Search Results (233)

Background/Objectives: Oral cancer resection often leads to maxillofacial defects and dentition loss, compromising patients’ quality of life. Implant-supported prosthetic rehabilitation offers a reliable solution to restore function, though factors such as bone reconstruction, radiotherapy, and timing of implant placement (immediate vs. delayed) may influence outcomes. This study aimed to evaluate long-term implant survival and rehabilitation timelines in oncologic patients, comparing two cohorts (2005–2014 and 2015–2024) to assess the impact of evolving clinical practices. Methods: A retrospective cohort study was conducted at Hospital General Universitario Gregorio Marañón (Madrid, Spain), including 304 patients who underwent ablative oral cancer surgery and subsequent implant-based rehabilitation between 2005 and 2024. Data on demographics, oncologic treatment, reconstruction, implant timing, and prosthetic rehabilitation were collected. Outcomes were compared using Kaplan–Meier analysis and appropriate statistical tests between the 2005–2014 (n = 122) and 2015–2024 (n = 182) cohorts. Results: A total of 2341 Ticare Implants^® were placed, supporting 281 prostheses. Implant placement during primary surgery increased from 41% to 71% (p < 0.001). The median time from surgery to prosthesis significantly decreased from 24 to 15 months (p < 0.001). Five-year implant survival was 95% in the early cohort versus 97% in the later cohort. Implant survival was comparable between irradiated and non-irradiated patients (~94–96%). Fixed prostheses became more frequent (92% vs. 79%, p = 0.002). Conclusions: Implant-supported rehabilitation in oncologic patients is highly feasible and durable, with improved timelines and functional outcomes associated with early implant placement and modern digital planning strategies. Full article

Evaluating the implant site immediately after implant removal is crucial for assessing its condition and ensuring morphological stability. Immediate reconstruction at the time of implant removal has been proposed as a strategy to preserve alveolar ridge width. This study aims to evaluate whether immediate alveolar bone reconstruction at the time of implant removal provides comparable or superior dimensional stability of the alveolar ridge compared to staged reconstruction approaches. The null hypothesis of this study is that there is no significant difference in alveolar bone dimensions between immediate and staged reconstructions following implant removal. This retrospective study included seven participants, consisting of six males and one female. The participants were categorized into three groups based on the treatment approach following implant removal. In Group 1, no bone grafting was performed after implant removal. In Group 2, bone grafting was conducted following implant removal, with an adequate healing period before implant placement. In Group 3, bone grafting was performed simultaneously with implant removal. Cone-beam computed tomography (CBCT) imaging was conducted before implant removal (T0), after implant removal or bone grafting (T1), and after implant placement (T2). All removed implants were successfully replaced with new ones, regardless of bone grafting. In terms of alveolar ridge width at 1 mm below the crest, Group 1 exhibited the greatest reduction (ΔT1 − T0 = −5.1 ± 3.7 mm), while Group 2 showed a mild increase (+1.1 ± 2.6 mm), and Group 3 had a moderate decrease (−1.3 ± 1.0 mm). This suggests that delayed bone grafting can better preserve or enhance bone volume during healing. A reduction in buccal ridge height between T1 and T0 (ΔT1 − T0) was observed, particularly in Group 1. In contrast, an increase in buccal ridge height was most pronounced in Group 2. Although immediate reconstruction (Group 3) did not result in statistically significant gains, it achieved successful implant placement without complications and reduced the total treatment duration, which might be beneficial from a clinical efficiency and patient satisfaction standpoint. Therefore, staged bone grafting (Group 2) appears to offer greater dimensional stability, particularly in maintaining ridge height, whereas immediate reconstruction (Group 3) remains a clinically viable alternative for stable healing in select cases, especially when shorter treatment timelines are prioritized. Full article

(1) Background: The present study was carried out to provide a state-of-the-art review of the prosthodontic factors related to customized subperiosteal implants (CSIs), and to offer clinical guidelines in this regard. (2) Methods: An expert consensus meeting was held in July 2024 in Santpedor (Manresa, Spain) to establish the most relevant clinical guidelines. (3) Results and (4) Conclusions: An interdisciplinary approach including surgeons, prosthodontists, bio-medical engineers and dental technicians, integrating both biological and mechanical considerations when designing CSI rehabilitations, is very important. While the reported survival rate of CSIs appears promising, their long-term performance beyond 5 years remains insufficiently documented. Thus, CSIs are a viable treatment option for patients with insufficient bone to place conventional implants, but there is a clear need to identify and analyze delayed-onset complications associated with these devices. The findings and their broader implications should be thoroughly examined, and potential future research directions should be highlighted. Full article

Background: In modern dentistry, alveolar socket preservation after tooth extraction plays a critical role in maintaining the alveolar ridge for future dental implants. This retrospective clinical study evaluated bone-level changes 15 years after immediate implant placement, coupled with alveolar ridge preservation. Methods: Fifty non-smoking patients aged 25 to 75 (30 males and 20 females) who underwent single-implant rehabilitation in both anterior and posterior regions of the upper and lower jaws were included. The study examined bone levels and implant survival over time, using standardized intraoral radiographs at 1, 5, and 15 years post-loading. Implants were placed immediately after atraumatic extraction, and the residual gap was grafted with bovine hydroxyapatite and covered with a collagen membrane. The primary outcome was bone-level stability, while secondary outcomes included implant failure. No temporary crowns or removable dentures were provided during healing. Radiographs were digitized for detailed analysis. Results: The results for 50 patients with immediate implant placement showed that bone-resorption levels were significantly higher in the upper jaw than in the lower jaw. Conclusions: Posterior implants exhibited greater bone loss than anterior implants, particularly at 1 year and 15 years, while no implant failures occurred. Full article

Background: This study aimed to evaluate and compare the survival rates of immediate dental implants (type 1) in patients who received different types of prophylactic antibiotics. Methods: This retrospective analysis examined data from 3351 immediate implants placed in 2391 patients (mean age 59.56 ± 13.42 years, 75.9% white, 53.6% female, 7.8% smokers, 6.7% with diabetes) within the BigMouth network between 2011 and 2022. Patient demographics, medical history, and the type of prophylactic antibiotic administered (amoxicillin, amoxicillin and clavulanic acid (Augmentin), clindamycin, azithromycin, ciprofloxacin, doxycycline, metronidazole) were analyzed in relation to implant survival or failure. Statistical analyses included descriptive statistics, chi-square tests, t-tests, Kaplan–Meier survival analysis, and Cox regression. All statistical analyses were performed with a significance level at p < 0.05. Results: The overall implant failure rate was 3.2% at the patient level (77 out of 2391 patients) and 1.9% at the implant level (65 out of 3351 implants), with a mean follow-up of 77 months. No significant associations were found between patient-related characteristics or implant position and implant failure, such as age (p = 0.84), gender (p = 0.30), or tobacco use (p = 0.83). Amoxicillin was the most frequently prescribed antibiotic (86.4%). Kaplan–Meier survival analysis revealed significantly shorter survival times for implants in patients who received ciprofloxacin and clindamycin compared to amoxicillin (n = 2894 implants) (p < 0.001). Cox regression analysis indicated a significantly increased risk of implant failure with ciprofloxacin (n = 5 implants) (HR: 16.50, p = 0.006) and clindamycin (n = 290 implants) (HR: 3.70, p < 0.001) compared to amoxicillin. Conclusion: The choice of prophylactic antibiotic significantly impacted the survival of immediate dental implants. Ciprofloxacin and clindamycin were associated with higher failure rates compared to amoxicillin. These findings underscore the importance of antibiotic selection in immediate implant procedures and highlight the need for further research to establish evidence-based guidelines for antibiotic prophylaxis in this context. Full article

Background: Eighty-five percent of peri-implant malignancies are oral squamous cell carcinomas (OSCCs), and most of them are misdiagnosed as peri-implantitis because of their clinical and radiological presentation; few studies have focused on addressing and solving the diagnostic issues related to peri-implant OSCCs. Objectives: The study aimed to describe the clinicopathological features of peri-implant OSCCs and to report the staging issues related to the diagnosis of these lesions. Methods: This retrospective cohort study included patients who received a diagnosis of and treatment for peri-implant OSCCs at the Unit of Dentistry of the “Aldo Moro” University of Bari (Italy) from 2018 to 2024. By using descriptive statistics, the authors highlighted the diagnostic issues related to the clinical presentation, radiological features, and histology of peri-implant OSCCs. Results: A total of 13 women and 8 men with a mean age of 70.6 ± 11.7 years met the inclusion criteria; the medical history of the participants showed potentially malignant disorders (OPMDs) in 52.4% of patients, whereas 14.3% had already developed an OSCC. The patients showed 24 peri-implant OSCCs; the clinical presentation was leuko-erythroplakia-like (41.7%) or erythroplakia-like (58.3%), thus simulating peri-implantitis; in addition, 52.0% of dental implants involved had a probing pocket depth ≥ 10 mm, further mimicking peri-implantitis. Panoramic radiograms and cone beam computed tomography were of little use in studying bundle bone–implant interfaces; in particular, the tomography showed circumferential bone resorption only in peri-implantitis-like OSCCs. In total, 91.6% of histological examinations of OSCCs showed peri-implantitis-like inflammation; early-stage lesions (pTNM I-II) accounted for 33.3%, whereas late-stage lesions (pTNM III-IV) accounted for 66.7%; lymph nodal metastases occurred in 25.0% and 62.5%, respectively. The mean follow-up was 3.4 ± 1.0 years; all patients with OPMDs had poorly differentiated tumors and thus showed a worse prognosis than those without OPMDs (mean disease-free survival of 15.5 ± 7.7 months and 44.7 ± 12.1 months, respectively). Conclusions: The results of the study showed that peri-implant OSCCs occurred most frequently in patients with OPMDs or previous OSCC; in addition, peri-implant OSCCs required demolition rather than conservative excision, and the prognosis of patients strictly depended on the grade of the cancer. In the authors’ experience, the clinical–radiological presentation simulating peri-implantitis was the feature that concurred most in complicating the diagnosis of those tumors. Full article

Objectives: This study aims to investigate the underlying causes of dental implant failure, focusing on implant-related complications and associated risk factors. Understanding these factors will help improve treatment planning and enhance implant success rates. Methods: A retrospective case-control study was conducted using clinical, medical, surgical, and radiographic records of patients who underwent dental implant removal due to complications. Key factors analyzed included patient-related variables (age, gender, medical conditions, periodontal disease), implant-related factors (implant site, implant system, restoration status), and procedural aspects (previous surgical interventions and reasons for implant removal). Results: The findings revealed that implant type (p = 0.004) and type of restoration (p = 0.001) significantly influenced implant survival. Gender (p = 0.001), medical conditions, smoking status (p = 0.004), and restoration status (p = 0.005) were significantly associated with specific failure mechanisms. Lack of osseointegration (36.4%) and absence of primary stability (22.4%) were the predominant causes of implant failure. Prior surgical interventions (p = 0.001) and decisions for re-implantation (p = 0.005) significantly affected implant removal frequency. Conclusions: Implant survival is influenced by multiple factors, with implant type, restoration type, and gender playing key roles in failure outcomes. Patient-specific risk assessment, particularly regarding medical conditions and smoking, meticulous surgical technique, and appropriate prosthetic planning, is vital for improving implant longevity and minimizing failure rates. Full article

Background/Objectives: Subperiosteal implants (SPIs) were first used in the 1940s, but due to their complications and the rise of dental implants, they were discontinued. Thanks to new technologies and new materials, nowadays they are being used again and studied as a treatment for severe bone defects. This review analyzes the clinical results—survival rates and complications—of SPIs used to support full arch rehabilitations of severely resorbed maxillae and mandibles, comparing the outcomes resulting from implant placement conducted in one or two surgical interventions. Methods: An automated search was conducted in four databases (Medline/Pubmed, Scopus, Web of Science, and Cochrane Library), as well as a manual search for relevant clinical articles published before 28 February 2025. The review included human studies with at least four patients, in which SPIs were placed to restore full-arch edentulous maxillae and mandibles. Quality of evidence was evaluated using the Newcastle–Ottawa Quality Assessment Scale and the Joanna Briggs Institute Critical Appraisal tool. Results: A total of 14 studies met the inclusion criteria and were included for analysis, including 958 patients and 973 SPIs. The survival rate was 100% when one surgical intervention was performed and 85% when two interventions were performed after 4–38 months and 3–22 years follow-up, respectively. Conclusions: SPIs would appear to offer a good alternative for patients with severe bone atrophies, especially SPIs fabricated using digital techniques in a single step, presenting promising survival rates and a low complication rate, although more randomized clinical trials with long-term follow-up are needed. Full article

Zirconia dental implants have emerged as a transformative material in implantology, offering a biocompatible, esthetic, and durable alternative to traditional titanium implants. This comprehensive review explores the key properties of zirconia, including high fracture resistance, esthetic superiority, and low bacterial affinity. The ability of zirconia to integrate with bone through osseointegration, coupled with its resistance to plaque and inflammation, results in a product that is particularly suitable for patients with metal sensitivities or high esthetic demands. However, challenges such as brittleness and complex manufacturing processes persist. Advances in surface modification techniques and material optimization are poised to address these limitations, paving the way for broader applications. The purpose of this descriptive review was to emphasize the mechanical, antibacterial, osteointegration and survival rates of zirconia implants. This paper also summarizes findings from recent empirical studies, highlighting zirconia’s clinical performance, biological responses, and future potential as a mainstream implant material. Full article

Background/Objectives: Dental implant success is influenced by a range of systemic and local factors. Emerging evidence suggests that metabolic markers such as lipid profiles and vitamin D levels may play a role in osseointegration and implant survival. The aim of this study was to evaluate the influence of low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides, and vitamin D levels on the short-term survival rate of dental implants. Materials and Methods: A prospective observational study was conducted on patients receiving dental implants. Preoperative serum levels of LDL, HDL, triglycerides, and vitamin D were recorded. A total of 556 conical, platform-switching implants were placed in 166 patients, smokers and no smokers with mean age 48 years ± 4.7. Implant survival was evaluated from 14 to 21 days after placement, at 6- and at a 12-month follow-up. Spearman’s rank correlation was performed to assess potential correlations between the abovementioned systemic factors and implant loss. Results: Out of 556 implants, 13 (2.34%) were lost from 14 to 21 days after placement, a further two (0.35%) were lost after 6 months after surgery and a further eight (1.44%) were lost 12 months after placement. No significant correlation was found between HDL levels, cholesterol levels, triglyceride levels and implant loss. Spearman’s correlation analysis revealed a strong negative correlation between vitamin D levels and implant loss with no statistical significance. Conclusions: Within the limitations of this study, no statistically significant associations were found between lipid profile markers or vitamin D levels and early dental implant loss. Further large-scale and long-term studies are warranted to validate these findings and better understand the interplay between systemic biochemical markers and implant survival rate. Full article

Background: Modern dentistry strives to achieve increasingly less invasive procedures as the ultimate therapeutic goal. The careful selection of suitable candidates for immediate dental implants can offer an opportunity to reduce treatment time, lower the relative costs and improve overall patient satisfaction. Methods: A systematic search was conducted in March 2025, without any time restrictions, in Medline, Pubmed and Web of Science databases. To identify other related references, further research was performed. Articles related to current knowledge about the immediate loading of dental implants supporting fixed partial prosthesis in the posterior region were included. Articles not available in abstract form and articles not published in the English language were excluded. Results: A total of ten studies were eligible for inclusion in the current study. The search strategy resulted in a survival rate ranging from 86% to 100%, and a failure rate of less than 21.6%, with a mean follow-up of 55.6 months. Statistical analysis revealed no significant differences in survival rates between implants placed in the maxilla and mandible (χ² = 0.42, p = 0.81, df = 2). Follow-up varied from one to ten years, reflecting variability both in study design and duration. Conclusions: The selected studies highlight the heterogeneity in immediate loading protocols for implant-supported fixed partial prosthesis in the posterior regions, emphasizing the variability in prosthetic materials and implant types, suggesting that immediate loading is a reliable, patient-centered therapeutic option with favorable long-term outcomes. Full article

The interaction between antiresorptive medication and dental implant procedures remains a subject of concern complicating the decision-making process for clinicians. The aim of the study is to conduct a literature review on the relationship between dental implant placement and the incidence of osteonecrosis of the jaw (ONJ) in patients receiving antiresorptive drugs. The systematic review relied on the PRISMA statement using the PICO tool. The literature search was performed using PubMed, EBSCOhost and Scopus for RCTs, controlled clinical trials and cohort studies. The choice of reference studies was made in a blind process with a 100% agreement rate. For all included studies, quality assessment was performed. The research led to the selection of 608 results. Only five studies were included in the review. Three of the included studies were judged as having a low risk of bias. Dental implants may not be linked to a higher risk of osteonecrosis of the jaw in patients taking low-dose bone-modifying agents. The long-term survival of implants in osteoporotic patients taking oral antiresorptive medication was similar to that in a healthy population and significantly higher than in untreated controls. Full article

Background: Autogenous bone grafting has long been the standard for augmenting bone prior to implant placement in atrophic ridges. However, innovative techniques are continually sought to enhance outcomes. This study introduces the honeycomb technique for horizontal bone augmentation in edentulous posterior mandibular ridges, presenting the methodology and long-term follow-up results of this novel approach. Methods: This study includes healthy patients with moderate to severe horizontal atrophy in posterior mandibular regions who underwent bone augmentation using the honeycomb technique and were followed up for a period of 10 to 14 years. The patients had orthoradiographs immediately post-surgery and underwent regular clinical and radiographic evaluations. Computed tomography at four months assessed the bone gain, followed by reentry for implant insertion and evaluation of the bone volume and quality. Fixed prosthesis-supported dental implants were placed four months post-insertion. The survival and success of the dental implants were evaluated based on the acceptable clinical and radiographic criteria. Results: A cohort of 23 patients (17 women, 6 men, mean age 47 years) underwent bone augmentation at 39 sites, with follow-up ranging from 10 to 14 years. The procedure demonstrated a 95–100% success rate with minimal morbidity and horizontal bone gain averaging 3–8 mm. Partial graft exposure occurred in two cases but was successfully managed without compromising augmentation. A total of 103 implants were placed in the augmented sites in 37 sites. The long-term survival of the dental implants was confirmed based on clinical and radiographic evaluation, with minimal marginal bone loss observed during the extended follow-up period. Conclusions: The honeycomb technique proves effective in horizontal bone augmentation of atrophic ridges in posterior mandibular defects. The satisfactory long-term outcomes validate its potential as a valuable addition to bone augmentation strategies preceding implant placement. Full article

Background: Peri-implantitis, the most prevalent cause of implant failure, is a multifaceted issue that is influenced by various factors that promote biofilm formation around the implant. Although various innovative methods for microbiological decontamination of dental implants exist, a universally accepted standard protocol has not yet been established. However, the potential of a device that generates an electric current (Ximplant^®) in reducing the survival of microorganisms within the biofilm is a promising development. Methods: In this in vitro study, five dental implants, contaminated using a microbial culture from a sample of saliva of a patient suffering from peri-implantitis, were decontaminated using the Ximplant^® peri-implantitis protocol. The experimental conditions included a simulated peri-implant site and a subsequent fluorescent assessment of the Live/Dead microbial population. Results: The qualitative and quantitative image analyses showed a predominant dead light signal on the treated sample, demonstrating the potential efficacy of applying the electrostatic field to the contaminated implant surface in reducing the viability of the microorganisms within the biofilm around dental implants. Conclusions: These findings could inspire a new era in peri-implantitis treatment. Full article

Objective: The aim of this systematic review is to compare the survival rates of zirconia and titanium dental implants, by evaluating the most recent scientific evidence, in order to comprehend the behaviour of zirconia implants as an alternative to titanium, due to the latter’s biological properties. Methods: An electronic search was performed on the Pubmed/MEDLINE and Scopus databases in November 2023 to identify clinical trials that investigated zirconia and titanium implants’ behaviour with a follow-up of at least 5 years. The primary outcome was the implant survival rate—defined as the maintenance of the implant in situ during the period of study. The secondary outcome was the implant success rate, which is associated with the values of the peri-implant variables—the probing depth, marginal bone loss, gingival recession, bleeding on probing, plaque index, and aesthetics scores. Results: A total of 17 articles were selected from the search, resulting in a sample of 364 studies. A total of 15 articles fulfilled the selection criteria. Zirconia implants showed satisfactory results. Due to the lack of data available with follow-up times of more than five years, it is not possible to conclusively describe the benefits of zirconia in comparison with titanium implants. Conclusions: While zirconia implants show promise as a future alternative to metal implants, more research is needed to understand their long-term benefits and peri-implant behaviour. Full article