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Clinical Oral Implants Research Sep 2019Implantoplasty, that is, the mechanical modification of the implant, including thread removal and surface smoothening, has been proposed during surgical peri-implantitis... (Review)
Review
OBJECTIVES
Implantoplasty, that is, the mechanical modification of the implant, including thread removal and surface smoothening, has been proposed during surgical peri-implantitis treatment. Currently, there is no information about any potential mechanical and/or biological complications after this approach. The aim of the current review was to systematically assess the literature to answer the focused question "Are there any mechanical and/or biological complications due to implantoplasty?".
MATERIALS AND METHODS
A systematic literature search was performed in three databases until 23/09/2018 to assess potential mechanical and/or biological complications after implantoplasty. All laboratory, preclinical in vivo, and clinical studies involving implantoplasty were included, and any complication potentially related to implantoplasty was recorded and summarized.
RESULTS
Out of 386 titles, 26 publications were included in the present review (six laboratory, two preclinical in vivo, and 18 clinical studies). Laboratory studies have shown that implantoplasty does not result in temperature increase, provided proper cooling is used, but leads in reduced implant strength in "standard" dimension implants; further, preclinical studies have shown titanium particle deposition in the surrounding tissues. Nevertheless, no clinical study has reported any remarkable complication due to implantoplasty; among 217-291 implants subjected to implantoplasty, no implant fracture was reported during a follow-up of 3-126 months, while only a single case of mucosal discoloration, likely due to titanium particle deposition, has been reported.
CONCLUSIONS
Based on all currently available, yet limited, preclinical in vivo and clinical evidence, implantoplasty seems not associated with any remarkable mechanical or biological complications on the short- to medium-term.
Topics: Dental Implants; Humans; Peri-Implantitis; Surface Properties; Titanium
PubMed: 31254417
DOI: 10.1111/clr.13499 -
The British Journal of Oral &... Dec 2022Computerised surgical planning (CSP) and computer-aided design and manufacturing (CAD/CAM) have been demonstrated to increase surgical accuracy and reduce operative time... (Meta-Analysis)
Meta-Analysis Review
Computerised surgical planning (CSP) and computer-aided design and manufacturing (CAD/CAM) have been demonstrated to increase surgical accuracy and reduce operative time in free flap mandibular reconstruction, but evidence is lacking as to their impact on patient-centred outcomes. Implant-supported dental prostheses, however, have been associated with improved quality of life outcomes following free flap mandibular reconstruction. We aim to review reported patient-centred outcomes in mandibular reconstruction with CSP and CAD/CAM and determine whether use of these technologies is associated with higher rates of dental implant placement following free flap mandibular reconstruction. On December 20, 2020, a systematic review and meta-analysis were conducted according to PRISMA guidelines for studies reporting quality of life, functional outcomes, and rates of dental implant placement in computer-aided free flap mandibular reconstruction. A random-effects meta-analysis was performed to compare dental implant placement rates between surgeries using CSP and those using conventional freehand techniques. A total of 767 articles were screened. Nine articles reporting patient-centred outcomes and 16 articles reporting dental implant outcomes were reviewed. Of those reporting dental implant outcomes, five articles, representing a total of 302 cases, were included in the meta-analysis. Use of CSP was associated with a significant increase in the likelihood of dental implant placement, with an odds ratio of 2.70 (95% CI 1.52 to 4.79, p = 0.0007). Standardised reporting methods and controlled studies are needed to further investigate the impact of CSP and CAD/CAM technologies on functional outcomes and patient-reported quality of life in free flap mandibular reconstruction. Use of CSP and CAD/CAM technologies is associated with higher rates of dental implant placement in patients undergoing free flap mandibular reconstruction when compared to conventional freehand techniques.
Topics: Humans; Dental Implants; Mandibular Reconstruction; Free Tissue Flaps; Quality of Life; Fibula; Computer-Aided Design
PubMed: 36280538
DOI: 10.1016/j.bjoms.2022.09.006 -
Journal of Long-term Effects of Medical... 2020In the present scenario, dental implants have proven to be a very reliable and popular treatment option for partial and completely edentulous arches. The biological,...
In the present scenario, dental implants have proven to be a very reliable and popular treatment option for partial and completely edentulous arches. The biological, chemical, local, clinician, and implant related factors determine sequence of bone turnover that eventually enhances the success of implant therapy. The positioning of implant is followed by an inflammatory process that results in de novo bone formation and deposition on the implant surface. Pure titanium is commercially the prime material of choice for an implant. The implant surface can be chemically altered by a change in manufacturing, finishing, thermal treatment, blasting etching, coatings, and even sterilization procedures. These techniques have led to major innovations in implant dentistry as they roughen the surface, promoting bone deposition and stability. The current paper gives a comprehensive review of the diverse topographical characteristics of an implant surface and the altered techniques offered to create appropriate roughness to enhance osseointegration starting from fundamental to the latest techniques.
Topics: Bone Remodeling; Dental Implants; Humans; Osseointegration; Prostheses and Implants; Surface Properties; Titanium
PubMed: 33463929
DOI: 10.1615/JLongTermEffMedImplants.2020036820 -
Oral and Maxillofacial Surgery Jun 2024Critically evaluate the existing literature and answer the question, "Does the dental implant/mini-implant design influence the stress distribution in prosthetic... (Review)
Review
PURPOSE
Critically evaluate the existing literature and answer the question, "Does the dental implant/mini-implant design influence the stress distribution in prosthetic overdentures according to finite element analysis?".
METHODS
This systematic review was registered in the Open Science Framework (osf.io/2bquj) and followed the PRISMA protocols. The custom search strategy was applied to 4 databases. In vitro experimental studies that evaluated the influence of dental implant/mini-implant design on stress distribution in overdentures by FEM, without time and language restrictions, were included. The selection process was carried out in two stages by two reviewers independently. Risk of bias analysis was performed by a checklist of important parameters.
RESULTS
Sixty articles were evaluated by their title and abstract, four were selected for full reading, three were relevant, and nine were included by additional search. The 12 studies have a low risk of bias. The meta-analysis could not be performed due to the heterogeneity of the data (implant type, design variation, load intensity, and direction).
CONCLUSION
It can be inferred from the evaluated literature that design modifications influence the stress distribution, but as the FEM presents limitations inherent to the in vitro study, clinical trials are necessary to infer the effectiveness of the modifications. It should be noted that there is no consensus on which is the best thread design and that implants with a very narrow diameter are subject to the highest stress concentration.
Topics: Denture, Overlay; Humans; Dental Implants; Finite Element Analysis; Dental Prosthesis, Implant-Supported; Dental Stress Analysis; Dental Prosthesis Design; Stress, Mechanical
PubMed: 37665393
DOI: 10.1007/s10006-023-01177-z -
Clinical Oral Investigations Dec 2023To assess the clinical outcomes of zirconia dental implants based on an updated systematic literature review. (Meta-Analysis)
Meta-Analysis Review
PURPOSE
To assess the clinical outcomes of zirconia dental implants based on an updated systematic literature review.
METHODS
An electronic search was performed in three databases, last updated in June 2023, supplemented by hand searching. The eligibility criteria were clinical studies reporting patients rehabilitated with zirconia implants. The cumulative survival rate (CSR) of implants was calculated. A meta-analysis for marginal bone loss (MBL) under different follow-up times and a meta-regression assessing the relationship between mean MBL and follow-up were done.
RESULTS
Twenty-five studies were included (4017 implants, 2083 patients). Seven studies had follow-up longer than 60 months. 172 implants failed, after a mean of 12.0 ± 16.1 months (min-max 0.3-86.0), of which 47 early failures, and 26 due to implant fracture, the majority in narrow-diameter implants. The 10-year CSR was 95.1%. Implants with coronal part prepared by drills presented statistically significant lower survival than non-prepared implants (p < 0.001). Two-piece implants presented lower survival than one-piece implants (p = 0.017). Implants discontinued from the market presented lower survival than the commercially available ones (p < 0.001). The difference in survival was not significant between implants in maxilla and mandible (p = 0.637). The mean MBL fluctuated between 0.632 and 2.060 mm over long periods of observation (up until 132 months). There was an estimated MBL increase of 0.005 mm per additional month of follow-up.
CONCLUSION
Zirconia implants present high 10-year CSR and short-term low MBL. The review was registered in PROSPERO (CRD42022342055).
CLINICAL RELEVANCE
The clinical outcomes observed for zirconia dental implants are very promising, although these have not yet been extensively studied as titanium alloy implants.
Topics: Humans; Dental Implants; Treatment Outcome; Dental Restoration Failure; Zirconium; Titanium; Dental Prosthesis Design
PubMed: 38135804
DOI: 10.1007/s00784-023-05401-8 -
Clinical Oral Implants Research Jun 2024To systematically analyze the accuracy of robotic surgery for dental implant placement. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To systematically analyze the accuracy of robotic surgery for dental implant placement.
MATERIALS AND METHODS
PubMed, Embase, and Cochrane CENTRAL were searched on October 25, 2023. Model studies or clinical studies reporting the accuracy of robotic surgery for dental implant placement among patients with missing or hopeless teeth were included. Risks of bias in clinical studies were assessed. Meta-analyses were undertaken.
RESULTS
Data from 8 clinical studies reporting on 109 patients and 242 implants and 13 preclinical studies were included. Positional accuracy was measured by comparing the implant plan in presurgery CBCT and the actual implant position in postsurgery CBCT. For clinical studies, the pooled (95% confidence interval) platform deviation, apex deviation, and angular deviation were 0.68 (0.57, 0.79) mm, 0.67 (0.58, 0.75) mm, and 1.69 (1.25, 2.12)°, respectively. There was no statistically significant difference between the accuracy of implants placed in partially or fully edentulous patients. For model studies, the pooled platform deviation, apex deviation, and angular deviation were 0.72 (0.58, 0.86) mm, 0.90 (0.74, 1.06) mm, and 1.46 (1.22, 1.70)°, respectively. No adverse event was reported.
CONCLUSION
Within the limitation of the present systematic review, robotic surgery for dental implant placement showed suitable implant positional accuracy and had no reported obvious harm. Both robotic systems and clinical studies on robotic surgery for dental implant placement should be further developed.
Topics: Humans; Robotic Surgical Procedures; Dental Implantation, Endosseous; Dental Implants; Cone-Beam Computed Tomography
PubMed: 38517053
DOI: 10.1111/clr.14255 -
Journal of Clinical Periodontology May 2023To evaluate outcome measures, methods of assessment, and analysis in clinical studies on the prevention and management of peri-implant mucositis and peri-implantitis. (Review)
Review
OBJECTIVES
To evaluate outcome measures, methods of assessment, and analysis in clinical studies on the prevention and management of peri-implant mucositis and peri-implantitis.
METHODS
Systematic electronic searches (CENTRAL/MEDLINE/SCOPUS) up to April 2021 were conducted to identify longitudinal clinical studies with ≥10 patients on either the prevention or management of peri-implant diseases. Outcome measures of this analysis were the choice of outcome measures, methods of assessment, and analytical methods. Risk of bias was evaluated according to study design. Data were extracted into evidence tables and outcomes were analysed in a descriptive manner.
RESULTS
The analysis of the 159 selected studies revealed that probing pocket depth (PPD) and bleeding/suppuration on probing (BOP) were reported in 89% and 87% of all studies, respectively. Additional outcome measures included plaque scores (reported in 64% of studies), radiographic outcomes (49%), soft tissue dimensions (34%), and composite outcomes (26%). Adverse events (8%) and patient-reported outcomes (6%) were only rarely mentioned. A primary outcome measure was clearly defined only in 36% of studies. Data on PPD, radiographic outcomes, and soft tissue dimensions were primarily reported as mean values and rarely as frequency distributions. For radiographic outcomes and soft tissue dimensions, it was frequently unclear how clustered data were handled.
CONCLUSIONS
PPD and BOP were routinely reported in studies on the prevention and management of peri-implant mucositis and peri-implantitis, while composite outcomes, adverse events, and patient-reported outcomes were only infrequently described.
Topics: Humans; Peri-Implantitis; Stomatitis; Mucositis; Dental Implants; Outcome Assessment, Health Care
PubMed: 35246865
DOI: 10.1111/jcpe.13608 -
Clinical Oral Implants Research May 2023To evaluate outcome measures, methods of assessment, and analysis in clinical studies on the prevention and management of peri-implant mucositis and peri-implantitis. (Review)
Review
OBJECTIVES
To evaluate outcome measures, methods of assessment, and analysis in clinical studies on the prevention and management of peri-implant mucositis and peri-implantitis.
METHODS
Systematic electronic searches (CENTRAL/MEDLINE/SCOPUS) up to April 2021 were conducted to identify longitudinal clinical studies with ≥10 patients on either the prevention or management of peri-implant diseases. Outcome measures of this analysis were the choice of outcome measures, methods of assessment, and analytical methods. Risk of bias was evaluated according to study design. Data were extracted into evidence tables and outcomes were analysed in a descriptive manner.
RESULTS
The analysis of the 159 selected studies revealed that probing pocket depth (PPD) and bleeding/suppuration on probing (BOP) were reported in 89% and 87% of all studies, respectively. Additional outcome measures included plaque scores (reported in 64% of studies), radiographic outcomes (49%), soft tissue dimensions (34%), and composite outcomes (26%). Adverse events (8%) and patient-reported outcomes (6%) were only rarely mentioned. A primary outcome measure was clearly defined only in 36% of studies. Data on PPD, radiographic outcomes, and soft tissue dimensions were primarily reported as mean values and rarely as frequency distributions. For radiographic outcomes and soft tissue dimensions, it was frequently unclear how clustered data were handled.
CONCLUSIONS
PPD and BOP were routinely reported in studies on the prevention and management of peri-implant mucositis and peri-implantitis, while composite outcomes, adverse events, and patient-reported outcomes were only infrequently described.
Topics: Humans; Peri-Implantitis; Stomatitis; Mucositis; Dental Implants; Outcome Assessment, Health Care
PubMed: 35343614
DOI: 10.1111/clr.13925 -
Clinical Oral Implants Research Jun 2022The use of intraoral scanners (IOSs) for digital implant impressions in daily clinical practice is increasing. However, no structured literature review on the accuracy... (Review)
Review
OBJECTIVES
The use of intraoral scanners (IOSs) for digital implant impressions in daily clinical practice is increasing. However, no structured literature review on the accuracy of digital implant impressions in clinical studies has been described to date. Therefore, this systematic review aimed to answer the PICO question: Which accuracy is described for digital implant impressions in clinical studies?
MATERIAL AND METHODS
An electronic database search was conducted in December 2021 using MeSH terms and free-text search. English-language studies addressing the accuracy of digital implant impressions in clinical studies involving at least 10 patients were included. All clinical indications were considered.
RESULTS
Eight publications between 2014 and 2021 matched the review criteria. However, the study designs showed considerable differences. The number of implants within the studies ranged from 1 to 6, and the number of patients ranged from 10 to 39. The oldest study (2014) revealed the highest deviation for linear distances at 1000 ± 650 µm, whereas the other studies reported data in the range of 360 ± 46 µm to 40 ± 20 µm. In one study, no numerical data were reported and all studies compared digital and conventional implant impressions.
CONCLUSIONS
The number of clinical studies on the accuracy of digital implant impressions is low. Thus, the impact of different factors, such as the scanpath or scanbody, could not be identified. However, the accuracy of recent IOSs for digital implant impressions in patients was shown to be clinically acceptable. Nevertheless, the transfer error still needs to be considered when fabricating implant-supported restorations.
Topics: Computer-Aided Design; Databases, Factual; Dental Implants; Dental Impression Technique; Humans; Imaging, Three-Dimensional; Models, Dental
PubMed: 35527511
DOI: 10.1111/clr.13951 -
Clinical Oral Investigations Oct 2022To assess the clinical performance of tooth implant-supported removable partial dentures in terms of abutment survival in relation to the attachment system used. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To assess the clinical performance of tooth implant-supported removable partial dentures in terms of abutment survival in relation to the attachment system used.
METHODS
An electronic search in MEDLINE/PubMed Web of Science and Cochrane Central Register of Controlled Trials databases was performed. The methodological quality of the studies was assessed using the Newcastle-Ottawa Scale. Survival rates after 3 years and 5 years, loss, and complication rates per 100 years were estimated by Poisson regression.
RESULTS
A total of twelve studies were included; eleven studies were used for the meta-analysis. Survival analysis for mixed attachments showed an estimated survival rate of 100% after 3 years and 5 years. For uniform attachments, the estimated survival rate was 99.3% after 3 years and 98.8% after 5 years. Tooth abutment survival analysis for mixed attachments estimated a survival rate of 95% after 3 years and 91.7% after 5 years: Uniform attachments reached a survival rate of 97.2% after 3 years and 95.4% after 5 years. The prosthetic survival rate was 100% for mixed and uniform abutments after 3 years and 5 years of function.
CONCLUSIONS
Tooth implant-supported removable partial dentures can be considered as a reliable option with excellent prosthetic and implant survival rates and favorable rates for the abutments after 3-year and 5-year follow-ups. Complications may be reduced when 5 or more abutments are used.
CLINICAL RELEVANCE
Tooth implant-supported removable partial dentures are a favorable and potential alternative to restore a partially edentulous arch by optimizing the number and distribution of abutments.
Topics: Dental Abutments; Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Partial, Removable; Humans; Mouth, Edentulous
PubMed: 35840738
DOI: 10.1007/s00784-022-04622-7