-
Journal of the Mechanical Behavior of... Jul 2022Maximum insertion torque (IT) for threaded dental implants is a primary clinical measurement to assess implant anchorage, and strongly influences the clinical outcome....
Maximum insertion torque (IT) for threaded dental implants is a primary clinical measurement to assess implant anchorage, and strongly influences the clinical outcome. Insertion torque is influenced by surgical technique, implant designs, and patient factors such as bone density and quality. In this study, an analytical model was proposed for IT to estimate contributions from the thread and taper separately. The purpose of this study was to test if the analytical model could 1. differentiate the parallel-walled and tapered implant; and, 2. represent four factors: bone surrogate density, drill protocol, implant surface finish and cutting flute. The IT was modeled as the sum of the torques from the thread's inclined plane and interface shear stress from the tapered body integrated over the surface area, respectively, with two main parameters: effective force, F, F and effective pressure, p. The effective force, relates to the clamping force from the thread, while the effective pressure, p, associates with the contact pressure at the bone-implant interface. The model performed well (R = 0.88-1.0) and differentiated between the parallel-walled (p= 0) and tapered implants (p= 0.12). The model's parameters could individually represent the effects of the four factors. High bone surrogate density, two-step drill protocol, and rough surface increased both F and p. The cutting flute had opposing effects on F and p (β = 0.35 and -0.24, respectively); and therefore, had the lowest net effect on IT. The proposed analytical model therefore improves the understanding of the principal contributors to dental implant IT by considering thread and taper mechanics independently.
Topics: Bone Density; Dental Implants; Dental Prosthesis Design; Humans; Mechanical Phenomena; Stress, Mechanical; Torque
PubMed: 35436718
DOI: 10.1016/j.jmbbm.2022.105223 -
British Dental Journal Feb 2020Dental implant treatment is a well-documented technology, but sadly with the passage of time, the vast majority of dental implants sold on the market today have little...
Dental implant treatment is a well-documented technology, but sadly with the passage of time, the vast majority of dental implants sold on the market today have little of their own documentation. All implants are not the same and the consequences of 'look-alike' implants relying on the documentation of others may be far-reaching. This opinion piece highlights concerns identified in the literature and exposes problems that are already occurring in reality.
Topics: Dental Implantation, Endosseous; Dental Implants; Dental Prosthesis Design
PubMed: 32112012
DOI: 10.1038/s41415-020-1302-7 -
Oral and Maxillofacial Surgery Clinics... Aug 2019Mandibular all-on-4 implant reconstruction techniques are less complex than maxillary but more complex than routine dental implant surgery, requiring advanced technical... (Review)
Review
Mandibular all-on-4 implant reconstruction techniques are less complex than maxillary but more complex than routine dental implant surgery, requiring advanced technical skills, deeper understanding of prosthodontic principles, and more complex surgical planning. Surgical simulation may assist experienced surgeons seeking to acquire new skills through increased planning ability, improved intraspecialty communication, and enhanced technical competence. Achieving competence is different for the trainee devoted to the learning process and the practicing surgeon with limited time and balancing other roles and responsibilities. Well-constructed continuing education incorporating simulation, 3-dimensional printed models, and computer-assisted planning may offer the most efficient path to competence.
Topics: Clinical Competence; Computer Simulation; Computer-Assisted Instruction; Dental Implants; Humans; Internship and Residency; Mandibular Reconstruction; Maxilla; Prosthodontics; Simulation Training; Surgery, Computer-Assisted
PubMed: 31104949
DOI: 10.1016/j.coms.2019.03.012 -
Periodontology 2000 Feb 2022Implant site preparation is a critical stage of implant surgery that may underpin various complications related to implant surgery. This review discusses the latest... (Review)
Review
Implant site preparation is a critical stage of implant surgery that may underpin various complications related to implant surgery. This review discusses the latest available scientific information on risk factors related to implant site preparation. The role of the drilling process in relation to the density of the available alveolar bone, the effects of insertion torque on peri-implant osseous healing, and implant-related variables such as macrodesign and implant-abutment connection are all factors that can influence implant success. Novel information that links osteotomy characteristics (including methods to improve implant initial stability, the impact of drilling speed, and increase of the implant insertion torque modifying the bone-implant interface) with the appropriate instrumentation techniques will be discussed, as well as interactions at the bone-biomaterial interface that may lead to biologic complications mediated by implant dissolution products.
Topics: Bone-Implant Interface; Dental Implantation, Endosseous; Dental Implants; Humans; Osteotomy; Torque
PubMed: 35103318
DOI: 10.1111/prd.12410 -
PloS One 2022The objective of this report was to provide a review of the minipig intraoral dental implant model including a meta-analysis to estimate osseointegration and crestal... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
The objective of this report was to provide a review of the minipig intraoral dental implant model including a meta-analysis to estimate osseointegration and crestal bone remodeling.
METHODS
A systematic review including PubMed and EMBASE databases through June 2021 was conducted. Two independent examiners screened titles/abstracts and selected full-text articles. Studies evaluating titanium dental implant osseointegration in native alveolar bone were included. A quality assessment of reporting was performed. Random-effects meta-analyses and meta-regressions were produced for bone-implant contact (BIC), first BIC, and crestal bone level.
RESULTS
125 out of 249 full-text articles were reviewed, 55 original studies were included. Quality of reporting was generally low, omissions included animal characteristics, examiner masking/calibration, and sample size calculation. The typical minipig model protocol included surgical extraction of the mandibular premolars and first molar, 12±4 wks post-extraction healing, placement of three narrow regular length dental implants per jaw quadrant, submerged implant healing and 8 wks of osseointegration. Approximately 90% of studies reported undecalcified incandescent light microscopy histometrics. Overall, mean BIC was 59.88% (95%CI: 57.43-62.33). BIC increased significantly over time (p<0.001): 40.93 (95%CI: 34.95-46.90) at 2 wks, 58.37% (95%CI: 54.38-62.36) at 4 wks, and 66.33% (95%CI: 63.45-69.21) beyond 4 wks. Variability among studies was mainly explained by differences in observation interval post-extraction and post-implant placement, and implant surface. Heterogeneity was high for all studies (I2 > 90%, p<0.001).
CONCLUSIONS
The minipig intraoral dental implant model appears to effectively demonstrate osseointegration and alveolar bone remodeling similar to that observed in humans and canine models.
Topics: Dental Implants
PubMed: 35226690
DOI: 10.1371/journal.pone.0264475 -
Journal of Stomatology, Oral and... Apr 2023The purpose of the present study was to retrospectively 1) investigate the association between implant-, patient- and bone-related parameters with the risk of implant...
PURPOSE
The purpose of the present study was to retrospectively 1) investigate the association between implant-, patient- and bone-related parameters with the risk of implant failure; 2) analyze the survival rates of dental implants placed in a university clinical setting.
METHODS
Data were retrieved from patient charts from the University of Minnesota School of Dentistry to identify patients older than 18 years of age who received dental implant treatment by faculty, residents or students in the university dental clinics. Implant-, patient- and bone-related parameters such as implant system, length, diameter, jaw, region, installation protocol, gender, smoking, medical history, history of periodontal disease, self-reported oral parafunctions, type of bone, and operator were manually retrieved and analyzed.
RESULTS
Five hundred and fifty-three implants were randomly selected from a total of 4,424. Of these 553 implants, 440 (79.6%) were associated with a >10 mm length, 371 (67.1%) with a >4 mm diameter and 431 (77.9%) had replaced a single tooth. Submerged healing mode was followed in 363 (65.6%) of the implants with the mean healing time being 3.2 months. History of periodontal disease was identified in 294 (53.2%) of these cases. A total of 17 implants failed after a mean time of 6.29 ± 6.75 months, resulting in an overall survival rate of 96.9%. Based on a univariate analysis, implant system, operator, time between extraction and implant surgery, time between bone grafting and implant placement, tobacco use as well as clenching and grinding were considered potential implant failure predictors and were further included in the multivariate logistic regression analysis. Tobacco use (p < 0.001) was significantly associated with implant failure.
CONCLUSION
Within the limitations of this retrospective randomly selected university-treated sample tobacco use increased the risk for implant failure. Failure occurred in 17 implants representing a 3.1% failure rate.
Topics: Humans; Dental Implants; Retrospective Studies; Follow-Up Studies; Dental Prosthesis Design; Periodontal Diseases
PubMed: 36280552
DOI: 10.1016/j.jormas.2022.10.013 -
Compendium of Continuing Education in... 2019As dental implants have become a popular treatment modality for edentulous sites, there is a need for a peri-implant maintenance protocol. This article reviews the... (Review)
Review
As dental implants have become a popular treatment modality for edentulous sites, there is a need for a peri-implant maintenance protocol. This article reviews the anatomy of peri-implant tissues, examines the etiology and risk factors of peri-implant diseases, and outlines nonsurgical and surgical treatment of these diseases. The clinical and radiographic steps necessary to diagnose peri-implant diseases during the phase of peri-implant maintenance, along with available treatment protocols to maintain or recover peri-implant health will be discussed.
Topics: Dental Implants; Patient Care Team
PubMed: 31478687
DOI: No ID Found -
Journal of Oral Rehabilitation May 2022Osseoperception is defined as the ability to perceive tactile sensation via mechanoreception in the peri-implant environment. The objective was to systematically review... (Review)
Review
OBJECTIVES
Osseoperception is defined as the ability to perceive tactile sensation via mechanoreception in the peri-implant environment. The objective was to systematically review the available literature on the osseoperception phenomenon following dental implant placement and to explore potential factors which might improve the perception capacity.
MATERIAL AND METHODS
A literature search was performed using PubMed, Cochrane, Embase, and Web of Science databases up to June 2021. Both human and animal studies assessing sensory capacity or innervation following implant placement were included in this review. Two reviewers independently performed the study selection, data extraction and quality assessment of the included studies. The methodological quality of the included papers was assessed using Cochrane risk of bias for human studies and SYRCLE's risk of bias tool for animal studies.
RESULTS
The electronic search of databases yielded 1667 results. Following removal of duplicates, title and abstract screening and full-text reading, 22 publications were eligible to be included in the review. Psychophysical evidence from 14 studies indicated a lower tactile function of implants, where active and passive threshold levels were found to be 5 and 50 times higher for implants compared to natural teeth, respectively. The neurophysiological evidence from three studies indicated cortical plasticity following dental implant placement, measured via trigeminal nerve evoked potentials and functional magnetic resonance imaging. Histological evidence from five studies demonstrated the presence of myelinated nerve fibres in the peri-implant tissues. Additionally, immediate implant placement and loading showed beneficial effect on peri-implant tissue (re)innervation; however, no other biological or physiological factors could be identified influencing osseoperception.
CONCLUSIONS
The reported evidence supported the existence of so-called osseoperception phenomenon for restoring the sensory feedback pathway following oral implant rehabilitation. Further studies are required to identify factors that might further assist physiological integration of the oral implants in the human body as such to approach natural oral function.
Topics: Animals; Dental Implantation, Endosseous; Dental Implants; Humans; Mouth, Edentulous; Touch
PubMed: 34911146
DOI: 10.1111/joor.13296 -
British Dental Journal May 2024Peri-implant diseases are frequent complications that occur around osseointegrated endosseous implants and are the result of an imbalance between the bacterial challenge... (Review)
Review
Peri-implant diseases are frequent complications that occur around osseointegrated endosseous implants and are the result of an imbalance between the bacterial challenge and host response. Peri-implant diseases may affect the peri-implant mucosa only (peri-implant mucositis) or also involve the supporting bone (peri-implantitis). Early detection of peri-implant diseases and timely treatment is important for the success of dental implant treatment. Peri-implant probing is essential to assess the peri-implant health status and should be done at each recall visit. Dental practitioners should be familiar with the clinical and radiological features of both conditions in order to make an accurate diagnosis and determine the appropriate treatment required. This article aims to provide clinicians with an understanding of the key differences between peri-implant health, peri-implant mucositis and peri-implantitis.
Topics: Humans; Dental Implants; Mucositis; Peri-Implantitis; Stomatitis
PubMed: 38789756
DOI: 10.1038/s41415-024-7402-z -
Journal of Periodontology Jun 2021A cross-sectional study was designed to shed light on the clinical sequelae and patient satisfaction after dental implant removal (IR).
BACKGROUND
A cross-sectional study was designed to shed light on the clinical sequelae and patient satisfaction after dental implant removal (IR).
METHODS
Patients undergoing ≥1 IRs were eligible. The reasons for implant failure, clinical and radiological parameters before and after IR, and the surgical and prosthetic treatments offered after IR was assessed. Patient satisfaction was recorded and the Oral Health Impact Profile (OHIP)-14 was used to document patient self-reported dysfunction and discomfort attributed to IR. Lastly, patient expectations after IR were also evaluated.
RESULTS
Thirty-one patients with 45 implants were analyzed. Peri-implantitis was the main reason for IR (64.5%). The average implant survival time before IR was 120.3 ± 88.2 months. Signs of infection (51.7%) and bleeding on probing (37.5%) were common signs detected at the time of IR. Guided bone regeneration was the intervention most commonly applied simultaneously to IR (74.1%). The reported degree of satisfaction was high, and the overall OHIP-14 score was low. However, a certain patient reluctance to undergo future implant placement in the same clinic or with the same professional was recorded, and a statistically significant increase in adherence to the implant maintenance routine was observed after IR.
CONCLUSIONS
Peri-implantitis is the leading cause for IR. Guided bone regeneration is commonly applied to attenuate the clinical sequelae of IR. Nonetheless, IR does not seem to affect patients' satisfaction nor their quality of life, though a certain patient reluctance to undergo future implant placement in the same clinic or with the same professional was reported.
Topics: Cross-Sectional Studies; Dental Implants; Humans; Perception; Peri-Implantitis; Quality of Life
PubMed: 32997346
DOI: 10.1002/JPER.20-0259