2015;17(Suppl 1):e107–16. https://doi.org/10.1111/cid.12135.
Demircan S, Çankaya AB. Is immediate implant placement possible in the maxillary molar area? An anatomical study. Qu...
Gallucci GO, Hamilton A, Zhou W, Buser D, Chen S. Implant placement and loading protocols in partially edentulous patients: a systematic review. Clin Oral Implants Res. 2018;29(Suppl 16):106–34. https://doi.org/10.1111/clr.13276.
Slagter KW, Den Hartog L, Bakker NA, Vissink A, Meijer HJA, Raghoebar GM. Immediate placement of dental implants in the esthetic zone: a systematic review and pooled a...
The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.
Within the limitations of this study, it has been demonstrated that immediate placement of regular diameter implants in molar post-extraction sites of maxilla and mandible resulted in a high implant failure rate during a 1-year follow-up period.
In an attempt to incorporate the concept of patient engagement, this study investigated the patients’ satisfaction with the rehabilitated posterior region by assessing specific patient-centred outcomes. This was done by the patients filling out the established questionnaire 1 year after restoration placement [26, 27]. All the questioned outcome measures showed high patient satisfaction which is...
The mean marginal bone level was 0.94 mm below the neck of the implant at 1 month after restoration placement (T1). The optimal position of the peri-implant bone after a maturation period should be at the same level as the neck of the implant. This means that part of the biological width of the present study, which is acting as a barrier, was in contact with the implant surface roughness and w...
Immediate placement of regular diameter implants in molar post-extraction sites of the maxilla and mandible resulted in a high implant failure rate during a 1-year follow-up period.
The implant survival rate was 73.3% after 1 year in function. The performance of immediate placements in post-extraction sites was also analysed in the Cafiero et al., Atieh et al., Tallarico et al., and Checchi et a...
All 15 consecutive patients eligible to join the study on the basis of the inclusion and exclusion criteria agreed to participate in this study. The patient characteristics are depicted in Table 1. All implant-supported restorations had natural antagonistic teeth. Four of the 15 patients treated had a mobile implant, which had to be removed (in two patients 3 months after crown placement and in...
Radiographs were taken and evaluated 1 month and 12 months after restoration placement using a parallel technique, with an X-ray holder for periapical radiographs. They were analysed using a specially designed computer software to perform linear measurements on digital radiographs. The calibration was carried out in the vertical plane of each radiograph by using the known distance of the implan...
An impression was made at implant level 2 weeks after the second stage of the surgery in order to fabricate a single crown. A definitive full-zirconia crown (yttria-stabilized zirconium oxide) with an angulated screw channel (NobelProcera FCZ Implant Crown, NobelBiocare AB) was manufactured in the determined colour at a centralized milling facility (NobelProcera Service Center, Mahwah, NJ, USA) a...
All patients referred to the Department of Oral and Maxillofacial Surgery (University of Groningen, University Medical Hospital), from January 2016 to July 2017, for single-tooth implant therapy in the maxillary and mandibular posterior region were considered for inclusion. The following inclusion criteria were applied:
One failing first or second molar in the maxilla or mandible;
Sufficient bon...
Implant placement and loading protocols are changing [1]. There is a growing tendency to place single tooth implants immediately after the extraction of a failing tooth, especially in the maxillary aesthetic region, and preferably combined with immediate provisionalization [2,3,4,5,6]. This tendency is related to evolving society factors, including more demanding patients and a wish for direct tre...
There is a growing tendency to place single tooth implants immediately after extracting a failing tooth in the posterior region. The aim of this prospective case series pilot study was to evaluate immediate implant placement in molar post-extraction sites during a 1-year follow-up period.
Fifteen consecutive patients with a single failing molar in the maxilla or mandible, and presenting enough bo...
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
ple. a Ground section stained with Levai-Laczkó. b Tissue identification of the ROI. c Closer view a bone and CCXBB. d Closer view of b
Fig. 5. Histomorphometric analysis of the same sample. a Ground section stained with Levai-Laczkó. b Tissue identification of the ROI. c Closer view a arrow pointing a cement line between new mineralized bone and CCXBB. d Closer view of b
Fig. 4. Histological samples. a CCXBB control without implantation. b Histologic samples with acute inflammatory infiltration. c Histologic sample with limited remaining CCXBB and large bone ingrowth
Fig. 4. Histological samples. a CCXBB control without implantation. b Histologic samples with acute inflammatory infiltration. c Histologic sample with limited remaining CCXBB and large bone ingr...
Fig. 3. Re-entry procedure of patient in Fig. 1. a Buccal aspect of the augmented region. b Horizontal bone augmentation. c Screws and pins removal and bone trephine sampling. d Implants placement and buccal bone width from the implant shoulder. e Primary flap closure. f Implants submerged healing
Fig. 3. Re-entry procedure of patient in Fig. 1. a Buccal aspect of the augmented region. b Ho...
Fig. 2. Lateral bone augmentation of the alveolar crest (a) atrophic ridge. b Perforations and adaptation of the cortical layer. c Shaping, pre-wetting and fixation of CCXBB with titanium screws. d Horizontal contour and peripheral gap between CCXBB and bone layer. e Outlying DBBM filling. f CM stabilized with pins
Fig. 2. Lateral bone augmentation of the alveolar crest (a) atrophic ridge. b ...
Fig. 1. Study chart and follow-up visits
Fig. 1. Study chart and follow-up visits
Differentiated tissues
Implant lost (Yes/no)
Mean
SD
Percentage
SD (%)
...
Patient
TRAP (%)
OPN (%)
ALP (%)
OSC (%)
1
...
Tissue type
Mean
Standard deviation
Median
CI 95%
Mineralized bone
...
Patient
Soft tissue dehiscence
Mineralized bone (%)
CCXBB (%)
Bone marrow (%)
Connect...
Ortiz-Vigón, A., Martinez-Villa, S., Suarez, I. et al. Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant placement.
Int J Implant Dent 3, 24 (2017). https://doi.org/10.1186/s40729-017-0087-1
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Received: 21 March 2017
Accepted: 12 June 2017
Published: 21 Ju...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
ETEP Research Group, Facultad de Odontología, Universidad Complutense de Madrid, Plaza Ramón y Cajal, 28040, Madrid, Spain
Alberto Ortiz-Vigón, Sergio Martinez-Villa, Iñaki Suarez, Fabio Vignoletti & Mariano Sanz
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We wish to acknowledge the dedication and scientific advise of Prof. Dr. Tord Berglundh on the histological analysis as well as the diligent work in processing the histological samples to Estela Maldonado for the immunohistochemistry and Asal Shikhan and Fernando Muñoz for the histomorphometry. The work of Esperanza Gross on the statistical analysis is highly acknowledged.
This study was partial...
Patti A, Gennari L, Merlotti D, Dotta F, Nuti R. Endocrine actions of osteocalcin. Int J Endocrinol. 2013;2013:846480.
Schwarz F, Herten M, Sager M, Wieland M, Dard M, Becker J. Histological and immunohistochemical analysis of initial and early osseous integration at chemically modified and conventional SLA titanium implants: preliminary results of a pilot study in dogs. Clin Oral Implants Res. 2...
Araujo MG, Linder E, Lindhe J. Bio-Oss collagen in the buccal gap at immediate implants: a 6-month study in the dog. Clin Oral Implants Res. 2011;22:1–8.
Chiapasco M, Colletti G, Coggiola A, Di Martino G, Anello T, Romeo E. Clinical outcome of the use of fresh frozen allogeneic bone grafts for the reconstruction of severely resorbed alveolar ridges: preliminary results of a prospective study. I...
Jeno L, Geza L. A simple differential staining method for semi-thin sections of ossifying cartilage and bone tissues embedded in epoxy resin. Mikroskopie. 1975;31:1–4.
Dias RR, Sehn FP, de Santana Santos T, Silva ER, Chaushu G, Xavier SP. Corticocancellous fresh-frozen allograft bone blocks for augmenting atrophied posterior mandibles in humans. Clin Oral Implants Res. 2016;27:39–46.
Nissan ...
Cremonini CC, Dumas M, Pannuti C, Lima LA, Cavalcanti MG. Assessment of the availability of bone volume for grafting in the donor retromolar region using computed tomography: a pilot study. Int J Oral Maxillofac Implants. 2010;25:374–8.
Nkenke E, Weisbach V, Winckler E, Kessler P, Schultze-Mosgau S, Wiltfang J, et al. Morbidity of harvesting of bone grafts from the iliac crest for preprosthetic...
Sanz M, Vignoletti F. Key aspects on the use of bone substitutes for bone regeneration of edentulous ridges. Dent Mater. 2015;31:640–7.
Benic GI, Hammerle CH. Horizontal bone augmentation by means of guided bone regeneration. Periodontology. 2014;66:13–40.
Beretta M, Cicciu M, Poli PP, Rancitelli D, Bassi G, Grossi GB, et al. A Retrospective Evaluation of 192 Implants Placed in Augmented Bon...
Alkaline phosphatase
Cone beam computed tomography
Collagen containing xenogeneic bone block
Native collagen membrane
Deproteinized bovine bone mineral
Etiology and Therapy of Periodontal Diseases
Osteopontin
Osteocalcine
Tartrate-resistant acid phosphatase
Within the limitations of this clinical study, we may conclude that the use of CCXBB in combination with DBBM particles and a native bilayer collagen membrane for staged lateral bone augmentation in severe atrophic alveolar crests achieved significant horizontal crestal width allowing for staged implant placement in most of the patients. Histological analysis and implant survival records indicate ...
The immune-histochemical results reported expression of osteopontin mainly at the border between mineralized vital bone (MVB) with CCXBB, what coincides with findings from previous reports [38,39,40]. Alkaline phosphatase (ALP) is considered as an early osteoblast differentiation marker [41]. ALP-positive cells were detectable, in all specimens on the periphery of MVB, associated to areas of new b...
When correlating the clinical results and the histological outcomes, there was a positive association between the presence of soft tissue dehiscence with CCXBB exposure and a diminished amount of new mineralized bone (p = 0.06). This lower amount of new bone within the xenogeneic graft suggests a lack of full graft integration and diminished vascular supply, what may have caused the soft tissu...
The purpose of this investigation was to evaluate histologically and immunohistochemically the behavior of CCXBB blocks when used for staged lateral bone augmentation in severe human horizontal residual bone defects. Six months after the regenerative intervention using the CCXBB blocks, the mean increase in bone width was 4.12 mm and hence, this outcome allowed for the placement of dental implant...
The results from the histomorphometric measurements are depicted in Table 2. Bone biopsies were composed by 21.37% (SD 7.36) of residual CCXBB, 26.90% (SD 12.21) of mineralized vital bone (MVB), 47.13% (SD 19.15) of non-mineralized tissue and 0.92% of DBBM (Fig. 5b). Biopsies from patients who lost their implants had a statistical significant lower amount of MVB (p = 0.01u) and a statistical...
Twenty-eight CCXBB blocks were placed in 15 patients that fulfilled the selection criteria (12 women and 3 men) with a mean age of 54.5 (SD 8.34).
The detailed clinical and radiographical outcomes have been reported previously [21]. In brief, one patient experienced pain and soft tissue dehiscence leading to removal of the graft material 3 days after the regenerative procedure. Another patient r...
For the immunohistochemical analysis, the semi-thin sections were incubated over night with primary antibodies at 4 °C (Santa Cruz Biotechnology Inc., Santa Cruz, Calif., USA). The antibody dilutions used were alkaline phosphatase (ALP) 1:100, osteopontin (OPN) 1:100, osteocalcin (OSC) 1:100, and tatrate resistant acid phosphatase (TRAP) 1:100.
The obtained semi-thin sections were evaluated wit...
Twenty-six weeks after the regenerative procedure the patient returned for the re-entry intervention for placement of dental implants. After raising full-thickness flaps, the augmented area was exposed and horizontal crestal width measurements were performed. Then, the surgeon evaluated the bone availability and if implant placement was considered possible, a core bone biopsy was harvested with th...
CCXBB (Bio-Graft® Geistlich Pharma) is a bone substitute material in a natural block form. The dimensions of the Bio-Graft block are 10 mm in height, 10 mm in length and 5 mm in width. It consists of a natural cancellous bone structure of hydroxyapatite and endogenous collagen type I and III, equine origin and is a class III medical device according to the Medical Device Directive 93/42 EECs...
The present manuscript reports the histological outcomes of a prospective single arm study evaluating the safety and clinical performance of CCXBB blocks when used as replacement bone grafts for lateral bone augmentation prior to staged implant placement. The results of the clinical and radiographic outcomes have been reported in a previous publication [21]. For correlation of the histological wit...
Different techniques and grafting materials have been used for the horizontal reconstruction of deficient alveolar processes before implant placement, resulting in different degrees of predictability and clinical outcomes [1]. Among the grafting materials, particulated xenogeneic materials have been extensively studied in both experimental and clinical studies and when combined with porcine-derive...
The osteoconductive properties of collagen containing xenogeneic bone blocks (CCXBB) remain unclear. The aim of this prospective single-arm clinical study was to assess the histological outcomes of CCXBB blocks used as bone replacement grafts for lateral bone augmentation procedures.
In 15 patients with severe horizontal alveolar ridge resorption, lateral augmentation procedures were performed us...
Fig. 7. ing a trephine bur. a Overview image of coronal-apical cut through the entire core biopsy showing formation of new bone (NB) next to old bone of the extraction socket (B). easy-graft CRYSTAL particles (Gr) are embedded in well perfused connective tissue (CT) and new bone (NB) (Azur II and Pararosanilin, original magnification ×50). b Integration of easy-graft CRYSTAL particle (Gr) into ...
Fig. 6. ntegration and preservation of ridge without collapse of the buccal or lingual cortical plates also showing the cross sections in the grafted area
Fig. 6. a–c Four-month postoperative CBCT showing graft integration and preservation of ridge without collapse of the buccal or lingual cortical plates also showing the cross sections in the grafted area
Fig. 5. CBCT images of the extraction site. a Preoperative CBCT showing fractured and un-restorable teeth #45 and #46 planned to be extracted. b–d Cross sectional views
Fig. 5. CBCT images of the extraction site. a Preoperative CBCT showing fractured and un-restorable teeth #45 and #46 planned to be extracted. b–d Cross sectional views
Fig. 4. excellent width of keratinized tissue which was also preserved. b Implant crowns placed and loaded after 3 months of placement
Fig. 4. a Second stage surgery followed by impression making. Note the excellent width of keratinized tissue which was also preserved. b Implant crowns placed and loaded after 3 months of placement
Fig. 3. Postoperative X ray showing the implant positions in the mandible where the teeth were extracted and ridge preservation was accomplished
Fig. 3. Postoperative X ray showing the implant positions in the mandible where the teeth were extracted and ridge preservation was accomplished
Fig. 2. ssue approximation. A good width of keratinized tissue is visible along with ridge preservation. Ready for implant placement in the grafted areas. b Implant placed in 45 area. Core biopsy sample taken from area 46. Note the integration of graft particles in the preserved alveolar ridge also inside the osteotomy site of 46. c Two Xive (Dentsply) implants placed in the preserved ridge. d. ...
Fig. 1. ft tissue and no flap reflection on the surgical site. c Graft material condensed into the extraction sockets showing good initial graft stability. d Black silk sutures placed with tissue approximation and no releasing incision in the flaps
Fig. 1. a Clinical occlusal view with fractured 45 and 46. b Post-extraction view of the socket. Note minimal trauma to the soft tissue and no fla...
Patient no.
Gender
Patient’s age
Tooth no.
Time post extraction [month]
% New bone
...
Patient no.
Tooth no.
Ridge width baseline [mm]
Ridge width implant placement [mm]
Ridge width changes [mm]
...
ISQ level at implant placement
ISQ level at loading
Patient no.
Tooth no.
Buccal
Palatal
...
Kakar, A., Rao, B.H.S., Hegde, S. et al. Ridge preservation using an in situ hardening biphasic calcium phosphate (β-TCP/HA) bone graft substitute—a clinical, radiological, and histological study.
Int J Implant Dent 3, 25 (2017). https://doi.org/10.1186/s40729-017-0086-2
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Received: 31 December 2016
Accepted: 25 May 2017
Published: 22 June 2017
DOI: htt...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Correspondence to
Ashish Kakar.
Yenepoya University Dental College, University Road, Mangalore, 575018, India
Ashish Kakar, Bappanadu H. Sripathi Rao & Shashikanth Hegde
Dental Foundations and Research Centre, Malad, Mumbai, 400064, India
Nikhil Deshpande
Department of Oral and Maxillofacial Surgery, Center for Dental Medicine, Medical Center—University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
Annette ...
We acknowledge Sunstar Suisse SA, Etoy, Switzerland, for partly supporting this clinical study with a study grant. The authors declare that there is no conflict of interest regarding the publication of this paper.
Ashish Kakar, Bappanadu H. Sripathi Rao, Shashikanth Hegde, Nikhil Deshpande, Annette Lindner, Heiner Nagursky, Aditya Patney, and Harsh Mahajan declare that they have no competing inte...
Lang NP, Pun L, Lau KY, Li KY, Wong MC. A systematic review on survival and success rates of implants placed immediately into fresh extraction sockets after at least 1 year. Clin Oral Implants Res. 2012;23 Suppl 5:39–66.
Smukler H, Landi L, Setayesh R. Hostomorphometric evaluation of extraction sockets and deficient alveolar ridges treated with allografts and barrier membrane. A pilot study. In...
Nair PNR, Luder H-U, Maspero FA, Fischer JH, Schug J. Biocompatibility of beta-tricalcium phosphateroot replicas in porcine tooth extraction sockets—a correlativehistological, ultrastructural, and x-ray microanalytical pilotstudy. J Biomater Appl. 2006;20(4):307–24.
Jensen SS, Terheyden H. Bone augmentation procedures in localized defects in the alveolar ridge: clinical results with different...
Araujo MG, Sukekava F, Wennstrom J, Lindhe J. Ridge alterations following implant placement in fresh extraction sockets: an experimental study in the dog. J Clin Periodontol. 2005;32:645–52.
Van der Weijden F, Dell'Acqua F, Slot DE DE. Alveolar bone dimensional changes of post-extraction sockets in humans: a systematic review. J Clin Periodontol. 2009;36(12):1048–58.
Schropp L, Wenzel A, Kos...
The results of this clinical study support the use of a biphasic in situ hardening alloplastic bone graft substitute for ridge preservation in intact post-extraction sites without the use of a dental membrane. Therefore, grafting of sockets without primary wound closure or using dental membranes or a soft tissue punch can be an effective minimally invasive method of preserving the contour and arch...
Likewise, the reported amount of residual grafting material in the defect site was similar. In average, only 26.2 ± 9.4% of the defect was occupied with residual graft material in this study which is well in line with 26.6 ± 5.2% reported for BCP but below the 37.7 ± 8.5% reported for xenograft [14].
All 15 implants could be placed without the need for additional bone augmentation....
As previously reported, secondary intention soft tissue healing of grafted post-extraction sites can be well achieved when using an in situ hardening and in situ stabilizing bone graft substitutes without the need of a dental membrane [18, 20]. Findings of the present report corroborate these results. The authors found that all sites healed uneventfully with coverage of soft tissue and no local co...
Ridge preservation following dental extractions is fundamental, preserving the ridge profile for subsequent implant placement and providing a sustained function and esthetics. This clinical trial reports on the successful application of an in situ hardening biphasic alloplastic bone graft substitute for ridge preservation and subsequent implant placement in 15 healthy patients. A routine but minim...
Cone beam computer tomography (CBCT) was performed before tooth extraction and at the time point of implant placement. Mean ridge width reduction before tooth extraction to implant placement was calculated to effect in 0.79 ± 0.73 mm horizontal bone loss (Table 2). Primary implant stability was achieved in all 15 cases, showed in average high ISQ levels 70.3 ± 9.7 (buccal/palatal), and...
Fifteen patients (4 females and 11 males) with a mean age of 51.3 + 14.8 years (range: 27 to 75 years) participated in this randomized clinical trial. The site specific areas and teeth numbers for the study are shown in Table 1.
In all cases, the postoperative healing was uneventful. Clinically, the soft tissue healing pattern observed was very similar in all cases. The soft tissue on all ...
Bone biopsies were harvested using a trephine bur at the site of implant placement. The trephine burs including the bone biopsies were fixed in 4% formalin for 5–7 days, rinsed in water, and dehydrated in serial steps of ethanol (70, 80, 90, and 100%), remaining for 1 day in each concentration. Specimens were then infiltrated, embedded, and polymerized in resin (Technovit 9100, Heraeus Kulzer,...
Antibiotic therapy consisting of 1 g amoxicillin every 12 h for 4 days and mouth rinsing with 0.2% chlorhexidine every 8 h for 10 days were prescribed. The suture was removed 1 week postoperatively. After 3 to 8 months (average 5.2 ± 2 months), the sites (Fig. 2a) were reentered for implant placement. A site-specific full thickness mucoperiosteal flap was elevated to expose the regen...
This study was approved by the Yenepoya University Ethics committee, Mangalore, India (Approval Number YOEC83/8/3/2014). Fifteen patients who required extraction of a maxillary or mandibular tooth and subsequent single-tooth implant placement and who met the inclusion and exclusion criteria were included in this prospective single-arm clinical study. The patients (4 females and 11 males) had a mea...
To our knowledge, this is the first systematic clinical, radiographic, and histological evaluation that assesses bone formation and ridge width preservation after socket grafting using an in situ hardening biphasic bone graft substitute in healthy patients.
Following tooth extraction, the alveolar ridge will decrease in volume and change its morphology [1, 2]. These changes are clinically significant [3] and can complicate the placement of a conventional bridge or an implant-supported crown. Post-extraction maintenance of the alveolar ridge following the principles of ridge preservation using bone graft substitutes minimizes ridge resorption and, thu...
Post-Extraction ridge preservation using bone graft substitutes is a conservative technique to maintain the width of the alveolar ridge. The objective of the present study was to evaluate an in situ hardening biphasic (HA/β-TCP) bone graft substitutes for ridge preservation without primary wound closure or a dental membrane.
A total of 15 patients reported for tooth extraction were enrolled in t...
Fig. 7. Vestibular view of the final restoration
Fig. 7. Vestibular view of the final restoration
Fig. 6. Occlusal view of the final restoration. In this case, with the longest cantilever extension on a final restoration within this collective
Fig. 6. Occlusal view of the final restoration. In this case, with the longest cantilever extension on a final restoration within this collective
Fig. 5. One-year post-surgery panoramic radiograph with final restoration
Fig. 5. One-year post-surgery panoramic radiograph with final restoration
Fig. 4. Occlusal view of implant-abutments 3 months post-surgery at the first removal of the temporary restoration
Fig. 4. Occlusal view of implant-abutments 3 months post-surgery at the first removal of the temporary restoration
Fig. 3. Fill-in of the occlusal perforations with self-curing resin to connect the prostheses to the temporary titanium cylinders
Fig. 3. Fill-in of the occlusal perforations with self-curing resin to connect the prostheses to the temporary titanium cylinders
Fig. 2. Preparation of the composite veneers for making the temporary restoration
Fig. 2. Preparation of the composite veneers for making the temporary restoration
Fig. 1. Preparation of implant cavity through corresponding metal sleeves after extraction of the central incisors using a surgical template supported by hopeless remaining teeth
Fig. 1. Preparation of implant cavity through corresponding metal sleeves after extraction of the central incisors using a surgical template supported by hopeless remaining teeth
Collective
Mesial
Distal
1 year
55 months (40–84)
1 year
...
Collective
ISQ
P
At insertion
3 months
Total (n = 57)
61.3 ± 7.8
...
Collective
PT value
P
At insertion
3 months
Total (n = 57)
−1.8 ± 2.4
...
Period
# of implants
# of failures
Survival rate (%)
Cumulative survival rate (%)
0 t...
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 retrospective data analysis was conducted in accordance with the Helsinki Declaration of 1975, as revised in 2008, and all patients signed an informed consent. After consulting the local ethic committee, the decision was that due to the retrospective character of this study, with no additional data acquisition, no ethical approval is needed according to the hospital laws of the appropriate sta...
Department of Prosthetic Dentistry, University Medical Center of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131, Mainz, Germany
S. Wentaschek & S. Hartmann
Department of Oral and Maxillofacial Surgery - Plastic Surgery, University Medical Center of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131, Mainz, Germany
C. Walter & W. Wagner
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The authors would like to thank Bredent Medical (Senden, Germany) for providing the 3D-planning system and supporting the treatment nonfinancially.
Bayer G, Kistler F, Kistler S, Adler S, Neugebauer J. Sofortversorgung mit reduzierter Implantatanzahl: Wissenschaftliche Konzeption und klinische Ergebnisse. Berlin: Quintessenz; 2011.
Hanley JA. Receiver operating characteristic (ROC) methodology: the state of the art. Crit Rev Diagn Imaging. 1989;29(3):307–35.
Atieh MA, Alsabeeha NH, Payne AG, de Silva RK, Schwass DS, Duncan WJ. The prognos...
Pommer B, Mailath-Pokorny G, Haas R, Busenlechner D, Furhauser R, Watzek G. Patients’ preferences towards minimally invasive treatment alternatives for implant rehabilitation of edentulous jaws. Eur J Oral Implantol. 2014;7(Suppl 2):S91–109.
Monje A, Suarez F, Galindo-Moreno P, Garcia-Nogales A, Fu JH, Wang HL. A systematic review on marginal bone loss around short dental implants (
Area under the curve
Implant stability quotient
Periotest
Receiver operating characteristic
Within the limits of this small group (n = 10 patients/60 implants), the failure rate of the analyzed implant system (n = 3 respective 5% implant loss) seems to be comparable with other immediate-loading protocols. On the other side, the implant loss rate of tilted implants (n = 2 of 20) in the atrophic upper jaw was quite high, but still, the aimed treatment concept could be achieved in eve...
Between baseline and first removal of the temporary restoration after 3 months, the mean ISQ increased and the mean PT value decreased significantly in the axial and tilted implants. This is in contrast to some other studies which evaluated no significant differences of stability parameters between primary and secondary stability with immediate loading in edentulous maxilla [16, 21, 22].
The pre...
The overall implant survival rate of 95% is slightly lower than the reported mean survival rates of the concept of tilted implants and immediate loading in edentulous jaws [11] but still close to them and maybe more comparable to investigations in which implants were also immediately loaded in the edentulous maxilla which were partly placed in fresh extraction sites [15, 16]. Nevertheless, what is...
After the temporary restoration with a fixed prosthesis, all 10 patients selected a fixed final restoration. These consisted of a cast metal framework with a full ceramic veneering including the replacement of at least the second premolars. They were made after a new impression on the abutment level (Figs. 6 and 7). The neck of the 20 tilted distal implants was positioned in region 4 (n = 5 impl...
Ten patients with a mean age at implant insertion of 64 ± 11.3 years (range 38 to 81 years; six women, four men) were included. Sixty titanium screw implants (Table 1) were inserted and immediately loaded between 09/2009 and 01/2013.
Seven patients had remaining teeth until implant surgery (two patients with 4, four patients with 7, and one patient with 12 teeth). Twenty-one (35%) of the 60 ...
Changes in marginal bone level were measured using the routinely made digital panoramic radiographs if these were available. The measurement tool was calibrated with the known respective implant length. To evaluate the bone loss, the difference was formed between the bone level at follow-up examination (Fig. 5) and at implant placement which is the baseline.
An implant was considered as successfu...
The patients were screened with preliminary panoramic radiographs, and since all the implants were 3D planned (SKYplanX™ program, Bredent GmbH, Senden, Germany) and inserted with a guiding template, a cone-beam CT (CBCT) was obtained eventually (KaVo 3D eXam™ unit, KaVo Dental GmbH, Biberach/Riss, Germany).
The drillings were performed using a 3D-planned surgical template with different metal...
In a retrospective study, all patients with immediately loaded implants in an edentulous maxillae with limited posterior ridge dimensions that received an equal concept were included if they had a follow-up of at least 3 years. The concept contained immediate loading with distal tilted implants and six implants per edentulous maxillae of a single implant system (blueSky™ implants, Bredent GmbH,...
For a few years, there has been a trend towards minimally invasive implant treatment concepts avoiding bone augmentation even in very atrophic edentulous jaws. These concepts aim to make an implant treatment with a shorter duration, with less inconvenience such as swelling or pain and possibly also economically more attractive [1]. If the implant treatment is less invasive, because of the possible...
The aim of this retrospective study was to evaluate the treatment outcome of six Bredent blueSky™ implants (Bredent GmbH, Senden, Germany) immediately loaded with a fixed full-arch prosthesis (two tilted posterior and four axial frontal and premolar implants).
All 10 patients with atrophic edentulous maxillae being treated with a standardized procedure from 09/2009 to 01/2013, who had a follow-...
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 (%)
...
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TRAP (%)
OPN (%)
ALP (%)
OSC (%)
1
...
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Mean
Standard deviation
Median
CI 95%
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...
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Soft tissue dehiscence
Mineralized bone (%)
CCXBB (%)
Bone marrow (%)
Connect...
Ortiz-Vigón, A., Martinez-Villa, S., Suarez, I. et al. Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant placement.
Int J Implant Dent 3, 24 (2017). https://doi.org/10.1186/s40729-017-0087-1
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Received: 21 March 2017
Accepted: 12 June 2017
Published: 21 Ju...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
ETEP Research Group, Facultad de Odontología, Universidad Complutense de Madrid, Plaza Ramón y Cajal, 28040, Madrid, Spain
Alberto Ortiz-Vigón, Sergio Martinez-Villa, Iñaki Suarez, Fabio Vignoletti & Mariano Sanz
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We wish to acknowledge the dedication and scientific advise of Prof. Dr. Tord Berglundh on the histological analysis as well as the diligent work in processing the histological samples to Estela Maldonado for the immunohistochemistry and Asal Shikhan and Fernando Muñoz for the histomorphometry. The work of Esperanza Gross on the statistical analysis is highly acknowledged.
This study was partial...
Patti A, Gennari L, Merlotti D, Dotta F, Nuti R. Endocrine actions of osteocalcin. Int J Endocrinol. 2013;2013:846480.
Schwarz F, Herten M, Sager M, Wieland M, Dard M, Becker J. Histological and immunohistochemical analysis of initial and early osseous integration at chemically modified and conventional SLA titanium implants: preliminary results of a pilot study in dogs. Clin Oral Implants Res. 2...
Araujo MG, Linder E, Lindhe J. Bio-Oss collagen in the buccal gap at immediate implants: a 6-month study in the dog. Clin Oral Implants Res. 2011;22:1–8.
Chiapasco M, Colletti G, Coggiola A, Di Martino G, Anello T, Romeo E. Clinical outcome of the use of fresh frozen allogeneic bone grafts for the reconstruction of severely resorbed alveolar ridges: preliminary results of a prospective study. I...
Jeno L, Geza L. A simple differential staining method for semi-thin sections of ossifying cartilage and bone tissues embedded in epoxy resin. Mikroskopie. 1975;31:1–4.
Dias RR, Sehn FP, de Santana Santos T, Silva ER, Chaushu G, Xavier SP. Corticocancellous fresh-frozen allograft bone blocks for augmenting atrophied posterior mandibles in humans. Clin Oral Implants Res. 2016;27:39–46.
Nissan ...
Cremonini CC, Dumas M, Pannuti C, Lima LA, Cavalcanti MG. Assessment of the availability of bone volume for grafting in the donor retromolar region using computed tomography: a pilot study. Int J Oral Maxillofac Implants. 2010;25:374–8.
Nkenke E, Weisbach V, Winckler E, Kessler P, Schultze-Mosgau S, Wiltfang J, et al. Morbidity of harvesting of bone grafts from the iliac crest for preprosthetic...
Sanz M, Vignoletti F. Key aspects on the use of bone substitutes for bone regeneration of edentulous ridges. Dent Mater. 2015;31:640–7.
Benic GI, Hammerle CH. Horizontal bone augmentation by means of guided bone regeneration. Periodontology. 2014;66:13–40.
Beretta M, Cicciu M, Poli PP, Rancitelli D, Bassi G, Grossi GB, et al. A Retrospective Evaluation of 192 Implants Placed in Augmented Bon...
Alkaline phosphatase
Cone beam computed tomography
Collagen containing xenogeneic bone block
Native collagen membrane
Deproteinized bovine bone mineral
Etiology and Therapy of Periodontal Diseases
Osteopontin
Osteocalcine
Tartrate-resistant acid phosphatase
Within the limitations of this clinical study, we may conclude that the use of CCXBB in combination with DBBM particles and a native bilayer collagen membrane for staged lateral bone augmentation in severe atrophic alveolar crests achieved significant horizontal crestal width allowing for staged implant placement in most of the patients. Histological analysis and implant survival records indicate ...
The immune-histochemical results reported expression of osteopontin mainly at the border between mineralized vital bone (MVB) with CCXBB, what coincides with findings from previous reports [38,39,40]. Alkaline phosphatase (ALP) is considered as an early osteoblast differentiation marker [41]. ALP-positive cells were detectable, in all specimens on the periphery of MVB, associated to areas of new b...
When correlating the clinical results and the histological outcomes, there was a positive association between the presence of soft tissue dehiscence with CCXBB exposure and a diminished amount of new mineralized bone (p = 0.06). This lower amount of new bone within the xenogeneic graft suggests a lack of full graft integration and diminished vascular supply, what may have caused the soft tissu...
The purpose of this investigation was to evaluate histologically and immunohistochemically the behavior of CCXBB blocks when used for staged lateral bone augmentation in severe human horizontal residual bone defects. Six months after the regenerative intervention using the CCXBB blocks, the mean increase in bone width was 4.12 mm and hence, this outcome allowed for the placement of dental implant...
The results from the histomorphometric measurements are depicted in Table 2. Bone biopsies were composed by 21.37% (SD 7.36) of residual CCXBB, 26.90% (SD 12.21) of mineralized vital bone (MVB), 47.13% (SD 19.15) of non-mineralized tissue and 0.92% of DBBM (Fig. 5b). Biopsies from patients who lost their implants had a statistical significant lower amount of MVB (p = 0.01u) and a statistical...
Twenty-eight CCXBB blocks were placed in 15 patients that fulfilled the selection criteria (12 women and 3 men) with a mean age of 54.5 (SD 8.34).
The detailed clinical and radiographical outcomes have been reported previously [21]. In brief, one patient experienced pain and soft tissue dehiscence leading to removal of the graft material 3 days after the regenerative procedure. Another patient r...
For the immunohistochemical analysis, the semi-thin sections were incubated over night with primary antibodies at 4 °C (Santa Cruz Biotechnology Inc., Santa Cruz, Calif., USA). The antibody dilutions used were alkaline phosphatase (ALP) 1:100, osteopontin (OPN) 1:100, osteocalcin (OSC) 1:100, and tatrate resistant acid phosphatase (TRAP) 1:100.
The obtained semi-thin sections were evaluated wit...
Twenty-six weeks after the regenerative procedure the patient returned for the re-entry intervention for placement of dental implants. After raising full-thickness flaps, the augmented area was exposed and horizontal crestal width measurements were performed. Then, the surgeon evaluated the bone availability and if implant placement was considered possible, a core bone biopsy was harvested with th...
CCXBB (Bio-Graft® Geistlich Pharma) is a bone substitute material in a natural block form. The dimensions of the Bio-Graft block are 10 mm in height, 10 mm in length and 5 mm in width. It consists of a natural cancellous bone structure of hydroxyapatite and endogenous collagen type I and III, equine origin and is a class III medical device according to the Medical Device Directive 93/42 EECs...
The present manuscript reports the histological outcomes of a prospective single arm study evaluating the safety and clinical performance of CCXBB blocks when used as replacement bone grafts for lateral bone augmentation prior to staged implant placement. The results of the clinical and radiographic outcomes have been reported in a previous publication [21]. For correlation of the histological wit...
Different techniques and grafting materials have been used for the horizontal reconstruction of deficient alveolar processes before implant placement, resulting in different degrees of predictability and clinical outcomes [1]. Among the grafting materials, particulated xenogeneic materials have been extensively studied in both experimental and clinical studies and when combined with porcine-derive...
The osteoconductive properties of collagen containing xenogeneic bone blocks (CCXBB) remain unclear. The aim of this prospective single-arm clinical study was to assess the histological outcomes of CCXBB blocks used as bone replacement grafts for lateral bone augmentation procedures.
In 15 patients with severe horizontal alveolar ridge resorption, lateral augmentation procedures were performed us...
Fig. 7. image of coronal-apical cut through the entire core biopsy showing formation of new bone (NB) next to old bone of the extraction socket (B). easy-graft CRYSTAL particles (Gr) are embedded in well perfused connective tissue (CT) and new bone (NB) (Azur II and Pararosanilin, original magnification ×50). b Integration of easy-graft CRYSTAL particle (Gr) into newly formed bone (NB) and conn...
Fig. 6. graft integration and preservation of ridge without collapse of the buccal or lingual cortical plates also showing the cross sections in the grafted area
Fig. 6. a–c Four-month postoperative CBCT showing graft integration and preservation of ridge without collapse of the buccal or lingual cortical plates also showing the cross sections in the grafted area
Fig. 5. CBCT images of the extraction site. a Preoperative CBCT showing fractured and un-restorable teeth #45 and #46 planned to be extracted. b–d Cross sectional views
Fig. 5. CBCT images of the extraction site. a Preoperative CBCT showing fractured and un-restorable teeth #45 and #46 planned to be extracted. b–d Cross sectional views
Fig. 4. lant crowns placed and loaded after 3 months of placement
Fig. 4. a Second stage surgery followed by impression making. Note the excellent width of keratinized tissue which was also preserved. b Implant crowns placed and loaded after 3 months of placement
Fig. 3. Postoperative X ray showing the implant positions in the mandible where the teeth were extracted and ridge preservation was accomplished
Fig. 3. Postoperative X ray showing the implant positions in the mandible where the teeth were extracted and ridge preservation was accomplished
Fig. 2. ximation. A good width of keratinized tissue is visible along with ridge preservation. Ready for implant placement in the grafted areas. b Implant placed in 45 area. Core biopsy sample taken from area 46. Note the integration of graft particles in the preserved alveolar ridge also inside the osteotomy site of 46. c Two Xive (Dentsply) implants placed in the preserved ridge. d. Postoperat...
Fig. 1. traction sockets showing good initial graft stability. d Black silk sutures placed with tissue approximation and no releasing incision in the flaps
Fig. 1. a Clinical occlusal view with fractured 45 and 46. b Post-extraction view of the socket. Note minimal trauma to the soft tissue and no flap reflection on the surgical site. c Graft material condensed into the extraction sockets sho...
Patient no.
Gender
Patient’s age
Tooth no.
Time post extraction [month]
% New bone
...
Patient no.
Tooth no.
Ridge width baseline [mm]
Ridge width implant placement [mm]
Ridge width changes [mm]
...
ISQ level at implant placement
ISQ level at loading
Patient no.
Tooth no.
Buccal
Palatal
...
Kakar, A., Rao, B.H.S., Hegde, S. et al. Ridge preservation using an in situ hardening biphasic calcium phosphate (β-TCP/HA) bone graft substitute—a clinical, radiological, and histological study.
Int J Implant Dent 3, 25 (2017). https://doi.org/10.1186/s40729-017-0086-2
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Received: 31 December 2016
Accepted: 25 May 2017
Published: 22 June 2017
DOI: htt...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Correspondence to
Ashish Kakar.
Yenepoya University Dental College, University Road, Mangalore, 575018, India
Ashish Kakar, Bappanadu H. Sripathi Rao & Shashikanth Hegde
Dental Foundations and Research Centre, Malad, Mumbai, 400064, India
Nikhil Deshpande
Department of Oral and Maxillofacial Surgery, Center for Dental Medicine, Medical Center—University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
Annette ...
We acknowledge Sunstar Suisse SA, Etoy, Switzerland, for partly supporting this clinical study with a study grant. The authors declare that there is no conflict of interest regarding the publication of this paper.
Ashish Kakar, Bappanadu H. Sripathi Rao, Shashikanth Hegde, Nikhil Deshpande, Annette Lindner, Heiner Nagursky, Aditya Patney, and Harsh Mahajan declare that they have no competing inte...
Lang NP, Pun L, Lau KY, Li KY, Wong MC. A systematic review on survival and success rates of implants placed immediately into fresh extraction sockets after at least 1 year. Clin Oral Implants Res. 2012;23 Suppl 5:39–66.
Smukler H, Landi L, Setayesh R. Hostomorphometric evaluation of extraction sockets and deficient alveolar ridges treated with allografts and barrier membrane. A pilot study. In...
Nair PNR, Luder H-U, Maspero FA, Fischer JH, Schug J. Biocompatibility of beta-tricalcium phosphateroot replicas in porcine tooth extraction sockets—a correlativehistological, ultrastructural, and x-ray microanalytical pilotstudy. J Biomater Appl. 2006;20(4):307–24.
Jensen SS, Terheyden H. Bone augmentation procedures in localized defects in the alveolar ridge: clinical results with different...
Araujo MG, Sukekava F, Wennstrom J, Lindhe J. Ridge alterations following implant placement in fresh extraction sockets: an experimental study in the dog. J Clin Periodontol. 2005;32:645–52.
Van der Weijden F, Dell'Acqua F, Slot DE DE. Alveolar bone dimensional changes of post-extraction sockets in humans: a systematic review. J Clin Periodontol. 2009;36(12):1048–58.
Schropp L, Wenzel A, Kos...
The results of this clinical study support the use of a biphasic in situ hardening alloplastic bone graft substitute for ridge preservation in intact post-extraction sites without the use of a dental membrane. Therefore, grafting of sockets without primary wound closure or using dental membranes or a soft tissue punch can be an effective minimally invasive method of preserving the contour and arch...
Likewise, the reported amount of residual grafting material in the defect site was similar. In average, only 26.2 ± 9.4% of the defect was occupied with residual graft material in this study which is well in line with 26.6 ± 5.2% reported for BCP but below the 37.7 ± 8.5% reported for xenograft [14].
All 15 implants could be placed without the need for additional bone augmentation....
As previously reported, secondary intention soft tissue healing of grafted post-extraction sites can be well achieved when using an in situ hardening and in situ stabilizing bone graft substitutes without the need of a dental membrane [18, 20]. Findings of the present report corroborate these results. The authors found that all sites healed uneventfully with coverage of soft tissue and no local co...
Ridge preservation following dental extractions is fundamental, preserving the ridge profile for subsequent implant placement and providing a sustained function and esthetics. This clinical trial reports on the successful application of an in situ hardening biphasic alloplastic bone graft substitute for ridge preservation and subsequent implant placement in 15 healthy patients. A routine but minim...
Cone beam computer tomography (CBCT) was performed before tooth extraction and at the time point of implant placement. Mean ridge width reduction before tooth extraction to implant placement was calculated to effect in 0.79 ± 0.73 mm horizontal bone loss (Table 2). Primary implant stability was achieved in all 15 cases, showed in average high ISQ levels 70.3 ± 9.7 (buccal/palatal), and...
Fifteen patients (4 females and 11 males) with a mean age of 51.3 + 14.8 years (range: 27 to 75 years) participated in this randomized clinical trial. The site specific areas and teeth numbers for the study are shown in Table 1.
In all cases, the postoperative healing was uneventful. Clinically, the soft tissue healing pattern observed was very similar in all cases. The soft tissue on all ...
Bone biopsies were harvested using a trephine bur at the site of implant placement. The trephine burs including the bone biopsies were fixed in 4% formalin for 5–7 days, rinsed in water, and dehydrated in serial steps of ethanol (70, 80, 90, and 100%), remaining for 1 day in each concentration. Specimens were then infiltrated, embedded, and polymerized in resin (Technovit 9100, Heraeus Kulzer,...
Antibiotic therapy consisting of 1 g amoxicillin every 12 h for 4 days and mouth rinsing with 0.2% chlorhexidine every 8 h for 10 days were prescribed. The suture was removed 1 week postoperatively. After 3 to 8 months (average 5.2 ± 2 months), the sites (Fig. 2a) were reentered for implant placement. A site-specific full thickness mucoperiosteal flap was elevated to expose the regen...
This study was approved by the Yenepoya University Ethics committee, Mangalore, India (Approval Number YOEC83/8/3/2014). Fifteen patients who required extraction of a maxillary or mandibular tooth and subsequent single-tooth implant placement and who met the inclusion and exclusion criteria were included in this prospective single-arm clinical study. The patients (4 females and 11 males) had a mea...
To our knowledge, this is the first systematic clinical, radiographic, and histological evaluation that assesses bone formation and ridge width preservation after socket grafting using an in situ hardening biphasic bone graft substitute in healthy patients.
Following tooth extraction, the alveolar ridge will decrease in volume and change its morphology [1, 2]. These changes are clinically significant [3] and can complicate the placement of a conventional bridge or an implant-supported crown. Post-extraction maintenance of the alveolar ridge following the principles of ridge preservation using bone graft substitutes minimizes ridge resorption and, thu...
Post-Extraction ridge preservation using bone graft substitutes is a conservative technique to maintain the width of the alveolar ridge. The objective of the present study was to evaluate an in situ hardening biphasic (HA/β-TCP) bone graft substitutes for ridge preservation without primary wound closure or a dental membrane.
A total of 15 patients reported for tooth extraction were enrolled in t...
Fig. 7. Vestibular view of the final restoration
Fig. 7. Vestibular view of the final restoration
Fig. 6. Occlusal view of the final restoration. In this case, with the longest cantilever extension on a final restoration within this collective
Fig. 6. Occlusal view of the final restoration. In this case, with the longest cantilever extension on a final restoration within this collective
Fig. 5. One-year post-surgery panoramic radiograph with final restoration
Fig. 5. One-year post-surgery panoramic radiograph with final restoration
Fig. 4. Occlusal view of implant-abutments 3 months post-surgery at the first removal of the temporary restoration
Fig. 4. Occlusal view of implant-abutments 3 months post-surgery at the first removal of the temporary restoration
Fig. 3. Fill-in of the occlusal perforations with self-curing resin to connect the prostheses to the temporary titanium cylinders
Fig. 3. Fill-in of the occlusal perforations with self-curing resin to connect the prostheses to the temporary titanium cylinders
Fig. 2. Preparation of the composite veneers for making the temporary restoration
Fig. 2. Preparation of the composite veneers for making the temporary restoration
Fig. 1. Preparation of implant cavity through corresponding metal sleeves after extraction of the central incisors using a surgical template supported by hopeless remaining teeth
Fig. 1. Preparation of implant cavity through corresponding metal sleeves after extraction of the central incisors using a surgical template supported by hopeless remaining teeth
Collective
Mesial
Distal
1 year
55 months (40–84)
1 year
...
Collective
ISQ
P
At insertion
3 months
Total (n = 57)
61.3 ± 7.8
...
Collective
PT value
P
At insertion
3 months
Total (n = 57)
−1.8 ± 2.4
...
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# of implants
# of failures
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Cumulative survival rate (%)
0 t...
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10 mm
12 mm
14 mm
16 mm
Axial
...
Wentaschek, S., Hartmann, S., Walter, C. et al. Six-implant-supported immediate fixed rehabilitation of atrophic edentulous maxillae with tilted distal implants.
Int J Implant Dent 3, 35 (2017). https://doi.org/10.1186/s40729-017-0096-0
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Received: 14 March 2017
Accepted: 13 July 2017
Published: 25 July 2017
DOI: https://doi.org/10.1186/s40729-017-0096-0
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...
The retrospective data analysis was conducted in accordance with the Helsinki Declaration of 1975, as revised in 2008, and all patients signed an informed consent. After consulting the local ethic committee, the decision was that due to the retrospective character of this study, with no additional data acquisition, no ethical approval is needed according to the hospital laws of the appropriate sta...
Department of Prosthetic Dentistry, University Medical Center of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131, Mainz, Germany
S. Wentaschek & S. Hartmann
Department of Oral and Maxillofacial Surgery - Plastic Surgery, University Medical Center of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131, Mainz, Germany
C. Walter & W. Wagner
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The authors would like to thank Bredent Medical (Senden, Germany) for providing the 3D-planning system and supporting the treatment nonfinancially.
Bayer G, Kistler F, Kistler S, Adler S, Neugebauer J. Sofortversorgung mit reduzierter Implantatanzahl: Wissenschaftliche Konzeption und klinische Ergebnisse. Berlin: Quintessenz; 2011.
Hanley JA. Receiver operating characteristic (ROC) methodology: the state of the art. Crit Rev Diagn Imaging. 1989;29(3):307–35.
Atieh MA, Alsabeeha NH, Payne AG, de Silva RK, Schwass DS, Duncan WJ. The prognos...
Pommer B, Mailath-Pokorny G, Haas R, Busenlechner D, Furhauser R, Watzek G. Patients’ preferences towards minimally invasive treatment alternatives for implant rehabilitation of edentulous jaws. Eur J Oral Implantol. 2014;7(Suppl 2):S91–109.
Monje A, Suarez F, Galindo-Moreno P, Garcia-Nogales A, Fu JH, Wang HL. A systematic review on marginal bone loss around short dental implants (
Area under the curve
Implant stability quotient
Periotest
Receiver operating characteristic
Within the limits of this small group (n = 10 patients/60 implants), the failure rate of the analyzed implant system (n = 3 respective 5% implant loss) seems to be comparable with other immediate-loading protocols. On the other side, the implant loss rate of tilted implants (n = 2 of 20) in the atrophic upper jaw was quite high, but still, the aimed treatment concept could be achieved in eve...
Between baseline and first removal of the temporary restoration after 3 months, the mean ISQ increased and the mean PT value decreased significantly in the axial and tilted implants. This is in contrast to some other studies which evaluated no significant differences of stability parameters between primary and secondary stability with immediate loading in edentulous maxilla [16, 21, 22].
The pre...
The overall implant survival rate of 95% is slightly lower than the reported mean survival rates of the concept of tilted implants and immediate loading in edentulous jaws [11] but still close to them and maybe more comparable to investigations in which implants were also immediately loaded in the edentulous maxilla which were partly placed in fresh extraction sites [15, 16]. Nevertheless, what is...
After the temporary restoration with a fixed prosthesis, all 10 patients selected a fixed final restoration. These consisted of a cast metal framework with a full ceramic veneering including the replacement of at least the second premolars. They were made after a new impression on the abutment level (Figs. 6 and 7). The neck of the 20 tilted distal implants was positioned in region 4 (n = 5 impl...
Ten patients with a mean age at implant insertion of 64 ± 11.3 years (range 38 to 81 years; six women, four men) were included. Sixty titanium screw implants (Table 1) were inserted and immediately loaded between 09/2009 and 01/2013.
Seven patients had remaining teeth until implant surgery (two patients with 4, four patients with 7, and one patient with 12 teeth). Twenty-one (35%) of the 60 ...
Changes in marginal bone level were measured using the routinely made digital panoramic radiographs if these were available. The measurement tool was calibrated with the known respective implant length. To evaluate the bone loss, the difference was formed between the bone level at follow-up examination (Fig. 5) and at implant placement which is the baseline.
An implant was considered as successfu...
The patients were screened with preliminary panoramic radiographs, and since all the implants were 3D planned (SKYplanX™ program, Bredent GmbH, Senden, Germany) and inserted with a guiding template, a cone-beam CT (CBCT) was obtained eventually (KaVo 3D eXam™ unit, KaVo Dental GmbH, Biberach/Riss, Germany).
The drillings were performed using a 3D-planned surgical template with different metal...
In a retrospective study, all patients with immediately loaded implants in an edentulous maxillae with limited posterior ridge dimensions that received an equal concept were included if they had a follow-up of at least 3 years. The concept contained immediate loading with distal tilted implants and six implants per edentulous maxillae of a single implant system (blueSky™ implants, Bredent GmbH,...
For a few years, there has been a trend towards minimally invasive implant treatment concepts avoiding bone augmentation even in very atrophic edentulous jaws. These concepts aim to make an implant treatment with a shorter duration, with less inconvenience such as swelling or pain and possibly also economically more attractive [1]. If the implant treatment is less invasive, because of the possible...
The aim of this retrospective study was to evaluate the treatment outcome of six Bredent blueSky™ implants (Bredent GmbH, Senden, Germany) immediately loaded with a fixed full-arch prosthesis (two tilted posterior and four axial frontal and premolar implants).
All 10 patients with atrophic edentulous maxillae being treated with a standardized procedure from 09/2009 to 01/2013, who had a follow-...
Fig. 1. Search strategy for BMAC
Fig. 1. Search strategy for BMAC
Study
Treatment groups
No. of patients (age range)
No. of maxillary sinuses evaluated
Donor site for BMAC
C...
Study
de Oliveira et al. [12]
Pasquali et al. [7]
Payer et al. [2]
Sauerbier et al. [11]
...
Ting, M., Afshar, P., Adhami, A. et al. Maxillary sinus augmentation using chairside bone marrow aspirate concentrates for implant site development: a systematic review of histomorphometric studies.
Int J Implant Dent 4, 25 (2018). https://doi.org/10.1186/s40729-018-0137-3
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Received: 20 February 2018
Accepted: 21 May 2018
Published: 03 September 2018
DOI:...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
This is a systematic review of published data; no patients were involved in the conduct of this review.
Miriam Ting, Philip Afshar, Arik Adhami, Stanton M. Braid, and Jon B. Suzuki declare that they have no competing interests.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Correspondence to
Miriam Ting.
Private practice in Periodontology, and Think Dental Learning Institute, Paoli, PA, 19301, USA
Miriam Ting
Temple University Kornberg School of Dentistry, 3223 North Broad Street, Philadelphia, PA, 19140, USA
Philip Afshar & Arik Adhami
Division of Oral and Maxillofacial Surgery, Department of Oral Medicine, Pathology and Surgery, Temple University Kornberg School of Dentistry, 3223 North Br...
All the data generated during this systematic review were included in this manuscript.
Rooney AA, Boyles AL, Wolfe MS, Bucher JR, Thayer KA. Systematic review and evidence integration for literature-based environmental health science assessments. Environ Health Perspect. 2014;122(7):711–8.
Sauerbier S, Rickert D, Gutwald R, Nagursky H, Oshima T, Xavier SP, et al. Bone marrow concentrate and bovine bone mineral for sinus floor augmentation: a controlled, randomized, single-blinded...
Tatum H Jr. Maxillary and sinus implant reconstructions. Dent Clin N Am. 1986;30(2):207–29.
Payer M, Lohberger B, Strunk D, Reich KM, Acham S, Jakse N. Effects of directly autotransplanted tibial bone marrow aspirates on bone regeneration and osseointegration of dental implants. Clin Oral Implants Res. 2014;25(4):468–74.
Chaushu G, Vered M, Mardinger O, Nissan J. Histomorphometric analysis a...
Bone marrow aspirate concentrate
Confidence limits
Ethylenediaminetetraacetic acid
Technique involving bone marrow-derived mononuclear cell isolation by synthetic polysaccharide
Mononuclear cells
Mesenchymal stem cells
Office of Health Assessment and Translation
Standard deviation
Within the limits of this systematic review, the chairside method to harvest BMAC is a viable option for maxillary sinus augmentation for implant site development. The implant survival of the BMAC group was similar to the laboratory FICOLL concentration of BMAC group, without the additional cost and time of laboratory cell isolation techniques. Single or double centrifugation of BMAC does not appe...
In addition, the parameters to evaluate new bone formation were variable. New bone formation and percentage of vital bone are different methods to measure bone formation, and the data from different methods could not be combined or analyzed together. Furthermore, the BMAC evaluated in test groups were prepared differently and were harvested from different sources (tibia or iliac). The control grou...
Although the variations of the materials and methods for BMAC preparation were discussed, this review was not aimed to compare materials and methods for BMAC preparation, but rather the end clinical result for new bone formation and implant survival. Although implant survival and new bone formation were not the only parameters to consider when evaluating sinus augmentation, these parameters were t...
It appears that BMAC offers no statistically significant advantage for regeneration of bone in the maxillary sinus for site preparation of dental implants. BMAC + bovine bone graft results in similar regeneration outcome measures histologically as alveolar bone alone at 3–4 months. Measured histomorphometrically MSCs treated by FICOLL–Hypaque centrifugation to consolidate osteogenic and osteo...
Pasquali et al. [7], in eight patients compared BMAC + bovine bone graft (test group) with bovine bone graft alone (control group). New bone (55.15%) was reported in the test group compared with new bone (27.3%) in the control group based on histomorphometric analyses. This reported observation indicating statistically more new bone regeneration in the BMAC + bovine bone graft group compared with ...
Sauerbier et al. [14] further compared BMAC + bovine bone grafts (test group) with alveolar bone, autologous + bovine bone grafts (control group) for maxillary sinus site preparation. New bone (31.3%) for the test group compared with new bone (19.3%) for the control group statistically indicated equivalence in histomorphometric outcome. Histologic images showing impressive new bone formation were ...
Mesenchymal stem cells (MSCs) in BMAC have the potential to renew, experience clonal expansion, and differentiate into musculoskeletal tissues [16]. MSCs are also known to have an immunoregulatory role and may enhance the normal healing response and angiogenesis [10]. BMAC has been used in bone, cartilage, and tendon injuries with encouraging results [16]. BMAC is a minimally invasive procedure, a...
The search generated 797 reviews in PubMed, 114 in Web of Science, 97 in Cochrane Library, and 319 in Google Scholar (Fig. 1). The following were selected after the title and abstract screening: 18 were selected from PubMed, 23 from Web of Science, 6 from Cochrane Library, 2 from Google Scholar, and 2 from hand searching the reference list of the selected article. After the duplicates were remove...
What are the histomorphometric outcomes of sinus augmentation with bone marrow aspirate concentrates obtained chairside?
PubMed, Web of Science, Cochrane Library, and Google Scholar were searched up to January 2017. Google scholar was searched for gray literature. The following keywords were used: “bone marrow aspirate concentrates,” “stem cells,” “histomorphometric,” and “bone graf...
Maxillary sinus augmentation is indicated when there is an inadequate vertical alveolar bone height to effectively support surgically placed dental implants. The sinus elevation procedure requires grafting bone material onto the sinus floor to regenerate sufficient vertical alveolar bone height [1, 2]. The ideal bone grafting material should be biocompatible, possess no risk of disease transmissio...
Maxillary sinus pneumatization following dental tooth extractions and maxillary alveolar bone resorption frequently leaves inadequate bone levels for implant placement. The objectives of this systematic review are to evaluate the effects of bone marrow aspirate concentrates (BMACs) used in maxillary sinus augmentation for implant site development.
A systematic search was conducted using PubMed, E...
Fig. 7. Multiple graphs comparing A-B distance (height bone) (a) and the C-D distance (tissue thickness) (b) among different groups. Differences between groups were assessed by Dunn’s multiple comparison test (*P
Fig. 6. Graph comparing the data of buccal (B) and lingual (L) measured the C-D distance (tissue thickness). Group 1 = implant installed in fresh extraction and submerged; group 2 = implants in fresh extraction and immediately exposed; group 3 = implants installed in healed site and submerged; and group 4 = implants in healed site and immediately exposed
Fig. 6. Graph comparing the data of bu...
Fig. 5. Graph comparing the data of buccal (B) and lingual (L) measured the A-B distance (bone height). Group 1 = implant installed in fresh extraction and submerged; group 2 = implants in fresh extraction and immediately exposed; group 3 = implants installed in healed site and submerged; and group 4 = implants in healed site and immediately exposed
Fig. 5. Graph comparing the data of buc...
Fig. 4. Images of groups 3 and 4 representing the implants place in healed alveolar sites. Picrosirius red staining. Original magnification × 4
Fig. 4. Images of groups 3 and 4 representing the implants place in healed alveolar sites. Picrosirius red staining. Original magnification × 4
Fig. 3. Images of groups 1 and 2 representing the implants place in fresh sockets sites. Picrosirius red staining. Original magnification × 4
Fig. 3. Images of groups 1 and 2 representing the implants place in fresh sockets sites. Picrosirius red staining. Original magnification × 4
Fig. 2. Parameters measured in each group. Crestal bone loss is the distance between the implant collar (A) and the first bone contact of the crestal bone (B) = A-B bone height; and, the tissue thickness that is the distance from the implant collar (C) to the more external portion of the tissues (D) = C-D tissue thickness. Picrosirius red staining. Original magnification × 16
Fig. 2. Param...
Fig. 1. Image of the implant (a) and surface (b) used in the present study
Fig. 1. Image of the implant (a) and surface (b) used in the present study
Group
1
2
3
4
Friedman test
...
Tissue thickness (C-D distance in mm)
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Lingual
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Group 2
Group 3
...
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Group 2
Group 3
...
Gehrke, S.A., Bragança, L.K., Velasco-Ortega, E. et al. Evaluation of dimensional behavior of peri-implant tissues in implants immediately exposed or submerged in fresh extraction and healed sites: a histological study in dogs.
Int J Implant Dent 4, 5 (2018). https://doi.org/10.1186/s40729-018-0120-z
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Received: 02 October 2017
Accepted: 10 January 2018
Pu...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
Sergio Alexandre Gehrke, Leana Kathleen Bragança, Eugenio Velasco-Ortega, and Jose Luis Calvo-Guirado declare that they have no competing interests.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Biotecnos Research Center, Calle Cuareim, 1483, CP: 11.100, Montevideo, Uruguay
Sergio Alexandre Gehrke
University Catholica San Antonio de Murcia (UCAM), Murcia, Spain
Sergio Alexandre Gehrke
Implant Dentistry, Seville University, Seville, Spain
Leana Kathleen Bragança
General Dentistry, Seville University, Seville, Spain
Eugenio Velasco-Ortega
Implant Dentistry Master, Seville Universit...
Trisi P, Lazzara R, Rao W, Rebaudi A. Bone-implant contact and bone quality: evaluation of expected and actual bone contact on machined and osseotite implant surfaces. Int J Periodontics Restorative Dent. 2002;22(6):535–45.
Calvo-Guirado JL, Ortiz-Ruiz AJ, Negri B, López-Marí L, Rodriguez-Barba C, Schlottig F. Histological and histomorphometric evaluation of immediate implant placement on a d...
Spray JR, Black CG, Morris HF, Ochi S. The influence of bone thickness on facial marginal bone response: stage 1 placement through stage 2 uncovering. Ann Periodontol. 2000;5(1):119–28.
Bornstein MM, Lussi A, Schmid B, Belser UC, Buser D. Early loading of nonsubmerged titanium implants with a sandblasted and acid-etched (SLA) surface: 3-year results of a prospective study in partially edentulou...
Lang NP, Pun L, Lau KY, Li KY, Wong MC. A systematic review on survival and success rates of implants placed immediately into fresh extraction sockets after at least 1 year. Clin Oral Implants Res. 2012;23(Suppl 5):39–66.
Bornstein MM, Valderrama P, Jones AA, Wilson TG, Seibl R, Cochran DL. Bone apposition around two different sandblasted and acid-etched titanium implant surfaces: a histomorpho...
Chen ST, Buser D. Esthetic outcomes following immediate and early implant placement in the anterior maxilla—a systematic review. Int J Oral Maxillofac Implants. 2014;29(Suppl):186–215.
Berberi AN, Tehini GE, Noujeim ZF, Khairallah AA, Abousehlib MN, Salameh ZA. Influence of surgical and prosthetic techniques on marginal bone loss around titanium implants. Part I: immediate loading in fresh ex...
Botticelli D, Berglundh T, Lindhe J. Hard-tissue alterations following immediate implant placement in extraction sites. J Clin Periodontol. 2004;31(10):820–8.
Araújo MG, Lindhe J. Dimensional ridge alterations following tooth extraction. An experimental study in the dog. J Clin Periodontol. 2005;32(2):212–8.
Araújo MG, Sukekava F, Wensström JL, Lindhe J. Ridge alterations following implan...
Within the limitations of this study, our findings suggest that the crestal bone height is larger when implants are inserted in healed areas in comparison with implants installed in fresh extraction sites. Moreover, significant differences were found between non-exposed and immediately exposed implants with regards to crestal bone height position, and higher thickness tissue values in the groups o...
New studies are needed to define the influence of other surface compositions and neck configurations for implants placed in fresh extraction sockets with/or without submerged and the influence of abutment change on crestal bone stabilization during the remodeling process. These would appear to be important factors for improving peri-implant bone and soft tissue stability and clinical outcomes, inc...
In the present study, the implants were positioned in the crestal bone level, by following Bornstein et al. [34, 35] which reported that the implants are often inserted within the bone crest. Tomasi et al. [36] in a clinical trial observed that the implant position conditioned the amount of buccal crest resorption. Moreover, the thickness of the buccal bone plate and the tridimensional positioning...
The immediate implants in fresh sockets have demonstrated a great success rate [18, 22,23,24]. However, the removal of a single tooth followed by immediate placement of an implant results in marked alterations of the ridge in the horizontal as well as in the vertical dimension. The early phases of tissue integration in immediate post-extraction implants have been well documented [1, 25, 26]. The i...
The surgical sites healed uneventfully. All animals presented appropriate healing during the first week following the surgical procedure. Post-surgical inspections for 2 weeks post-operatively indicated the absence of infection or inflammation. All implants presented osseointegration after the proposed period and were available for histological analysis.
Direct contact was observed between livin...
A power analysis was conducted to determine appropriate sample size; although it was determined that 6 samples from each group would generate a 95% confidence limit (G3Power), 10 samples were proposed for each situation to increase the level of significance.
The hemimandibles were removed with care to preserve the integrity of both peri-implant hard and soft tissues, washed in saline solution and fixed in 10% buffered formalin, and sent for processing at the Laboratory of Ucam-Biotecnos (Murcia, Spain). Specimens were dehydrated in ascending series of alcohol rinses and embedded in a glycol methacrylate resin (Technovit 7200 VLC; Kulzer, Wehrheim, Ger...
A total of 40 implants were installed (ICI implant, Galimplant, Sarria, Spain), with 3.5 mm in diameter by 10 mm in length. Eight implants in each dog, half per hemimandible. The surface treatment of this implant model is developed by blasting with three different granulometries of Al2O3 and pickling using a hydrofluoric solution (HF) at low temperature and short time, which aims to remove any t...
Then, the good results were obtained with both techniques (implants placed into fresh alveolus and implants non-submerged); these have been joined together with the objective to reduce the time of the treatment. However, the esthetic results can directly influence by the peri-implant tissue dimension (vertical or horizontal) and position in relationship of the cervical implant portion. In this way...
After the tooth loss, there is a progressive involution of the alveolar bone both in the horizontal and the vertical dimensions [1, 2]. Moreover, the most rapid reduction in the alveolar bone after tooth extraction occurs during the first 3 months [3, 4]. Implants immediately positioned in alveolus after the surgical extraction of the tooth exhibit a success ranging from 92.7 to 98.0% [5]. Some a...
The aim of this study was to compare histologically the dimensional behavior of peri-implant tissues during osseointegration of immediately exposed or submerged implant placement in fresh extraction and healed sites.
Four fresh extraction and four delayed implant sites were placed in each hemimandible of five dogs at the bone crest level. In 2 implants of each side were installed a healing abutme...
Fig. 7. Scatter plots representing correlations between measured and calculated platelet counts in P-PRP and L-PRP preparations. Note: a strong correlation was observed only in P-PRP. N = 32 and 50 for P-PRP and L-PRP, respectively
Fig. 7. Scatter plots representing correlations between measured and calculated platelet counts in P-PRP and L-PRP preparations. Note: a strong correlation was ...
Fig. 6. Scatter plots representing possible correlations between platelet (PLT) and WBC counts and between platelet and RBC counts in P-PRP and L-PRP preparations. Note: strong positive correlations were observed between platelets and RBC in both PRP types. N = 32 and 50 for P-PRP and L-PRP, respectively
Fig. 6. Scatter plots representing possible correlations between platelet (PLT) and WB...
Fig. 5. Counts of platelets (PLT), WBCs, and RBCs in P-PRP and L-PRP preparations prepared for validation testing. N = 32 and 50 for P-PRP and L-PRP, respectively
Fig. 5. Counts of platelets (PLT), WBCs, and RBCs in P-PRP and L-PRP preparations prepared for validation testing. N = 32 and 50 for P-PRP and L-PRP, respectively
Fig. 4. Calibration curves of measured platelet counts versus absorbance in P-PRP and L-PRP preparations. The samples were serially diluted by PPP, and the platelet counts were determined using an AHA and SPM. N = 14 for each type of PRP
Fig. 4. Calibration curves of measured platelet counts versus absorbance in P-PRP and L-PRP preparations. The samples were serially diluted by PPP, and th...
Fig. 3. Counts of platelets (PLT), WBCs, and RBCs in P-PRP and L-PRP preparations prepared for calibration curves. N = 14 for each type of PRP
Fig. 3. Counts of platelets (PLT), WBCs, and RBCs in P-PRP and L-PRP preparations prepared for calibration curves. N = 14 for each type of PRP
Fig. 2. The appearance of blood sampled after gravity fractionation and the resulting P-PRP and L-PRP. In the first low-speed spin, samples were centrifuged for 10 min at 533×g. For P-PRP preparation, the upper plasma fraction, which was 2 mm beyond the interface between plasma and RBC fractions, was transferred into sample tubes for the second high-speed spin (2656×g, 5 min). In contrast, ...
Fig. 1. A compact SPM with its remote controller installed on an iPad Air. iPhones and other Android devices can be used instead of the iPad Air
Fig. 1. A compact SPM with its remote controller installed on an iPad Air. iPhones and other Android devices can be used instead of the iPad Air
Kitamura, Y., Suzuki, M., Tsukioka, T. et al. Spectrophotometric determination of platelet counts in platelet-rich plasma.
Int J Implant Dent 4, 29 (2018). https://doi.org/10.1186/s40729-018-0140-8
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Received: 13 April 2018
Accepted: 29 June 2018
Published: 02 October 2018
DOI: https://doi.org/10.1186/s40729-018-0140-8
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...
The study design and consent forms of all the procedures performed were approved by the ethics committee for human participants of the Niigata University School of Medicine (Niigata, Japan) in accordance with the Helsinki Declaration of 1964 as revised in 2013. Written informed consents to participate in the study were obtained from all the participants.
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YK, MS, TyTo, and TK conceived and designed the study, performed the experiments and data analysis, and wrote the manuscript. KI, TaTn, ...
Tokyo Plastic Dental Society, Kita-ku, Tokyo, Japan
Yutaka Kitamura, Masashi Suzuki, Tsuneyuki Tsukioka, Kazushige Isobe, Tetsuhiro Tsujino, Taisuke Watanabe, Takao Watanabe & Hajime Okudera
Bioscience Medical Research Center, Niigata University Medical and Dental Hospital, Niigata, Japan
Koh Nakata
Department of Materials Science and Technology, Niigata University, Niigata, Japan
Tak...
Because an article performed and prepared in parallel is now submitted elsewhere for publication, the authors do not wish to share their data at present time.
Xu Z, Yin W, Zhang Y, Qi X, Chen Y, Xie X, Zhang C. Comparative evaluation of leukocyte- and platelet-rich plasma and pure platelet-rich plasma for cartilage regeneration. Sci Rep. 2017;7:43301.
Yin W, Qi X, Zhang Y, Sheng J, Xu Z, Tao S, Xie X, Li X, Zhang C. Advantages of pure platelet-rich plasma compared with leukocyte- and platelet-rich plasma in promoting repair of bone defects. J Transl Me...
Guder WG, da Fonseca-Wollheim F, Heil W, Schmitt YM, Töpfer G, Wisser H, Zawta B. The Haemolytic, Icteric and Lipemic Sample Recommendations Regarding their Recognition and Prevention of Clinically Relevant Interferences. Recommendations of the Working Group on Preanalytical Variables of the German Society for Clinical Chemistry and the German Society for Laboratory Medicine. LaboratoriumsMedizin...
Hazan R, Que YA, Maura D, Rahme LG. A method for high throughput determination of viable bacteria cell counts in 96-well plates. BMC Microbiol. 2012;12:259.
Lee VS, Tarassenko L. An optical method for the determination of platelet count in platelet samples contaminated with red blood cells. J Biochem Biophys Methods. 1992;24:215–23.
Davis VL, Abukabda AB, Radio NM, Witt-Enderby PA, Clafshenkel...
Marx RE, Carlson ER, Eichstaedt RM, Schimmele SR, Strauss JE, Georgeff KR. Platelet-rich plasma: Growth factor enhancement for bone grafts. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998;85:638–46.
Etulain J. Platelets in wound healing and regenerative medicine. Platelets. 2018:1–13.
Hou X, Yuan J, Aisaiti A, Liu Y, Zhao J. The effect of platelet-rich plasma on clinical outcomes of t...
Acid-citrate-dextrose solution
Automated hematology analyzer
Leukocyte-rich PRP
Prostaglandin E1
Platelet-poor plasma
Platelet-rich fibrin
Platelet-rich plasma
Pure-PRP
Red blood cell
Standard deviation
Spectrophotometer
Leukocyte
In normal blood samples composed of light yellow plasma, spectrophotometric determination of platelet counts would be useful for quality assurance of individual PRP preparations. For accurate determination, however, operators should handle samples with care to minimize the inclusion of WBCs and RBCs in PRP preparations.
Consistent with the clinical significance of platelet counting, several studies have reported that the platelet concentration is the most reliable criterion for the regenerative ability of PRP [27, 28] because platelets increase the number of anabolic signaling molecules. Conversely, as WBCs increase the number of catabolic signaling molecules, the quality of PRP can, perhaps, be considerably alte...
Another limitation is the color of plasma. In terms of color, blood samples obtained from the donors participating in this study were light yellow and could be evaluated as “normal.” However, we have sometimes encountered colored plasma samples in clinical practice. For example, when blood triglyceride levels are high, the plasma turns milky white or turbid [22,23,24]. Hemolytic plasma looks r...
Since determination of bacterial cell number is a fundamental procedure in the field of microbiology, several methods have been developed and widely employed depending on the purpose of cell counting. SPM is one of the common methods used to estimate bacterial load [12]. The advantage of SPM is speed and convenience without additional preparation steps. On the other hand, the limitations are the i...
For validation of these calibration curves, P-PRP and L-PRP preparations prepared by three independent operators were employed. Blood cell counts are shown in Fig. 5. As observed in the calibration curves for the samples, significant differences were found in WBC and RBC counts, but not in platelet counts, between the P-PRP and L-PRP preparations. Correlations between platelet counts and WBC or R...
The appearance of the blood-collection tube after the first low-speed spin and representative P-PRP and L-PRP preparations after the second high-speed spin and subsequent re-suspension are shown in Fig. 2. Although low-speed spinning did not result in the formation of a clear buffy coat in the interface between the plasma and RBC fractions, the buffy coat corresponding to the plasma was not inclu...
Using the data obtained with both the AHA and SPM, scattered plots were created to examine correlations and obtain formulas to calculate platelet counts.
P-PRP and L-PRP preparations were independently prepared from the 11 donors by three well-trained operators. Platelet counts were first determined using the AHA and aliquots of the PRP preparations were measured using the SPM. Platelet counts we...
Blood samples were collected from 11 non-smoking healthy male volunteers aged 33 to 69 years. The study design and consent forms for all the procedures were approved by the ethics committee for human participants at the Niigata University School of Medicine (Niigata, Japan) in accordance with the Helsinki Declaration of 1964 as revised in 2013.
Peripheral blood (~ 9 mL) was collected into pla...
In this study, we focused on the possibility of spectrophotometric determination and validated the applicability of the proposed method on platelet counts in PRP preparations. This idea was based on bacterial cell counting [12] and a similar challenge was reported in 1992 [13]. However, this optical method has not been further modified for PRP as a grafting material for regenerative therapy in acc...
Almost two decades have passed since platelet concentrates, such as platelet-rich plasma (PRP), were first introduced to the field of regenerative medicine by Marx et al. [1]. To date, PRP has been modified to create different variations and has increasingly been used in various fields of regenerative therapy around the world. However, negative data obtained from clinical applications of PRP have ...
Platelet-rich plasma (PRP) is widely used in regenerative dentistry and other medical fields. However, its effectiveness has often been questioned. For better evaluation, the quality of individual PRP preparations should be assured prior to use. We proposed a spectrophotometric method for determination of platelet counts and validated its applicability using two types of PRP preparations.
Blood s...
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 6. SEM picture of implant with external hexagonal connection
Figure 5. SEM picture of CAMLOG implant after torsion test
Figure 5. SEM picture of CAMLOG implant after torsion test
Figure 4. The mean value of torsional yield strength
Figure 3. The mean value of maximum fracture torque strength
Figure 1. Torsion testing device
For comparison between the mechanical strength of CP-Ti screw implants with internal tube-in-tube implant-abutment connections and that of external hexagonal-type connections, all abutments and CP-Ti implants with external hexagonal-type connections were heavily damaged or destroyed in all phases of loading. A typical fracture curve for CP-Ti implants with external connections is shown. The propor...
Discussion
During the physiological function of chewing, or the non-physiological function of bruxism, compressive, bending, and torsional stresses are generated in teeth or prosthetics. These stress will cause the abutment screw loosening or fracture, fracture of the abutment, fracture of the implant, and the implant/abutment connection. The extent of the damage is influenced by the design o...
Methods
Thirty titanium screw implants of five different diameters (3.3, 3.8, 4.3, 5.0, and 6.0 mm) with tube-in-tube implant-abutment connections (CAMLOG Biotechnologies, Wimsheim, Germany) were used as test specimens. Implants of each size were connected to abutments, and abutment screws were tightened to 20 N · cm using a digital torque meter (Hios HDM-5; Hios Inc, Chiba...
Background
A single-tooth osseointegrated implant is composed of an implant body, an abutment, an abutment screw, and an artificial crown. The implant and abutment are typically connected by an abutment screw. The degree of mechanical integrity at the implant-abutment interface depends on screw preload, abutment connection design, the fitness of all components, and dynamic loading conditions. F...
Abstract
Background
Fractured connections between implants and implant abutments or abutment screws are frequently encountered in a clinical setting. The purpose of this study was to investigate fracture strength using a torsion test at the interface between the implant and the abutment.
Methods
Thirty screw-type implant with diameters of 3.3, 3.8, 4.3, 5.0, and 6.0 mm were submitted to a t...
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...
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...
Wedharan
Laporan ini menunjukkan bahwa implan pendek dapat mencapai weton klinis dan radiografis yang optimal pada tindak lanjut 1 tahun ketika digunakan untuk restorasi tunggal atau ketika terhubung dengan implant lain guna mengganti lebih dari satu gigi. Tidak ada perbedaan weton antara restorasi rahang bawah dan restorasi rahang atas meskipun volume tulang dengan kuantitas yang lebih tinggi di...
Dalam laporan sementara ini, data 1 tahun mengenai resorpsi tulang dinilai. Tingkat kelangsungan hidup implant dan tingkat sukses dievaluasi dengan membandingkan implant rahang atas dan rahang bawah, implant belat dan implant tunggal, dan implant dengan panjang yang berbeda. Tes Student t digunakan untuk membandingkan resorpsi tulang antara implant rahang bawah dan implant rahang atas serta antara...
Evaluasi klinis dilakukan setiap 6 bulan sekali untuk 2 tahun pertama. Selanjutnya, evaluasi klinis dilakukan setahun sekali. Tingkat kelangsungan hidup implant dan tingkat sukses dievaluasi dan direkam. Komplikasi bedah, prostetik, dan klinis direkam. Kesuksesan prostetik dievaluasi sebagai berikut: prostesis berfungsi, tidak bergerak, dan tidak nyeri, bahkan bila satu implant atau lebih akan lep...
Profilaksis antibiotik dengan amoksisilin 2 g diberikan kepada semua pasien 1 jam sebelum operasi pada semua pasien. Semua implant ditempatkan di tempat yang disembuhkan dan soket tulang disiapkan menggunakan teknik atraumatik standar dengan urutan pengeboran bersesuaian dengan peningkatan diameter pada panjang yang telah ditentukan. Situs implant selalu disiapkan kurang dari seharusnya, dengan ...
Penelitian kohort tunggal prospektif ini dirancang dan dilakukan mengikuti prinsip-prinsip the World Medical Association Helsinki Declaration 1975 untuk riset biomedis yang melibatkan subyek manusia, seperti yang direvisi pada tahun 2000. Persetujuan etika untuk penelitian ini telah diperoleh dari Parepatan Peninjau IRCCS Istituto Ortopedico Galeazzi. Semua pasien diberi informasi tentang tuj...
Pendahuluan
Rehabilitasi implant di derah posterior rahang atas dan rahang bawah bisa jadi rehabilitasi yang rumit dalam kasus susut volume tulang dampak resorpsi tulang setelah cabut gigi atau kondisi anatomi tertentu. Faktanya, susut tinggi tulang dapat mencegah pemasangan implant panjang (> 10 mm) karena risiko melibatkan struktur anatomi, seperti sinus maksilaris atau...
Short Implants in Maxillary and Mandibular Rehabilitations: Interim Results (6 to 42 Months) of a Prospective Study
J Oral Implantol (2015) 41 (1): 50–55.
https://doi.org/10.1563/AAID-JOI-D-12-00206
Penelitian kohort tunggal ini bertujuan untuk mengevaluasi kelangsungan hidup klinis dan keberhasilan rehabilitasi parsial yang didukung oleh implant yang p...
Pada umumnya, sistem sel yang terisolasi punya sensitivitas yang lebih tinggi kala kontak dengan bahan/ materi dari luar sistem natural dibandingkan dengan sistem jaringan tubuh. Hal ini termasuk bahan implan.
Riset yang berhubungan dengan prakara ini dengan menerapkan beberapa metode yang praktis secara in vitro terus bertambah semakin banyak. Dengan adanya mekanisme penilaian toksisitas seluler...
Kesarasan mulut berhubungan dengan diabetes dan sebaliknya. Pasien yang punya banyak abses dalam mulutnya perlu dicurigai apakah ia menderita diabetes. Pasien demikian perlu diperiksa dengan tes toleransi glukosa. Demikian menurut Susan Karabin, presiden Akademi Periodontologi Amerika Serikat.
Menurut Genco, sekitar 1/3 jumlah manusia penderita diabetes tidak sadar bila mereka mengidap diabetes....
Tes biokompatibilitas implant pada pokoknya mengikuti standar ISO 10993 dan FDA. ISO 10993 sudah diperbarui berkali-kali. Yang paling baru kala ini adalah 10993:55. Implan yang mengikuti ISO 10993 dan lolos FDA punya biokompatibilitas yang tinggi dan relatif lebih aman ditanamkan dalam tubuh manusia.ISO 10993 ISO singkatan dari The International Organization for Standardization (Organisasi St...
William Thomas Green Morton adalah dokter gigi yang pertama berhasil mendemonstrasikan anestesia umum di depan publik dengan mencabut gigi tanpa sakit. Keberhasilannya membuat anestesia bukan hanya diterapkan di bidang kedokteran gigi, tapi juga di kedokteran umum.Pada tanggal 30 September 1846, Thomas Morton melakukan demonstrasi pencabutan gigi pertama tanpa rasa sakit setelah membius pasiennya...
Reverse Torque Test (RTT) atau Tes Torsi Terbalik disulkan oleh Roberts et al. (1984) dan dikembangkan oleh Johansson dan Albrektsson (1987, 1991a, 1991b). Tes tersebut mengukur ambang torsi "kritis" kala BIC rusak. Penerapan tes diusulkan sebagai metode untuk menilai stabilitas implant pada koneksi abutmen (Sullivan, 1996). Bila implant berputar kala diberi torsi terbalik ini, maka implant ...
Anastesi lokal pertama kali digunakan di bidang kedokteran gigi oleh Dr. William Halsted pada tanggal 26 November 1884.Mekanisme Aksi Anestesi LokalAnestesi lokal memblokir rasa sakit dengan mengganggu pembentukan impuls penyebab rasa sakit di sepanjang serabut syaraf perifer. Hal ini dicapai dengan mengurangi permeabilitas membran sel syaraf terhadap ion-ion Natrium.Faktor Yang MemengaruhiAda be...
Pasien mendapat penjelasan yang lengkap mengenai prosedurnya. Dan setiap tahapan, pasien diberikan informasi/ aba-aba mengenai apa yang harus dilakukan, sehingga proses berjalan dengan baik dan lancar, dan hasil memuaskan.
Testimonial Ny. V***** (45 tahun) dari Bogor, Jawa Barat
Giginya jadi lebih baik. Pelayanannya bagus. Susternya ramah-ramah.
Setelah gigi diimplan, terasa nyaman dan enak mengunyah. Senyumpun jadi lebih indah. Pelayanannya sangat bagus dan memuaskan.
Giginya jadi utuh lagi dan lebih kuat dari gigi asli. Pelayanannya sudah cukup bagus.
Pelayanannya bagus, dokternya ramah, sabar, penjelasannya bagus.
Pelayanan bagus. Hasilnya bagus.
Pelayanannya memuaskan dan menyenangkan. Tindakan yang dilakukan dokter sesuai yang diharapkan, ramah, dan familiar serta mudah untuk berkonsultasi. Mudah-mudahan klinik ini terus meningkat.
Tidak ada keluhan yang berarti karena dokternya sudah profesional. Tingkatkan terus kinerja yang ada. Semoga nantinya doctor✚dentist menjadi klinik yang besar. Amiin.
Pekerjaan cepat dan rapi. Lokasi agak jauh dari rumah dan macet.
Pelayanan bagus dan proses yang cepat. Pemasangan tidak sakit sama sekali, dokter sangat perhatian dengan aestetis dan kenyamanan pasien. Tidak ada keluhan yang signifikan, hanya terkadang harus nunggu lama. Tapi tidak apa-apa karena tunggunya sepadan dengan servisnya.
Impannya memuaskan. Bersihin karang gigi teliti sekali. Saya senang sekali melihat hasilnya. Tambal giginya juga sesuai dengan apa yang saya ingini.
Implannya bagus, hasilnya sama seperti gigi asli, nggak nyangka banget deh. Suster dan dokternya oke-oke, ramah, sabar, baik.
Parkiran tolong ditambah. Yang mau implant susah parkir. T_T
Pelayanan dan hasil sangat memuaskan dan harga terjangkau. Pelayanan lebih meningkat dan sukses selalu. Terima kasih.
Dokter Andreas sangat komunikatif. Saya sangat senang dipegang oleh dokter. Implan yang dipasang pun nyaman dan serasa mempunyai gigi sejati lagi. Apalagi bagian geraham yang sangat saya butuhkan buat mengunyah.
Dokter Andreas orangnya telaten dan sabar, cooperative, good result.
Finally Merdeka!
Thank you so much dokter Andreas. GOD BLESS YOU and family abundantly.
MAJU TERUS. Tetap semangat
Terima kasih buat tim doctor✚dentist telah membantu saya dalam proses implan gigi saya yang patah. Pelayanan dokter dan tim perawat dan Customer Service sangat memuaskan. Hasil implant sangat mirip dengan gigi aslinya. Selama proses berjalan lancar karena info dan bimbingan yang jelas dari tim dokter. Sekali lagi terima kasih.
Sukses buat tim doctor✚dentist
Penuh perjuangan dan ketabahan, tapi hasilnya memuaskan.
Terima kasih kepada dokter Andreas dan juga pada asisten. Pelayanannya sangat ramah dan bagus. Mudah-mudahan dapat terus dipertahankan.
Saya menjadi lebih percaya diri setelah pemasangan gigi implan, karena gigi kembali utuh dan rapi, serta lebih nikmat untuk mengunyah makanan.
Terima kasih
Gembira, sudah bisa mengunyah makanan dan saya puas, baik pelayanan dokternya, maupun pelayanan kliniknya.
Pada kala pertama kali mau diimplan, ada rasa takut. Tapi, pada kala selesai, pengerjaan yang pertama kali ternyata tidak seperti yang dibayangkan, dan dalam menunggu 3 bulan, tidak ada prakara yang aneh. Enak-enak saja. Pun pada setiap proses tidak ada rasa sakit. Setelah dipasang giginya, makin happy aja, karena hasilnya bagus. Lebih percaya diri dan pipi yang tadinya pas gigi ompong agak ga pro...
Rasanya mantap, puas. Pelayanannya pun sangat memuaskan. Full assist from the doctor. Lebaran pun dikerjakan demi pasien.
Kayak gigi asli, jadi percaya diri. Dengan gigi implan, enak makan.
Makan lebih enak.
Tidak ada keluhan.
Seperti gigi asli.
Memuaskan. Pelayanan dan fasilitas di klinik "doctor✚dentist" sangat memadai dan memuaskan. Selain nyaman, dokter gigi Andreas dan timnya juga sangat ramah. Penjelasan akan permasalahan gigi dan mulut juga sangat baik dan kritis. Selama proses implant gigi, mulai dari purwa hingga pemasangan mahkota gigi, pun berjalan dengan lancar. Terima kasih & sukses selalu
Terharu. Sampai nangis. Yang pasti, manfaat dan rasa seperti gigi alami dan mendekati gigi asli. Membuat hidup terasa jadi lebih berharga. Pelayanannya prima.
Implan gigi aman untuk rehabilitasi gigi pasien diabetes mellitus yang terkontrol dengan baik. Penelitian Naujokat, Kunzendorf, dan Wiltfang (2016: 9) di Jerman dan penelitian Dubey, Gupta, dan Singh (2013: 142) di India menunjukkan, implan gigi pada pasien diabetes ini tampak sama sukses dengan implan pada pasien normal. Di samping itu, tingkat sintasan implant pada pasien diabetes tidak ber...