-
Head & Neck Sep 2020The aim of this review was to provide an update on survival rates of osseointegrated implants into common composite free flaps used for maxillary and mandibular... (Review)
Review
The aim of this review was to provide an update on survival rates of osseointegrated implants into common composite free flaps used for maxillary and mandibular reconstructions and identify factors affecting outcomes. PubMed, Medline, Embase, and Cochrane databases were searched. Included studies reported implant survival by flap type. Results were pooled and survival was estimated with the Kaplan-Meier method. Variables affecting survival were assessed using Cox regression. Thirty-two of the 2631 articles retrieved were included, totaling 2626 implants placed into fibula, iliac crest, scapula, and radial forearm free flaps. Pooled survival showed 94% 5-year survival of implants in fibula and iliac crest with no difference between groups (P = .3). Factors effecting survival included radiotherapy (HR 2.3, 95% CI 1.2-4.6, P = .027) and malignant disease (HR 2.2, 95%CI 1.6-3.1, Pā<ā.001). Implant survival appears adequate across common flap types; however, there are limited numbers reported in less common flaps.
Topics: Bone Transplantation; Bone-Anchored Prosthesis; Fibula; Free Tissue Flaps; Humans; Plastic Surgery Procedures; Retrospective Studies; Survival Rate
PubMed: 32400954
DOI: 10.1002/hed.26238 -
Journal of Clinical Orthopaedics and... Feb 2020Socket prosthesis attachment is the current gold standard for limb amputees. Osseointegrated implantation is a novel technique that has many proposed advantages over the...
OBJECTIVE
Socket prosthesis attachment is the current gold standard for limb amputees. Osseointegrated implantation is a novel technique that has many proposed advantages over the current gold standard. Clear advantages for its use over socket prosthetic attachment has been well established in literature. It decreases socket problems as pinching, pressure points, chronic skin problems and frequent socket change due to atrophy of muscles.
METHODS
We reviewed primary research articles documenting complication rates and outcome measures in patients with osseointegrated prosthesis implantation after limb amputation.
RESULTS
Nine studies were identified with a total of 211-242 patients. Clinical, radiographic, and functional outcomes, as well as complications were considered. The mean duration of follow-up was greater than 12 months in all studies.
CONCLUSIONS
Osseointegration is an effective alternative to socket prosthesis in transfemoral amputees. Transtibial and upper extremity implants are underreported in the literature and clear indication for their effectiveness over socket prosthesis does not exist. Minor complications are most common, such as soft tissue infections, and may be mitigated in the future by improvements in surgical technique and implant design.The level of evidence is 3.
PubMed: 31992935
DOI: 10.1016/j.jcot.2019.05.025 -
Medicina (Kaunas, Lithuania) May 2024: The present systematic review and meta-analysis were conducted to evaluate and compare the long-term clinical outcomes of immediate implants placed into fresh sockets... (Meta-Analysis)
Meta-Analysis Comparative Study Review
: The present systematic review and meta-analysis were conducted to evaluate and compare the long-term clinical outcomes of immediate implants placed into fresh sockets with and without periapical pathology. : After the search and review of the literature in the electronic databases, 109 publications were achieved. The titles and abstracts of 66 publications were screened. After the evaluation of the full text of 22 publications, based on the inclusion criteria, six controlled clinical studies were included in this systematic review and meta-analysis. The statistical calculation showed no heterogeneity among the studies included. The implant survival was 99.6% in the test (socket with periapical pathology) and control (socket without periapical pathology) groups of all the clinical trials. The results of the meta-analysis showed no statistically significant difference between test and control groups regarding the marginal bone level and the width of keratinized mucosa in all the studies. Other parameters indicating plaque level, bleeding on probing, and gingival recession also did not differ between test and control groups at the final follow-up in nearly all studies. : Within the limitation of this systemic review and meta-analysis, the obtained data suggest that implants immediately placed into the extraction sockets of teeth exhibiting periapical pathology can be successfully osseointegrated for an extended period.
Topics: Humans; Tooth Socket; Dental Implantation, Endosseous; Dental Implants; Immediate Dental Implant Loading
PubMed: 38929509
DOI: 10.3390/medicina60060893 -
Annals of Palliative Medicine Dec 2021With the continuous improvement of human living standards, more and more dental patients are requiring oral implant restoration treatment. However, there is still... (Meta-Analysis)
Meta-Analysis
BACKGROUND
With the continuous improvement of human living standards, more and more dental patients are requiring oral implant restoration treatment. However, there is still controversy regarding the influence of risk factors such as osteoporosis, radiotherapy, diabetes, and smoking on the failure of oral implants. This study aimed to explore the correlation between risk factors and failure of oral implant restoration treatment.
METHODS
The databases of China National Knowledge Infrastructure (CNKI), Baidu Academic, Weipu, Wanfang, PubMed, EBSCO, Medline, Web of knowledge, Ovid, and the Cochrane Library were searched. The search strategies included: subject terms related to research results such as survival, osseointegration, failure, removal, replacement, and loss; related to risk factors: osteoporosis, head and neck cancer, diabetes, and smoking; and oral implantology as a keyword.
RESULTS
Thirty-two articles were included in meta-analysis, there was a high heterogeneity between radiotherapy and dental implant failure (I2=71.6%, P=0.000), and there was an obvious correlation between radiotherapy and dental implant failure [relative risk (RR) =2.09, 95% confidential interval (CI): 1.68-2.61]. There was heterogeneity between diabetes and oral implant failure in the included articles (I2=59.6%, P=0.084). There was no remarkable correlation between osteoporosis and dental implant failure (RR =1.19, 95% CI: 0.81-1.74). There was a high heterogeneity between smoking and dental implant failure in the included articles (I2=33.8%, P=0.092), showing obvious correlation (RR =1.80, 95% CI: 1.53-2.11).
DISCUSSION
The results of meta-analysis confirmed that radiotherapy and smoking were greatly associated with oral implant failure.
Topics: Administration, Oral; Diabetes Mellitus; Humans; Osteoporosis; Risk Factors; Smoking
PubMed: 35016469
DOI: 10.21037/apm-21-3449 -
BioMed Research International 2017. The information available about osseointegration and the bone to implant interaction of zirconia implants with various surface modifications is still far from... (Meta-Analysis)
Meta-Analysis Review
. The information available about osseointegration and the bone to implant interaction of zirconia implants with various surface modifications is still far from sufficient. . The purpose of this systematic review and meta-analysis was to evaluate and compare zirconia dental implants with different surface topographies, with a focus on bone to implant contact and removal torque. . The systematic review of the extracted publications was performed to compare the bone to implant contact (BIC) with removal torque (RT) values of titanium dental implants and machined and surfaced modified zirconia implants. . A total of fifteen articles on BIC and RT values were included in the quantitative analysis. No significant difference in the BIC values was observed between titanium and machined zirconia implants ( = 0.373; 95% CI: -0.166 to 0.443). However, a significantly better BIC values were observed for acid etched zirconia implants compared with those of titanium implants ( = 0.032; 95% CI: 0.068 to 1.461). Unmodified zirconia implants showed favorable BIC values compared to modified-surface zirconia implants ( = 0.021; 95% CI: -0.973 to -0.080). . Acid etched zirconia implants may serve as a possible substitute for successful osseointegration.
Topics: Acid Etching, Dental; Bone and Bones; Dental Implants; Dental Prosthesis Design; Humans; Osseointegration; Surface Properties; Titanium; Torque; Zirconium
PubMed: 28299337
DOI: 10.1155/2017/9246721 -
Journal of Clinical Periodontology Feb 2017To analyse the effect of leucocyte- and platelet-rich fibrin (L-PRF) on bone regeneration procedures and osseointegration. (Review)
Review
AIM
To analyse the effect of leucocyte- and platelet-rich fibrin (L-PRF) on bone regeneration procedures and osseointegration.
MATERIALS AND METHODS
An electronic and hand search was conducted in three databases (MEDLINE, EMBASE and Cochrane). Only randomized clinical trials, written in English where L-PRF was applied in bone regeneration and implant procedures, were selected. No follow-up restrictions were applied.
RESULTS
A total of 14 articles were included and processed. Three subgroups were created depending on the application: sinus floor elevation (SFE), alveolar ridge preservation and implant therapy. In SFE, for a lateral window as well as for the trans-alveolar technique, histologically faster bone healing was reported when L-PRF was added to most common xenografts. L-PRF alone improved the preservation of the alveolar width, resulting in less buccal bone resorption compared to natural healing. In implant therapy, better implant stability over time and less marginal bone loss were observed when L-PRF was applied. Meta-analyses could not be performed due to the heterogeneity of the data.
CONCLUSIONS
Despite the lack of strong evidence found in this systematic review, L-PRF might have a positive effect on bone regeneration and osseointegration.
Topics: Alveolar Bone Loss; Biological Therapy; Bone Regeneration; Humans; Leukocytes; Osseointegration; Platelet-Rich Fibrin; Randomized Controlled Trials as Topic; Sinus Floor Augmentation
PubMed: 27891638
DOI: 10.1111/jcpe.12658 -
Clinical Oral Investigations May 2016The aim of the present systematic review was to assess the efficacy of parathyroid hormone supplementation on the osseointegration of implants. (Review)
Review
OBJECTIVE
The aim of the present systematic review was to assess the efficacy of parathyroid hormone supplementation on the osseointegration of implants.
METHODS
The addressed focused question was Does parathyroid hormone supplementation affect osseointegration around implants? Indexed databases were searched from 1965 up to and including April 2015 using various key words including: Bone to implant contact; implant; parathyroid hormone; and osseointegration. Letters to the Editor, case-reports/case-series, historic reviews, commentaries and articles published in languages other than English were excluded. The pattern of the present systematic review was customized to primarily summarize the pertinent data.
RESULTS
Eighteen studies fulfilled the eligibility criteria. Evidence was limited to preclinical animal studies only (11 studies in rodents, 4 in dogs and 3 in rabbits). Number of titanium implants placed ranged between 20 and 80 implants. Results from 16 studies showed that PTH supplementation enhanced new bone formation and/or BIC around implants. One study suggests that PTH-coated implants improve BIC and BA. One study showed no significant difference in BIC and new bone formation around implants with PTH hydrogel placement.
CONCLUSION
Efficacy of PTH supplementation on osseointegration of implants shows promising results in animal models, however further investigation is necessary to assess the effectiveness in humans.
Topics: Animals; Dental Implants; Dogs; Humans; Osseointegration; Parathyroid Hormone; Prostheses and Implants; Titanium
PubMed: 26689569
DOI: 10.1007/s00784-015-1691-1 -
Archives of Osteoporosis Jan 2022Due to age and gender, patients awaiting total knee or hip arthroplasty (TKA/THA) are at a higher risk of osteoporosis. In joint arthroplasty, low bone mineral density... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
Due to age and gender, patients awaiting total knee or hip arthroplasty (TKA/THA) are at a higher risk of osteoporosis. In joint arthroplasty, low bone mineral density (BMD) is a risk factor for implant osseointegration, durability, and prosthesis complications. This study aims to investigate the prevalence and treatment rate of osteoporosis in patients undergoing total joint arthroplasty (TJA).
METHODS
We applied a comprehensive literature search through PubMed, Cochrane Library, and EMBASE from inception to July 10, 2021, for studies investigating the prevalence and treatment rate of osteoporosis in TJA patients. The aggregated prevalence was calculated with the random-effects model, and the heterogeneity between studies was checked by Cochran's Q test and quantified by the I statistic. We performed subgroup analyses and meta-regression analyses to determine the source of heterogeneity. Publication bias was assessed by a funnel plot and verified by Egger's test. Anti-osteoporosis treatment for TJA patients was described qualitatively and quantitatively.
RESULTS
Of 4561 citations identified by the search strategy, 11 studies including 3462 patients were eligible for inclusion. The pooled prevalence of osteoporosis and osteopenia in TJA patients was 24.8% (95%CI: 14.1-37.2%) and 38.5% (95%CI: 29.3-48.0%), respectively. The prevalence of osteoporosis/osteopenia in TJA patients was 64.0% (95%CI: 45.8-80.3%). In terms of gender, the pooled prevalence of osteoporosis in males, females, and postmenopausal females were 5.5% (95%CI: 1.5-11.4%), 29.0% (95%CI: 18.3-41.1%), and 38.3% (95%CI: 13.2-67.1%), respectively. The treatment rate of osteoporosis in TJA patients was 32.9% (95%CI: 15.2-53.1%) by a random-effects model.
CONCLUSIONS
Osteoporosis is highly prevalent in patients undergoing TJA, especially in postmenopausal females. However, the treatment rate of osteoporosis is low. Considering the possibility of surgical complications, clinicians should strengthen their awareness of pre-operative BMD assessment and manage osteoporosis in high-risk patients.
Topics: Arthroplasty, Replacement, Hip; Arthroplasty, Replacement, Knee; Female; Humans; Knee Joint; Male; Osteoporosis; Prevalence
PubMed: 35029750
DOI: 10.1007/s11657-021-01055-9 -
Maxillofacial Plastic and... Jul 2022After tooth extraction, dimensional changes affect the alveolar socket, leading to loss in alveolar bone height and width. Histological modifications also occur, with... (Review)
Review
After tooth extraction, dimensional changes affect the alveolar socket, leading to loss in alveolar bone height and width. Histological modifications also occur, with initial formation of a blood clot that is replaced with granulation tissue and subsequently with a provisional connective tissue matrix. Spontaneous healing ends with socket filling with woven bone, which is gradually replaced with lamellar bone and bone marrow. Adequate alveolar ridge dimensions and bone quality are required to assure optimal stability and osseointegration following dental implant placement. When a tooth is extracted, alveolar ridge preservation (ARP) procedures are an effective method to prevent collapse of the post-extraction socket. Heterologous bone is widely chosen by clinicians for ARP, and anorganic bone xenografts (ABXs) made bioinert by heat treatment represents the most used biomaterial in clinical applications. Collagen-preserving bone xenografts (CBXs) made of porcine or equine bone are fabricated by less invasive chemical or enzymatic treatments to remove xenogenic antigens, and these are also effective in preserving post-extraction sites. Clinical differences between anorganic bone substitutes and collagen-preserving materials are not well documented in the literature but understanding these differences could clarify how processing protocols influence biomaterial behavior in situ. This systematic review of the literature compares the dimensional changes and histological features of ABXs versus CBXs in ridge preservation procedures to promote awareness of different bone xenograft efficacies in stimulating the healing of post-extraction sockets.
PubMed: 35821286
DOI: 10.1186/s40902-022-00349-3 -
European Journal of Oral Implantology 2017Compromised fit between the contact surfaces of screw-retained implant-supported fixed dentures (IFDs) is thought to create uncontrolled strains in the prosthetic... (Review)
Review
BACKGROUND AND AIM
Compromised fit between the contact surfaces of screw-retained implant-supported fixed dentures (IFDs) is thought to create uncontrolled strains in the prosthetic components and peri-implant tissues, thus evoking biological and technical complications such as bone loss, screw loosening, component fractures and, at worst, loss of implants or prostheses. The aim of this systematic review was to evaluate the impact of marginal misfit on the clinical outcomes of IFDs, and to elucidate definition and assessment methods for passive fit.
MATERIALS AND METHODS
A systematic review of the literature was conducted with a PICO question: "For partially or complete edentulous subjects with screw-retained IFDs, does the marginal misfit at the implant-prosthesis interfaces have an impact on the clinical outcomes?". A literature search was performed electronically in PubMed (MEDLINE) with the help of Boolean operators to combine key words, and by hand search in relevant journals. English written in vivo studies published before August 31, 2016 that reported on both clinical outcome and related implant prosthesis misfit (gap, strains, torque) were selected using predetermined inclusion criteria.
RESULTS
The initial search yielded 2626 records. After screening and a subsequent filtering process, five human and five animal studies were included in the descriptive analysis. The selected studies used different methods to assess misfit (linear distortion, vertical gap, strains, screw torque). While two human studies evaluated the biological response and technical complications prospectively over 6 and 12 months, the animal studies had an observation period < 12 weeks. Four human studies analysed retrospectively the 3 to 32 years' outcomes. Screw-related complications were observed, but biological sequelae could not be confirmed. Although the animal studies had different designs, bone adaptation and implant displacement was found in histological analyses. Due to the small number of studies and the heterogenic designs and misfit assessment methods, no meta-analysis of the data could be performed.
CONCLUSIONS
The current literature provides insufficient evidence as to the effect of misfit at the prosthesis-implant interface on clinical outcomes of screw-retained implant-supported fixed dentures. Marginal gaps and static strains due to screw tightening were not found to have negative effects on initial osseointegration or peri-implant bone stability over time. Based on two clinical studies, the risk for technical screw-related complications was slightly higher. While the degree of tolerable misfit remains a matter of debate, the present data do not imply that clinicians neglect good fit, but aim to achieve the least misfit possible. Conflict of interest statement: The authors declare no conflict of interest. The review was conducted as part of the 2016 Foundation of Oral Rehabilitation Consensus Conference on "Prosthetic Protocols in Implant-based Oral Rehabilitation".
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Denture Design; Denture, Partial, Fixed; Humans; Prosthesis Fitting
PubMed: 28944373
DOI: No ID Found