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Journal of Periodontology Jun 2023In this commentary, a practical system for estimating the prognosis for dental implants is presented. Evidence for factors influencing implant prognosis is reviewed. The... (Review)
Review
In this commentary, a practical system for estimating the prognosis for dental implants is presented. Evidence for factors influencing implant prognosis is reviewed. The system is based on the stability of implant supporting tissues as opposed to implant loss.
Topics: Humans; Dental Implants; Prognosis
PubMed: 36740787
DOI: 10.1002/JPER.22-0196 -
Journal of Esthetic and Restorative... Jan 2021To provide a contemporary and comprehensive overview of the hard and soft tissue biological structures surrounding an osseointegrated dental implant (peri-implant... (Review)
Review
OBJECTIVE
To provide a contemporary and comprehensive overview of the hard and soft tissue biological structures surrounding an osseointegrated dental implant (peri-implant referred to as the peri-implant phenotype), in the context of peri-implant esthetic complications.
OVERVIEW
The individual components of the peri-implant phenotype (keratinized mucosa width, mucosal thickness, supracrestal tissue height, and the peri-implant buccal bone) have been linked to different aspects of implant esthetics, as well as health-related aspects. At the time of implant therapy, respecting the biology of the peri-implant hard and soft tissues, and anticipating their remodeling patterns can alleviate future esthetic complications.
CONCLUSIONS
While the current literature may not allow for a point-by-point evidence based-recommendation for the required amount of each peri-implant structure, bearing in mind the proposed values for the components of the peri-implant phenotype, at the time of and prior to implant therapy can lead to more predictable treatment outcomes, and the avoidance of esthetic complications.
CLINICAL SIGNIFICANCE
Knowledge of hard and soft tissue components surrounding and osseointegrated dental implant, and their underlying biological remodeling process is crucial for carrying out a successful therapy and alleviating possible future esthetic challenges.
Topics: Dental Implantation, Endosseous; Dental Implants; Dental Implants, Single-Tooth; Esthetics, Dental; Phenotype
PubMed: 33459483
DOI: 10.1111/jerd.12709 -
International Journal of Oral... Aug 2021To provide an up to date, contemporary and concise evidence-based review of peri-implant diseases and conditions and discuss the current therapeutic approaches to... (Review)
Review
PURPOSE
To provide an up to date, contemporary and concise evidence-based review of peri-implant diseases and conditions and discuss the current therapeutic approaches to managing these diseases.
MATERIALS AND METHODS
A literature review was conducted focusing on peri-implant health, peri-implant mucositis and peri-implantitis, as described according to the 2017 World Workshop on the Classification of Periodontal and Peri-implant Diseases and Conditions.
RESULTS AND CONCLUSIONS
Peri-implant health is described when there are no clinical signs of inflammation, and when no further bone loss after physiological remodelling or increase in probing depth can be observed. Peri-implant mucositis is a reversible inflammatory lesion that affects the soft tissues surrounding a dental implant in the absence of radiographic bone loss, whereas peri-implantitis is an irreversible pathological condition affecting the hard and soft tissues around an osseointegrated dental implant. Clinical diagnosis of peri-implant disease is in some ways similar to that of periodontitis, but their prevalence varies significantly due to many confounding variables. Different treatment modalities have been proposed and tested in the literature; as yet, however, no standard treatment protocol has been proven superior or completely effective. In future research, well-designed studies are required to assess treatment responses and evaluate additional approaches that may lead to improved outcomes.
Topics: Dental Implants; Dental Plaque; Humans; Peri-Implantitis; Prevalence; Stomatitis
PubMed: 34415128
DOI: No ID Found -
Dental Traumatology : Official... Dec 2019Teeth are vital sensory organs that contribute to our daily activities of living. Unfortunately, teeth can be lost for several reasons including trauma, caries, and... (Review)
Review
Teeth are vital sensory organs that contribute to our daily activities of living. Unfortunately, teeth can be lost for several reasons including trauma, caries, and periodontal disease. Although dental trauma injuries and caries are more frequently encountered in a younger population, tooth loss because of periodontal disease occurs in the older population. In the dental implant era, the trend sometimes seems to be to extract compromised teeth and replace them with dental implants. However, the long-term prognosis of teeth might not be comparable with the prognosis of dental implants. Complications, failures, and diseases such as peri-implantitis are not uncommon, and, despite popular belief, implants are not 99% successful. Other treatment options that aim to save compromised or diseased teeth such as endodontic treatment, periodontal treatment, intentional replantation, and autotransplantation should be considered on an individual basis. These treatments have competing success rates to dental implants but, more importantly, retain the natural tooth in the dentition for a longer period of time. These options are important to discuss in detail during treatment planning with patients in order to clarify any misconceptions about teeth and dental implants. In the event a tooth does have to be extracted, procedures such as decoronation and orthodontic extrusion might be useful to preserve hard and soft tissues for future dental implant placement. Regardless of the treatment modality, it is critical that strict maintenance and follow-up protocols are implemented and that treatment planning is ethically responsible and evidence based.
Topics: Dental Caries; Dental Implants; Humans; Tooth; Tooth Loss
PubMed: 31132200
DOI: 10.1111/edt.12492 -
Acta Odontologica Scandinavica Jan 2021The aim of this study was to explore the possible association between diabetes mellitus and dental implant complications. (Meta-Analysis)
Meta-Analysis
OBJECTIVES
The aim of this study was to explore the possible association between diabetes mellitus and dental implant complications.
MATERIAL AND METHODS
A systematic literature review was conducted to answer the following PICO (Participants, Intervention, Comparison, and Outcome) question: Is there association between diabetes mellitus and dental implant complications? Two independent searchers performed a literature search of the PubMed/MEDLINE, Web of Science, Cochrane Library and EMBASE databases for studies published until February 2020, focussing on studies including continuous outcomes, marginal bone loss (primary outcome), probing depth, and bleeding upon probing (secondary outcomes).
RESULTS AND CONCLUSIONS
A final total of 10 published studies were included in this systematic review. There were statistically significant differences between the groups with regard to marginal bone loss ( < .00001), probing depth ( < .00001) and bleeding around dental implants ( < .00001), and subjects without diabetes had lower complication rates. Additionally, in the subgroup analysis performed with loading time and HbA1c levels, a more evident association was found in immediate loading for probing depth. Moreover, the analysis results of bleeding around dental implants suggested that as HbA1c level increases, the bleeding of the tissues surrounding the implant will also increase. With regard to dental implant complications, there were statistically significant differences favouring patients without diabetes mellitus.
Topics: Alveolar Bone Loss; Dental Implantation, Endosseous; Dental Implants; Dental Restoration Failure; Diabetes Mellitus; Humans; Immediate Dental Implant Loading
PubMed: 32401121
DOI: 10.1080/00016357.2020.1761031 -
Journal of Prosthodontic Research Jan 2022Dental implant therapy is a common clinical treatment for missing teeth. However, the esthetic result is not as satisfactory as expected in some cases, especially in the...
PURPOSE
Dental implant therapy is a common clinical treatment for missing teeth. However, the esthetic result is not as satisfactory as expected in some cases, especially in the anterior maxillary area. Poor esthetic results are caused by inadequate preparation of the hard and soft tissues in this area before treatment. The socket shield technique may be an alternative for a desirable esthetic outcome in dental implant treatments.
STUDY SELECTION
In the present systematic review, PubMed-Medline, Google Scholar, and ScienceDirect were searched for clinical studies published from January 2000 to December 2018.
RESULTS
Twenty studies were included, comprising one randomized controlled trial, two cohort studies, 14 clinical human case reports, and three retrospective case series. In total, 288 patients treated with the socket shield technique with immediate implant placement and follow-up between 3-60 months after placement were included. A quality assessment showed that 12 of the 20 included studies were of good quality. Twenty-six of the 274 (9.5%) cases developed complications or adverse effects related to the socket shield technique. Most studies reported implant survival without the complications (90.5%); most of the cases that were followed up for more than 12 months after implant placement achieved a good esthetic appearance. The failure rate was low without the complications, although there were some failures due to failed implant osseointegration, socket shield mobility and infection, socket shield exposure, socket shield migration, and apical root resorption.
CONCLUSIONS
The socket shield technique can be used in dental implant treatment, but it remains difficult to predict the long-term success of this technique until high-quality evidence becomes available.
Topics: Dental Implantation, Endosseous; Dental Implants; Dental Implants, Single-Tooth; Esthetics, Dental; Humans; Immediate Dental Implant Loading; Retrospective Studies; Tooth Extraction; Tooth Socket; Treatment Outcome
PubMed: 33692284
DOI: 10.2186/jpr.JPR_D_20_00054 -
Hua Xi Kou Qiang Yi Xue Za Zhi = Huaxi... Feb 2017The development of clinical implant dentistry was intensively affected by dental implant design improvement and innovation, which brought about new concept, even...
The development of clinical implant dentistry was intensively affected by dental implant design improvement and innovation, which brought about new concept, even milestone-like changes of clinical protocol. The current improvements of dental implant design and their clinical importance could be highlighted as followings: 1) The implant apical design influences the implant preliminary stability in immediate implant. The apical 3-5 mm design of implant makes implant stable in immediate implant, because this part would be screwed into alveolar bone through fresh socket, the other part of implant could not be tightly screwed in the socket because of smaller implant diameter. Implant apical form, screw design, self-taping of apical part would be essential for immediate implant. 2) The enough preliminary stability of implant makes immediate prosthesis possible. When osseointegration does not occur, the implant stability comes from a mechanical anchorage, which depends on implant form, screw thread and self-taping design. 3) Implant neck design may have influence for soft tissue recession in esthetic zone. The implant with large shoulder would not be selected for the esthetic area. The platform design may be more favorable in the area. 4) The connection design between implant and abutment is thought a very important structure in implant long-term stability. Moose taper and "tube in tube" were well documented structure design in 20-year clinical practice in Peking University. 5) In last 15 years, the plenty studies showed the platform design of implant had positive influence in implant marginal bone level. Whatever in single implant restoration or multi-implant prosthesis. 6) The digital technology makes clinical work more precise and high-tech. This would be a trend in implant dentistry. New generation of chair-side digital computer-aided design/computer-aided manufacturing makes immediate prosthesis without conventional impression possible. 7) New abutment design have changed clinical protocol greatly. The All-on-four concept and Weldone concept benefit both from the abutment innovation, which were large angulated abutment and special welding abutment materials.
Topics: Computer-Aided Design; Dental Implants; Dental Prosthesis Design; Humans; Osseointegration
PubMed: 28326723
DOI: 10.7518/hxkq.2017.01.003 -
Journal of Dental Research Dec 2018Dental implants have become an increasingly popular treatment choice for replacing missing teeth. Yet, little is known about the prevalence and sociodemographic...
Dental implants have become an increasingly popular treatment choice for replacing missing teeth. Yet, little is known about the prevalence and sociodemographic distribution of dental implant use in the United States. To address this knowledge gap, we analyzed data from 7 National Health and Nutrition Examination Surveys from 1999 to 2016. We estimated dental implant prevalence among adults missing any teeth for each survey period overall as stratified by sociodemographic characteristics. We calculated absolute and relative differences from 1999-2000 to 2015-2016 and fit logistic regression models to estimate changes over time. We also used multivariable logistic regression to estimate independent associations of sociodemographic covariates with the presence of any implant. We projected the proportion of patients treated with dental implants into the year 2026 under varying assumptions of how the temporal trend would continue. There has been a large increase in the prevalence of dental implants, from 0.7% in 1999 to 2000 to 5.7% in 2015 to 2016. The largest absolute increase in prevalence (12.9%) was among individuals 65 to 74 y old, whereas the largest relative increase was ~1,000% among those 55 to 64 y old. There was an average covariate-adjusted increase in dental implant prevalence of 14% per year (95% CI, 11% to 18%). Having private insurance (vs. none or public insurance) or more than a high school education (vs. high school or less) was each associated with a 2-fold increase in prevalence, with an almost 13-fold (95% CI, 8 to21) increase for older adults. Dental implant prevalence projected to 2026 ranged from 5.7% in the most conservative scenario to 23% in the least. This study demonstrates that dental implant prevalence among US adults with missing teeth has substantially increased since 1999. Yet access overall is still very low, and prevalence was consistently higher among more advantaged groups.
Topics: Adult; Aged; Aged, 80 and over; Cross-Sectional Studies; Dental Implantation, Endosseous; Dental Implants; Female; History, 20th Century; History, 21st Century; Humans; Male; Middle Aged; Nutrition Surveys; Prevalence; Socioeconomic Factors; United States
PubMed: 30075090
DOI: 10.1177/0022034518792567 -
Journal of Clinical Periodontology Jan 2022To assess the microbial effects of mechanical debridement in conjunction with a mouthrinse on sites with peri-implant mucositis and gingivitis. (Randomized Controlled Trial)
Randomized Controlled Trial
AIM
To assess the microbial effects of mechanical debridement in conjunction with a mouthrinse on sites with peri-implant mucositis and gingivitis.
MATERIALS AND METHODS
Eighty-nine patients with peri-implant mucositis were included in a double-blinded, randomized, placebo-controlled trial with mechanical debridement and 1-month use of either delmopinol, chlorhexidine (CHX), or a placebo mouthrinse. Submucosal and subgingival plaque samples of implants and teeth were collected at baseline and after 1 and 3 months, processed for 16S V4 rRNA gene amplicon sequencing, and analysed bioinformatically.
RESULTS
The sites with peri-implant mucositis presented with a less diverse and less anaerobic microbiome. Exposure to delmopinol or CHX, but not to the placebo mouthrinse resulted in microbial changes after 1 month. The healthy sites around the teeth harboured a more diverse and more anaerobe-rich microbiome than the healthy sites around the implants.
CONCLUSIONS
Peri-implant sites with mucositis harbour ecologically less complex and less anaerobic biofilms with lower biomass than patient-matched dental sites with gingivitis while eliciting an equal inflammatory response. Adjunctive antimicrobial therapy in addition to mechanical debridement does affect both dental and peri-implant biofilm composition in the short term, resulting in a less dysbiotic subgingival biofilm.
Topics: Dental Implants; Dental Plaque; Humans; Microbiota; Mucositis; Peri-Implantitis
PubMed: 34664294
DOI: 10.1111/jcpe.13566 -
Journal of Clinical Periodontology Apr 2020The present systematic review and meta-analysis was performed to investigate if there was a significantly enhanced risk of dental implant failure due to the increased... (Meta-Analysis)
Meta-Analysis
AIM
The present systematic review and meta-analysis was performed to investigate if there was a significantly enhanced risk of dental implant failure due to the increased number of cigarettes smoked per day.
MATERIALS AND METHODS
Four databases, including PubMed, Embase, Web of Science and Scopus, were searched until January, 2019. The search terms "dental implant, oral implant, smoking, smoker, tobacco, nicotine and non-smoker" were used in combination to identify the publications providing data for dental implant failures related to the smoking habit. Publications were excluded if the quantity of cigarettes consumed per day was not reported. Fixed- or random-effects meta-analyses were used to pool the estimates of relative risk (RR) with 95% confidence intervals (CI).
RESULTS
Having additional information supplied by the authors, 23 articles were selected for final analysis. The meta-analyses based on implant- and patient-related data showed a significant increase in the RR of implant failure in patients who smoked >20 cigarettes per day compared with non-smokers (implant based: p = .001; RR: 2.45; CI: 1.42-4.22 and patient based: p < .001; RR: 4; CI: 2.72-5.89).
CONCLUSION
The risk of implant failure was elevated with an increase in the number of cigarettes smoked per day.
Topics: Dental Implants; Dental Restoration Failure; Humans; Smokers; Smoking
PubMed: 31955453
DOI: 10.1111/jcpe.13257