Search Results (95)

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

Achieving the appropriate primary stability for immediate or early loading in areas with low-density bone, such as the posterior maxilla, is challenging. A three-dimensional (3D) stabilization implant design featuring a tapered body with continuous cutting flutes along the length of the external thread form, with a combination of curved and linear geometric surfaces on the thread’s crest, has the capacity to enhance early biomechanical and osseointegration outcomes compared to implants with traditional buttressed thread profiles. Commercially available implants with a buttress thread design (TP), and an experimental implant that incorporated the 3D stabilization trimmed-thread design (TP 3DS) were used in this study. Six osteotomies were surgically created in the ilium of adult sheep (N = 14). Osteotomy sites were randomized to receive either the TP or TP 3DS implant to reduce site bias. Subjects were allowed to heal for either 3 or 12 weeks (N = 7 sheep/time point), after which samples were collected en bloc (including the implants and surrounding bone) and implants were either subjected to bench-top biomechanical testing (e.g., lateral loading), histological/histomorphometric analysis, or nanoindentation testing. Both implant designs yielded high insertion torque (ITV ≥ 30 N⋅cm) and implant stability quotient (ISQ ≥ 70) values, indicative of high primary stability. Qualitative histomorphological analysis revealed that the TP 3DS group exhibited a continuous bone–implant interface along the threaded region, in contrast to the TP group at the early, 3-week, healing time point. Furthermore, TP 3DS’s cutting flutes along the entire length of the implant permitted the distribution of autologous bone chips within the healing chambers. Histological evaluation at 12 weeks revealed an increase in woven bone containing a greater presence of lacunae within the healing chambers in both groups, consistent with an intramembranous-like healing pattern and absence of bone dieback. The TP 3DS macrogeometry yielded a ~66% increase in average lateral load during pushout testing at baseline (T = 0 weeks, p = 0.036) and significantly higher bone-to-implant contact (BIC) values at 3 weeks post-implantation (p = 0.006), relative to the traditional TP implant. In a low-density (Type IV) bone model, the TP 3DS implant demonstrated improved performance compared to the conventional TP, as evidenced by an increase in baseline lateral loading capacity and increased BIC during the early stages of osseointegration. These findings indicate that the modified implant configuration of the TP 3DS facilitates more favorable biomechanical integration and may promote more rapid and stable bone anchorage under compromised bone quality conditions. Therefore, such improvements could have important clinical implications for the success and longevity of dental implants placed in regions with low bone density. Full article

Background: This retrospective clinical cohort study aimed to evaluate, over an 18-month follow-up period, implant survival rates, marginal bone loss, peri-implant parameters, and surgical and prosthetic complications in immediately loaded post-extraction implants used for single or partial implant-prosthetic rehabilitations. Methods: Ninety-nine met the inclusion criteria and received a total of 147 implants. Follow-up assessments were conducted at one week and at three, six, and twelve months after prosthesis delivery. Clinical and radiographic parameters were evaluated by three independent practitioners. The variables considered included smoking, systemic conditions, implant site, and prosthetic type. Results: The implant survival rate was 95.92% at 18 months. Failures were more frequent in smokers, patients with systemic diseases, and in the posterior maxilla. Marginal bone loss increased over time, with higher values in posterior regions and in patients with systemic conditions or smoking habits. Peri-implant clinical parameters values negatively increased in smokers. Surgical complications occurred only in smokers and patients with systemic conditions, more frequently in fixed bridge rehabilitations. Prosthetic complications were limited, more common in posterior regions and multi-unit restorations. Conclusions: Immediately loaded post-extraction implants demonstrated high reliability. Careful patient selection and structured follow-up are essential to reduce complications and ensure long-term success. 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

One of the key factors influencing osseointegration is the hydrophilicity of the surface of dental implants; high hydrophilicity is more advantageous than low hydrophilicity. This study aimed to compare the hydrophilic properties of titanium and zirconia implants from different manufacturers. An in vitro analysis was conducted on 15 implants—13 titanium and 2 zirconia—each featuring distinct compositions and surface treatments. Their hydrophilicity was assessed using the contact angle method, where a drop of saline solution was pipetted onto the apical part of the implant. For each implant, 30 contact angle measurements were taken at three different surface wetting time intervals. The contact angle is defined as the internal angle between the tangent to the surface of the liquid and the surface at the point of tangency; a smaller angle means a higher hydrophilicity. The results show that titanium implants from BTI UniCa, Nobel TiUltra, and Straumann Roxolid SLActive—which are classified as premium implants—exhibited the highest hydrophilicity. In contrast, zirconia implants demonstrated significantly lower hydrophilicity. Within this group, the Nobel Pearl implant exhibited smaller contact angles than the Bredent WhiteSKY implant. Our findings confirm that high-quality titanium implants show superior hydrophilicity, potentially improving clinical outcomes by accelerating healing and facilitating immediate loading protocols, but this could only be proven with an in vivo animal study. Conversely, the relatively lower hydrophilicity of zirconia implants highlights the need for continued advancements in zirconia composition and surface modification to optimize their osseointegration potential. Full article

Background/Objectives: A novel tool based on artificial intelligence (AIT) to evaluate immediate loading feasibility was recently introduced. The aim of this study is to evaluate the correspondence between the AIT prediction and the operator’s evaluation in a large sample of implants. Methods: 11 operators were asked to classify the recorded insertion curves of all the implants placed during the period between September 2022 and August 2023 as suitable or non-suitable for immediate loading. Next, the same curves were analyzed by the AIT, which classified them as belonging to YES (suitable for immediate loading) or NO (non-suitable for immediate loading) class. Results: 1320 dental implants were placed and a total of 21 different implant systems were used. According to the surgeons’ evaluation, 999 curves were suitable and 321 were non-suitable for immediate loading; when evaluated by the AIT, 916 curves belonged to class YES, while 404 belonged to class NO. The resulted sensitivity was 90.49% (95% CI = 88.5% to 92.2), specificity was 96.26% (95% CI = 93.6% to 98.1%), PPV was 98.7% (95% CI = 97.7% to 99.3%), and NPV was 76.5% (95% CI = 72% to 80.5%). Conclusions: The AIT tested in the present clinical multicenter study demonstrated a high level of accuracy in the prediction of immediate loading feasibility. Full article

Objective: This review article aims to analyze the existing relevant literature comparing the clinical outcomes and underlining the most common complications associated with immediate, early, and delayed dental implant placement in order to determine the most favorable timing for achieving optimal functional and esthetic results for the patient. Methods: A comprehensive review of the literature was conducted using PubMed-MEDLINE and Cochrane Library and a number of keywords, including “dental implant placement timing”, “immediate implant”, “early implant”, “delayed implant”, “clinical outcomes”, “complications”, and “implant success”, focusing on studies comparing immediate, early, and delayed implant placement. The primary outcome variable was implant survival rate, while secondary outcome variables included implant success rate, complications, and patient-reported outcomes. Results: A total of 9774 articles were identified. The articles included a variety of studies, including randomized controlled trials, prospective cohort studies, and retrospective studies. Immediate implant placement was associated with a high survival rate (93.8–100%), but also with an increased risk of complications, such as gingival recession and implant exposure. Early implant placement (4–8 weeks or 12–16 weeks after extraction) showed similar survival rates (95–100%) and fewer complications compared with immediate placement. Delayed implant placement (more than 4 months after extraction) was the most commonly used protocol and demonstrated high survival rates (92–100%) with predictable outcomes. Implant success rates varied depending on the criteria used, but all types of placements showed acceptable success rates (83.3–100%). The choice of loading protocol (immediate, early, or conventional) also influences treatment outcomes. Conclusions: The timing of dental implant placement and loading should be individualized based on patient-specific factors, such as bone and soft tissue conditions, medical history, esthetic considerations, and patient preferences. Immediate placement can be successful in ideal conditions but requires careful patient selection and surgical expertise. Early and delayed placement offer more predictable outcomes and are suitable for a wider range of patients. Full article

Background/Objectives: Primary stability is an important factor for dental implant success, and a high insertion torque (IT) is recommended in cases where an immediate load is required or desired. At the same time, some authors have claimed that it can interfere with bone-to-implant healing. This study aimed to compare the survival rates of implants inserted with different torques in full-arch cases, with or without immediate load, with up to 2-year follow-up. Methods: This study included subjects who required full-arch rehabilitation with implants. All cases were planned for the placement of four implants on each arch and were divided into groups according to the IT and had implant stability quotient (ISQ) measurements taken periodically for up to 2 years. Results: No implant was lost during this period, and no significant differences in peri-implant bone loss were observed. The paired t-test was performed to determine the association between ISQ and IT. Conclusions: The results suggest that initial torques higher than 75 Ncm may not be harmful to the stability of implants placed for full-arch rehabilitation, at least during the study period. Further clinical studies with longer follow-up periods are necessary to confirm these results. Full article

The study aimed to assess the success and survival rates of post-extraction implants with immediate loading. A systematic search was performed in the Medline (PubMed), Cochrane Library (Wiley), and Scopus (Elsevier) databases to identify randomized and non-randomized studies of intervention (NRSI) on bone loss and success and survival rates in post-extraction implants with immediate, early, and delayed loading. Articles were selected based on predefined inclusion and exclusion criteria, and the risk of bias was assessed following Cochrane guidelines, and the Newcastle–Ottawa Scale was used to assess quality. A fixed-effect meta-analysis was conducted to evaluate bone loss using mean, median, and standard deviation, and to calculate odds ratios for success-survival rates. Of the 13 studies identified, three met the criteria for inclusion in the meta-analysis, involving a total of 178 patients and 296 post-extraction implants. Bone loss was the lowest in the delayed loading group (0.51 mm) compared to immediate (0.55 mm) and early loading (0.54 mm). Implant failures were similar in the immediate and early groups (one case each), while two failures were reported in the delayed group. Delayed loading reduced peri-implant bone loss, but immediate loading showed a slightly higher success-survival rate. Further high-quality studies are needed to strengthen the evidence on the long-term effects of the different implant loading protocols. Full article

Objectives: The purpose of this clinical study is to compare implant full-arch intraoral scans taken immediately after implant placement with those obtained after tissue healing in patients rehabilitated with implant-supported fixed prostheses. Methods: Between September 2023 and March 2024, a total of 19 patients with compromised residual dentition (6 women; 13 men) were rehabilitated using 4-to-6 immediately loaded post-extraction implants. These implants supported fixed full-arch screw-retained prostheses either in the lower jaw (9 patients) or upper jaw (10 patients). Intraoral scans were taken immediately after implant placement (termed “immediate scan”). After a healing period of four months, the provisional prosthesis was removed, and a second intraoral scan was performed using the same scan bodies and scan pattern as the initial scan (termed “delayed scan”). The two scans were overlaid, and the discrepancies between them were measured. Results: The average discrepancy between the immediate and delayed scans was 0.1905 mm. Our statistical analysis revealed larger discrepancies for implants placed in the posterior areas, with the implant in site 1.6 (Implant 1) showing a discrepancy of 0.2326 mm, and the implant in site 2.6 (Implant 4) showing a discrepancy of 0.2124 mm (p = 0.05). No statistically significant difference was observed when comparing patients treated in the upper and lower jaws. Conclusions: Within the limitations of the study and based on this result, clinicians should be aware that an immediate post-surgical intraoral digital scan for implant-supported full-arch rehabilitations may result in a higher risk of imprecision. Furthermore, according to the results of the study, the accuracy of the digital impression on implant full-arch rehabilitations seems to be influenced by the clinician’s skills. Further studies with larger sample sizes are required to confirm our results. Full article

Implant-supported immediate loading full-arch rehabilitation has been documented in the literature. More recently, computed surgical guides have frequently been used since they facilitate planning and performing surgical treatment without the need to raise a flap, thus reducing trauma and morbidity. This case report describes an immediate full-arch, fixed rehabilitation with full loading placed on four commercially available 3D-printed implants, with a 24-month follow-up. The implants were placed with the help of a digitally planned 3D-printed surgical guide. The provisional fixed prosthesis installed immediately was replaced after 3 months. At the time, the soft and hard tissue around the implants appeared stable, without signs of inflammation. The same situation was observed at the 24-month follow-up. Three-dimensional-printed implants seem to be a promising choice in this case. However, further clinical studies with longer follow-up periods are necessary to confirm their efficacy. Full article

The aim of the present in vitro comparative study is to validate a novel composite polymer, named “ONLY”, developed to overcome the mechanical drawbacks of conventional, metal-reinforced poly(methyl methacrylate) (PMMA) interim restoration. Ten interim restorations were designed and fabricated (five in the composite “ONLY” group, and five in the metal-reinforced PMMA group). All the samples were screwed into the prototype models, simulating a complete edentulous mandible rehabilitated with six straight implants. Outcome measures were break point (load, N) and displacement (mm) through a static compression test, and material behavior through a dynamic cyclic test method (fatigue test). A total of 20 samples were tested (10 for static and 10 for dynamic). In each group, five samples (test and control) were used. All the specimens completed the mechanical tests, as planned. There was no statistically significant difference between groups for any test. In the test group, the break point was 1953.19 ± 543.73 N, while it was 2031.10 ± 716.68 N in the control group (p = 0.775). The displacement was 1.89 ± 0.34 mm in the test group and 1.98 ± 0.75 mm in the control group (p = 0.763). Using the dynamic cyclic test method, in the control group the mean load was 2504.60 ± 972.15 N, while in the test group the mean load was 3382.00 ± 578.50 N. The difference between groups was 877.40 ± 579.30 N (p value = 0.121). Within the limitations of this in vitro study, the novel composite polymer can be used to immediately load dental implants. Further clinical research is needed to confirm these preliminary results. Full article

Background: The long-term success of dental implants largely depends on achieving primary stability, previously described as crucial to obtaining osseointegration and immediate loading protocol requirements. Implant thread depths seem to be one of the key factors influencing primary stability, particularly in low-density bone. Insertion torque (IT) and resonance frequency analysis (RFA) are considered the most reliable tests to assess primary stability. The aim of this work was to evaluate how different thread depths of commercially available dental implants affect primary stability in low-density D3 bone. Materials and Methods: An in vitro study was carried out between February 2024 and March 2024. Twenty-four dental implants were divided into four groups (six implants each) according to their thread depths (Group A: 4 mm, Group B: 4.5 mm, Group C: 5 mm, Group D: 5.5 mm) and were inserted in D3-type artificial bone blocks. The main outcome variables were the IT and the Implant Stability Quotient (ISQ) measured in four different areas of the implant (buccal, lingual, mesial, and distal) with an Osstel^® ISQ reader. Descriptive and inferential analyses of the data were performed, and the significance value was set at 5%. Results: A total of 24 implants were analyzed. The highest IT values were obtained in Group D, with a mean of 54.03 Ncm (standard deviation (SD) = 8.99), while the lowest measurements were observed in Group A (mean = 25.12; SD: 2.96 N.cm). The mean ISQ values were consistently higher in Group D for each analyzed area, with a mean of 70.13 N.cm (SD = 1.12). Conclusions: Taking into consideration the limitations of this in vitro study, greater thread depths seem to increase the primary stability of dental implants placed in soft bone. Furthermore, a positive correlation was observed between all IT and ISQ values, regardless of the thread depth. Full article

Background/Objectives: The insertion of dental implants using dynamic 3D navigated surgery while applying immediate function protocols for full-arch rehabilitations warrants further research. This study aimed to evaluate the outcomes of All-on-4^® rehabilitations using 3D Dynamic navigated surgery (X-Guide™). Methods: This study included 10 patients (women: 7; men: 3; average age: 59.9 years) rehabilitated with full-arch prostheses through the All-on-4^® concept, with 48 dental implants inserted using navigated surgery. The primary outcome evaluation was prosthetic/implant cumulative survival (CS), estimated using life tables. Secondary outcome evaluations were marginal bone resorption (MBR), biological complications, and mechanical complications. The evaluation parameters were measured between 1 and 3 years. Results: No patients were lost to follow-up. Two implants (4.2%) were lost in one patient (10%) with smoking habits, resulting in an implant CS rate of 95.8%. The average MBR was 0.51 mm ± 0.62 mm at the 1-year follow-up. The incidence rate of mechanical complications was 40% (n = 4 patients), all occurring in provisional prosthesis. No biological complications were registered. The patients maintained their prostheses in function throughout the follow-up of the study. Conclusions: Within the limitations of this study and based on the results, it can be concluded that the insertion of dental implants assisted by dynamic navigation for full-arch rehabilitation through the All-on-4^® concept may be a valid treatment alternative in the short-term follow-up. However, more studies are necessary to validate this treatment modality. Full article

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