Dentistry Journal

Research

10 pages, 5539 KiB

Open AccessArticle

Clinical Outcomes of CAD-CAM Subperiosteal Implants for the Rehabilitation of Atrophic Jaws

by Giulio Gasparini, Mattia Todaro, Paolo De Angelis, Roberto Boniello, Gianmarco Saponaro, Edoardo Rella, Enrico Foresta, Horia Vasile Hreniuc, Francesca Azzuni, Ermal Pashaj, Alessandro Moro and Giuseppe D’Amato

Dent. J. 2024, 12(8), 241; https://doi.org/10.3390/dj12080241 - 29 Jul 2024

Viewed by 1227

Abstract

Thanks to the use of new digital technologies and innovations in materials, there has been an increasing interest in subperiosteal implants. These implants are considered to be helpful for the rehabilitation of severe jaw atrophies, as they overcome some disadvantages of endosseous implantology. [...] Read more.

Thanks to the use of new digital technologies and innovations in materials, there has been an increasing interest in subperiosteal implants. These implants are considered to be helpful for the rehabilitation of severe jaw atrophies, as they overcome some disadvantages of endosseous implantology. In the present clinical retrospective study, 18 patients were treated and the clinical outcomes of the treatment were recorded after 12 months of follow-up. Full article

(This article belongs to the Special Issue Oral Implantology and Rehabilitation)

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20 pages, 15562 KiB

Open AccessArticle

Biomechanical Effects of Different Load Cases with an Implant-Supported Full Bridge on Four Implants in an Edentulous Mandible: A Three-Dimensional Finite Element Analysis (3D-FEA)

by Árpád László Szabó, Danica Matusovits, Haydar Slyteen, Éva Ilona Lakatos and Zoltán Baráth

Dent. J. 2023, 11(11), 261; https://doi.org/10.3390/dj11110261 - 7 Nov 2023

Viewed by 3040

Abstract

The long-term success and predictability of implant-supported restorations largely depends on the biomechanical forces (stresses) acting on implants and the surrounding alveolar bone in the mandible. The aim of our study was to investigate the biomechanical behavior of an edentulous mandible with an [...] Read more.

The long-term success and predictability of implant-supported restorations largely depends on the biomechanical forces (stresses) acting on implants and the surrounding alveolar bone in the mandible. The aim of our study was to investigate the biomechanical behavior of an edentulous mandible with an implant-supported full bridge on four implants under simulated masticatory forces, in the context of different loading schemes, using a three-dimensional finite element analysis (3D-FEA). A patient-specific 3D finite element model was constructed using pre- and post-implantation computer tomography (CT) images of a patient undergoing implant treatment. Simplified masticatory forces set at 300 N were exerted vertically on the denture in four different simulated load cases (LC1–LC4). Two sets of simulations for different implants and denture materials (S1: titanium and titanium; S2: titanium and cobalt-chromium, respectively) were made. Stress outputs were taken as maximum (P_max) and minimum principal stress (P_min) and equivalent stress (P_eqv) values. The highest peak P_max values were observed for LC2 (where the modelled masticatory force excluded the cantilevers of the denture extending behind the terminal implants), both regarding the cortical bone (S1 P_max: 89.57 MPa, S2 P_max: 102.98 MPa) and trabecular bone (S1 P_max: 3.03 MPa, S2 P_max: 2.62 MPa). Overall, LC1—where masticatory forces covered the entire mesio−distal surface of the denture, including the cantilever—was the most advantageous. Peak P_max values in the cortical bone and the trabecular bone were 14.97–15.87% and 87.96–94.54% higher in the case of S2, respectively. To ensure the long-term maintenance and longevity of treatment for implant-supported restorations in the mandible, efforts to establish the stresses of the surrounding bone in the physiological range, with the most even stress distribution possible, have paramount importance. Full article

(This article belongs to the Special Issue Oral Implantology and Rehabilitation)

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11 pages, 2547 KiB

Open AccessArticle

Effect of Implant Macro-Design and Magnetodynamic Surgical Preparation on Primary Implant Stability: An In Vitro Investigation

by Alessandro Antonelli, Selene Barone, Ferdinando Attanasio, Marianna Salviati, Maria Giulia Cerra, Elena Calabria, Francesco Bennardo and Amerigo Giudice

Dent. J. 2023, 11(10), 227; https://doi.org/10.3390/dj11100227 - 24 Sep 2023

Cited by 10 | Viewed by 2255

Abstract

Background: Macro-geometry and surgical implant site preparation are two of the main factors influencing implant stability and potentially determining loading protocol. The purpose of this study was to assess the initial stability of various implant macro-designs using both magnetodynamic and traditional osteotomy techniques [...] Read more.

Background: Macro-geometry and surgical implant site preparation are two of the main factors influencing implant stability and potentially determining loading protocol. The purpose of this study was to assess the initial stability of various implant macro-designs using both magnetodynamic and traditional osteotomy techniques in low-density bone. The parameters examined included peak insertion torque (PIT), implant stability quotient (ISQ), and peak removal torque (PRT). Methods: Four groups of 34 implants each were identified in accordance with the surgery and implant shape: T5 group (Five implant and osteotomy using drills); M5 group (Five implant and magnetodynamic osteotomy using Magnetic Mallet); TT group (TiSmart implant and osteotomy with drills); and MT group (TiSmart implant and magnetodynamic osteotomy). Every implant was placed into a low-density bone animal model and scanned using CBCT. The PIT and PRT were digitally measured in Newton-centimeters (Ncm) using a torque gauge device. The ISQ was analyzed by conducting resonance frequency analysis. Results: The PIT values were 25.04 ± 4.4 Ncm for T5, 30.62 ± 3.81 Ncm for M5, 30 ± 3.74 Ncm for TT, and 32.05 ± 3.55 Ncm for MT. The average ISQ values were 68.11 ± 3.86 for T5, 71.41 ± 3.69 for M5, 70.88 ± 3.08 for TT, and 73 ± 3.5 for MT. The PRT values were 16.47 ± 4.56 Ncm for T5, 26.02 ± 4.03 Ncm for M5, 23.91 ± 3.28 Ncm for TT, and 26.93 ± 3.96 Ncm for MT. Based on our data analysis using a t-test with α = 0.05, significant differences in PIT were observed between TT and T5 (p < 0.0001), M5 and T5 (p < 0.0001), and MT and TT (p = 0.02). Significant differences in the ISQ were found between TT and T5 (p = 0.001), M5 and T5 (p < 0.001), and MT and TT (p = 0.01). The PRT also exhibited significant differences between TT and T5, M5 and T5, and MT and TT (p < 0.0001). Conclusion: Our data showed favorable primary implant stability (PS) values for both implant macro-geometries. Furthermore, the magnetodynamic preparation technique appears to be more effective in achieving higher PS values in low-density bone. Full article

(This article belongs to the Special Issue Oral Implantology and Rehabilitation)

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11 pages, 3205 KiB

Open AccessArticle

Reliability and Failure Mode of Ti-Base Abutments Supported by Narrow/Wide Implant Systems

by Ernesto B. Benalcázar-Jalkh, Laura F. de Carvalho, Larissa M. M. Alves, Tiago M. B. Campos, Edisa de Oliveira Sousa, Edmara T. P. Bergamo, Paulo G. Coelho, Petra C. Gierthmuehlen, Frank A. Spitznagel, Abbas Zahoui and Estevam A. Bonfante

Dent. J. 2023, 11(9), 207; https://doi.org/10.3390/dj11090207 - 29 Aug 2023

Viewed by 1650

Abstract

To assess the reliability and failure modes of Ti-base abutments supported by narrow and wide-diameter implant systems. Narrow (Ø3.5 × 10 mm) and wide (Ø5 × 10 mm) implant systems of two different manufacturers with internal conical connections (16°) and their respective Ti-base [...] Read more.

To assess the reliability and failure modes of Ti-base abutments supported by narrow and wide-diameter implant systems. Narrow (Ø3.5 × 10 mm) and wide (Ø5 × 10 mm) implant systems of two different manufacturers with internal conical connections (16°) and their respective Ti-base abutments (3.5 and 4.5 mm) were evaluated. Ti-base abutments were torqued to the implants, standardized metallic maxillary incisor crowns were cemented, and step stress accelerated life testing of eighteen assemblies per group was performed in three loading profiles: mild, moderate, and aggressive until fracture or suspension. Reliability for missions of 100,000 cycles at 100 and 150 N was calculated, and fractographic analysis was performed. For missions at 100 N for 100,000 cycles, both narrow and wide implant systems exhibited a high probability of survival (≥99%, CI: 94–100%) without significant differences. At 150 N, wide-diameter implants presented higher reliability (≥99%, CI: 99–100%) compared to narrow implants (86%, CI: 61–95%), with no significant differences among manufacturers. Failure mode predominantly involved Ti-base abutment fractures at the abutment platform. Ti-base abutments supported by narrow and wide implant systems presented high reliability for physiologic masticatory forces, whereas for high load-bearing applications, wide-diameter implants presented increased reliability. Failures were confined to abutment fractures. Full article

(This article belongs to the Special Issue Oral Implantology and Rehabilitation)

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12 pages, 3192 KiB

Open AccessArticle

Accuracy of Zygomatic Implant Placement Using a Full Digital Planning and Custom-Made Bone-Supported Guide: A Retrospective Observational Cohort Study

by Francesco Gallo, Francesco Zingari, Alessandro Bolzoni, Selene Barone and Amerigo Giudice

Dent. J. 2023, 11(5), 123; https://doi.org/10.3390/dj11050123 - 4 May 2023

Cited by 4 | Viewed by 2188

Abstract

The aim of the study was to evaluate the accuracy of zygomatic implant placement using customized bone-supported laser-sintered titanium templates. Pre-surgical computed tomography (CT) scans allowed to develop the ideal virtual planning for each patient. Direct metal laser-sintering was used to create the [...] Read more.

The aim of the study was to evaluate the accuracy of zygomatic implant placement using customized bone-supported laser-sintered titanium templates. Pre-surgical computed tomography (CT) scans allowed to develop the ideal virtual planning for each patient. Direct metal laser-sintering was used to create the surgical guides for the implant placement. Post-operative CT scans were taken 6 months after surgery to assess any differences between the planned and placed zygomatic implants. Qualitative and quantitative three-dimensional analyses were performed with the software Slicer3D, recording linear and angular displacements after the surface registration of the planned and placed models of each implant. A total of 59 zygomatic implants were analyzed. Apical displacement showed a mean movement of 0.57 ± 0.49 mm on the X-axis, 1.1 ± 0.6 mm on the Y-axis, and 1.15 ± 0.69 mm on the Z-axis for the anterior implant, with a linear displacement of 0.51 ± 0.51 mm on the X-axis, 1.48 ± 0.9 mm on the Y-axis, and 1.34 ± 0.9 mm on the Z-axis for the posterior implant. The basal displacement showed a mean movement of 0.33 ± 0.25 mm on the X-axis, 0.66 ± 0.47 mm on the Y-axis, and 0.58 ± 0.4 mm on the Z-axis for the anterior implant, with a linear displacement of 0.39 ± 0.43 mm on the X-axis, 0.42 ± 0.35 mm on the Y-axis, and 0.66 ± 0.4 mm on the Z-axis for the posterior implant. The angular displacements recorded significative differences between the anterior implants (yaw: 0.56 ± 0.46°; pitch: 0.52 ± 0.45°; roll: 0.57 ± 0.44°) and posterior implants (yaw: 1.3 ± 0.8°; pitch: 1.3 ± 0.78°; roll: 1.28 ± 1.1°) (p < 0.05). Fully guided surgery showed good accuracy for zygomatic implant placement and it should be considered in the decision-making process. Full article

(This article belongs to the Special Issue Oral Implantology and Rehabilitation)

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20 pages, 9404 KiB

Open AccessArticle

Evaluation of Two Configurations of Hydroxyapatite and Beta-Tricalcium Phosphate in Sinus Grafts with Simultaneous Implant Installation: An Experimental Study in Rabbits

by Ricardo Garcia Mureb Jacob, Ana Cláudia Ervolino da Silva, Liat Chaushu, Niklaus Peter Lang, Ciro Borges Duailibe de Deus, Daniele Botticelli and Idelmo Rangel Garcia Júnior

Dent. J. 2023, 11(5), 121; https://doi.org/10.3390/dj11050121 - 4 May 2023

Cited by 1 | Viewed by 2456

Abstract

Background: This study aimed to evaluate peri-implant bone formation in rabbits after sinus grafting mediated by hydroxyapatite and beta-tricalcium phosphate (HA + β-TCP) in granule or paste configurations, concomitant with immediate implant installation. Material & methods: Thirty-four rabbit maxillary sinuses were grafted with [...] Read more.

Background: This study aimed to evaluate peri-implant bone formation in rabbits after sinus grafting mediated by hydroxyapatite and beta-tricalcium phosphate (HA + β-TCP) in granule or paste configurations, concomitant with immediate implant installation. Material & methods: Thirty-four rabbit maxillary sinuses were grafted with HA + β-TCP, half of which were applied in a granule and half in a paste composition. Implant placement was performed simultaneously. At 7 and 40 days postoperatively, the animals were euthanized, and samples were prepared for tomographic, microtomographic, histological, histometric (hematoxylin and eosin staining, HE), and immunohistochemical (labeling of transcription factor Runx-2 [RUNX2], vascular endothelial growth factor [VEGF], osteocalcin [OCN], and tartrate-resistant acid phosphatase [TRAP]) analysis. Implant removal torque was also measured. Results: On tomography, maintenance of sinus membrane integrity was observed in both the groups. Higher values of morphometric parameters evaluated by micro-CT were found in the “paste group” after seven days. At 40 days, there were no significant differences between the groups in most of the microtomographic parameters evaluated. In histological sections stained with HE, a higher percentage of newly formed bone was observed in the “granule group” after 40 days. Similar positive immunolabeling was observed for both RUNX2 and OCN in both the experimental groups. TRAP immunolabeling was similar in both groups as well. VEGF labeling increased in the “granule group”, indicating a higher osteoconductive potential in this biomaterial. Similar removal torque values were observed in both groups. Thus, the two HA + β-TCP configurations showed similar healing patterns of simultaneously installed implants adjacent to sinus floor elevation. However, significantly higher bone values were observed for the “granule configuration”. Conclusions: The HA + β-TCP granules and paste presentations showed favorable long-term healing results, with bone formation in similar quantities and quality adjacent to the implants. Full article

(This article belongs to the Special Issue Oral Implantology and Rehabilitation)

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10 pages, 711 KiB

Open AccessFeature PaperEditor’s ChoiceArticle

An Analysis of Different Techniques Used to Seal Post-Extractive Sites—A Preliminary Report

by Paolo Pesce, Eitan Mijiritsky, Luigi Canullo, Maria Menini, Vito Carlo Alberto Caponio, Andrea Grassi, Luca Gobbato and Domenico Baldi

Dent. J. 2022, 10(10), 189; https://doi.org/10.3390/dj10100189 - 9 Oct 2022

Cited by 8 | Viewed by 2345

Abstract

Background: Bone grafting in post-extractive site improves tissue regeneration. Soft tissue sealing of the grafted post-extractive alveolus is supposed to limit microbiological contamination from the oral cavity and to stabilize the coagulum. Several techniques are presented in the literature to reach this goal [...] Read more.

Background: Bone grafting in post-extractive site improves tissue regeneration. Soft tissue sealing of the grafted post-extractive alveolus is supposed to limit microbiological contamination from the oral cavity and to stabilize the coagulum. Several techniques are presented in the literature to reach this goal using different heterologous matrices or autogenous grafts. In addition, recently, a technique based on the use of granulation tissue in the post-extractive alveolus has been proposed. Aim: To compare the effect of different graft sealing approaches in post-extractive sites by qualitatively evaluating their healing process. Materials and Methods: This retrospective investigation included 30 patients requiring post-extractive site regeneration in the aesthetic area. Post-extractive sites were regenerated using a bovine bone matrix and patients were divided into three groups (10 patients in each group) according to the material used to seal the alveolar socket. In the UD group, the granulation tissue was used to seal the defect; in the PC group, epithelial-connective soft tissue graft was used, and in the COLL group, a collagen-based membrane was employed. Images of the post-extractive sites at different follow-up periods (2 and 12 weeks) were taken and the healing process was blindly evaluated by two independent practitioners. The Healing Index (HI) by Landry, Turnbull and Howley was used to assess the quality of the healing process. The combination of presence/absence of five clinical criteria defines an HI ranging from 1 (very poor) to 5 (excellent). Patients’ clinical-pathological variables were recorded. One-way ANOVA was used to explore the dependence of HI on the different socket preservation protocols. Results: Based on clinical-pathological characteristics of the included patients, there were no statistically significant differences among the different sealing techniques. At the 2-week follow-up appointment, HI did not differ among the socket preservation protocols evaluated. Moreover, smoking status and reason for extraction did not influence the HI among the three groups (two-way ANOVA p-value = 0.686, p-value = 0.248 respectively). At the 2-week follow-up appointment, HI was significantly different among the socket preservation protocols investigated. Specifically, the group undergoing collagen-based socket preservation procedure reported the highest HI, compared to the other two techniques (COLL mean 4.60 ± 0.5; PC mean 3.5 ± 1.2; UD mean 3.4 ± 0.5, one-way ANOVA p-value 0.006). Conclusions: The use of collagen porcine membranes may represent a suitable option to improve the patient healing process in grafted post-extractive sites together with reducing the surgical intervention time compared to alternative sealing techniques. Full article

(This article belongs to the Special Issue Oral Implantology and Rehabilitation)

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13 pages, 4061 KiB

Open AccessEditor’s ChoiceArticle

Mesiodistal Measurements for Dental Implant Planning: A Prospective Clinical Study of Linear Measurements on Cone-Beam Computed Tomography Images in Comparison with Caliper-Based Measurements on Plaster Casts

by Lydia Vazquez, Ramona Buser and Jean-Pierre Carrel

Dent. J. 2022, 10(9), 169; https://doi.org/10.3390/dj10090169 - 7 Sep 2022

Viewed by 3210

Abstract

Althouh cone beam computed tomography (CBCT) is popular for dental implant planning, the horizontal mesiodistal space of the edentulous ridge is still conventionally measured with a handheld sliding caliper in the oral cavity or on a plaster cast. For clinical application in implant [...] Read more.

Althouh cone beam computed tomography (CBCT) is popular for dental implant planning, the horizontal mesiodistal space of the edentulous ridge is still conventionally measured with a handheld sliding caliper in the oral cavity or on a plaster cast. For clinical application in implant planning, our aim was to evaluate the accuracy of CBCT horizontal mesiodistal linear measurements in comparison with conventionally obtained direct measurements on plaster casts. Postoperative CBCT acquisitions and plaster casts of 27 patients with adjacent posterior mandibular implants were analyzed in a prospective clinical study. On CBCT images, two observers assessed the inter-implant distances on axial and sagittal views. On plaster casts, the inter-implant distances were measured with a digital caliper. CBCT measurements on axial and sagittal views were, on average, 0.2 mm larger than measurements on plaster casts. Correlation was perfect between measurements of the same inter-implant distance performed by the observers on CBCT images and on plaster casts. When compared with conventionally obtained direct measurements on plaster casts, CBCT views slightly overestimated (mean 0.2 mm) the horizontal mesiodistal measurements between two implants as reference points. CBCT imaging is sufficiently accurate to evaluate mesiodistal distances on axial and sagittal views for dental implant planning in clinical practice. Full article

(This article belongs to the Special Issue Oral Implantology and Rehabilitation)

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Review

Jump to: Research, Other

18 pages, 1014 KiB

Open AccessFeature PaperReview

Advanced Antimicrobial and Anti-Infective Strategies to Manage Peri-Implant Infection: A Narrative Review

by Yihan Li, Cameron A. Stewart and Yoav Finer

Dent. J. 2024, 12(5), 125; https://doi.org/10.3390/dj12050125 - 6 May 2024

Viewed by 1819

Abstract

Despite reductions in bacterial infection and enhanced success rate, the widespread use of systemic antibiotic prophylaxis in implant dentistry is controversial. This use has contributed to the growing problem of antimicrobial resistance, along with creating significant health and economic burdens. The basic mechanisms [...] Read more.

Despite reductions in bacterial infection and enhanced success rate, the widespread use of systemic antibiotic prophylaxis in implant dentistry is controversial. This use has contributed to the growing problem of antimicrobial resistance, along with creating significant health and economic burdens. The basic mechanisms that cause implant infection can be targeted by new prevention and treatment methods which can also lead to the reduction of systemic antibiotic exposure and its associated adverse effects. This review aims to summarize advanced biomaterial strategies applied to implant components based on anti-pathogenic mechanisms and immune balance mechanisms. It emphasizes that modifying the dental implant surface and regulating the early immune response are promising strategies, which may further prevent or slow the development of peri-implant infection, and subsequent failure. Full article

(This article belongs to the Special Issue Oral Implantology and Rehabilitation)

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Graphical abstract

13 pages, 1095 KiB

Open AccessReview

Are Allergy-Induced Implant Failures Actually Hypersensitivity Reactions to Titanium? A Literature Review

by Megumi Watanabe, Lipei Liu and Tetsuo Ichikawa

Dent. J. 2023, 11(11), 263; https://doi.org/10.3390/dj11110263 - 9 Nov 2023

Cited by 1 | Viewed by 3058

Abstract

Purpose: This literature review was performed to assess whether implant failures are associated with titanium allergy. Materials and Methods: An electronic search of the MEDLINE/PubMed, Cochrane Library, and Scopus databases up to April 2021 was conducted, and the obtained articles were independently assessed [...] Read more.

Purpose: This literature review was performed to assess whether implant failures are associated with titanium allergy. Materials and Methods: An electronic search of the MEDLINE/PubMed, Cochrane Library, and Scopus databases up to April 2021 was conducted, and the obtained articles were independently assessed by two reviewers. Articles describing cases of implant failure in which the cause of implant failure was only identified as allergy were included. Results: Twelve studies were included. Eight studies identified Ti allergy by clinical examinations, of which four used patch tests, three used the lymphocyte transformation test (LTT)/memory lymphocyte immunostimulation assay (MELISA), and one used both tests. Nine studies reported cases of titanium hypersensitivity in combination with other systemic allergy-related disorders, with eight cases also showing positive results for Ni, Hg, Cr, and Co hypersensitivity. Ten papers reported the improvement of symptoms after the removal of the Ti implants and their replacement with zirconia implants, and two of these papers showed good results. Conclusion: Cases of probable titanium allergy included those with true titanium allergies and those with a potentially different cause. However, the differentiation of these cases is difficult. Since no definitive method has been established for diagnosing titanium allergy, a comprehensive diagnosis based on the clinical course and clinical examination using a patch test/LTT/MELISA is necessary. Implant treatment should be performed with caution in patients with any preoperative allergies. Full article

(This article belongs to the Special Issue Oral Implantology and Rehabilitation)

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17 pages, 6128 KiB

Open AccessReview

Alveolar Ridge Preservation with Autologous Platelet-Rich Fibrin (PRF): Case Reports and the Rationale

by Cemal Ucer and Rabia S. Khan

Dent. J. 2023, 11(10), 244; https://doi.org/10.3390/dj11100244 - 23 Oct 2023

Cited by 4 | Viewed by 4947

Abstract

In dental implantology, alveolar ridge preservation (ARP) has emerged as a standard technique to address dimensional changes that affect alveolar ridge morphology following tooth loss. Various alternative graft materials, including xenografts, alloplasts, and allografts, have been effectively employed in fresh extraction sites for [...] Read more.

In dental implantology, alveolar ridge preservation (ARP) has emerged as a standard technique to address dimensional changes that affect alveolar ridge morphology following tooth loss. Various alternative graft materials, including xenografts, alloplasts, and allografts, have been effectively employed in fresh extraction sites for ARP. Current evidence suggests that these materials primarily serve as bio-scaffolds, which are slowly incorporated, thus necessitating a waiting period of at least 4–6 months before implant placement. Consequently, the ARP technique extends the overall duration of implant treatment by several months. Recently, the incorporation of a form of autologous platelet concentrate, known as platelet-rich fibrin (PRF), has been advocated in conjunction with ARP as a method of bioenhancement of soft- and hard-tissue healing and regeneration. PRF contains platelet-derived growth factors, hormones, and bioactive components like cytokines that have demonstrated the ability to stimulate angiogenesis and tissue regeneration throughout all phases of wound healing. Additionally, the concentration of leukocytes present in the PRF matrix plays a vital role in tissue healing and regeneration as part of the osteoimmune response. The reported advantages of incorporating autogenous PRF platelet concentrates during ARP encompass reduced healing time, improved angiogenesis and bone regeneration, socket sealing through the fibrin matrix, antibacterial properties, and decreased post-extraction pain and infection risk. Therefore, the objective of this paper is to review the existing evidence regarding the application of PRF in alveolar ridge preservation (ARP) following tooth extraction. Two clinical case studies are presented, wherein ARP was enhanced with PRF, followed by implant placement within a relatively short period of 8 weeks. These cases serve as further proof of concept for supporting the adjuvant use of PRF to enhance healing and accelerate implant placement after ARP. Full article

(This article belongs to the Special Issue Oral Implantology and Rehabilitation)

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20 pages, 2421 KiB

Open AccessReview

Extraction Socket Augmentation with Autologous Platelet-Rich Fibrin (PRF): The Rationale for Socket Augmentation

by Cemal Ucer and Rabia S. Khan

Dent. J. 2023, 11(8), 196; https://doi.org/10.3390/dj11080196 - 14 Aug 2023

Cited by 6 | Viewed by 3211

Abstract

After tooth extraction, the alveolar ridge undergoes a physiological process of remodelling and disuse atrophy. Socket augmentation (SA) has been shown to preserve alveolar bone volume in order to facilitate implant placement and reduce the need for staged grafting at a later date. [...] Read more.

After tooth extraction, the alveolar ridge undergoes a physiological process of remodelling and disuse atrophy. Socket augmentation (SA) has been shown to preserve alveolar bone volume in order to facilitate implant placement and reduce the need for staged grafting at a later date. Although autogenic grafting has been shown to be the gold standard in bone regeneration, it has significant disadvantages. To prevent post-extraction volumetric alterations and alveolar bone resorption occurring, alternative grafting materials, including xenografts, alloplasts, and allografts, have been used successfully in fresh extraction sites. However, these materials act mostly as bio-scaffolds and require a slower integration period of 6–8 months prior to implant placement. Recently, the use of autologous platelet-rich fibrin (PRF) has been advocated alongside socket augmentation as a method of bio-enhancement of healing of soft and hard tissues. PRF contains platelet-derived growth factors, hormones, and bioactive components such as cytokines that have been shown to promote angiogenesis and tissue regeneration during wound healing. The aim of this article is to review the evidence base for the SA technique Clinical benefits of SA will be discussed with a reference to two cases. Therefore, this narrative review will discuss the post-extraction bone changes, the importance of SA, and the bio-enhancement role of PRF in the management of extraction site defects when the alternative technique of immediate implant placement is not possible or contraindicated. Full article

(This article belongs to the Special Issue Oral Implantology and Rehabilitation)

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14 pages, 615 KiB

Open AccessReview

The Use of Zirconia for Implant-Supported Fixed Complete Dental Prostheses: A Narrative Review

by Chiara Cinquini, Fortunato Alfonsi, Vincenzo Marchio, Francesco Gallo, Francesco Zingari, Alessandro Remigio Bolzoni, Stefano Romeggio and Antonio Barone

Dent. J. 2023, 11(6), 144; https://doi.org/10.3390/dj11060144 - 1 Jun 2023

Cited by 12 | Viewed by 4215

Abstract

The success of implant-supported fixed complete dental prostheses (ISFCDPs) depends on multiple factors: some are related to the fixtures, such as fixture material, surface characteristics, positioning, and type of connection to prosthetic components; others are related to the prostheses, such as design and [...] Read more.

The success of implant-supported fixed complete dental prostheses (ISFCDPs) depends on multiple factors: some are related to the fixtures, such as fixture material, surface characteristics, positioning, and type of connection to prosthetic components; others are related to the prostheses, such as design and materials used. Zirconia is a material widely used in fixed prosthodontics, whether on natural teeth or on implants, with excellent results over time. Regarding the use of zirconia for ISFCDPs, the 2018 ITI Consensus Report stated that “implant-supported monolithic zirconia prostheses may be a future option with more supporting evidence”. Since CAD/CAM technology and zirconia are being continuously innovated to achieve better results and performances over time, a narrative review of the literature seems necessary to focus research efforts towards effective and durable solutions for implant-supported, full-arch rehabilitations. The objective of the present narrative review was to search the literature for studies regarding the clinical performance of zirconia-based ISFCDPs. According to the results of this review, the use of zirconia for ISFCDPs showed good clinical outcomes, with high survival rates ranging from 88% to 100% and prosthetic complications that were restorable by the clinicians in most cases. Full article

(This article belongs to the Special Issue Oral Implantology and Rehabilitation)

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Other

Jump to: Research, Review

23 pages, 2613 KiB

Open AccessSystematic Review

Survival Rates of Short Dental Implants (≤6 mm) Used as an Alternative to Longer (>6 mm) Implants for the Rehabilitation of Posterior Partial Edentulism: A Systematic Review of RCTs

by Rodopi Emfietzoglou and Xanthippi Dereka

Dent. J. 2024, 12(6), 185; https://doi.org/10.3390/dj12060185 - 17 Jun 2024

Cited by 1 | Viewed by 1351

Abstract

Short dental implants have been proposed as an alternative treatment option to bone regeneration procedures for the rehabilitation of resorbed alveolar ridges. The aim of this paper was to systematically review randomized controlled trials (RCTs) comparing short implants (≤6 mm) and longer implants [...] Read more.

Short dental implants have been proposed as an alternative treatment option to bone regeneration procedures for the rehabilitation of resorbed alveolar ridges. The aim of this paper was to systematically review randomized controlled trials (RCTs) comparing short implants (≤6 mm) and longer implants (>6 mm) in atrophic alveolar ridges in terms of implant survival rates, peri-implant marginal bone loss (MBL), prevalence of peri-implantitis and technical complications. A thorough electronic search was performed until September 2023. RCTs with follow-up of at least 1-year post-loading comparing short implants with rough surfaces to longer implants in the posterior jaws of systemically and periodontally healthy, partially edentulous adults were considered. Studies with incomplete information on the number of patients, follow-up or definition of “short implants” were excluded. The revised Cochrane risk-of-bias tool for randomized trials was used for Risk of bias assessment. Fixed-effects meta-analysis of the selected studies was applied to compare the outcome variables. Random-effect meta-analysis was performed, on the basis of within-study comparisons. In total, 16 articles were selected for meta-analysis and incorporated 408 short implants and 475 longer implants inserted in 317 and 388 patients, respectively. The survival rates of longer implants in pristine or augmented bone were significantly increased compared to short implants (95%CI: 2–5%, p < 0.001). Standard-length implants displayed increased, although non-statistically significant MBL (95%CI: −0.17–0.04, p > 0.05), and prevalence of peri-implantitis (95%CI: 0–5%, p > 0.05). No statistically significant differences were observed between short and long implants in terms of technical complications (implant-level 95%CI: −4–6%, p > 0.05). Short implants represent a promising alternative treatment option for the rehabilitation of posterior jaws to avoid additional bone augmentation procedures. Nonetheless, they should be selected cautiously due to a potentially limited survival rate compared to longer implants. A major limitation of this study is the variability in the included studies regarding sample size, patient profile, type of bone, loading protocol, definition of peri-implantitis, among others. This study received no external funding. The study protocol was registered in PROSPERO (CRD42023485514). Full article

(This article belongs to the Special Issue Oral Implantology and Rehabilitation)

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14 pages, 1948 KiB

Open AccessSystematic Review

Association of Connective Tissue Grafts in Immediate Implants: Systematic Review and Meta-Analysis

by Marta Torra-Moneny, Elisabet Mauri-Obradors, Sonia Egido-Moreno, Joan Valls-Roca-Umbert, Antonio Marí-Roig and José López-López

Dent. J. 2024, 12(6), 183; https://doi.org/10.3390/dj12060183 - 17 Jun 2024

Cited by 1 | Viewed by 1648

Abstract

Background: The increase in soft tissue (ST) around implants can benefit peri-implant health and aesthetic results. The objective was to compare the gingival and esthetic health benefits of immediate implant placement (IIP) with simultaneous or delayed connective tissue graft (CTG) compared to IIP [...] Read more.

Background: The increase in soft tissue (ST) around implants can benefit peri-implant health and aesthetic results. The objective was to compare the gingival and esthetic health benefits of immediate implant placement (IIP) with simultaneous or delayed connective tissue graft (CTG) compared to IIP without CTG. Methods: A systematic review was carried out by two reviewers in Medline-Pubmed, Scopus, and Cochrane. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were considered. Randomized Clinical Trials (RCTs) that were published between April 2017 and February 2024 were used. Studies that analyzed the performance of a simultaneous or deferred CTG after the placement of an implant in the aesthetic zone, with or without immediate provisionalization, without previous regeneration, with a follow-up of 6 months, and that were performed in humans were included. Results: Quantitative analysis was performed using data provided by the RCTs. The five RCTs that were selected analyzed a total “n” of 245 subjects who met the inclusion criteria and focused on the subject of the study. In the quantitative analysis, four RCTs were included. The studies evaluated buccal gingiva levels when placing the IIP with and without CTG, obtaining a mean buccal gingiva level difference of 0.09 mm (95% CI: −0.54 to 0.72, p = 0.05), statistically not significant, but with a favorable trend. Conclusions: The use of CTG associated with the II can maintain the gum level but not increase the volume. CTG is favorable for achieving successful esthetic results when immediate placement of an implant with a provisional prosthesis is planned. Full article

(This article belongs to the Special Issue Oral Implantology and Rehabilitation)

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11 pages, 7274 KiB

Open AccessTechnical Note

Computer Aided Full Arch Restoration by Means of One-Piece Implants and Stackable Guide: A Technical Note

by Mattia Manfredini, Pier Paolo Poli, Carlo Maiorana, Federica Eugenia Salina, Marco Tandurella and Mario Beretta

Dent. J. 2023, 11(11), 256; https://doi.org/10.3390/dj11110256 - 1 Nov 2023

Cited by 2 | Viewed by 2758

Abstract

This technical note aims to present a recently developed computer-guided protocol characterized by titanium-reinforced stackable surgical guides during post-extractive implant placement and subsequent immediate loading. A full maxillary edentulism was rehabilitated with one-piece implants, starting from a pre-existing removable denture. 3D digital scans [...] Read more.

This technical note aims to present a recently developed computer-guided protocol characterized by titanium-reinforced stackable surgical guides during post-extractive implant placement and subsequent immediate loading. A full maxillary edentulism was rehabilitated with one-piece implants, starting from a pre-existing removable denture. 3D digital scans of the removable denture and upper and lower arches were performed. On this basis, a prototype with ideal esthetic and functional outcomes was realized and replicated into a custom-made radiological stent with markers. The superimposition of STL and DICOM files allowed virtual planning of one-piece implants in the ideal prosthetically driven position. The stackable guides, composed of a fixed base template and additional removable components, were then realized. The fixed template, initially secured with anchor pins to the bone, was no longer removed. The removable components, which were screwed to the base template, were used to perform implant surgery and immediate prosthetic loading. No surgical complications occurred, the implants achieved a minimum insertion torque of 35 Ncm, and immediate prosthetic loading was performed. The base template allowed for the maintenance of a fixed reference during the entire workflow, improving the transition between the digital project, the surgical procedure, and the prosthetic rehabilitation. Full article

(This article belongs to the Special Issue Oral Implantology and Rehabilitation)

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16 pages, 1137 KiB

Open AccessSystematic Review

Differences in Dental Implant Survival between Immediate vs. Delayed Placement: A Systematic Review and Meta-Analysis

by Rishi Patel, Cemal Ucer, Simon Wright and Rabia S. Khan

Dent. J. 2023, 11(9), 218; https://doi.org/10.3390/dj11090218 - 15 Sep 2023

Cited by 7 | Viewed by 5172

Abstract

Objectives: To compare the impact of immediate and delayed implant placement upon the survival of implants and to investigate the differences in implant survival between immediate and delayed placement in adults. Methods: A search for the relevant literature was performed using the databases [...] Read more.

Objectives: To compare the impact of immediate and delayed implant placement upon the survival of implants and to investigate the differences in implant survival between immediate and delayed placement in adults. Methods: A search for the relevant literature was performed using the databases of CENTRAL, MEDLINE and Scopus. The studies found were limited to publications between 2014 and 2022, written in the English language, peer-reviewed, and were randomised trials or comparative studies. The quality of the evidence was assessed using the Cochrane Risk of Bias 2.0 and Risk of Bias in Non-randomised Studies—of Interventions appraisal tools and implant survival, and the primary outcome was meta-analysed using RevMan v.5.3. Results: A total of 10 studies were eligible for inclusion, including six randomised controlled trials and four non-randomised comparative studies. Five of the six randomised trials observed a low risk of bias, while the comparative studies had a moderate-to-serious risk of bias. The search strategy resulted in 341 implants placed immediately into fresh extraction sites (332 survived, 97.4%) and 359 implants inserted into delayed sites (350 survived, 97.5%). Conclusion: The meta-analysis demonstrated that there was no significant difference in the implant survival rates between immediately placed implants and implants placed using a delayed timing protocol (risk ratio 0.99; 95% CI 0.96, 1.02, Z = 0.75, p = 0.45). However, the detailed analysis showed that slightly more implant failures happened in the immediate dental implant placement group, with survival rates in some studies ranging between 90 and 95%, while the delayed placement group had survival rates of more than 95%. Full article

(This article belongs to the Special Issue Oral Implantology and Rehabilitation)

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9 pages, 42300 KiB

Open AccessCase Report

Digital Planning for Immediate Implants in Anterior Esthetic Area: Immediate Result and Follow-Up after 3 Years of Clinical Outcome—Case Report

by Saulo Henrique Salviano, João Carlos Amorim Lopes, Igor da Silva Brum, Kelly Machado, Marco Tulio Pedrazzi and Jorge José de Carvalho

Dent. J. 2023, 11(1), 15; https://doi.org/10.3390/dj11010015 - 3 Jan 2023

Cited by 2 | Viewed by 3051

Abstract

In this case report, we demonstrate how the correct positioning of implants, associated with optimal gingival conditioning, and the correct choice of biomaterial can yield very predictable and fantastic aesthetic results. Objective: We aimed to use dental implants to rehabilitate the area of [...] Read more.

In this case report, we demonstrate how the correct positioning of implants, associated with optimal gingival conditioning, and the correct choice of biomaterial can yield very predictable and fantastic aesthetic results. Objective: We aimed to use dental implants to rehabilitate the area of elements #11 and #21 in a satisfactory surgical and prosthetic manner, using guided surgery, connective tissue, nano-biomaterials, and a porcelain prosthesis. Case Report: A 32-year-old male patient presented with bone loss of elements #11 and #21, which was proven radiographically and clinically. Thus, oral rehabilitation with the use of dental implants was required. It was decided to proceed via digital planning with the DSD program (Digital smile design) and with the software Exoplan, (Smart Dent-Germany) whenever it was possible to plan immediate provisional and accurate dental implant positioning through reverse diagnostics (Software Exoplan, Smart Dent-German). The dental elements were extracted atraumatically; then, a guide was established, the implants were positioned, the prosthetic components were placed, the conjunctive tissue was removed from the palate and redirected to the vestibular wall of the implants, the nano-graft (Blue Bone^®) was conditioned in the gaps between the vestibular wall and the implants, and, finally, the cemented provision was installed. Results: After a 5-month accompaniment, an excellent remodeling of the tissues had been achieved by the implants; consequently, the final prosthetic stage could begin, which also achieved a remarkable aesthetic result. Conclusions: This report demonstrates that the correct planning of dental implants, which is associated with appropriate soft tissue and bone manipulation, allows for the achievement of admirable clinical results. Full article

(This article belongs to the Special Issue Oral Implantology and Rehabilitation)

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