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Clinical Implant Dentistry and Related... Jun 2022To assess the effect of grafting the gap (SG) between the implant surface and alveolar socket on hard and soft tissue changes following single immediate implant... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To assess the effect of grafting the gap (SG) between the implant surface and alveolar socket on hard and soft tissue changes following single immediate implant placement (IIP).
MATERIALS AND METHODS
Two independent reviewers conducted an electronic literature search in Pubmed, Web of Science, Embase and Cochrane databases as well as a manual search to identify eligible clinical studies up to August 2021. Randomized controlled trials (RCTs) comparing IIP with and without SG were included for a qualitative analysis. Meta-analyses were performed when possible.
RESULTS
Out of 3627 records, 15 RCTs were selected and reported on 577 patients who received 604 single immediate implants (IIP + SG: 298 implants in 292 patients; IIP: 306 implants in 285 patients) with a mean follow-up ranging from 4 to 36 months. Two RCTs showed low risk of bias. Meta-analysis revealed 0.59 mm (95% CI [0.41; 0.78], p < 0.001) or 54% less horizontal buccal bone resorption following IIP + SG when compared to IIP alone. In addition, 0.58 mm (95% CI [0.28; 0.88], p < 0.001) less apical migration of the midfacial soft tissue level was found when immediate implants were installed with SG. A trend towards less distal papillary recession was found (MD 0.60 mm, 95% CI [-0.08; 1.28], p = 0.080) when SG was performed, while mesial papillae appeared not significantly affected by SG. Vertical buccal bone changes were also not significantly affected by SG. Insufficient data were available for meta-analyses on horizontal midfacial soft tissue changes, pink esthetic score, marginal bone level changes, probing depth and bleeding on probing. Based on GRADE guidelines, a moderate recommendation for SG following IIP can be made.
CONCLUSION
SG may contribute to horizontal bone preservation and soft tissue stability at the midfacial aspect of immediate implants. Therefore, SG should be considered as an adjunct to IIP in clinical practice.
Topics: Dental Implantation, Endosseous; Dental Implants; Dental Implants, Single-Tooth; Esthetics, Dental; Humans; Immediate Dental Implant Loading; Tooth Socket
PubMed: 35313067
DOI: 10.1111/cid.13079 -
BMC Oral Health Jul 2022Implantology represents the gold standard for oral rehabilitation, unfortunately, often, despite there are no local contraindications to this type of rehabilitation,...
OBJECTIVE
Implantology represents the gold standard for oral rehabilitation, unfortunately, often, despite there are no local contraindications to this type of rehabilitation, there are uncertainties regarding the general health of our patients. Many patients nowadays take bisphosphonate drugs, often without first seeking advice from an oral surgeon or a dentist. The purpose of this review is precisely to highlight any contraindications to this type of treatment reported in the literature, in patients who take or have taken bisphosphonate drugs.
METHODS
For this study the scientific information sources were consulted using as search terms "("bisphosphonate AND "dental implant")", obtaining 312 results, these were subsequently skimmed according to the inclusion and exclusion criteria, and further evaluated their relevance to the study and the presence of requested outcomes.
RESULTS
Only 9 manuscripts (RCTs, Multicentric studies and Clinical Trials) were included in this review, as they respected the parameters of this review, they were analyzed and it was possible to draw important results from them. Surely from this study it is understood that the use of bisphosphonate drugs does not represent an absolute contraindication to implant therapy, it is evident how adequate pharmacological prophylaxis, and an adequate protocol reduce the risks regarding implant failures. Furthermore, the values of marginal bone loss over time seem, even if not statistically significant, to be better in implant rehabilitation with bisphosphonate drugs association. Only a few molecules like risedronate, or corticosteroids, or some conditions like smoking or diabetes have shown a high risk of surgical failure.
CONCLUSION
Although this study considered different studies for a total of 378 patients and at least 1687 different dental implants, showing better results in some cases for dental implant therapy in cases of bisphosphonate intake, further clinical, randomized and multicentric studies are needed, with longer follow-ups, to fully clarify this situation which often negatively affects the quality of life of our patients and places clinicians in the face of doubts.
Topics: Dental Implantation, Endosseous; Dental Implants; Dental Restoration Failure; Diphosphonates; Humans; Quality of Life
PubMed: 35843929
DOI: 10.1186/s12903-022-02330-y -
Journal of Esthetic and Restorative... Nov 2019The unavoidable extraction of teeth in the esthetic area can be overcome through different treatment modalities. Recently, immediate implants appeared as a minimally...
OBJECTIVE
The unavoidable extraction of teeth in the esthetic area can be overcome through different treatment modalities. Recently, immediate implants appeared as a minimally invasive approach to resolving these cases; however, immediate implant loading is not always possible or indicated. In these cases, an innovative approach through customized healing abutments could be used to preserve the soft tissue contour, eliminating the need for reopening surgery and the use of provisional restorations to condition the mucosal contour.
CLINICAL CONSIDERATIONS
The present cases describe a simplified chairside approach to use customized healing abutments for immediate implants placed after tooth extraction in the anterior and posterior areas in order to maintain the soft tissue contours while reducing the clinical steps until delivering the final restorations.
CONCLUSIONS
This technique seems to be effective to guide the soft tissue healing around dental implants allowing a natural emergence profile with implant-supported restorations, reducing the number of treatment steps.
CLINICAL SIGNIFICANCE
The use of customized healing abutments prepares soft tissue for the prosthetic stage preserving its contours and eliminating the need for reopening surgery.
Topics: Dental Abutments; Dental Implantation, Endosseous; Dental Implants; Dental Implants, Single-Tooth; Dental Prosthesis, Implant-Supported; Humans; Immediate Dental Implant Loading; Tooth Extraction
PubMed: 31268244
DOI: 10.1111/jerd.12512 -
Dental Clinics of North America Jan 2021In the past, the only way to replace missing teeth was to have a removable appliance. However, these days, dental implants are commonly being used to replace missing... (Review)
Review
In the past, the only way to replace missing teeth was to have a removable appliance. However, these days, dental implants are commonly being used to replace missing teeth. The dental implants are improving as a result of new technological and scientific advances. Different materials have been used in the past for dental implants such as lead, stainless steel, and gold. Currently, the focus is on using Roxolid, surface-modified titanium implants, and zirconia. These materials have superior esthetic and functional characteristics for dental implants.
Topics: Dental Implants; Dental Materials; Esthetics, Dental; Humans; Materials Science; Titanium; Zirconium
PubMed: 33213717
DOI: 10.1016/j.cden.2020.09.006 -
Clinical Oral Implants Research Jun 2022To assess the impact of implant placement and temporization timing on esthetic outcomes of single maxillary anterior implants with intact bone walls and interproximal... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
To assess the impact of implant placement and temporization timing on esthetic outcomes of single maxillary anterior implants with intact bone walls and interproximal bone.
MATERIALS AND METHODS
Test group patients received an immediate implant with immediate provisional restoration and socket preservation, while patients in the control group received an early implant placement with guided bone regeneration and delayed loading. Patients were followed for 1 year after final prosthetic and pink esthetic score (PES), mid-buccal mucosal level (MBML), crestal bone changes (CBC), and peri-implant soft tissue parameters, and patient chair time was recorded.
RESULTS
Fifty patients received the intended treatment (25 test and 25 control). No implants failed. PES after 1 year was 12.8 ± 1.19 for the test group and 12.5 ± 1.36 for the control group (p = .362). MBML difference between baseline (after final crown delivery) and the 1-year follow-up was gain of 0.2 ± 1.02 mm for the test group (p = .047) and no change in the control group. CBC after 1 year were 0.1 mm ± 0.21 mm (mesial) and 0.2 mm ± 0.22 mm (distal) for the test group and 0.2 mm ± 0.25 mm (mesial) and 0.3 mm ± 0.19 mm (distal) for the control group, p = .540 (mesial) and p = .462 (distal). Test group required half the chair time (127 ± 13 min) when compared to the control group (259 ± 15 min, p < .001).
CONCLUSIONS
Within the limits of this trial, both treatment protocols resulted in excellent esthetic outcomes with PES >12 after 1-year follow-up.
Topics: Dental Implants; Dental Implants, Single-Tooth; Esthetics, Dental; Humans; Immediate Dental Implant Loading; Maxilla; Treatment Outcome
PubMed: 35318752
DOI: 10.1111/clr.13924 -
Journal of Clinical Periodontology Feb 2021To assess the effect of connective tissue graft (CTG) in terms of vertical mid-facial soft tissue change when applied at the buccal aspect following single immediate... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To assess the effect of connective tissue graft (CTG) in terms of vertical mid-facial soft tissue change when applied at the buccal aspect following single immediate implant placement (IIP).
MATERIALS AND METHODS
Two independent reviewers conducted an electronic literature search in PubMed, Web of Science, EMBASE and Cochrane databases as well as a manual search to identify eligible clinical studies up to January 2020. Randomized controlled trials (RCTs) and non-randomized controlled studies (NRSs) comparing IIP with CTG and without CTG over a mean follow-up of at least 12 months were included for a qualitative analysis. Meta-analyses were performed on data provided by RCTs.
RESULTS
Out of 1814 records, 5 RCTs and 3 NRSs reported on 409 (IIP + CTG: 246, IIP: 163) immediately installed implants with a mean follow-up ranging from 12 to 108 months. Only 1 RCT showed low risk of bias. Meta-analysis revealed a significant difference in terms of vertical mid-facial soft tissue change between IIP + CTG and IIP pointing to 0.41 mm (95% CI [0.21; 0.61], p < .001) in favour of soft tissue grafting. This outcome was clinically relevant since the risk for ≥1 mm asymmetry in mid-facial vertical soft tissue level was 12 times (RR 12.10, 95% CI [2.57; 56.91], p = .002) lower following IIP + CTG. Soft tissue grafting also resulted in a trend towards less bleeding on probing (MD 17%, 95% CI [-35%; 1%], p = .06). Meta-analyses did not reveal significant differences in terms of pink aesthetic score, marginal bone level change and probing depth. Results were inconclusive for horizontal mid-facial soft tissue change and papilla height change. Based on GRADE guidelines, a moderate recommendation for the use of a CTG following IIP can be made.
CONCLUSION
CTG contributes to mid-facial soft tissue stability following IIP. Therefore, CTG should be considered when elevated risk for mid-facial recession is expected in the aesthetic zone (thin gingival biotype, <0.5 mm buccal bone thickness).
Topics: Connective Tissue; Dental Implantation, Endosseous; Dental Implants; Dental Implants, Single-Tooth; Esthetics, Dental; Immediate Dental Implant Loading; Treatment Outcome
PubMed: 33125754
DOI: 10.1111/jcpe.13397 -
Journal of Clinical Periodontology Sep 2019This randomized controlled clinical trial (RCT) aimed to compare the accuracy of implant positions between static computer-assisted implant surgery (CAIS) and freehand... (Randomized Controlled Trial)
Randomized Controlled Trial
AIM
This randomized controlled clinical trial (RCT) aimed to compare the accuracy of implant positions between static computer-assisted implant surgery (CAIS) and freehand implant surgery in a single edentulous space.
MATERIALS AND METHODS
Sites with single edentulous spaces and neighbouring natural teeth were randomized into static CAIS or freehand implant surgery groups. In both groups, digital implant planning was performed using data from cone beam computed tomography (CBCT) and surface scans. In the static CAIS group, a surgical guide was produced and used for fully guided implant surgery, while in the freehand group, the implants were placed in a freehand manner. Postoperative CBCT was used for nine measurements representing the deviations in angles, implant shoulders and apexes between planned and actual implant positions.
RESULTS
Fifty-two patients received 60 single implants. The median (IQR) deviations in angles, shoulders and apexes were 2.8 (2.6)°, 0.9 (0.8) mm and 1.2 (0.9) mm, respectively, in the static CAIS group, and 7.0 (7.0)°, 1.3 (0.7) mm and 2.2 (1.2) mm, respectively, in the freehand group. Statistically significant differences were found in 6 out of nine measured parameters using Mann-Whitney U test (p < 0.05).
CONCLUSION
Static CAIS provided more accuracy in implant positions than freehand placement in a single edentulous space.
Topics: Computer-Aided Design; Cone-Beam Computed Tomography; Dental Implantation, Endosseous; Dental Implants; Dental Implants, Single-Tooth; Humans; Imaging, Three-Dimensional; Mouth, Edentulous; Patient Care Planning; Surgery, Computer-Assisted
PubMed: 31241782
DOI: 10.1111/jcpe.13160 -
Clinical Implant Dentistry and Related... Aug 2023As more patients choose dental implants as their primary treatment option to restore edentulous ridges or to replace compromised dentition, preventive strategies for... (Review)
Review
BACKGROUND
As more patients choose dental implants as their primary treatment option to restore edentulous ridges or to replace compromised dentition, preventive strategies for peri-implant diseases and complications have become an important topic.
PURPOSE
The aim of the review article is to summarize the current available evidence on the potential risk factors/indicators for peri-implant disease development and then focus on the preventive strategies for peri-implant diseases and conditions.
MATERIALS AND METHODS
After reviewing the diagnostic criteria and the etiology of peri-implant diseases and conditions, evidence on the possible associated risk factors/indicators for peri-implant diseases were searched and identified. Recent studies were also surveyed to explore the preventive measures for peri-implant diseases.
RESULTS
The possible associated risk factors of peri-implant diseases can be divided into the following categories: patient-specific factors, implant-specific factors, and long-term factors. Patient-specific factors such as history of periodontitis and smoking have been conclusively associated with peri-implant diseases, whereas findings on others, such as diabetes and genetic factors, remain inconclusive. It has been suggested that both implant-specific factors, such as implant position, soft tissue characteristics, and the type of connection used, and long-term factors, such as poor plaque control and a lack of maintenance program, have a strong impact on maintaining the health of a dental implant. Assessment tool for evaluating the risk factors can be a potential preventive measure for peri-implant disease prediction, and it is needed to be properly validated.
CONCLUSION
Proper maintenance program for early intervention to control peri-implant diseases at the initial stage and pretreatment assessment of the potential risk factors is the best strategy to prevent implant diseases.
Topics: Humans; Peri-Implantitis; Dental Implants; Risk Factors; Smoking; Periodontitis
PubMed: 37042296
DOI: 10.1111/cid.13206 -
The Journal of Oral Implantology Oct 2021Mini dental implants can be used to support crowns and partial and complete dentures in compromised edentulous sites. Lack of bone width or site length may be treated... (Review)
Review
Mini dental implants can be used to support crowns and partial and complete dentures in compromised edentulous sites. Lack of bone width or site length may be treated with mini implants. Mini implants have less percutaneous exposure and displacement that may reduce complications. Nonetheless, mini implants transmit about twice the load to the supporting bone, and thus, control of occlusal loading is important. In fixed prosthetics, rounded flat cusps, splinting, implant protective occlusal schemes, and placement only in dense bone sites are features of successful mini implant treatment. With removable prosthetics, multiple mini implants may be needed for appropriate retention and load resistance. Maxillary lateral incisor and mandibular incisor sites may be best suited for mini implant treatment. However, past research on dental implants has been directed at standard sized implants. While mini implants are indeed dental implants, they behave somewhat differently under functional load, and the clinician should be circumspect and very judicious in their use. This article is a mini review and not a systematic review. The topics covered are not pervasive because each would require a monograph or textbook for a complete discussion.
Topics: Crowns; Dental Implantation, Endosseous; Dental Implants; Dental Prosthesis Design; Dental Prosthesis, Implant-Supported; Mandible
PubMed: 32663848
DOI: 10.1563/aaid-joi-D-19-00317 -
Compendium of Continuing Education in... 2020Achieving predictable outcomes in implant dentistry requires not only an understanding of surgical and prosthetic protocols but also knowledge of bone biology. Regarding... (Review)
Review
Achieving predictable outcomes in implant dentistry requires not only an understanding of surgical and prosthetic protocols but also knowledge of bone biology. Regarding implant stability, a distinction exists between non-osseointegrated and osseointegrated implants. Primary or mechanical stability at implant placement is different than secondary or biological stability. Bone quality, implant length, and implant width all influence the achievement of primary stability. This article reviews the contemporary literature on dental implant osseointegration, with the intent of presenting clinicians scientific information concerning the biomechanical parameters and limitations of endosseous implants and their components during the osseointegration phase, as well as their behavior once occlusal forces are present following osseointegration.
Topics: Dental Implantation, Endosseous; Dental Implants; Dental Prosthesis Design; Osseointegration
PubMed: 32687377
DOI: No ID Found