Editorial

4 pages, 192 KiB

Open AccessEditorial

Science, Innovation and Education as Pillars of High-Quality Implant Dentistry: Overcoming Challenges through Innovation Dictates Trends

by Miguel de Araújo Nobre

J. Clin. Med. 2020, 9(5), 1575; https://doi.org/10.3390/jcm9051575 - 22 May 2020

Cited by 1 | Viewed by 2563

Abstract

The evolution of implant dentistry since the discovery of the osseointegration concept has been remarkable [...] Full article

(This article belongs to the Special Issue Implant Dentistry—Trends, Challenges and Innovations)

Research

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14 pages, 710 KiB

Open AccessArticle

Prevalence of Peri-Implant Disease in Patients with Stage III or IV Periodontitis: Results of a Long-Term Follow-Up from a Specialized Periodontal Practice

by Pia-Merete Jervøe-Storm, Michael Marder, Martin Hagner, Ina Menn, Philipp Menn and Søren Jepsen

J. Clin. Med. 2023, 12(17), 5547; https://doi.org/10.3390/jcm12175547 - 25 Aug 2023

Viewed by 719

Abstract

The aim of this study was to examine the conditions of implants that had been in function for 5–17 years in stage III/IV periodontitis patients of a specialized periodontal practice. There were 83 patients (43 female/40 male, mean age 64.4 (9.69) years), with [...] Read more.

The aim of this study was to examine the conditions of implants that had been in function for 5–17 years in stage III/IV periodontitis patients of a specialized periodontal practice. There were 83 patients (43 female/40 male, mean age 64.4 (9.69) years), with a total of 213 implants, who participated in the study. Assessments included periodontal and peri-implant probing depths, bleeding and plaque scores, and a radiographic examination. Smoking habits, participation in a supportive care program (SCP), and the Implant Disease Risk Assessment (IDRA) scores were recorded. A total of 44 patients presented with stage III periodontitis, and 39 with stage IV. In all, 85% of patients had adhered to regular SCP. On an implant/patient level, peri-implant health was found in 37.1.7% (79 implants)/24.1% (20 patients), peri-implant mucositis in 58.7% (125 implants)/66.3% (55 patients), and peri-implantitis in 4.2% (9 implants)/9.6% (8 patients). IDRA scores showed 30.5% of implants at moderate and 69.5% at high risk. The present long-term analysis shows a high prevalence of peri-implant disease in patients treated for advanced periodontitis. These findings underline the challenges involved in the long-term maintenance of oral health in stage III/IV periodontitis patients restored with dental implants. Full article

(This article belongs to the Special Issue Implant Dentistry—Trends, Challenges and Innovations)

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13 pages, 1613 KiB

Open AccessArticle

Evaluation of Implant Stability According to Implant Placement Site and Duration in Elderly Patients: A Prospective Multi-Center Cohort Study

by Ji-Suk Shim, Moon-Young Kim, Se-Jun An, Eun-Sung Kang and Yu-Sung Choi

J. Clin. Med. 2023, 12(15), 5087; https://doi.org/10.3390/jcm12155087 - 02 Aug 2023

Cited by 1 | Viewed by 1045

Abstract

The aim of this prospective study is to investigate implant stability and the reliability of different measuring devices according to implant placement site and duration in patients aged over 65 years. The study evaluated 60 implants (diameter: 3.5/4.0/4.5/5.0 mm and length: 8.5/10.0/11.5 mm) [...] Read more.

The aim of this prospective study is to investigate implant stability and the reliability of different measuring devices according to implant placement site and duration in patients aged over 65 years. The study evaluated 60 implants (diameter: 3.5/4.0/4.5/5.0 mm and length: 8.5/10.0/11.5 mm) in 60 patients aged ≥ 65 years. The implant placement sites were divided into six evenly distributed sections (n = 10), i.e., maxillary right-posterior, A; maxillary anterior, B; maxillary left-posterior, C; mandibular right-posterior, D; mandibular anterior, E; mandibular left-posterior, F. Participants visited the hospital six times: implant surgery, 1V; stitch removal, 2V; 1-month follow-up, 3V; 2-month follow-up, 4V; before final restoration delivery, 5V; and after final restoration delivery, 6V. The implant stability was evaluated with the Osstell Mentor (ISQ), Periotest M (PTV), and Anycheck (IST). The mean values of ISQ, PTV, and IST were analyzed (α = 0.05). ISQ, PTV, and IST results of 4V and 5V were significantly higher than those of 1V (p < 0.05). The lowest ISQ results occurred in the E location at 4V and 5V (p < 0.05). In all mandibular locations, IST results of 6V were significantly higher than those of 1V, 2V, 3V, and 4V (p < 0.05). ISQ results were negatively correlated with PTV and positively correlated with IST, and PTV was negatively correlated with IST. By considering various factors affecting the stability of the implant, it is necessary to determine the appropriate implant load application time. This could help increase the implant success rate in elderly patients. And as a diagnostic device for implant stability and the evaluation of osseointegration in elderly patients, Anycheck was also able to prove its relative reliability compared to Osstell ISQ Mentor and Periotest M. Full article

(This article belongs to the Special Issue Implant Dentistry—Trends, Challenges and Innovations)

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13 pages, 2697 KiB

Open AccessArticle

Relevant Aspects of the Dental Implant Design on the Insertion Torque, Resonance Frequency Analysis (RFA) and Micromobility: An In Vitro Study

by Mariano Herrero-Climent, Artur Falcao, Joao Tondela, Aritza Brizuela, Blanca Rios-Carrasco and Javier Gil

J. Clin. Med. 2023, 12(3), 855; https://doi.org/10.3390/jcm12030855 - 20 Jan 2023

Cited by 4 | Viewed by 1698

Abstract

The major problems for the osseointegration of dental implants are the loosening of the screw that fixes the dental implant to the abutment and the micromovements that are generated when mechanical loads are applied. In this work, torque differences in the tightening and [...] Read more.

The major problems for the osseointegration of dental implants are the loosening of the screw that fixes the dental implant to the abutment and the micromovements that are generated when mechanical loads are applied. In this work, torque differences in the tightening and loosening of the connection screws after 1 cycle, 10 cycles and 1000 cycles for 4 dental implants with 2 external and 2 internal connections were analyzed. The loosening of 240 implants (60 for each system) was determined using high-precision torsimeters and an electromechanical testing machine. A total of 60 dental implants for each of the 4 systems were inserted into fresh bovine bone to determine the micromovements. The implant stability values (ISQ) were determined by RFA. The mechanical loads were performed at 30° from 20 N to 200 N. By means of the Q-star technique, the micromovements were determined. It was observed that, for a few cycles, the loosening of the screw did not exceed a loss of tightening of 10% for both connections. However, for 1000 cycles, the loss for the external connection was around 20% and for the internal connection it was 13%. The micromovements showed a lineal increase with the applied load for the implant systems studied. An external connection presented greater micromotions for each level of applied load and lower ISQ values than internal ones. An excellent lineal correlation between the ISQ and micromobility was observed. These results may be very useful for clinicians in the selection of the type of dental implant, depending on the masticatory load of the patient as well as the consequences of the insertion torque of the dental implant and its revisions. Full article

(This article belongs to the Special Issue Implant Dentistry—Trends, Challenges and Innovations)

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14 pages, 1496 KiB

Open AccessArticle

Long-Term Outcome of Dental Implants in Immediate Function Inserted on Autogenous Grafted Bone

by Miguel de Araújo Nobre, Francisco Salvado, João André Correia, Maria Cristina Faria Teixeira and Francisco Azevedo Coutinho

J. Clin. Med. 2023, 12(1), 261; https://doi.org/10.3390/jcm12010261 - 29 Dec 2022

Viewed by 2498

Abstract

Background: There is a need for long-term evidence of immediate function dental implants inserted in grafted bone. The aim of this retrospective study was to investigate the outcome of full-arch rehabilitations supported by implants in grafted bone. Methods: Thirty-six patients (women: 24; men: [...] Read more.

Background: There is a need for long-term evidence of immediate function dental implants inserted in grafted bone. The aim of this retrospective study was to investigate the outcome of full-arch rehabilitations supported by implants in grafted bone. Methods: Thirty-six patients (women: 24; men: 12; average age: 53.5 years) were included (225 implants). Primary outcome measure: to assess implant cumulative success rates evaluated through life tables. Secondary outcome measures: to evaluate implant and prosthetic survival, marginal bone loss, and the incidence of both biological and mechanical complications. Results: Twenty-five implants were unsuccessful giving a dental implant CS rate of 88.1% at 14 years and a 76.8% survival estimation (Kaplan–Meier) using the patient as the unit of analysis. No prosthesis was lost. Average MBL at 10 years was 2.01 mm. The incidence of biological complications was 36%, with smoking affecting it significantly (p < 0.001). The incidence of mechanical complications was 86.1% (45.2% and 54.8% in provisional and definitive prosthesis, respectively. Conclusions: The rehabilitation of atrophic maxillae through dental implants in immediate function inserted in grafted bone is a valid treatment alternative, despite the relevant rate of implant failures and incidence of complications. Full article

(This article belongs to the Special Issue Implant Dentistry—Trends, Challenges and Innovations)

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14 pages, 1340 KiB

Open AccessArticle

The Characteristics of Microbiome and Cytokines in Healthy Implants and Peri-Implantitis of the Same Individuals

by Lu Song, Jimin Jiang, Jia Li, Chuan Zhou, Yanqi Chen, Hongye Lu and Fuming He

J. Clin. Med. 2022, 11(19), 5817; https://doi.org/10.3390/jcm11195817 - 30 Sep 2022

Cited by 10 | Viewed by 1694

Abstract

Aim: To characterize the profile of submucosal microbiome and cytokine levels in peri-implant crevicular fluid (PICF) from clinically healthy implants and peri-implantitis in the same individuals. Material and Methods: A total of 170 patients were screened and, finally, 14 patients with at least [...] Read more.

Aim: To characterize the profile of submucosal microbiome and cytokine levels in peri-implant crevicular fluid (PICF) from clinically healthy implants and peri-implantitis in the same individuals. Material and Methods: A total of 170 patients were screened and, finally, 14 patients with at least one healthy implant and one peri-implantitis implant were included. Submucosal microbiota and cytokines from 28 implants were analyzed using 16S rRNA gene sequencing and multifactor assays, respectively. Correlations of clinical indexes and microbiota or cytokines were analyzed using Spearman’s correlation coefficient. A random forest classification model was constructed. Results: Peri-implantitis sites harbored higher microbial diversity, as well as more Gram-negative bacteria and anaerobic bacteria, compared with healthy implants sites. The genera of Peptostreptococcaceae XIG-1, Treponema, Porphyromonas, and Lachnospiraceae G-8, as well as the cytokines of IL-17A, IL-6, IL-15, G-CSF, RANTES, and IL-1β were significantly higher in peri-implantitis than healthy implants. Furthermore, these genera and cytokines had positive relationships with clinical parameters, including probing depth (PD), bleeding on probing (BOP), and marginal bone loss (MBL). The classification model picked out the top 15 biomarkers, such as IL-17A, IL-6, IL-15, VEGF, IL-1β, Peptostreptococcaceae XIG-1, Haemophilus, and Treponema, and obtained an area under the curve (AUC) of 0.85. Conclusions: There are more pathogenic bacteria and inflammatory cytokines in peri-implantitis sites, and biomarkers could facilitate the diagnosis of peri-implantitis. Full article

(This article belongs to the Special Issue Implant Dentistry—Trends, Challenges and Innovations)

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14 pages, 1487 KiB

Open AccessArticle

The 10 Year Outcomes of Implants Inserted with Dehiscence or Fenestrations in the Rehabilitation of Completely Edentulous Jaws with the All-on-4 Concept

by Miguel de Araújo Nobre, Armando Lopes and Elsa Antunes

J. Clin. Med. 2022, 11(7), 1939; https://doi.org/10.3390/jcm11071939 - 31 Mar 2022

Cited by 2 | Viewed by 2702

Abstract

Background: There is a need for a long-term evidence of implants placed in challenging conditions. The aim of this study was to investigate the outcome of full-arch rehabilitations with the All-on-4 concept for implants inserted with dehiscence or fenestrations. Methods: This retrospective cohort [...] Read more.

Background: There is a need for a long-term evidence of implants placed in challenging conditions. The aim of this study was to investigate the outcome of full-arch rehabilitations with the All-on-4 concept for implants inserted with dehiscence or fenestrations. Methods: This retrospective cohort study included 123 patients (dehiscence, n = 87 patients; fenestrations, n = 28 patients; both conditions, n = 8 patients), with a total of 192 implants in immediate function presenting dehiscence (n = 150), fenestrations (n = 40), or both conditions (n = 2). Primary outcome measures were cumulative implant survival (CSurR) and success (CSucR) rates. Secondary outcome measures were prosthetic survival, marginal bone loss, and incidence of biological complications. Results: CSurRs were 94.1% (overall), 95.6% (dehiscence), and 88.1% (fenestrations) at 10 years using the patient as the unit of analysis. Smoking affected implant failure significantly (p = 0.019). Implant-level CSurRs and CSucRs at 10 years were 96.2% and 93.5% (overall), 97.2% and 94.6% (dehiscence), and 90.0% and 87.6% (fenestrations), respectively. Average bone resorption at 5 and 10 years was 1.22 mm and 1.53 mm, respectively. Biological complications occurred in 18 patients (n = 18 implants). Conclusions: Implants inserted with dehiscence or fenestrations demonstrate good long-term outcomes with overall high success and survival rates and low average marginal bone resorption, despite an inferior outcome in implants with fenestrations and smoking’s negative effect. Full article

(This article belongs to the Special Issue Implant Dentistry—Trends, Challenges and Innovations)

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14 pages, 1916 KiB

Open AccessArticle

Zygomatic Implants Placed in Immediate Function through Extra-Maxillary Surgical Technique and 45 to 60 Degrees Angulated Abutments for Full-Arch Rehabilitation of Extremely Atrophic Maxillae: Short-Term Outcome of a Retrospective Cohort

by Armando Lopes, Miguel de Araújo Nobre, Ana Ferro, Carlos Moura Guedes, Ricardo Almeida and Mariana Nunes

J. Clin. Med. 2021, 10(16), 3600; https://doi.org/10.3390/jcm10163600 - 16 Aug 2021

Cited by 4 | Viewed by 3760

Abstract

The use of new devices for the rehabilitation of the severely atrophic maxillae needs validation. We aimed to report the short-term outcome of severely atrophic jaws rehabilitated with zygomatic implants with no implant head angulation placed extramaxillary in conjunction with standard implants. Forty-four [...] Read more.

The use of new devices for the rehabilitation of the severely atrophic maxillae needs validation. We aimed to report the short-term outcome of severely atrophic jaws rehabilitated with zygomatic implants with no implant head angulation placed extramaxillary in conjunction with standard implants. Forty-four patients were consecutively included with 77 zygomatic implants (31 abutments of 45 degrees and 46 abutments of 60 degrees) and 115 standard implants. Outcome measures were prosthetic survival, implant/abutment success, complications, modified plaque index (mPLI), modified bleeding index (mBI), mucosal seal efficacy evaluation (MSEE) >4 mm, and Zygomatic implants classification level (ZICL). Two patients (4.5%) were lost to follow-up. No prosthesis was lost; one patient lost one zygomatic implant; two angulated abutments of 60 degrees needed to be replaced in one patient due to an aesthetic complaint; rendering a cumulative success rate at 2-years of 95.3% and 95.9% using patient and implant/abutment as unit of analysis, respectively. Mechanical and biological complications occurred in 13 and six patients, respectively; all resolved. The median mPLI and mBI was 1; MSEE > 4 mm occurred in 17% and 21% of patients at 1- and 2-years, respectively; ZICL1 was registered in 80% of patients. The current protocol enabled good short-term outcomes. Full article

(This article belongs to the Special Issue Implant Dentistry—Trends, Challenges and Innovations)

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12 pages, 1568 KiB

Open AccessArticle

Treatment of Periimplantitis with Electrolytic Cleaning versus Mechanical and Electrolytic Cleaning: 18-Month Results from a Randomized Controlled Clinical Trial

by Markus Schlee, Hom-Lay Wang, Thomas Stumpf, Urs Brodbeck, Dieter Bosshardt and Florian Rathe

J. Clin. Med. 2021, 10(16), 3475; https://doi.org/10.3390/jcm10163475 - 06 Aug 2021

Cited by 14 | Viewed by 4689

Abstract

Aim of the study: This RCT assesses patients’ 18-month clinical outcomes after the regenerative therapy of periimplantitis lesions using either an electrolytic method (EC) to remove biofilms or a combination of powder spray and an electrolytic method (PEC). Materials and Methods: Twenty-four patients [...] Read more.

Aim of the study: This RCT assesses patients’ 18-month clinical outcomes after the regenerative therapy of periimplantitis lesions using either an electrolytic method (EC) to remove biofilms or a combination of powder spray and an electrolytic method (PEC). Materials and Methods: Twenty-four patients (24 implants) suffering from periimplantitis were randomly treated by EC or PEC followed by augmentation and submerged healing. Probing pocket depth (PPD), Bleeding on Probing (BoP), suppuration, and standardized radiographs were assessed before surgery (T0), 6 months after augmentation (T1), and 6 (T2) and 12 (T3) months after the replacement of the restoration. Results: The mean PPD changed from 5.8 ± 1.6 mm (T0) to 3.1 ± 1.4 mm (T3). While BoP and suppuration at T0 were 100%, BoP decreased at T2 to 36.8% and at T3 to 35.3%. Suppuration was found to be at a level of 10.6% at T2 and 11.8% at T3. The radiologic bone level measured from the implant shoulder to the first visible bone to the implant contact was 4.9 ± 1.9 mm at mesial sites and 4.4 ± 2.2 mm at distal sites at T0 and 1.7 ± 1.7 mm and 1.5 ± 17 mm at T3. Conclusions: Significant radiographic bone fill and the improvement of clinical parameters were demonstrated 18 months after therapy. Full article

(This article belongs to the Special Issue Implant Dentistry—Trends, Challenges and Innovations)

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12 pages, 3069 KiB

Open AccessArticle

Risk Indicators Affecting the Survival of the Mandibular First Molar Adjacent to an Implant at the Mandibular Second Molar Site: A Retrospective Study

by Won-Bae Park, Koo-Hyun Kwon, Kyung-Gyun Hwang and Ji-Young Han

J. Clin. Med. 2021, 10(12), 2543; https://doi.org/10.3390/jcm10122543 - 08 Jun 2021

Cited by 2 | Viewed by 1739

Abstract

This study aimed to compare the survival of mandibular first molars (MnM1s) adjacent to implants placed in mandibular second molar sites (ImM2s) with MnM1s adjacent to mandibular second molars (MnM2s) and to investigate risk indicators affecting the survival of MnM1s adjacent to ImM2s. [...] Read more.

This study aimed to compare the survival of mandibular first molars (MnM1s) adjacent to implants placed in mandibular second molar sites (ImM2s) with MnM1s adjacent to mandibular second molars (MnM2s) and to investigate risk indicators affecting the survival of MnM1s adjacent to ImM2s. A total of 144 patients who had MnM1s adjacent to ImM2s and MnM1s adjacent to MnM2s on the contralateral side were included in this study. Clinical variables and radiographic bone levels were evaluated. The survival of MnM1s adjacent to ImM2s or MnM2s was evaluated using a Kaplan–Meier analysis and Cox proportional hazards model. The 5-year cumulative survival rates of MnM1s adjacent to ImM2s and MnM2s were 85% and 95%, respectively. MnM1s adjacent to ImM2s of the internal implant-abutment connection type had higher multivariate hazard ratios (HR) for loss. MnM1s that had antagonists with implant-supported prostheses also had higher HR for loss. The multivariate HR for the loss of MnM1s adjacent to ImM2s with peri-implant mucositis was 3.74 times higher than MnM1s adjacent to healthy ImM2s. This study demonstrated several risk indicators affecting the survival of MnM1s adjacent to ImM2s. It is suggested that supportive periodontal and peri-implant therapy combined with meticulous occlusal adjustment can prolong the survival of MnM1s and ImM2s. Full article

(This article belongs to the Special Issue Implant Dentistry—Trends, Challenges and Innovations)

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18 pages, 2119 KiB

Open AccessArticle

Hybrid Polyetheretherketone (PEEK)–Acrylic Resin Prostheses and the All-on-4 Concept: A Full-Arch Implant-Supported Fixed Solution with 3 Years of Follow-Up

by Miguel de Araújo Nobre, Carlos Moura Guedes, Ricardo Almeida, António Silva and Nuno Sereno

J. Clin. Med. 2020, 9(7), 2187; https://doi.org/10.3390/jcm9072187 - 10 Jul 2020

Cited by 24 | Viewed by 5648

Abstract

Background: The aim of this three-year prospective study was to examine the outcome of a solution for full-arch rehabilitation through a fixed implant-supported hybrid prosthesis (polyetheretherketone (PEEK)-acrylic resin) used in conjunction with the All-on-4 concept. Methods: Thirty-seven patients (29 females, 8 males), with [...] Read more.

Background: The aim of this three-year prospective study was to examine the outcome of a solution for full-arch rehabilitation through a fixed implant-supported hybrid prosthesis (polyetheretherketone (PEEK)-acrylic resin) used in conjunction with the All-on-4 concept. Methods: Thirty-seven patients (29 females, 8 males), with an age range of 38 to 78 years (average: 59.8 years) were rehabilitated with 49 full-arch implant-supported prostheses (12 maxillary rehabilitations, 13 mandibular rehabilitations and 12 bimaxillary rehabilitations). The primary outcome measure was prosthetic survival. Secondary outcome measures were marginal bone loss, plaque and bleeding scores, veneer adhesion issues, biological complications, mechanical complications, and the patients’ subjective evaluation. Results: There were two patients (maxillary rehabilitations) lost to follow-up, while one patient withdrew (maxillary rehabilitation). One patient with bimaxillary rehabilitation fractured the mandibular PEEK framework, rendering a 98% prosthetic survival rate. Implant survival was 100%. Average (standard deviation) marginal bone loss at 3-years was 0.40 mm (0.73 mm). Veneer adhesion was the only technical complication (n = 8 patients), resolved for all patients. Nine patients (n = 11 prostheses) experienced mechanical complications (all resolved): fracture of acrylic resin crowns (n = 3 patients), prosthetic and abutment screw loosening (n = 4 patients and 3 patients, respectively), abutment wearing (n = 1 patient). One patient experienced a biological complication (peri-implant pathology), resolved through non-surgical therapy. A 90% satisfaction rate was registered for the patients’ subjective evaluation. Conclusions: Based on the results, the three-year outcome suggests the proposed rehabilitation solution as a legitimate treatment option, providing a potential shock-absorbing alternative that could benefit the implant biological outcome. Full article

(This article belongs to the Special Issue Implant Dentistry—Trends, Challenges and Innovations)

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11 pages, 4010 KiB

Open AccessArticle

A New Site Preparation Protocol That Supports Bone Quality Evaluation and Provides Predictable Implant Insertion Torque

by Stefan Velikov, Cristiano Susin, Peter Heuberger and Ainara Irastorza-Landa

J. Clin. Med. 2020, 9(2), 494; https://doi.org/10.3390/jcm9020494 - 11 Feb 2020

Cited by 9 | Viewed by 5285

Abstract

When preparing an implant site, clinicians often base their assessment of the bone on subjective tactile and visual cues. This assessment is used to plan the surgical procedure for site preparation, including how many drilling steps will be used. The subjective nature of [...] Read more.

When preparing an implant site, clinicians often base their assessment of the bone on subjective tactile and visual cues. This assessment is used to plan the surgical procedure for site preparation, including how many drilling steps will be used. The subjective nature of bone evaluation, consequently, results in poor reproducibility and may lead to under or over preparation of the site. Recently, an unconventional site preparation protocol was developed in which the decision of which instruments to use is dictated by insertion torque of the novel site preparation instrument (OsseoShaper^™, Nobel Biocare AB, Gothenburg, Sweden). The aim of this study was to quantify the correlation of the site preparation torques of the new instrument with bone density and maximum implant insertion torques. In vitro and in vivo data showed strong linear correlation between site preparation torque and density and resulted in reliable implant insertion torques, respectively. From our analysis, we conclude that this new instrument and protocol has the potential to eliminate the need for additional intraoperative bone evaluation and may reduce the risk of inadequate preparation of the site due to the ability to serve as a predictor of the final implant insertion torque. Full article

(This article belongs to the Special Issue Implant Dentistry—Trends, Challenges and Innovations)

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11 pages, 604 KiB

Open AccessArticle

Clinical Performance of Zygomatic Implants—Retrospective Multicenter Study

by Ruben Davó, Simonas Bankauskas, Remigijus Laurincikas, Ismail Doruk Koçyigit and José Eduardo Mate Sanchez de Val

J. Clin. Med. 2020, 9(2), 480; https://doi.org/10.3390/jcm9020480 - 09 Feb 2020

Cited by 15 | Viewed by 6432

Abstract

The main objective of this analysis was to evaluate (1) implant survival, (2) biologic complications, and (3) demographics associated with zygomatic implants placed according to the zygomatic anatomy-guided approach (ZAGA). This retrospective multicenter study reviewed data from the charts of 82 consecutive patients [...] Read more.

The main objective of this analysis was to evaluate (1) implant survival, (2) biologic complications, and (3) demographics associated with zygomatic implants placed according to the zygomatic anatomy-guided approach (ZAGA). This retrospective multicenter study reviewed data from the charts of 82 consecutive patients who had received 182 zygomatic implants. Patients were fully edentulous (62.2%), partially edentulous (22.0%), or had failing dentition (15.9%). Most patients (87.5%) did not have previous sinusitis and 11.3% had been previously treated for it. Additionally, about half of the patients (53.8%) did not present periodontal pathology, and one-third (36.3%) did, but were subsequently treated. Most implants (93.8%) were loaded immediately, i.e., within 48 h of placement. Implants were followed for 10.5 ± 7.2 months, and all were recorded as surviving and stable at last follow-up. Post-operative complications were infrequent and included sinusitis (10.1%) and peri-implant hyperplasia (0.8%). The low complication rate and 100% implant survival and stability indicate that zygomatic implants offer a viable treatment option when performing graftless restoration of severely resorbed maxilla, including immediate loading protocols. Full article

(This article belongs to the Special Issue Implant Dentistry—Trends, Challenges and Innovations)

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14 pages, 19720 KiB

Open AccessArticle

Electrochemical Disinfection of Dental Implants Experimentally Contaminated with Microorganisms as a Model for Periimplantitis

by Maximilian Koch, Maximilian Göltz, Meng Xiangjun, Matthias Karl, Stefan Rosiwal and Andreas Burkovski

J. Clin. Med. 2020, 9(2), 475; https://doi.org/10.3390/jcm9020475 - 09 Feb 2020

Cited by 14 | Viewed by 3406

Abstract

Despite several methods having been described for disinfecting implants affected by periimplantitis, none of these are universally effective and may even alter surfaces and mechanical properties of implants. Boron-doped diamond (BDD) electrodes were fabricated from niobium wires and assembled as a single instrument [...] Read more.

Despite several methods having been described for disinfecting implants affected by periimplantitis, none of these are universally effective and may even alter surfaces and mechanical properties of implants. Boron-doped diamond (BDD) electrodes were fabricated from niobium wires and assembled as a single instrument for implant cleaning. Chemo-mechanical debridement and air abrasion were used as control methods. Different mono-species biofilms, formed by bacteria and yeasts, were allowed to develop in rich medium at 37 °C for three days. In addition, natural multi-species biofilms were treated. Implants were placed in silicone, polyurethane foam and bovine ribs for simulating different clinical conditions. Following treatment, the implants were rolled on blood agar plates, which were subsequently incubated at 37 °C and microbial growth was analyzed. Complete electrochemical disinfection of implant surfaces was achieved with a maximum treatment time of 20 min for Candida albicans, Candida dubliniensis, Enterococcus faecalis, Roseomonas mucosa, Staphylococcus epidermidis and Streptococcus sanguinis, while in case of spore-forming Bacillus pumilus and Bacillus subtilis, a number of colonies appeared after BDD electrode treatment indicating an incomplete disinfection. Independent of the species tested, complete disinfection was never achieved when conventional techniques were used. During treatment with BDD electrodes, only minor changes in temperature and pH value were observed. The instrument used here requires optimization so that higher charge quantities can be applied in shorter treatment times. Full article

(This article belongs to the Special Issue Implant Dentistry—Trends, Challenges and Innovations)

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16 pages, 25685 KiB

Open AccessArticle

The Workflow of a New Dynamic Navigation System for the Insertion of Dental Implants in the Rehabilitation of Edentulous Jaws: Report of Two Cases

by Armando Lopes, Miguel de Araújo Nobre and Diogo Santos

J. Clin. Med. 2020, 9(2), 421; https://doi.org/10.3390/jcm9020421 - 04 Feb 2020

Cited by 18 | Viewed by 5855

Abstract

Background: This case series describes the surgical workflow during maxillary full-arch rehabilitations in two patients through the All-on-4 concept (standard and hybrid) assisted by DTX Studio Implant Software planning and X-Guide Navigation. Results: The X-Guide Navigation enabled the drills and implants to be [...] Read more.

Background: This case series describes the surgical workflow during maxillary full-arch rehabilitations in two patients through the All-on-4 concept (standard and hybrid) assisted by DTX Studio Implant Software planning and X-Guide Navigation. Results: The X-Guide Navigation enabled the drills and implants to be positioned and oriented precisely, allowing the implants to be positioned favorably under the surgical and prosthetic points of view through the avoidance of damage to the maxillary sinus and nasal cavity. Dynamic navigation-assisted surgery provided advantages, including the possibility to modify the implants’ system, length, or location perioperatively. However, it must be underlined that to achieve proficiency with this technology it is necessary to consider a necessary learning curve. Conclusion: The insertion of dental implants assisted by dynamic navigation for maxillary full-arch rehabilitations was considered a safe and predictable procedure. Nevertheless, it can be improved (such as with a simpler fiducial markers protocol), aiming to simplify the procedure. Full article

(This article belongs to the Special Issue Implant Dentistry—Trends, Challenges and Innovations)

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13 pages, 2635 KiB

Open AccessArticle

Long-Term Influence of Platelet-Rich Plasma (PRP) on Dental Implants after Maxillary Augmentation: Implant Survival and Success Rates

by Sameh Attia, Clara Narberhaus, Heidrun Schaaf, Philipp Streckbein, Jörn Pons-Kühnemann, Christian Schmitt, Friedrich Wilhelm Neukam, Hans-Peter Howaldt and Sebastian Böttger

J. Clin. Med. 2020, 9(2), 391; https://doi.org/10.3390/jcm9020391 - 01 Feb 2020

Cited by 11 | Viewed by 4848

Abstract

The atrophic maxilla often requires bone augmentation before implant placement to ensure long-term implant success. A previous prospective clinical trial examined the use of platelet-rich plasma (PRP) during maxillary augmentation. The short-term results showed no positive effect of PRP. The aim of this [...] Read more.

The atrophic maxilla often requires bone augmentation before implant placement to ensure long-term implant success. A previous prospective clinical trial examined the use of platelet-rich plasma (PRP) during maxillary augmentation. The short-term results showed no positive effect of PRP. The aim of this study was to evaluate the same patient collective of the previous study regarding the PRP long-term impact on the survival and success of dental implants. Fifty-three patients from the previous study diagnosed with maxillary atrophy and augmented with autologous bone grafts from the iliac crest and dental implants, were included in this study. Treatment was carried out on both sides in 34 patients with a split-mouth-design in which one randomly chosen side was treated additionally with PRP, the other side was the control-side. Nineteen patients were treated only on one side and were assigned to the PRP—or the control group randomly. Implant follow-up of the patients from the previous study was performed after an average time of 13 years. Implant success was evaluated using two different success criteria. Thitry-seven patients (25 women and 12 men) were investigated in this study. Seventeen patients (12 female, 5 male) were included in the PRP group, while 20 patients (13 female, 7 male) participated in the control group. A total of 210 implants were inserted. Of these, 102 implants (48.57%) were placed in the PRP group and 108 implants (51.42%) in the control group. Out of 102 investigated implants in the PRP group, 6 were removed (survival rate 94.1%). While two of the 108 implants in the control group were loss (survival rate 98.1%). In the PRP group, the cumulative probability of survival after 15.1 years was 94.1% and in the control group, was 98.1%, with no significant difference between the two groups. Higher significant difference for the control group was found in the cumulative success probability using Albrektson criteria (p = 0.05). Positive impact of PRP on long-term implant survival and success could not be found. Full article

(This article belongs to the Special Issue Implant Dentistry—Trends, Challenges and Innovations)

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17 pages, 1149 KiB

Open AccessArticle

Long-Term Influence of Platelet-Rich Plasma (PRP) on Dental Implants after Maxillary Augmentation: Retrospective Clinical and Radiological Outcomes of a Randomized Controlled Clinical Trial

by Sameh Attia, Clara Narberhaus, Heidrun Schaaf, Philipp Streckbein, Jörn Pons-Kühnemann, Christian Schmitt, Friedrich Wilhelm Neukam, Hans-Peter Howaldt and Sebastian Böttger

J. Clin. Med. 2020, 9(2), 355; https://doi.org/10.3390/jcm9020355 - 28 Jan 2020

Cited by 9 | Viewed by 2720

Abstract

The long-term clinical and radiological outcomes of dental implants inserted in augmented bone treated with platelet-rich plasma (PRP) has not been well addressed in the literature yet. This study is based on a collection of patients from a randomized controlled trial (RCT) that [...] Read more.

The long-term clinical and radiological outcomes of dental implants inserted in augmented bone treated with platelet-rich plasma (PRP) has not been well addressed in the literature yet. This study is based on a collection of patients from a randomized controlled trial (RCT) that did not report any short-term positive effects of PRP on bone healing after sinus lift surgery using autologous iliac crest bone graft. This study aimed to evaluate the long-term impact of PRP regarding clinical and radiological outcomes on the inserted implants in the previous RCT. For this evaluation, we considered the following variables: plaque index, probing depth, bleeding index, mobility grade, Periotest^® values, and radiological bone loss. Out of 53 patients (n = 306 implants) included in the previous study we were able to reinvestigate 37 patients (n = 210 implants) in two centers (31 in Giessen, Germany and 6 in Erlangen, Germany). Clinical and radiographic parameters suggested overall healthy conditions of the peri-implant tissue. The PRP-group and the control group did not differ significantly in the majority of the parameters. The overall evaluation showed that result data of the PRP-group was inferior to the control group in 64 percent of the evaluated parameters. The present study cannot provide evidence of a positive effect of PRP on the long-term implant clinical and radiological outcomes. In fact, a tendency towards inferior long-term results in the PRP-group was detected without reaching a significant threshold. Further controlled trials need to be conducted to investigate this correlation. Full article

(This article belongs to the Special Issue Implant Dentistry—Trends, Challenges and Innovations)

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11 pages, 2045 KiB

Open AccessArticle

Low-Level Laser Therapy with a 635 nm Diode Laser Affects Orthodontic Mini-Implants Stability: A Randomized Clinical Split-Mouth Trial

by Rafał Flieger, Tomasz Gedrange, Kinga Grzech-Leśniak, Marzena Dominiak and Jacek Matys

J. Clin. Med. 2020, 9(1), 112; https://doi.org/10.3390/jcm9010112 - 31 Dec 2019

Cited by 34 | Viewed by 4231

Abstract

Background: The study aimed to clinically estimate an influence of a 635 nm diode laser on the stability of orthodontic mini-implants, to assess mini-implants loss, and to evaluate a pain level after the treatment. Materials and Methods: The randomized clinical split-mouth trial included [...] Read more.

Background: The study aimed to clinically estimate an influence of a 635 nm diode laser on the stability of orthodontic mini-implants, to assess mini-implants loss, and to evaluate a pain level after the treatment. Materials and Methods: The randomized clinical split-mouth trial included 20 subjects (13 women and 7 men; age: 32.5 ± 6.1 years), 40 implants (RMO, West Colfax Ave., Denver, CO, USA) with a diameter 1.4 mm and length of 10 mm. Mini-implants were placed in the area of the attached gingiva between the second premolar and first molar teeth, 2 mm below the mucogingival junction of both sides of the maxilla. Each implant on the right side (G1, n = 20) of the maxilla was irradiated with a diode laser, and the implants on the opposite side (left, G2, n = 20) were a control group (without laser irradiation). The 635-nm laser parameters; dose: 10 J per point (20 J/cm²), time: 100 s per point, two points (irradiation on a buccal, and a palatal side of the alveolus/implant), the total energy per session 20 J. Laser application protocol: immediately and 3, 6, 9, 12, 15, and 30 days after surgery. The total energy after all therapeutic sessions was 140 J. The implants’ stability was measured employing a Periotest device (Periotest Test Value—PTV) immediately and 3, 6, 9, 12, 15, 30, and 60 days after the insertion of the mini-implants. Results: We found significantly higher secondary stability, lower mean PTV (6.18 ± 5.30) and (1.51 ± 2.25), for self-drilling mini-implants (G1, test group) in contrast to the control, G2 group (9.17 ± 8.25) and (5.00 ± 3.24), after 30 (p = 0.0003) and 60 days (p = 0.0000). Moreover, the analysis of the mini-implants stability after 635-nm diode laser application revealed significant higher stability in comparison with none irradiated implants (G2 group) after 3 days. (p = 0.0000) There was no significant difference in pain level measured on the NRS-11 scale on both sides of the maxilla. (p = 0.3665) An important finding was that all inserted mini-implants survived during a two-month observation period. Conclusions: 635-nm diode laser at laser irradiation increases the secondary stability of orthodontic mini-implants. Full article

(This article belongs to the Special Issue Implant Dentistry—Trends, Challenges and Innovations)

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16 pages, 4927 KiB

Open AccessArticle

Influence of Biologically Oriented Preparation Technique on Peri-Implant Tissues; Prospective Randomized Clinical Trial with Three-Year Follow-Up. Part II: Soft Tissues

by Rubén Agustín-Panadero, Naia Bustamante-Hernández, Carlos Labaig-Rueda, Antonio Fons-Font, Lucía Fernández-Estevan and María Fernanda Solá-Ruíz

J. Clin. Med. 2019, 8(12), 2223; https://doi.org/10.3390/jcm8122223 - 16 Dec 2019

Cited by 15 | Viewed by 3709

Abstract

Purpose: The objective of this prospective randomized clinical trial (RCT) was to analyze and compare the clinical behavior of three types of prosthesis supported by single implants in the posterior region after three years of functional loading. Materials and methods: Seventy-five [...] Read more.

Purpose: The objective of this prospective randomized clinical trial (RCT) was to analyze and compare the clinical behavior of three types of prosthesis supported by single implants in the posterior region after three years of functional loading. Materials and methods: Seventy-five implants were divided into three groups according to the type of prosthetic restoration: screw-retained crown (group GS); cemented crown without finishing line (biologically oriented preparation technique) (group GBOPT); and conventional cemented crown with finishing line (group GCC). After three years in function, clinical parameters (presence of keratinized mucosa, probing depths, bleeding on probing, and radiographic bone loss) were compared between the three experimental groups. The possible correlation between soft tissue clinical parameters and bone loss was also analyzed. Results: Statistical analysis found significant differences in clinical parameters between the different types of crown, with the cemented restoration without finishing line (BOPT) presenting fewer complications and better peri-implant health outcomes including: significantly different KMW data (mm), with significant differences between groups GBOPT and GCC (p < 0.001, Kruskal–Wallis test), with GBOPT obtaining larger quantities of keratinized mucosa (KM); statistically significant differences in probing depth (PD) values between groups GBOPT and GCC (p = 0.010, Kruskal–Wallis test); significant differences in bleeding on probing (BOP) between groups GBOPT and GCC (p = 0.018, Chi² test) in favor of GBOPT. Conclusions: Soft tissue behavior around implants is related to the type of prosthetic restoration used, with cemented prostheses with BOPT presenting better peri-implant soft tissue behavior. Full article

(This article belongs to the Special Issue Implant Dentistry—Trends, Challenges and Innovations)

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15 pages, 2046 KiB

Open AccessArticle

Influence of Biologically Oriented Preparation Technique on Peri-Implant Tissues; Prospective Randomized Clinical Trial with Three-Year Follow-Up. Part I: Hard Tissues

by Rubén Agustín-Panadero, Naia Bustamante-Hernández, María Fernanda Solá-Ruíz, Álvaro Zubizarreta-Macho, Antonio Fons-Font and Lucía Fernández-Estevan

J. Clin. Med. 2019, 8(12), 2183; https://doi.org/10.3390/jcm8122183 - 11 Dec 2019

Cited by 11 | Viewed by 3896

Abstract

Purpose: The objective of this prospective randomized clinical trial (RCT) was to analyze and compare the clinical behavior of three types of prosthesis supported by single implants in the posterior region after three years functional loading. Materials and Methods: Seventy-five implants were divided [...] Read more.

Purpose: The objective of this prospective randomized clinical trial (RCT) was to analyze and compare the clinical behavior of three types of prosthesis supported by single implants in the posterior region after three years functional loading. Materials and Methods: Seventy-five implants were divided into three groups according to the type of prosthetic restoration: screw-retained crown (Group GS); cemented crown without finishing line (biologically oriented preparation technique) (Group GBOPT); and conventional cemented crown with finishing line (Group GCC). The clinical behavior of each restoration type was analyzed after 3 years functional loading by analyzing radiographic peri-implant bone loss. Results: GBOPT obtained the least bone loss (p < 0.01) in comparison with GS and GCC. Conclusions: Bone loss around implants is related to the type of prosthetic restoration it supports, whereby cemented BOPT crowns present less bone loss. Full article

(This article belongs to the Special Issue Implant Dentistry—Trends, Challenges and Innovations)

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9 pages, 4864 KiB

Open AccessArticle

Accuracy of Computer-Aided Dynamic Navigation Compared to Computer-Aided Static Navigation for Dental Implant Placement: An In Vitro Study

by Alfonso Mediavilla Guzmán, Elena Riad Deglow, Álvaro Zubizarreta-Macho, Rubén Agustín-Panadero and Sofía Hernández Montero

J. Clin. Med. 2019, 8(12), 2123; https://doi.org/10.3390/jcm8122123 - 02 Dec 2019

Cited by 67 | Viewed by 5313

Abstract

Aim: To analyze the accuracy capability of two computer-aided navigation procedures for dental implant placement. Materials and Methods: A total of 40 dental implants were selected, which were randomly distributed into two study groups, namely, group A, consisting of those implants that were [...] Read more.

Aim: To analyze the accuracy capability of two computer-aided navigation procedures for dental implant placement. Materials and Methods: A total of 40 dental implants were selected, which were randomly distributed into two study groups, namely, group A, consisting of those implants that were placed using a computer-aided static navigation system (n = 20) (guided implant (GI)) and group B, consisting of those implants that were placed using a computer-aided dynamic navigation system (n = 20) (navigation implant (NI)). The placement of the implants from group A was performed using surgical templates that were designed using 3D implant-planning software based on preoperative cone-beam computed tomography (CBCT) and a 3D extraoral surface scan, and the placement of group B implants was planned and performed using the dynamic navigation system. After placing the dental implants, a second CBCT was performed and the degree of accuracy of the planning and placement of the implants was analyzed using therapeutic planning software and Student’s t-test. Results: The paired t-test revealed no statistically significant differences between GI and NI at the coronal (p = 0.6535) and apical (p = 0.9081) levels; however, statistically significant differences were observed between the angular deviations of GI and NI (p = 0.0272). Conclusion: Both computer-aided static and dynamic navigation procedures allow accurate implant placement. Full article

(This article belongs to the Special Issue Implant Dentistry—Trends, Challenges and Innovations)

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14 pages, 2511 KiB

Open AccessArticle

Oral Rehabilitation of Hypodontia Patients Using an Endosseous Dental Implant: Functional and Aesthetic Results

by Sameh Attia, Heidrun Schaaf, Thaqif El Khassawna, Deeksha Malhan, Katharina Mausbach, Hans-Peter Howaldt and Philipp Streckbein

J. Clin. Med. 2019, 8(10), 1687; https://doi.org/10.3390/jcm8101687 - 15 Oct 2019

Cited by 14 | Viewed by 6461

Abstract

Hypodontia often leads to limited bone availability of the alveolar ridges. Oral rehabilitation of severe hypodontia patients is challenging. In this retrospective study, we evaluated the functional and aesthetic results after dental implants in hypodontia patients, corroborated by Albrektsson implant success criteria. Over [...] Read more.

Hypodontia often leads to limited bone availability of the alveolar ridges. Oral rehabilitation of severe hypodontia patients is challenging. In this retrospective study, we evaluated the functional and aesthetic results after dental implants in hypodontia patients, corroborated by Albrektsson implant success criteria. Over a period of 15 years (2000–2015), a total of 43 patients were diagnosed with hypodontia and 165 dental implants were inserted. Six patients who received 10 implants were lost in the follow-up. We examined 155 implants in 37 patients between December 2015 and May 2017. Besides family history, patients evaluated the general satisfaction, functionality, and aesthetics of the implants. Study subjects were between 17 and 44 years old (mean ± SD: 21.4 ± 5.6). Hypodontia patients were missing one to five teeth (n = 28), whereas patients diagnosed with oligodontia (≥6 missing teeth, n = 9). In this study, 24 patients (64.9%) with hypodontia had a positive family history; the remaining 13 patients had no family member with hypodontia. The final follow-up time ranged between 5 and 189 months after implant placement. Orthodontic treatment was performed in 32 patients (86%) before implant placement. Rehabilitation resulted in 62% of the cases being treated with 1–2 implants and 38% treated with 3–15 implants. However, out of 155 inserted dental implants, 18 implants failed to meet Albrektsson criteria, under which two implants were removed. Only autografts were used for bone augmentation with 97 implants. More than two-thirds of the patients showed high general satisfaction and masticatory function (69.4%) as well as phonetic ability (80.6%). The aesthetic outcome was rated as excellent by 17 patients (47.2%). The findings emphasize the importance of interdisciplinary treatment of hypodontia, leading to a satisfactory, functional, and long-term fixed prosthodontics using dental implants. Full article

(This article belongs to the Special Issue Implant Dentistry—Trends, Challenges and Innovations)

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13 pages, 2913 KiB

Open AccessArticle

Long Term Retention of Gingival Sealing around Titanium Implants with CaCl₂ Hydrothermal Treatment: A Rodent Study

by Yasunori Ayukawa, Wakana Oshiro, Ikiru Atsuta, Akihiro Furuhashi, Ryosuke Kondo, Yohei Jinno and Kiyoshi Koyano

J. Clin. Med. 2019, 8(10), 1560; https://doi.org/10.3390/jcm8101560 - 29 Sep 2019

Cited by 13 | Viewed by 3082

Abstract

We previously reported that CaCl₂ hydrothermal-treated (Ca-HT) titanium (Ti) implants induced a tight sealing at the interface between the implant and peri-implant epithelium (PIE) after implantation. However, it is not clear how long this improved epithelium sealing can be maintained. We subsequently [...] Read more.

We previously reported that CaCl₂ hydrothermal-treated (Ca-HT) titanium (Ti) implants induced a tight sealing at the interface between the implant and peri-implant epithelium (PIE) after implantation. However, it is not clear how long this improved epithelium sealing can be maintained. We subsequently investigated whether the positive effect of Ca-HT to promote sealing between the PIE and implant was sustained longer term. Maxillary molars were extracted from rats and replaced with either Ca-HT implants (Ca-HT group), distilled water-HT implants (DW-HT group) or non-treated implants (control group). After 16 weeks, the majority of implants in the Ca-HT group remained at the maxillary with no apical extension of the PIE. Conversely, half the number of control implants was lost following down-growth of the PIE. The effect of Ca-HT on migration and proliferation of rat oral epithelial cells (OECs) was also investigated. In OECs cultured on Ca-HT Ti plates, protein expression in relation to cell migration decreased, and proliferation was higher than other groups. Surface analysis indicated HT enhanced the formation of surface TiO₂ layer without altering surface topography. Consequently, Ca-HT of Ti reduced PIE down-growth via tight epithelial attachment to the surface, which may enhance implant capability for a longer time post-implantation. Full article

(This article belongs to the Special Issue Implant Dentistry—Trends, Challenges and Innovations)

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11 pages, 2209 KiB

Open AccessArticle

High-Frequency Ultrasound for Assessment of Peri-Implant Bone Thickness

by Juliana Marotti, Sarah Neuhaus, Daniel Habor, Lauren Bohner, Stefan Heger, Klaus Radermacher and Stefan Wolfart

J. Clin. Med. 2019, 8(10), 1539; https://doi.org/10.3390/jcm8101539 - 25 Sep 2019

Cited by 4 | Viewed by 3917

Abstract

Purpose: The aim of this study was to evaluate the accuracy of high-frequency ultrasound (HFUS) for measurement of bone thickness surrounding dental implants. Methods: Eight porcine bone samples containing dental implants were scanned by a HFUS scanner and compared using cone-beam computed tomography [...] Read more.

Purpose: The aim of this study was to evaluate the accuracy of high-frequency ultrasound (HFUS) for measurement of bone thickness surrounding dental implants. Methods: Eight porcine bone samples containing dental implants were scanned by a HFUS scanner and compared using cone-beam computed tomography (CBCT) and an optical scanner. Bone thickness was measured in the buccolingual region of dental implants in 10 points distributed between the platform and apical portion of the implant. Results: The mean measurement error for the ultrasound method was 0.11 mm, whereas CBCT showed a measurement error of 0.20 mm. For both devices, the maximal measurement error was 0.28 mm. Conclusion: Within the simulated limited conditions of this study, high-frequency ultrasound, with optical scanning used as a reference, presented higher accuracy in comparison to CBCT, and seems to be a promising tool for measuring peri-implant bone. Full article

(This article belongs to the Special Issue Implant Dentistry—Trends, Challenges and Innovations)

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14 pages, 2071 KiB

Open AccessArticle

Management of Schneiderian Membrane Perforations during Sinus Augmentation Procedures: A Preliminary Comparison of Two Different Approaches

by Horia Mihail Barbu, Stefania Andrada Iancu, Iasmin Jarjour Mirea, Michele Davide Mignogna, Nachum Samet and José Luis Calvo-Guirado

J. Clin. Med. 2019, 8(9), 1491; https://doi.org/10.3390/jcm8091491 - 19 Sep 2019

Cited by 18 | Viewed by 4876

Abstract

Background: The aim of this study was to retrospectively analyze two different sealing techniques for sinus membrane perforations produced during sinus floor augmentation by a lateral approach. Methods: A total of 172 lateral-approach sinus floor augmentation surgeries were performed on 130 patients. Sixty-one [...] Read more.

Background: The aim of this study was to retrospectively analyze two different sealing techniques for sinus membrane perforations produced during sinus floor augmentation by a lateral approach. Methods: A total of 172 lateral-approach sinus floor augmentation surgeries were performed on 130 patients. Sixty-one membrane perforations (35%) were reported. Most of the perforations were caused by accidental membrane tearing and 16 (26%) were caused by deliberate incision for mucocele removal. In 31 perforation cases (51%), the Schneiderian membrane was sealed by suturing, while the remaining 30 cases (49%) were sealed using a low-resorption collagen membrane coverage. Results: Out of the 31 cases treated with a suture-sealing techniques, 26 (84%) were successful, presenting graft integration. Failure occurred in the other five (16%) cases. Out of the 30 perforations sealed with low-resorption collagen membranes, 28 (93%) presented successful graft integration, while two (7%) failed. Conclusions: Both surgical techniques yielded therapeutic success. Full article

(This article belongs to the Special Issue Implant Dentistry—Trends, Challenges and Innovations)

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14 pages, 2064 KiB

Open AccessArticle

Elevated Systemic L-Kynurenine/L-Tryptophan Ratio and Increased IL-1 Beta and Chemokine (CX3CL1, MCP-1) Proinflammatory Mediators in Patients with Long-Term Titanium Dental Implants

by José Joaquín Merino, María Eugenia Cabaña-Muñoz, Adolfo Toledano Gasca, Alba Garcimartín, Juana Benedí, Fabio Camacho-Alonso and José María Parmigiani-Izquierdo

J. Clin. Med. 2019, 8(9), 1368; https://doi.org/10.3390/jcm8091368 - 02 Sep 2019

Cited by 8 | Viewed by 3256

Abstract

Titanium is the mean biocompatible metal found in dental titanium alloys (Ti-6Al-4V). The safety of certain dental biomaterial amalgams has been questioned in patients. The levels of several systemic cytokines (interleukin (IL)-1 beta, IL-4: pg/mL) and chemokines (monocyte chemoattractant protein-1 (MCP-1), soluble fractalkine [...] Read more.

Titanium is the mean biocompatible metal found in dental titanium alloys (Ti-6Al-4V). The safety of certain dental biomaterial amalgams has been questioned in patients. The levels of several systemic cytokines (interleukin (IL)-1 beta, IL-4: pg/mL) and chemokines (monocyte chemoattractant protein-1 (MCP-1), soluble fractalkine (CX3CL1: pg/mL) were determined using ELISA and compared between these study groups. The study included 30 controls without dental materials (cont), 57 patients with long-term titanium dental implants plus amalgams (A + I group) as well as 55 patients with long-term dental amalgam alone (A group). All patients (except controls) have had dental titanium implants (Ti-6Al-4V) and/or amalgams for at least 10 years (average: 15 years). We evaluated whether systemic levels of cytokines/chemokines, kyn/L-trp ratio and aromatic amino acid levels (HPLC: mM/L, Phe, L-Trp, His, Treo) could be altered in patients with long-term dental titanium and/or amalgams. These systemic markers were evaluated in 142 patients. The A + I group had higher L-Kynurenine/L-Tryptophan ratios than patients with long-term dental amalgam fillings alone (A). In addition, levels of IL-1 Beta cytokine, CX3CL1 and MCP-1 chemokines were higher in the A + I group than in the A group (A). The increased L-kyn/L-trp ratio and MCP-1 and fractalkine receptor (CX3CR1) elevations could suggest enhanced chemotactic responses by these chemokines in the A + I group. Full article

(This article belongs to the Special Issue Implant Dentistry—Trends, Challenges and Innovations)

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17 pages, 2448 KiB

Open AccessArticle

A Prognostic Model for the Outcome of Nobel Biocare Dental Implants with Peri-Implant Disease after One Year

by Miguel de Araújo Nobre, Francisco Salvado, Paulo Nogueira, Evangelista Rocha, Peter Ilg and Paulo Maló

J. Clin. Med. 2019, 8(9), 1352; https://doi.org/10.3390/jcm8091352 - 01 Sep 2019

Cited by 3 | Viewed by 2960

Abstract

Background: This investigation, based on a 1-year retrospective cohort study, aimed to estimate and validate a prognostic model for ailing and failing implants due to peri-implant disease. Methods: A total of 240 patients (male: 97; female: 143; average age of 57.3 years) with [...] Read more.

Background: This investigation, based on a 1-year retrospective cohort study, aimed to estimate and validate a prognostic model for ailing and failing implants due to peri-implant disease. Methods: A total of 240 patients (male: 97; female: 143; average age of 57.3 years) with at least one ailing or failing implant were included: 120 patients for model derivation and 120 patients for model validation. The primary outcome measure was the implant status: success, defined as the arrest of the disease, or failure defined as implant extraction, prevalence or re-incidence of peri-implant disease). Potential prognostic risk indicators were collected at the baseline evaluation. The relative risk (RR) was estimated for the predictors through logistic regression and the c-statistic (95% confidence interval) was calculated for both derivation and validation sets. The significance level was set at 5%. Results: The risk model retrieved the prognostic factors age (RR = 1.04), history of Periodontitis (RR = 3.13), severe peri-implant disease status (RR = 3.26), implant length (RR = 3.52), early disease development (RR = 3.99), with good discrimination in both the derivation set (0.763 [0.679; 0.847]) and validation set (0.709 [0.616; 0.803]). Conclusions: A prognostic risk model for estimating the outcome of implants with peri-implant disease is available, with a good performance considering the c-statistic evaluation. Full article

(This article belongs to the Special Issue Implant Dentistry—Trends, Challenges and Innovations)

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12 pages, 1739 KiB

Open AccessArticle

Clinical Evaluation of Three Surgical Modalities in the Treatment of Peri-Implantitis: A Randomized Controlled Clinical Trial

by Selena Toma, Michel C. Brecx and Jerome F. Lasserre

J. Clin. Med. 2019, 8(7), 966; https://doi.org/10.3390/jcm8070966 - 03 Jul 2019

Cited by 30 | Viewed by 7899

Abstract

Objectives: To compare the efficacy of three mechanical procedures for surgically treating peri-implantitis. Materials and Methods: In a randomized, prospective, parallel-group study, 47 patients with peri-implantitis were treated with (a) plastic curettes (n = 15 patients, 25 implants), (b) an air-abrasive device [...] Read more.

Objectives: To compare the efficacy of three mechanical procedures for surgically treating peri-implantitis. Materials and Methods: In a randomized, prospective, parallel-group study, 47 patients with peri-implantitis were treated with (a) plastic curettes (n = 15 patients, 25 implants), (b) an air-abrasive device (Perio-Flow^®, n = 16 patients,22 implants), or (c) a titanium brush (Ti-Brush^®, n = 16 patients, 23 implants). Patients were assessed for the following measures at three timepoints (baseline, and three and six months after surgery): plaque index, bleeding on probing, gingival index, probing pocket depth (PPD), relative attachment level, and bone loss. Treatment outcome was considered successful when the implant was still present with PPD ≤ 5 mm, no bleeding on probing, and no further mean bone loss ≥ 0.5 mm. Results: A greater reduction of gingival index and PPD was observed in the titanium brush group than in the other groups at six months (P < 0.001). Relative attachment level decreased from baseline in each group at three months but was more marked in the titanium brush group (P < 0.001). At six months, there was less bone loss in the titanium brush group than in the plastic curette group (P < 0.001; linear mixed model and Kruskal–Wallis). A successful outcome was observed in 22% of implants in the plastic curette group, 27% in the Perio-Flow^® group, and 33% in the Ti-Brush^® group. Conclusions: The titanium brush and glycine air-polishing device were more effective than the other methods, but treatment success remained low. Combining mechanical procedures with antimicrobials and/or antibiotics might be a more effective strategy and warrants careful investigation. Full article

(This article belongs to the Special Issue Implant Dentistry—Trends, Challenges and Innovations)

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16 pages, 5022 KiB

Open AccessArticle

An In Vitro Study of Osteoblast Response on Fused-Filament Fabrication 3D Printed PEEK for Dental and Cranio-Maxillofacial Implants

by Xingting Han, Neha Sharma, Zeqian Xu, Lutz Scheideler, Jürgen Geis-Gerstorfer, Frank Rupp, Florian M. Thieringer and Sebastian Spintzyk

J. Clin. Med. 2019, 8(6), 771; https://doi.org/10.3390/jcm8060771 - 31 May 2019

Cited by 74 | Viewed by 7122

Abstract

Polyetheretherketone (PEEK) is a prime candidate to replace metallic implants and prostheses in orthopedic, spine and cranio-maxillofacial surgeries. Fused-filament fabrication (FFF) is an economical and efficient three-dimensional (3D) printing method to fabricate PEEK implants. However, studies pertaining to the bioactivity of FFF 3D [...] Read more.

Polyetheretherketone (PEEK) is a prime candidate to replace metallic implants and prostheses in orthopedic, spine and cranio-maxillofacial surgeries. Fused-filament fabrication (FFF) is an economical and efficient three-dimensional (3D) printing method to fabricate PEEK implants. However, studies pertaining to the bioactivity of FFF 3D printed PEEK are still lacking. In this study, FFF 3D printed PEEK samples were fabricated and modified with polishing and grit-blasting (three alumina sizes: 50, 120, and 250 µm) to achieve varying levels of surface roughness. In vitro cellular response of a human osteosarcoma cell line (SAOS-2 osteoblasts, cell adhesion, metabolic activity, and proliferation) on different sample surfaces of untreated, polished, and grit-blasted PEEK were evaluated. The results revealed that the initial cell adhesion on different sample surfaces was similar. However, after 5 days the untreated FFF 3D printed PEEK surfaces exhibited a significant increase in cell metabolic activity and proliferation with a higher density of osteoblasts compared with the polished and grit-blasted groups (p < 0.05). Therefore, untreated FFF 3D printed PEEK with high surface roughness and optimal printing structures might have great potential as an appropriate alloplastic biomaterial for reconstructive cranio-maxillofacial surgeries. Full article

(This article belongs to the Special Issue Implant Dentistry—Trends, Challenges and Innovations)

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13 pages, 2186 KiB

Open AccessArticle

Comparative Study between an Immediate Loading Protocol Using the Digital Workflow and a Conventional Protocol for Dental Implant Treatment: A Randomized Clinical Trial

by Piyanut Rattanapanich, Weerapan Aunmeungtong, Pisaisit Chaijareenont and Pathawee Khongkhunthian

J. Clin. Med. 2019, 8(5), 622; https://doi.org/10.3390/jcm8050622 - 07 May 2019

Cited by 14 | Viewed by 4382

Abstract

Background: The purposes of this randomized clinical trial study was to compare the immediate loading of dental implants while employing digital workflow and conventional implants in terms of the success rate, marginal bone level, and patient satisfaction. Methods: Fifty patients who [...] Read more.

Background: The purposes of this randomized clinical trial study was to compare the immediate loading of dental implants while employing digital workflow and conventional implants in terms of the success rate, marginal bone level, and patient satisfaction. Methods: Fifty patients who had edentulous area on the mandibular premolar or molar area were included in the study. Twenty-five patients were assigned to immediate loading implant treatment using the digital technique and 25 patients were assigned to conventional loading implant treatment. In the first group, the patients were received digital impression (Cerec Omnicam, Dentsply Sirona^®, York, PA, USA), designed, producing zirconia crown, and inserted on the same surgery day. The second group, after a healing period of three months, was received analog impression following conventional impression for the zirconia crown. Clinical outcome and radiographic bone level were evaluated after three, six, and 12 months. Patient satisfaction was measured at 12 months after inserting the implant. Results: There was no implants and protheses failure in both groups. The mean resonance frequency analysis values at the day of surgery were 78.26 ± 4.09 in immediate loading using the digital group (ILD) and 73.74 ± 5.14 in the conventional loading group (CL), respectively. Insertion torque values at the day of surgery were 36.60 ± 12.64 in ILD and 38.8 ± 12.19 CL, respectively. The marginal bone level in CL at three, six, and 12 months were 0.14 ± 0.28 mm, 0.18 ± 0.30 mm, and 0.17 ± 0.29 mm, respectively, while in ILD at three, six, and 12 months were 0.18 ± 0.33 mm and 0.16 ± 0.27 mm and 0.15 ± 0.31, respectively. There was no statistically significant difference between the two groups. Only one question in patient satisfaction’s questionnaire was “Now, can your dental implant and crown be used well?” had been significantly different in favor to the conventional group. Conclusion: Within the limitation of this study, it may be concluded that, after one-year follow up, there were no statistically significant differences between the immediate loading of dental implants employed from the digital workflow and conventional implant treatment technique in the success rate and marginal bone level. In patient satisfaction, there was only statistic significant difference in question related to implant prosthetic function in favor of the CL group, whereas the question concerning speaking, cleansing, price, and expectation displayed no difference. Full article

(This article belongs to the Special Issue Implant Dentistry—Trends, Challenges and Innovations)

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9 pages, 3028 KiB

Open AccessArticle

Patient Eligibility for Standardized Treatment of the Edentulous Mandible: A Retrospective CBCT-Based Assessment of Mandibular Morphology

by Walid Aouini, France Lambert, Luc Vrielinck and Bart Vandenberghe

J. Clin. Med. 2019, 8(5), 616; https://doi.org/10.3390/jcm8050616 - 07 May 2019

Cited by 3 | Viewed by 2965

Abstract

The aim of the study was to evaluate the proportion of patients recommended for full-arch mandibular restoration that would be eligible for treatment with a recently developed premanufactured full-arch prosthesis (Trefoil™, Nobel Biocare) based on the morphology of their lower jaw. Anonymized cone [...] Read more.

The aim of the study was to evaluate the proportion of patients recommended for full-arch mandibular restoration that would be eligible for treatment with a recently developed premanufactured full-arch prosthesis (Trefoil™, Nobel Biocare) based on the morphology of their lower jaw. Anonymized cone beam computed tomography (CBCT) data from 100 partially and fully edentulous patients referred for full-arch mandibular restoration were retrospectively collected from an imaging center database. Using custom-built software, CBCTs of mandibles were registered to a reference CBCT of a patient treated previously with a premanufactured full-arch prosthesis to determine if patients had adequate horizontal width and vertical height for implant placement. Bone height and thickness around simulated implants and distances to the incisive canal were evaluated. Mandibular arch width and semi-automated volume calculations were also performed. Using the system-specific 5.0 mm diameter implants with lengths of 13 and 11.5 mm, 85% and 86% of patients, respectively, were eligible for treatment with the standardized prosthesis. Eligibility was higher for men than women (odds ratio = 3.9, p = 0.045) due to increased bone volume. Based on mandibular morphology, our results suggest that the standardized treatment concept could serve a large percentage of patients with edentulous mandibles or failing dentition in the mandible. Full article

(This article belongs to the Special Issue Implant Dentistry—Trends, Challenges and Innovations)

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16 pages, 1838 KiB

Open AccessArticle

Accuracy of Customized Prefabricated Screw-Type Immediate Provisional Restorations after Single-Implant Placement

by Kyung Chul Oh, Jee-Hwan Kim, Chang-Woo Woo and Hong Seok Moon

J. Clin. Med. 2019, 8(4), 490; https://doi.org/10.3390/jcm8040490 - 11 Apr 2019

Cited by 11 | Viewed by 3944

Abstract

Limited evidence is available comparing the differences between pre-operative and post-operative 3D implant positions from the viewpoint of prosthetics. We aimed to investigate the differences between preplanned positions of virtual provisional restorations and their actual positions following fully guided single-implant placement. Ten maxillary [...] Read more.

Limited evidence is available comparing the differences between pre-operative and post-operative 3D implant positions from the viewpoint of prosthetics. We aimed to investigate the differences between preplanned positions of virtual provisional restorations and their actual positions following fully guided single-implant placement. Ten maxillary typodonts with missing right central incisors were imaged using cone-beam computed tomography, and digital impressions were obtained using an intraoral scanner. These data were imported into implant-planning software, following which the provisional restorations were designed. After data superimposition, an appropriate implant position was determined, and a computer-assisted implant surgical guide was designed for each typodont. Orders generated from the implant-planning software were imported into relevant computer-aided design software to design the custom abutments. The abutments, provisional restorations, and surgical guides were fabricated, and each restoration was cemented to the corresponding abutments, generating a screw-type immediate provisional restoration. The implants were placed using the surgical guides, and the screw-type provisional restorations were engaged to the implants. The typodonts were then rescanned using the intraoral scanner. The restorations designed at the treatment planning stage were compared with those in the post-operative scan using metrology software. The angular deviation around the central axis of the implant was measured, and the differences in the crown position were converted to root mean square (RMS) values. The post-operative provisional restorations exhibited an absolute angular deviation of 6.94 ± 5.78° and an RMS value of 85.8 ± 20.2 µm when compared with their positions in the pre-operative stage. Within the limitations of the present in vitro study, the results highlight the potential application of customized prefabricated immediate provisional restorations after single-implant placement. Full article

(This article belongs to the Special Issue Implant Dentistry—Trends, Challenges and Innovations)

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12 pages, 1287 KiB

Open AccessArticle

A Peri-Implant Disease Risk Score for Patients with Dental Implants: Validation and the Influence of the Interval between Maintenance Appointments

by Miguel de Araújo Nobre, Francisco Salvado, Paulo Nogueira, Evangelista Rocha, Peter Ilg and Paulo Maló

J. Clin. Med. 2019, 8(2), 252; https://doi.org/10.3390/jcm8020252 - 17 Feb 2019

Cited by 10 | Viewed by 5058

Abstract

Background: There is a need for tools that provide prediction of peri-implant disease. The purpose of this study was to validate a risk score for peri-implant disease and to assess the influence of the recall regimen in disease incidence based on a five-year [...] Read more.

Background: There is a need for tools that provide prediction of peri-implant disease. The purpose of this study was to validate a risk score for peri-implant disease and to assess the influence of the recall regimen in disease incidence based on a five-year retrospective cohort. Methods: Three hundred and fifty-three patients with 1238 implants were observed. A risk score was calculated from eight predictors and risk groups were established. Relative risk (RR) was estimated using logistic regression, and the c-statistic was calculated. The effect/impact of the recall regimen (≤ six months; > six months) on the incidence of peri-implant disease was evaluated for a subset of cases and matched controls. The RR and the proportional attributable risk (PAR) were estimated. Results: At baseline, patients fell into the following risk profiles: low-risk (n = 102, 28.9%), moderate-risk (n = 68, 19.3%), high-risk (n = 77, 21.8%), and very high-risk (n = 106, 30%). The incidence of peri-implant disease over five years was 24.1% (n = 85 patients). The RR for the risk groups was 5.52 (c-statistic = 0.858). The RR for a longer recall regimen was 1.06, corresponding to a PAR of 5.87%. Conclusions: The risk score for estimating peri-implant disease was validated and showed very good performance. Maintenance appointments of < six months or > six months did not influence the incidence of peri-implant disease when considering the matching of cases and controls by risk profile. Full article

(This article belongs to the Special Issue Implant Dentistry—Trends, Challenges and Innovations)

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Review

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19 pages, 2146 KiB

Open AccessReview

Photo and Plasma Activation of Dental Implant Titanium Surfaces. A Systematic Review with Meta-Analysis of Pre-Clinical Studies

by Paolo Pesce, Maria Menini, Gregorio Santori, Emanuele De Giovanni, Francesco Bagnasco and Luigi Canullo

J. Clin. Med. 2020, 9(9), 2817; https://doi.org/10.3390/jcm9092817 - 31 Aug 2020

Cited by 24 | Viewed by 2508

Abstract

Background: Ultraviolet (UV) and non-thermal plasma functionalization are surface treatment modalities that seem able to improve osseointegration. The aim of this systematic review and meta-analysis is to assess the effect of the two methods and possible differences. Materials and Methods: The systematic research [...] Read more.

Background: Ultraviolet (UV) and non-thermal plasma functionalization are surface treatment modalities that seem able to improve osseointegration. The aim of this systematic review and meta-analysis is to assess the effect of the two methods and possible differences. Materials and Methods: The systematic research of pre-clinical animal studies was conducted up to May 2020 in the databases PubMed/Medline, Scopus and the Cochrane Lybrary. A meta-analysis was performed by using the DerSimonian–Laird estimator in random-effects models. Results: Through the digital search, 518 articles were identified; after duplicate removal and screening process 10 papers were included. Four studies evaluating UV treatment in rabbits were included in the meta-analysis. The qualitative evaluation of the included studies showed that both UV photofunctionalization and non-thermal plasma argon functionalization of titanium implant surfaces might be effective in vivo to improve the osseointegration. The meta-analysis on four studies evaluating UV treatment in rabbits showed that bone to implant contact values (expressed as standardized mean differences and raw mean differences) were significantly increased in the bio-activated groups when follow-up times were relatively homogeneous, although a high heterogeneity (I² > 75%) was found in all models. Conclusions: The present systematic review and meta-analysis on pre-clinical studies demonstrated that chair-side treatment of implants with UV or non-thermal plasma appear to be effective for improving osseointegration. This systematic review supports further clinical trials on this topic. Full article

(This article belongs to the Special Issue Implant Dentistry—Trends, Challenges and Innovations)

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16 pages, 1129 KiB

Open AccessReview

A Systematic Review of Survival Rates of Osseointegrated Implants in Fully and Partially Edentulous Patients Following Immediate Loading

by Massimo Del Fabbro, Tiziano Testori, Vladan Kekovic, Funda Goker, Margherita Tumedei and Hom-Lay Wang

J. Clin. Med. 2019, 8(12), 2142; https://doi.org/10.3390/jcm8122142 - 04 Dec 2019

Cited by 39 | Viewed by 4807

Abstract

Background: The aim of this systematic review was to evaluate the survival rates of immediately loaded implants after at least five years. Besides implant failure, the amount of marginal bone loss around implants and the complication type were assessed. Methods: The electronic search [...] Read more.

Background: The aim of this systematic review was to evaluate the survival rates of immediately loaded implants after at least five years. Besides implant failure, the amount of marginal bone loss around implants and the complication type were assessed. Methods: The electronic search was undertaken on Medline, Scopus, and Cochrane Central Register of Controlled Trials using key terms such as: “immediate loading”, “immediate function”, “immediate restoration”, “immediate temporization”, “dental implants”, “fully edentulous patients”, “partially edentulous patients”. The search terms were combined using the Boolean operators AND, OR. The last electronic search was performed on 15 February 2018. Two authors independently screened the studies, extracted the data, and assessed the risk-of bias. The main outcomes recorded for each study were: implant and prosthesis success and survival, marginal bone level change, incidence and type of complications. Kaplan–Meier analysis was used to estimate cumulative survival rates. Results: Thirty-four prospective studies with at least five-year follow-up, published between 2007 and 2017 were included. A total of 5349 immediately loaded implants in 1738 patients were analyzed. The mean follow-up was 72.4 months (median 60 months, 95% confidence intervals (CI): 64.53, 80.25 months, range 60 to 147 months). The mean weighted implant survival was 97.4% (median 98.15%, 95% CI: 96.29%, 98.54%, range 83.80% to 100%). Cumulative survival rate of implants placed in the mandible was significantly higher than for the maxilla (p < 0.01). No significant difference in failure rate was found among the types of prosthesis employed (p = 0.27). The mean peri-implant bone level change at the end of the follow-up in each study ranged from 0.3 to 1.7 mm. Conclusion: Immediate loading of implants appears to have long-term predictability and success rate under well-defined circumstances. Full article

(This article belongs to the Special Issue Implant Dentistry—Trends, Challenges and Innovations)

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28 pages, 6797 KiB

Open AccessReview

Achievements in the Topographic Design of Commercial Titanium Dental Implants: Towards Anti-Peri-Implantitis Surfaces

by Gerardo Asensio, Blanca Vázquez-Lasa and Luis Rojo

J. Clin. Med. 2019, 8(11), 1982; https://doi.org/10.3390/jcm8111982 - 14 Nov 2019

Cited by 39 | Viewed by 10101

Abstract

Titanium and its alloys constitute the gold standard materials for oral implantology in which their performance is mainly conditioned by their osseointegration capacity in the host’s bone. We aim to provide an overview of the advances in surface modification of commercial dental implants [...] Read more.

Titanium and its alloys constitute the gold standard materials for oral implantology in which their performance is mainly conditioned by their osseointegration capacity in the host’s bone. We aim to provide an overview of the advances in surface modification of commercial dental implants analyzing and comparing the osseointegration capacity and the clinical outcome exhibited by different surfaces. Besides, the development of peri-implantitis constitutes one of the most common causes of implant loss due to bacteria colonization. Thus, a synergic response from industry and materials scientists is needed to provide reliable technical and commercial solutions to this issue. The second part of the review focuses on an update of the recent findings toward the development of new materials with osteogenic and antibacterial capacity that are most likely to be marketed, and their correlation with implant geometry, biomechanical behavior, biomaterials features, and clinical outcomes. Full article

(This article belongs to the Special Issue Implant Dentistry—Trends, Challenges and Innovations)

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Graphical abstract

11 pages, 1703 KiB

Open AccessReview

Innovative Trends in Implant Dentistry Training and Education: A Narrative Review

by Ana Santos Ferro, Ken Nicholson and Sreenivas Koka

J. Clin. Med. 2019, 8(10), 1618; https://doi.org/10.3390/jcm8101618 - 04 Oct 2019

Cited by 23 | Viewed by 6501

Abstract

Background: The field of implant dentistry education is rapidly evolving as new technologies permit innovative methods to teach the fundamentals of implant dentistry. Methods: Literature from the fields of active learning, blended learning, augmented reality, artificial intelligence, haptics, and mixed reality were reviewed [...] Read more.

Background: The field of implant dentistry education is rapidly evolving as new technologies permit innovative methods to teach the fundamentals of implant dentistry. Methods: Literature from the fields of active learning, blended learning, augmented reality, artificial intelligence, haptics, and mixed reality were reviewed and combined with the experience and opinions of expert authors. Both positive and negative aspects of the learning methods are presented. Results and Conclusion: The fundamental objectives of teaching and learning remain unchanged, yet the opportunities to reach larger audiences and integrate their learning into active experiences are evolving due to the introduction of new teaching and learning methodologies. The ability to reach a global audience has never been more apparent. Nevertheless, as much as new technology can be alluring, each new method comes with unique limitations. Full article

(This article belongs to the Special Issue Implant Dentistry—Trends, Challenges and Innovations)

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21 pages, 1213 KiB

Open AccessReview

Systematic Review of the Long-Term Effects of Transgender Hormone Therapy on Bone Markers and Bone Mineral Density and Their Potential Effects in Implant Therapy

by Rafael Delgado-Ruiz, Patricia Swanson and Georgios Romanos

J. Clin. Med. 2019, 8(6), 784; https://doi.org/10.3390/jcm8060784 - 01 Jun 2019

Cited by 18 | Viewed by 8312

Abstract

This study seeks to evaluate the long-term effects of pharmacologic therapy on the bone markers and bone mineral density of transgender patients and to provide a basis for understanding its potential implications on therapies involving implant procedures. Following the referred Reporting Items for [...] Read more.

This study seeks to evaluate the long-term effects of pharmacologic therapy on the bone markers and bone mineral density of transgender patients and to provide a basis for understanding its potential implications on therapies involving implant procedures. Following the referred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and well-defined PICOT (Problem/Patient/Population, Intervention, Comparison, Outcome, Time) questionnaires, a literature search was completed for articles in English language, with more than a 3 year follow-up reporting the long-term effects of the cross-sex pharmacotherapy on the bones of adult transgender patients. Transgender demographics, time under treatment, and treatment received were recorded. In addition, bone marker levels (calcium, phosphate, alkaline phosphatase, and osteocalcin), bone mineral density (BMD), and bone turnover markers (Serum Procollagen type I N-Terminal pro-peptide (PINP), and Serum Collagen type I crosslinked C-telopeptide (CTX)) before and after the treatment were also recorded. The considerable variability between studies did not allow a meta-analysis. All the studies were completed in European countries. Transwomen (921 men to female) were more frequent than transmen (719 female to male). Transwomen’s treatments were based in antiandrogens, estrogens, new drugs, and sex reassignment surgery, meanwhile transmen’s surgeries were based in the administration of several forms of testosterone and sex reassignment. Calcium, phosphate, alkaline phosphatase, and osteocalcin levels remained stable. PINP increased in transwomen and transmen meanwhile, CTX showed contradictory values in transwomen and transmen. Finally, reduced BMD was observed in transwomen patients receiving long-term cross-sex pharmacotherapy. Considering the limitations of this systematic review, it was concluded that long-term cross-sex pharmacotherapy for transwomen and transmen transgender patients does not alter the calcium, phosphate, alkaline phosphatase, and osteocalcin levels, and will slightly increase the bone formation in both transwomen and transmen patients. Furthermore, long-term pharmacotherapy reduces the BMD in transwomen patients. Full article

(This article belongs to the Special Issue Implant Dentistry—Trends, Challenges and Innovations)

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Other

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22 pages, 3942 KiB

Open AccessSystematic Review

The Accuracy of Zygomatic Implant Placement Assisted by Dynamic Computer-Aided Surgery: A Systematic Review and Meta-Analysis

by Shengchi Fan, Gustavo Sáenz-Ravello, Leonardo Diaz, Yiqun Wu, Rubén Davó, Feng Wang, Marko Magic, Bilal Al-Nawas and Peer W. Kämmerer

J. Clin. Med. 2023, 12(16), 5418; https://doi.org/10.3390/jcm12165418 - 21 Aug 2023

Cited by 3 | Viewed by 1051

Abstract

Purpose: The present systematic review aimed to investigate the accuracy of zygomatic implant (ZI) placement using dynamic computer-aided surgery (d-CAIS), static computer-aided surgery (s-CAIS), and a free-hand approach in patients with severe atrophic edentulous maxilla and/or deficient maxilla. Methods: Electronic and manual literature [...] Read more.

Purpose: The present systematic review aimed to investigate the accuracy of zygomatic implant (ZI) placement using dynamic computer-aided surgery (d-CAIS), static computer-aided surgery (s-CAIS), and a free-hand approach in patients with severe atrophic edentulous maxilla and/or deficient maxilla. Methods: Electronic and manual literature searches until May 2023 were performed in the PubMed/Medline, Scopus, Cochrane Library, and Web of Science databases. Clinical trials and cadaver studies were selected. The primary outcome was planned/placed deviation. Secondary outcomes were to evaluate the survival of ZI and surgical complications. Random-effects meta-analyses were conducted and meta-regression was utilized to compare fiducial registration amounts for d-CAIS and the different designs of s-CAIS. Results: A total of 14 studies with 511 ZIs were included (Nobel Biocare: 274, Southern Implant: 42, SIN Implant: 16, non-mentioned: 179). The pooled mean ZI deviations from the d-CAIS group were 1.81 mm (95% CI: 1.34–2.29) at the entry point and 2.95 mm (95% CI: 1.66–4.24) at the apex point, and angular deviations were 3.49 degrees (95% CI: 2.04–4.93). The pooled mean ZI deviations from the s-CAIS group were 1.19 mm (95% CI: 0.83–1.54) at the entry point and 1.80 mm (95% CI: 1.10–2.50) at the apex point, and angular deviations were 2.15 degrees (95% CI: 1.43–2.88). The pooled mean ZI deviations from the free-hand group were 2.04 mm (95% CI: 1.69–2.39) at the entry point and 3.23 mm (95% CI: 2.34–4.12) at the apex point, and angular deviations were 4.92 degrees (95% CI: 3.86–5.98). There was strong evidence of differences in the average entry, apex, and angular deviation between the navigation, surgical guide, and free-hand groups (p < 0.01). A significant inverse correlation was observed between the number of fiducial screws and the planned/placed deviation regarding entry, apex, and angular measurements. Conclusion: Using d-CAIS and modified s-CAIS for ZI surgery has shown clinically acceptable outcomes regarding average entry, apex, and angular deviations. The maximal deviation values were predominantly observed in the conventional s-CAIS. Surgeons should be mindful of potential deviations and complications regardless of the decision making in different guide approaches. Full article

(This article belongs to the Special Issue Implant Dentistry—Trends, Challenges and Innovations)

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13 pages, 511 KiB

Open AccessSystematic Review

Correlations between Dental Implant Infectious Pathologies and Maxillary Sinusitis: A Review Article

by Simina Angela Lăcrimioara Iușan, Carmen Costache, Ondine Patricia Lucaciu, Bianca-Nausica Petrescu, Ioana Codruța Mirică, Dan-Alexandru Toc and Silviu Albu

J. Clin. Med. 2023, 12(15), 5059; https://doi.org/10.3390/jcm12155059 - 01 Aug 2023

Viewed by 881

Abstract

(1) Background: The demands of patients for aesthetic and functional rehabilitation of edentulous areas led to the use of dental implants as therapeutic means on an increasingly large scale. This aspect determined the appearance of some infectious pathologies with a peri-implant starting point [...] Read more.

(1) Background: The demands of patients for aesthetic and functional rehabilitation of edentulous areas led to the use of dental implants as therapeutic means on an increasingly large scale. This aspect determined the appearance of some infectious pathologies with a peri-implant starting point that can be complicated by various sinus diseases. The purpose of this review article is to synthesize the existing information in the specialized literature regarding the existing correlations between peri-implant and maxillary sinusitis. (2) Methods: The articles published in five databases were researched using different combinations of search terms. We selected 12 articles from the 250 found, by applying the inclusion and exclusion criteria and removing duplicates. (3) Results: We analyzed the included studies and we found that all of them reported a positive correlation between maxillary sinusitis and peri-implant infectious diseases. There are also reported other pathologies with a peri-implant infectious disease as a starting point such as abscesses, oro-antral communications, or foreign body reactions due to implant or bone graft materials migration. (4) Conclusions: This scoping review highlighted the existence of correlations between peri-implant and sinus pathology and the importance of preventing peri-implant diseases of an infectious nature to avoid the occurrence of these complications. Full article

(This article belongs to the Special Issue Implant Dentistry—Trends, Challenges and Innovations)

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10 pages, 8545 KiB

Open AccessTechnical Note

Analogical and Digital Workflow in the Design and Preparation of the Emergence Profile of Biologically Oriented Preparation Technique (BOPT) Crowns over Implants in the Working Model

by Guillermo Cabanes-Gumbau, David Soto-Peñaloza, Miguel Peñarrocha-Diago and María Peñarrocha-Diago

J. Clin. Med. 2019, 8(9), 1452; https://doi.org/10.3390/jcm8091452 - 12 Sep 2019

Cited by 7 | Viewed by 6362

Abstract

: The Biologically Oriented Preparation Technique (BOPT), developed by Ignacio Loi and published in 2008, is a consolidated concept in the modeling and preservation of pericoronal soft tissues. The present study describes the analogical and digital methods allowing adequate design and preparation of [...] Read more.

: The Biologically Oriented Preparation Technique (BOPT), developed by Ignacio Loi and published in 2008, is a consolidated concept in the modeling and preservation of pericoronal soft tissues. The present study describes the analogical and digital methods allowing adequate design and preparation of the emergence profile of BOPT crowns in the working model, with a view to comparing the workflow and advantages of each method. At present, not all the digital procedures have been fully optimized to completely replace the traditional analogical methods. Nevertheless, it is only a matter of time until dental digitalization technology totally replaces the analogical clinical methods. The digital workflow for this procedure is quickly implemented and optimized, and represents the most realistic option, with possibilities for further development in the immediate future. Full article

(This article belongs to the Special Issue Implant Dentistry—Trends, Challenges and Innovations)

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8 pages, 2355 KiB

Open AccessCase Report

Esthetic Rehabilitation of Maxillary Anterior Teeth, Including an Immediate Provisionalization with an Implant-Supported Fixed Dental Prosthesis

by Kyung Chul Oh, Jeongwon Paik and Jee-Hwan Kim

J. Clin. Med. 2019, 8(4), 428; https://doi.org/10.3390/jcm8040428 - 28 Mar 2019

Cited by 4 | Viewed by 5895

Abstract

This report describes the case of a patient who required rehabilitation of their maxillary anterior teeth following a traumatic injury through a physical altercation. The decision was made to extract the maxillary central incisors and maxillary right lateral incisor, perform immediate implantation on [...] Read more.

This report describes the case of a patient who required rehabilitation of their maxillary anterior teeth following a traumatic injury through a physical altercation. The decision was made to extract the maxillary central incisors and maxillary right lateral incisor, perform immediate implantation on the maxillary right lateral incisor and left central incisor areas, and place a three-unit immediate provisional restoration. Predesigned virtual teeth enabled efficient fabrication of the immediate provisional restoration following the implant placement. After a sufficient healing period with periodic check-ups, final impressions were made using a digital approach, with meticulous care taken to preserve the gingival architecture around the sites of rehabilitation. Thus, the custom abutments and definitive restoration were placed without eliciting an uncomfortable feeling in the patient. Both esthetic and functional outcomes were satisfactory. Reduced soft tissue volume around the implant restoration was observed, primarily within the two months post-extraction/implantation, based on superimposition of the serial scan data. Soft tissue volume changes in the present case suggest the need for controlled clinical studies of three-dimensional changes of gingival contours after extraction and/or implantation. Full article

(This article belongs to the Special Issue Implant Dentistry—Trends, Challenges and Innovations)

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