International Journal of Environmental Research and Public Health

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12 pages, 2725 KiB

Open AccessArticle

Retrospective Study: Lateral Ridge Augmentation Using Autogenous Dentin: Tooth-Shell Technique vs. Bone-Shell Technique

by Michael Korsch and Marco Peichl

Int. J. Environ. Res. Public Health 2021, 18(6), 3174; https://doi.org/10.3390/ijerph18063174 - 19 Mar 2021

Cited by 17 | Viewed by 3893

Abstract

In the literature, autogenous dentin is considered a possible alternative to bone substitute materials and autologous bone for certain indications. The aim of this proof-of-concept study was to use autogenous dentin for lateral ridge augmentation. In the present retrospective study, autogenous dentin slices [...] Read more.

In the literature, autogenous dentin is considered a possible alternative to bone substitute materials and autologous bone for certain indications. The aim of this proof-of-concept study was to use autogenous dentin for lateral ridge augmentation. In the present retrospective study, autogenous dentin slices were obtained from teeth and used for the reconstruction of lateral ridge defects (tooth-shell technique (TST): 28 patients (15 females, 13 males) with 34 regions and 38 implants). The bone-shell technique (BST) according to Khoury (31 patients (16 females, 15 males) with 32 regions and 41 implants) on autogenous bone served as the control. Implants were placed simultaneously in both cases. Follow-up was made 3 months after implantation. Target parameters during this period were clinical complications, horizontal hard tissue loss, osseointegration, and integrity of the buccal lamella. The prosthetic restoration with a fixed denture was carried out after 5 months. The total observation period was 5 months. A total of seven complications occurred. Of these, three implants were affected by wound dehiscences (TST: 1, BST: 2) and four by inflammations (TST: 0, BST: 4). There were no significant differences between the two groups in terms of the total number of complications. One implant with TST exhibited a horizontal hard tissue loss of 1 mm and one with BST of 0.5 mm. Other implants were not affected by hard tissue loss. There were no significant differences between the two groups. Integrity of the buccal lamella was preserved in all implants. All implants were completely osseointegrated in TST and BST. All implants could be prosthetically restored with a fixed denture 5 months after augmentation. TST showed results comparable to those of the BST. Dentin can therefore serve as an alternative material to avoid bone harvesting procedures and thus reduce postoperative discomfort of patients. Full article

(This article belongs to the Special Issue Impact of Dental Implants on Oral Health)

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19 pages, 1440 KiB

Open AccessArticle

A Radiographic and Clinical Comparison of Immediate vs. Early Loading (4 Weeks) of Implants with a New Thermo-Chemically Treated Surface: A Randomized Clinical Trial

by Matteo Albertini, Federico Herrero-Climent, Carmen María Díaz-Castro, Jose Nart, Ana Fernández-Palacín, José Vicente Ríos-Santos and Mariano Herrero-Climent

Int. J. Environ. Res. Public Health 2021, 18(3), 1223; https://doi.org/10.3390/ijerph18031223 - 29 Jan 2021

Cited by 5 | Viewed by 3788

Abstract

Background: Implant dentistry has evolved over time, resulting in better treatment outcomes for both patients and clinicians. The aim of this trial was to test whether the immediate loading of implants with a platform-switching design influences the marginal bone level, compared to four-week [...] Read more.

Background: Implant dentistry has evolved over time, resulting in better treatment outcomes for both patients and clinicians. The aim of this trial was to test whether the immediate loading of implants with a platform-switching design influences the marginal bone level, compared to four-week loading, after one year of follow-up. Moreover, a comparison of clinical data regarding implant survival, implant stability, and patient-reported outcome measures (PROMs) was conducted. Methods: Klockner^® VEGA^® implants with a ContacTi^® surface were placed in partially edentulous patients in the posterior areas. Group A received an immediately loaded prosthesis (one week) and Group B received an early-loaded prosthesis (four weeks). All abutments were placed at the time of surgery. Radiographic and clinical data were recorded. Results: Twenty-one patients were treated (35 implants). No implants were lost during the study. The final marginal bone level did not show differences between groups. The bone loss at 12 months at the implant level was 0.00 mm for both groups (median). The final implant quotient stability (ISQ) values did not differ between groups (median 73 and 70.25), nor did the other clinical parameters or PROMs. Conclusions: The results suggest that neither of the loading protocols with the implants used influenced the marginal bone level—not the osseointegration rate, clinical conditions, or PROMs. Full article

(This article belongs to the Special Issue Impact of Dental Implants on Oral Health)

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13 pages, 4143 KiB

Open AccessArticle

Sinus Floor Elevation via an Osteotome Technique without Biomaterials

by Rodrigo Andrés-García, José Vicente Ríos-Santos, Mariano Herrero-Climent, Pedro Bullón, Javier Fernández-Farhall, Alberto Gómez-Menchero, Ana Fernández-Palacín and Blanca Ríos-Carrasco

Int. J. Environ. Res. Public Health 2021, 18(3), 1103; https://doi.org/10.3390/ijerph18031103 - 27 Jan 2021

Cited by 16 | Viewed by 4974

Abstract

According to classic Hirschfeld studies, the first teeth to be lost are the first and second maxillary molars. After the teeth are extracted and the alveolar process is developed, the maxillary sinus is reabsorbed and pneumatized with a decrease in bone availability in [...] Read more.

According to classic Hirschfeld studies, the first teeth to be lost are the first and second maxillary molars. After the teeth are extracted and the alveolar process is developed, the maxillary sinus is reabsorbed and pneumatized with a decrease in bone availability in the posterior sector of the maxilla. This process often creates the need to perform regeneration techniques for the placement of implants in this area due to the low availability of bone. The most frequently used and documented technique for the elevation of the sinus maxillary floor is elevation by the side window, as proposed by Tatum. In 1994, Summers proposed a technique that allowed the elevation of the sinus floor from a crestal access using an instrument called an osteotome, as well as the placement of the implant in the same surgical act. The aimed of the study was to evaluate the survival of 32 implants placed in posterior maxilla with bone availability less than 5 mm performing a sinus lift augmentation technique with osteotome without biomaterials. The results of this study show a survival rate of 100% for 32 implants placed in situations with an initial bone availability of 2 to 5 mm without the use of graft material. The infra-drilling technique used offers an increase in the primary stability of implants that allows adequate osteointegration Implants placed were charged at 12 weeks. In all cases, spontaneous bone formation was observed, even in cases where a positive Valsalva maneuver was observed. This proposed technique reduces treatment time and the need for more invasive maxillary sinus augmentation techniques. Full article

(This article belongs to the Special Issue Impact of Dental Implants on Oral Health)

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16 pages, 5077 KiB

Open AccessArticle

Influence of Removing or Leaving the Prosthesis after Regenerative Surgery in Peri-Implant Defects: Retrospective Study: 32 Clinical Cases with 2 to 8 Years of Follow-Up

by Víctor Astolfi, Alberto Gómez-Menchero, José Vicente Ríos-Santos, Pedro Bullón, Francisco Galeote, Blanca Ríos-Carrasco, Beatriz Bullón de la Fuente and Mariano Herrero-Climent

Int. J. Environ. Res. Public Health 2021, 18(2), 645; https://doi.org/10.3390/ijerph18020645 - 13 Jan 2021

Cited by 7 | Viewed by 2849

Abstract

Purpose: The aim of this retrospective study was to compare the influence of removing or not removing a prosthesis after regenerative surgery on peri-implant defects. Methods: Two different groups were compared (Group 1: removing the prosthesis; Group 2: maintaining the prosthesis), analyzing radiographic [...] Read more.

Purpose: The aim of this retrospective study was to compare the influence of removing or not removing a prosthesis after regenerative surgery on peri-implant defects. Methods: Two different groups were compared (Group 1: removing the prosthesis; Group 2: maintaining the prosthesis), analyzing radiographic bone filling (n = 32 implants) after regenerative treatment in periapical radiographs. The peri-implant defects were measured before and after regenerative treatment using Bio-Oss^® (Geistlich Pharma, Wohhusen, Switzerland) and a reabsorbable collagen membrane (Jason^®, Botis, Berlin, Germany), the healing period was two years after peri-implant regenerative surgery. Statistical analysis was performed, and a Chi square test was carried out. To determine the groups that made the difference, corrected standardized Haberman residuals were used, and previously a normality test had been applied; therefore, an ANOVA or Mann–Whitney U test was used for the crossover with the non-normal variables in Group 1 and Group 2. Results: The results obtained suggest that a regenerative procedure with xenograft, resorbable membrane, and detoxifying the implant surface with hydrogen peroxide form a reliable technique to achieve medium-term results, obtaining an average bone gain at a radiographic level of 2.84 mm (±1.78 mm) in patients whose prosthesis was not removed after peri-implant bone regenerative therapy and 2.18 mm (±1.41 mm) in patients whose prosthesis was removed during the healing period. Conclusions: There are no statistically significant differences in the response to treatment when removing or keeping the prosthesis after regenerative surgery in peri-implant defects. Full article

(This article belongs to the Special Issue Impact of Dental Implants on Oral Health)

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12 pages, 3240 KiB

Open AccessArticle

Influence of Connection Type and Platform Diameter on Titanium Dental Implants Fatigue: Non-Axial Loading Cyclic Test Analysis

by Ana I. Nicolas-Silvente, Eugenio Velasco-Ortega, Ivan Ortiz-Garcia, Alvaro Jimenez-Guerra, Loreto Monsalve-Guil, Raul Ayuso-Montero, Javier Gil and Jose Lopez-Lopez

Int. J. Environ. Res. Public Health 2020, 17(23), 8988; https://doi.org/10.3390/ijerph17238988 - 2 Dec 2020

Cited by 10 | Viewed by 2709

Abstract

Two-pieces dental implants must provide stability of the implant-abutment-interface. The connection type and platform diameter could influence the biomechanical resistance and stress distribution. This study aims to evaluate the fatigue for different types of connections, external and internal, and different platform diameters. Three [...] Read more.

Two-pieces dental implants must provide stability of the implant-abutment-interface. The connection type and platform diameter could influence the biomechanical resistance and stress distribution. This study aims to evaluate the fatigue for different types of connections, external and internal, and different platform diameters. Three implant designs with the same length were used: (a) external hexagon/narrow platform; (b) internal double hexagon/narrow platform; (c) internal octagon/regular platform. A fatigue test was developed to establish the number of cycles needed before fracture. A 30º oblique load with a sinusoidal function of fatigue at a frequency of 15 Hz and 10% stress variation was applied to each system. The fatigue load limit (FLL) for design (a) was 190 N, being the nominal-curvature-moment (NCM) = 1.045; FLL = 150 N, with a NCM = 0.825 for (b), and FLL = 325 N, with a NCM = 1.788 for (c). The platform diameter affects the FLL, obtaining lower FLL on a narrow platform. The connection type interferes with the implant walls’ width, especially in narrow implants, making internal connections more unstable at this level. Long-term clinical studies to assess the restoration’s success rate and survival are mandatory. Full article

(This article belongs to the Special Issue Impact of Dental Implants on Oral Health)

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12 pages, 1847 KiB

Open AccessArticle

Effects of Different Undersizing Site Preparations on Implant Stability

by Bernardo Ferreira Lemos, Paula Lopez-Jarana, Carlos Falcao, Blanca Ríos-Carrasco, Javier Gil, José Vicente Ríos-Santos and Mariano Herrero-Climent

Int. J. Environ. Res. Public Health 2020, 17(23), 8965; https://doi.org/10.3390/ijerph17238965 - 2 Dec 2020

Cited by 7 | Viewed by 2731

Abstract

As immediate loading protocols are becoming more frequent, the primary stability of implants has become an essential criterion for the osseointegration of dental implants. Based on this, the objective of this study was to understand the influence of different undersized surgical preparation sites [...] Read more.

As immediate loading protocols are becoming more frequent, the primary stability of implants has become an essential criterion for the osseointegration of dental implants. Based on this, the objective of this study was to understand the influence of different undersized surgical preparation sites on the insertion torque (IT) and implant stability quotient (ISQ). Four different site-preparation protocols were performed on fresh humid type III bovine bone: one control, the standard protocol recommended by the manufacturer (P1), and three variations of undersized techniques (P2, P3 and P4). The implant used was VEGA by Klockner Implant System. The sample size was n = 40 for each of the four groups. A torquemeter was used to measure the IT, and the ISQ was measured with a Penguin RFA. Both variables showed a tendency to increase as the preparation technique was reduced, although not all the values were statistically significant (p < 0.05) when comparing with the standard preparation. The preparations without a cortical drill, P2 and P4, showed better results than those with a cortical drill. Given the limitations of this study, it can be concluded that reducing the implant preparation can increase both the IT and ISQ. Removing the cortical drill is an effective method for increasing implant stability, although it should be used carefully. Full article

(This article belongs to the Special Issue Impact of Dental Implants on Oral Health)

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13 pages, 2589 KiB

Open AccessArticle

Reliability of the Resonance Frequency Analysis Values in New Prototype Transepithelial Abutments: A Prospective Clinical Study

by María Guerrero-González, Francesca Monticelli, David Saura García-Martín, Mariano Herrero-Climent, Blanca Ríos-Carrasco, José-Vicente Ríos-Santos and Ana Fernández-Palacín

Int. J. Environ. Res. Public Health 2020, 17(18), 6733; https://doi.org/10.3390/ijerph17186733 - 16 Sep 2020

Cited by 7 | Viewed by 2394

Abstract

Resonance frequency analysis (RFA) requires abutment disconnection to monitor implant stability. To overcome this limitation, an experimental transepithelial abutment was designed to allow a SmartPeg to be screwed onto it, in order to determine the prototype abutments repeatability and reproducibility using Osstell ISQ [...] Read more.

Resonance frequency analysis (RFA) requires abutment disconnection to monitor implant stability. To overcome this limitation, an experimental transepithelial abutment was designed to allow a SmartPeg to be screwed onto it, in order to determine the prototype abutments repeatability and reproducibility using Osstell ISQ and to assess whether implant length and diameter have an influence on the reliability of these measurements. RFA was conducted with a SmartPeg screwed directly into the implant and onto experimental abutments of different heights of 2, 3.5 and 5 mm. A total of 32 patients (116 implants) were tested. RFA measurements were taken twice for each group from mesial, distal, buccal and palatal/lingual surfaces. Mean values and SD were calculated and Intraclass Correlation Coefficients (ICC) (p < 0.05, IC 95%). The implant stability quotient (ISQ) mean values were 72.581 measured directly to implant and 72.899 (2 mm), 72.391 (3.5 mm) and 71.458 (5 mm) measured from the prototypes. ICC between measurements made directly to implant and through 2-, 3.5- and 5-mm abutments were 0.908, 0.919 and 0.939, respectively. RFA values registered through the experimental transepithelial abutments achieved a high reliability. Neither the implant length nor the diameter had any influence on the measurements’ reliability. Full article

(This article belongs to the Special Issue Impact of Dental Implants on Oral Health)

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10 pages, 798 KiB

Open AccessArticle

Comparative Evaluation of Dental Implant Failure among Healthy and Well-Controlled Diabetic Patients—A 3-Year Retrospective Study

by Mohammed Ghazi Sghaireen, Abdulrahman A. Alduraywish, Kumar Chandan Srivastava, Deepti Shrivastava, Santosh R Patil, Selham Al Habib, May Hamza, Saifulizan Ab Rahman, Edward Lynch and Mohammad Khursheed Alam

Int. J. Environ. Res. Public Health 2020, 17(14), 5253; https://doi.org/10.3390/ijerph17145253 - 21 Jul 2020

Cited by 25 | Viewed by 4915

Abstract

Diabetes mellitus is known to compromise the various aspects of homeostasis, including the immune response and the composition of oral microflora. One of the oral manifestations of diabetes mellitus is tooth loss and the survival rate of dental implants chosen as a treatment [...] Read more.

Diabetes mellitus is known to compromise the various aspects of homeostasis, including the immune response and the composition of oral microflora. One of the oral manifestations of diabetes mellitus is tooth loss and the survival rate of dental implants chosen as a treatment modality for its rehabilitation is controversial. The current study aims to evaluate and compare the failure rate of dental implants between well-controlled diabetic and healthy patients. A retrospective study of case-control design was conceptualized with 121 well-controlled diabetic and 136 healthy individuals. Records of subjects who had undergone oral rehabilitation with dental implants between the periods of January 2013 to January 2016 were retrieved. Post-operative evaluation was carried out for all patients for about three years to assess the immediate and long-term success of the procedure. From a total of 742 dental implants, 377 were placed in well-controlled diabetic patients (case group) and 365 in healthy subjects (control group). A comparable (9.81%), but non-significant (p = 0.422) failure rate was found in the case group in comparison to the control group (9.04%). A non-significant (p = 0.392) raised number (4.98%) of failure cases were reported among females in comparison to males (4.44%). In respect to arch, the mandibular posterior region was reported as the highest failure cases (3.09%; p = 0.411), with 2.29% of cases reported in the mandibular anterior (p = 0.430) and maxillary posterior (p = 0.983) each. The maxillary anterior region was found to have the least number (1.75%; p = 0.999) of failure cases. More (4.98%; p = 0.361) cases were reported to fail during the functional loading stage in contrast to osseointegration (4.44%; p = 0.365). A well-controlled diabetic status does not impose any additional risk for individuals undergoing dental implant therapy. Full article

(This article belongs to the Special Issue Impact of Dental Implants on Oral Health)

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13 pages, 3836 KiB

Open AccessArticle

A Non-Interventional Study Documenting Use and Success of Tissue Level Implants

by Carmen María Díaz-Castro, Pedro Lázaro Calvo, Francisco Javier Gil, Ana Fernández-Palacín, José-Vicente Ríos-Santos and Mariano Herrero-Climent

Int. J. Environ. Res. Public Health 2020, 17(13), 4816; https://doi.org/10.3390/ijerph17134816 - 4 Jul 2020

Cited by 3 | Viewed by 2446

Abstract

Numerous randomised controlled multicentric studies have investigated various responses to different treatment modalities with dental implants. These studies do not always show the results of daily practice as they are performed under controlled and strict clinical conditions. This multicentric, non-interventionist trial aimed to [...] Read more.

Numerous randomised controlled multicentric studies have investigated various responses to different treatment modalities with dental implants. These studies do not always show the results of daily practice as they are performed under controlled and strict clinical conditions. This multicentric, non-interventionist trial aimed to document the behaviour of implants when used in daily dental practice, without inclusion or exclusion criteria. One hundred and ninety-six screw-shaped, tissue-level implants were placed, and each clinician decided which implant, surgical loading and prosthetic protocol to use. At surgery, data related to the implants were recorded. Additionally, the crestal bone level changes were evaluated for up to two years of follow-up. Two implants were lost before they were loaded. The success rate was 98.31%, and the survival rate was 98.79%. The implant stability quotient (ISQ) at surgery was 68.61 ± 10.35 and at 2 years was 74.39 ± 9.64. The crestal–shoulder distances were 1.25 ± 1.09 mm and 1.68 ± 1.07 mm in the mesial and distal aspects on the day of surgery, respectively, and 2.04 ± 0.91 and 2.16 ± 0.99 mm at 2 years, respectively. At 2 years, 69.3% of the patients were highly satisfied. The use of implants under standard conditions seemed to have success rates similar to their placement in controlled studies. Full article

(This article belongs to the Special Issue Impact of Dental Implants on Oral Health)

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17 pages, 10819 KiB

Open AccessArticle

Effect of Different Implant Designs on Strain and Stress Distribution under Non-Axial Loading: A Three-Dimensional Finite Element Analysis

by Hélder Oliveira, Aritza Brizuela Velasco, José-Vicente Ríos-Santos, Fernando Sánchez Lasheras, Bernardo Ferreira Lemos, Francisco Javier Gil, Alexandrine Carvalho and Mariano Herrero-Climent

Int. J. Environ. Res. Public Health 2020, 17(13), 4738; https://doi.org/10.3390/ijerph17134738 - 1 Jul 2020

Cited by 31 | Viewed by 4167

Abstract

Implant design evolved alongside the development of implant therapy. The purpose of this finite element analysis (FEA) study was to analyze the influence of different implant designs on the stress and strain distribution to the implants and surrounding bone. Three implant designs with [...] Read more.

Implant design evolved alongside the development of implant therapy. The purpose of this finite element analysis (FEA) study was to analyze the influence of different implant designs on the stress and strain distribution to the implants and surrounding bone. Three implant designs with the same length and diameter were used. The three-dimensional geometry of the bone was simulated with a cortical bone of three different thicknesses and two medullar bone densities: low density (150 Hounsfield units) and high density (850 Hounsfield units). A 30° oblique load of 150 N was applied to the implant restoration. Displacement and stress (von Mises) results were obtained for bone and dental implants. The strain and stress distributions to the bone were higher for the tissue-level implant for all types of bone. The maximum principal strain and stress decreased with an increase in cortical bone thickness for both cancellous bone densities. The distribution of the load was concentrated at the coronal portion of the bone and implants. All implants showed a good distribution of forces for non-axial loads, with higher forces concentrated at the crestal region of the bone–implant interface. Decrease in medullar bone density negatively affects the strain and stress produced by the implants. Full article

(This article belongs to the Special Issue Impact of Dental Implants on Oral Health)

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13 pages, 1598 KiB

Open AccessArticle

Influence of Implant Design and Under-Preparation of the Implant Site on Implant Primary Stability. An In Vitro Study

by Mariano Herrero-Climent, Bernardo Ferreira Lemos, Federico Herrero-Climent, Carlos Falcao, Helder Oliveira, Manuela Herrera, Francisco Javier Gil, Blanca Ríos-Carrasco and José-Vicente Ríos-Santos

Int. J. Environ. Res. Public Health 2020, 17(12), 4436; https://doi.org/10.3390/ijerph17124436 - 20 Jun 2020

Cited by 24 | Viewed by 3636

Abstract

The aim of this study was to evaluate the effects of different implant sites an under-preparation sequence associated with two different implant designs on implant primary stability measured by two parameters: insertion torque (IT) and implant stability quotient (ISQ). It used two different [...] Read more.

The aim of this study was to evaluate the effects of different implant sites an under-preparation sequence associated with two different implant designs on implant primary stability measured by two parameters: insertion torque (IT) and implant stability quotient (ISQ). It used two different implants: one cylindrical as a control and another one with a tapered design. The implants were inserted in type III fresh humid bovine bone and four drilling sequences were used: one control, the one proposed by the implant company (P1), and three different undersized (P2, P3 and P4). P2 was the same as P1 without the cortical drill, P3 was without the last pilot drill and P4 was without both of them. The sample size was n = 40 for each of the eight groups. Final IT was measured with a torquemeter and the ISQ was measured with Penguin resonance frequency analysis. Results showed that both ISQ and IT have a tendency to increase as the preparation technique reduces the implant site diameter when compared with the standard preparation, P1. The preparations without cortical drill, P2 and P4, showed the best results when compared with the ones with a cortical drill. Tapered implants always showed higher or the same ISQ and IT values when compared with the cylindrical implants. Giving the limitations of this study, it can be concluded that reducing implant preparation can increase IT and ISQ values. Removing the cortical drill and the use of a tapered design implant are also effective methods of increasing primary implant stability. Full article

(This article belongs to the Special Issue Impact of Dental Implants on Oral Health)

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15 pages, 7846 KiB

Open AccessArticle

Influence of the CAD-CAM Systems on the Marginal Accuracy and Mechanical Properties of Dental Restorations

by Roberto Padrós, Luís Giner, Mariano Herrero-Climent, Carlos Falcao-Costa, José-Vicente Ríos-Santos and Francisco Javier Gil

Int. J. Environ. Res. Public Health 2020, 17(12), 4276; https://doi.org/10.3390/ijerph17124276 - 15 Jun 2020

Cited by 18 | Viewed by 3509

Abstract

The aim of this study was to compare the quality of different computer-assisted-design and computer assisted manufacturing systems (CAD-CAM) generated by only one scanner, focusing on vertical fit discrepancies and the mechanical properties. A master model was obtained from a real clinical situation: [...] Read more.

The aim of this study was to compare the quality of different computer-assisted-design and computer assisted manufacturing systems (CAD-CAM) generated by only one scanner, focusing on vertical fit discrepancies and the mechanical properties. A master model was obtained from a real clinical situation: the replacement of an absent (pontic) tooth, with the construction of a fixed partial denture on natural abutments with three elements. Nine scans were performed by each tested and 36 copies were designed using a dental CAD-CAM software (Exocad). The frameworks were manufactured using three-axis and five-axis, with the same batch of the chrome-cobalt (CrCo) alloy. The frameworks were not cemented. A focus ion beam-high resolution scanning electron microscope (FIB-HRSEM) allowed us to obtain the vertical gap measurements in five points for each specimen. Roughness parameters were measured using white light interferometry (WLI). The samples were mechanically characterized by means of flexural tests. A servo-hydraulic testing machine was used with a cross-head rate of 1 mm/min. One-way ANOVA statistical analysis was performed to determine whether the vertical discrepancies and mechanical properties were significantly different between each group (significance level p < 0.05). The overall mean marginal gap values ranged: from 92.38 ± 19.24 µm to 19.46 ± 10.20 µm, for the samples produced by three-axis and five-axis machines, respectively. Roughness was lower in the five-axis machine than the three-axis one, and as a consequence, the surface quality was better when the five-axis machine was used. These results revealed a statistically significant difference (p < 0.005) in the mean marginal gap between the CAD-CAM systems studied. The flexural strength for these restorations range from 6500 to 7000 N, and does not present any statistical differences’ significance between two CAD-CAM systems studied. This contribution suggests that the number of axes improves vertical fit and surface quality due to the lower roughness. These claims show some discrepancies with other studies. Full article

(This article belongs to the Special Issue Impact of Dental Implants on Oral Health)

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23 pages, 606 KiB

Open AccessArticle

Complications of Fixed Full-Arch Implant-Supported Metal-Ceramic Prostheses

by Ignacio Gonzalez-Gonzalez, Hector deLlanos-Lanchares, Aritza Brizuela-Velasco, Jose-Antonio Alvarez-Riesgo, Santiago Llorente-Pendas, Mariano Herrero-Climent and Angel Alvarez-Arenal

Int. J. Environ. Res. Public Health 2020, 17(12), 4250; https://doi.org/10.3390/ijerph17124250 - 14 Jun 2020

Cited by 20 | Viewed by 4022

Abstract

We aimed to assess the biological and mechanical-technical complications and survival rate of implants of full-arch metal-ceramic prostheses, during five years of follow-up. 558 implants (of three different brands) retaining 80 full-arch metal-ceramic prostheses were placed in 65 patients, all of whom were [...] Read more.

We aimed to assess the biological and mechanical-technical complications and survival rate of implants of full-arch metal-ceramic prostheses, during five years of follow-up. 558 implants (of three different brands) retaining 80 full-arch metal-ceramic prostheses were placed in 65 patients, all of whom were examined annually for biological and mechanical-technical complications during the five years of follow-up. Descriptive statistics and univariate logistic regression were calculated. The cumulative survival rate of the implants was 99.8%, and 98.8% prosthesis-based. Mucositis was the most frequent of the biological complications and peri-implantitis was recorded as 13.8% at restoration-level, 16.9% at patient level and 2.0% at implant level. An implant length greater than 10 mm was shown to be a protective factor against biological complications. The mechanical-technical complications were associated with implant diameter, abutment/implant connection and retention system. Loss of screw access filling was the most frequent prosthetic complication, followed by the fracture of the porcelain. Full-arch metal-ceramic prostheses show a high prevalence of implant and prosthesis survival, with few biological and mechanical-technical complications. Full article

(This article belongs to the Special Issue Impact of Dental Implants on Oral Health)

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14 pages, 2291 KiB

Open AccessArticle

Is It Possible to Monitor Implant Stability on a Prosthetic Abutment? An In Vitro Resonance Frequency Analysis

by Paula López-Jarana, Carmen María Díaz-Castro, Artur Falcão, Blanca Ríos-Carrasco, Ana Fernandez-Palacín, José-Vicente Ríos-Santos and Mariano Herrero-Climent

Int. J. Environ. Res. Public Health 2020, 17(11), 4073; https://doi.org/10.3390/ijerph17114073 - 8 Jun 2020

Cited by 3 | Viewed by 2663

Abstract

In order to apply the “one-abutment–one-time” concept, we evaluated the possibility of measuring resonance frequency analysis (RFA) on the abutment. This trial aimed to compare the Implant Stability Quotient (ISQ) values obtained by the Penguin^RFA when screwing the transducer onto the implant [...] Read more.

In order to apply the “one-abutment–one-time” concept, we evaluated the possibility of measuring resonance frequency analysis (RFA) on the abutment. This trial aimed to compare the Implant Stability Quotient (ISQ) values obtained by the Penguin^RFA when screwing the transducer onto the implant or onto abutments with different heights and angulations. Eighty implants (VEGA^®, Klockner Implant System, SOADCO, Les Escaldes, Andorra) were inserted into fresh bovine ribs. The groups were composed of 20 implants, 12 mm in length, with two diameters (3.5 and 4 mm). Five different abutments for screwed retained restorations (Permanent^®) were placed as follows: straight with 1, 2, and 3 mm heights, and angulated at 18° with 2 and 3 mm heights. The mean value of the ISQ measured directly on the implant was 75.72 ± 4.37. The mean value of the ISQ registered over straight abutments was 79.5 ± 8.50, 76.12 ± 6.63, and 71.42 ± 6.86 for 1, 2, and 3 mm height abutments. The mean ISQ over angled abutments of 2 and 3 mm heights were 68.74 ± 4.68 and 64.51 ± 4.53 respectively. The present study demonstrates that, when the ISQ is registered over the straight abutments of 2 and 3 mm heights, the values decrease, and values are lower for angled, 3 mm height abutments. Full article

(This article belongs to the Special Issue Impact of Dental Implants on Oral Health)

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Review

Jump to: Research

20 pages, 877 KiB

Open AccessReview

Digital Impressions in Implant Dentistry: A Literature Review

by Simone Marques, Paulo Ribeiro, Carlos Falcão, Bernardo Ferreira Lemos, Blanca Ríos-Carrasco, José Vicente Ríos-Santos and Mariano Herrero-Climent

Int. J. Environ. Res. Public Health 2021, 18(3), 1020; https://doi.org/10.3390/ijerph18031020 - 24 Jan 2021

Cited by 51 | Viewed by 9010

Abstract

Introduction. Digital impressions in implant dentistry rely on many variables, and their accuracy, particularly in complete edentulous patients, is not well understood. Aim. The purpose of this literature review was to determine which factors may influence the accuracy of digital impressions in implant [...] Read more.

Introduction. Digital impressions in implant dentistry rely on many variables, and their accuracy, particularly in complete edentulous patients, is not well understood. Aim. The purpose of this literature review was to determine which factors may influence the accuracy of digital impressions in implant dentistry. Emphasized attention was given to the design of the intra-oral scan body (ISB) and scanning techniques. Materials and methods. A Medline, PubMed and EBSCO Host databases search, complemented by a hand search, was performed in order to select relevant reports regarding the appliance of digital impressions in implant dentistry. The search subject included but was not limited to accuracy of digital impressions in implant dentistry, digital scanning techniques, the design and material of the ISBs, and the depth and angulation of the implant. The related titles and abstracts were screened, and the remaining articles that fulfilled the inclusion criteria were selected for full-text readings. Results. The literature search conducted for this review initially resulted in 108 articles, among which only 21 articles fulfilled the criteria for inclusion. Studies were evaluated according to five subjects: accuracy of digital impressions in implant dentistry; the design and material of the intra-oral scan bodies; scanning technique; the influence of implants depth/angulations on the digital impression and accuracy of different intra-oral scanner devices. Conclusions. The accuracy of digital impressions in implant dentistry depends on several aspects. The depth/angulation of the implant, the experience of the operator, the intra-oral scanner used, and environmental conditions may influence the accuracy of digital impressions in implant dentistry. However, it seems that ISBs’ design and material, as well as scanning technique, have a major impact on the trueness and precision of digital impressions in implant dentistry. Future research is suggested for the better understanding of this subject, focusing on the optimization of the ISB design and scanning protocols. Full article

(This article belongs to the Special Issue Impact of Dental Implants on Oral Health)

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12 pages, 1260 KiB

Open AccessReview

Clinical Efficacy of Mesenchymal Stem Cells in Bone Regeneration in Oral Implantology. Systematic Review and Meta-Analysis

by Sonia Egido-Moreno, Joan Valls-Roca-Umbert, Juan Manuel Céspedes-Sánchez, José López-López and Eugenio Velasco-Ortega

Int. J. Environ. Res. Public Health 2021, 18(3), 894; https://doi.org/10.3390/ijerph18030894 - 21 Jan 2021

Cited by 10 | Viewed by 3458

Abstract

In bone regeneration, obtaining a vital bone as similar as possible to native bone is sought. This review aimed to evaluate the efficacy of stem cells in maxillary bone regeneration for implant rehabilitation and to review the different techniques for obtaining and processing [...] Read more.

In bone regeneration, obtaining a vital bone as similar as possible to native bone is sought. This review aimed to evaluate the efficacy of stem cells in maxillary bone regeneration for implant rehabilitation and to review the different techniques for obtaining and processing these cells. A systematic review and meta-analysis were performed using the Pubmed/Medline (NCBI), Cochrane, Scielo, and Scopus databases, without restriction on the publication date. The following Mesh terms were used, combined by the Boolean operator “AND”: “dental implants” AND “stem cells” AND “bioengineering”. Applying inclusion and exclusion criteria, five articles were obtained and three were added after manual search. The results from the meta-analysis (18 patients) did not provide significant differences despite the percentage of bone formed in the maxillary sinus, favoring the stem cell group, and the analysis of the percentage of residual Bio-Oss^® showed results favoring the control group. Stem cell regeneration usually shows positive vascular and viable bone formation. In conclusion, using mesenchymal stem cells in bone regeneration provides benefits in the quality of bone, similar or even superior to autologous bone, all this through a minimally invasive procedure. Full article

(This article belongs to the Special Issue Impact of Dental Implants on Oral Health)

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20 pages, 497 KiB

Open AccessReview

Review of the Mechanical Behavior of Different Implant–Abutment Connections

by Ana Sofia Vinhas, Carlos Aroso, Filomena Salazar, Paula López-Jarana, José Vicente Ríos-Santos and Mariano Herrero-Climent

Int. J. Environ. Res. Public Health 2020, 17(22), 8685; https://doi.org/10.3390/ijerph17228685 - 23 Nov 2020

Cited by 44 | Viewed by 5974

Abstract

Introduction: Different implant–abutment connections have been developed to reduce mechanical and biological failure. The most frequent complications are loss of preload, screw loosening, abutment or implant fracture, deformations at the different interfaces, and bacterial microleakage. Aim: To review the evidence indicating whether the [...] Read more.

Introduction: Different implant–abutment connections have been developed to reduce mechanical and biological failure. The most frequent complications are loss of preload, screw loosening, abutment or implant fracture, deformations at the different interfaces, and bacterial microleakage. Aim: To review the evidence indicating whether the implant–abutment connection type is significant regarding the following issues: (1) maintenance of the preload in static and dynamic in vitro studies; (2) assessment of possible deformations at the implant–abutment interfaces, after repeated application of the tightening torque; (3) evaluation of the sealing capability of different implant connections against microleakage. Materials and Methods: In June 2020, an electronic literature search was performed in Medline, EBSCO host, and PubMed databases. The search was focused on the ability of different implant connections to maintain preload, resist deformation after tightening and retightening, and prevent microleakage. The related titles and abstracts available in English were screened, and the articles that fulfilled the inclusion criteria were selected for full-text reading. Results: The literature search conducted for this review initially resulted in 68 articles, among which 19 articles and 1 systematic review fulfilled the criteria for inclusion. The studies were divided according to the three proposed objectives, with some studies falling into more than one category (maintenance of preload, surface abutment–implant deformation, and resistance to microleakage). Conclusions: Conical abutment appears to result in fewer mechanical complications, such as screw loosening or fractures, and higher torque preservation. After SEM evaluation, damage was observed in the threads of the abutment screws, before and after loading in internal and external connections. Internal hexagon implants and predominantly internal conical (Morse taper) implants showed less microleakage in dynamic loading conditions. We suggest further studies to guarantee excellence in methodological quality. Full article

(This article belongs to the Special Issue Impact of Dental Implants on Oral Health)

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