-
Plastic and Reconstructive Surgery Sep 2020Maxillofacial reconstruction with vascularized bone restores facial contour and provides structural support and a foundation for dental rehabilitation. Routine implant... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Maxillofacial reconstruction with vascularized bone restores facial contour and provides structural support and a foundation for dental rehabilitation. Routine implant placement in such cases, however, remains uncommon. This study aims to determine dental implant survival in patients undergoing vascularized maxillary or mandibular reconstruction through a systematic review of the literature.
METHODS
Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, the literature was queried for implant placement in reconstructed jaws using Medical Subject Headings terms on PubMed, Embase, and Cochrane platforms. Weighted implant survivals were calculated for the entire cohort and subcohorts stratified by radiotherapy. Meta-analyses were performed to estimate effect of radiation on implant osseointegration.
RESULTS
Of 3965 publications identified, 42 were reviewed, including 1084 patients with 3636 dental implants. Weighted implant survival was 92.2 percent at a median follow-up of 36 months. Survival was 97.0 percent in 269 implants placed immediately in 60 patients versus 89.9 percent in 1897 delayed implants placed in 597 patients, with follow-up of 14 and 40 months, respectively. Dental implants without radiotherapy exposure had better survival than those exposed to radiation (95.3 versus 84.6 percent; p < 0.01) at a median follow-up of 36 months. Meta-analyses showed that radiation significantly increased the risk of implant failure (risk ratio, 4.74; p < 0.01) and suggested that implants placed before radiotherapy trended toward better survival (88.9 percent versus 83.4 percent, p = 0.07; risk ratio, 0.52; p = 0.14).
CONCLUSIONS
Overall implant survival was 92.2 percent; however, radiotherapy adversely impacted outcomes. Implants placed before radiotherapy may demonstrate superior survival than implants placed after.
Topics: Bone Transplantation; Dental Implantation, Endosseous; Humans; Mandibular Reconstruction; Osseointegration; Plastic Surgery Procedures; Surgical Flaps
PubMed: 32459736
DOI: 10.1097/PRS.0000000000007077 -
Journal of Taibah University Medical... Oct 2017Bisphosphonates (BPs) are a class of drugs that are used to treat osteoporosis. It has been suggested that BP coatings on dental implants have a positive effect on new... (Review)
Review
OBJECTIVES
Bisphosphonates (BPs) are a class of drugs that are used to treat osteoporosis. It has been suggested that BP coatings on dental implants have a positive effect on new bone formation. The purpose of this review is to analyse the currently available data concerning the clinical and experimental efficacy of BP-releasing titanium implants such that their potential in clinical oral implant dentistry may be ascertained.
METHODS
Based on a literature review, a focused research question was constructed: what is the effect of a BP-releasing coating on the osseointegration of titanium dental implant? The databases of PubMED/MEDLINE; ISI Web of Knowledge; Embase and Google Scholar were searched electronically using the keywords 'dental implant'; 'bisphosphonate' and 'titanium.' The quality; general characteristics and outcomes of each study were summarized and analysed systematically.
RESULTS
A total of eleven articles fulfilled the criteria to be included in this review. Eight studies were experimental; two studies were clinical; and one study was experimental and clinical. In nine studies (82%), BP-coated implants resulted in higher osseointegration, as indicated by higher resonance frequency values, removal torque, bone-implant contact and new bone formation. In two studies (18%), there was no difference between the osseointegration of BP-coated implants and controls.
CONCLUSIONS
Bisphosphonates-loaded implants may have a positive effect on osseointegration. However, more well-designed clinical studies are required to demonstrate their osseoconductive effects.
PubMed: 31435266
DOI: 10.1016/j.jtumed.2017.05.007 -
Journal of Clinical Medicine Aug 2020Ultraviolet (UV) and non-thermal plasma functionalization are surface treatment modalities that seem able to improve osseointegration. The aim of this systematic review... (Review)
Review
BACKGROUND
Ultraviolet (UV) and non-thermal plasma functionalization are surface treatment modalities that seem able to improve osseointegration. The aim of this systematic review and meta-analysis is to assess the effect of the two methods and possible differences.
MATERIALS AND METHODS
The systematic research of pre-clinical animal studies was conducted up to May 2020 in the databases PubMed/Medline, Scopus and the Cochrane Lybrary. A meta-analysis was performed by using the DerSimonian-Laird estimator in random-effects models.
RESULTS
Through the digital search, 518 articles were identified; after duplicate removal and screening process 10 papers were included. Four studies evaluating UV treatment in rabbits were included in the meta-analysis. The qualitative evaluation of the included studies showed that both UV photofunctionalization and non-thermal plasma argon functionalization of titanium implant surfaces might be effective in vivo to improve the osseointegration. The meta-analysis on four studies evaluating UV treatment in rabbits showed that bone to implant contact values (expressed as standardized mean differences and raw mean differences) were significantly increased in the bio-activated groups when follow-up times were relatively homogeneous, although a high heterogeneity ( > 75%) was found in all models.
CONCLUSIONS
The present systematic review and meta-analysis on pre-clinical studies demonstrated that chair-side treatment of implants with UV or non-thermal plasma appear to be effective for improving osseointegration. This systematic review supports further clinical trials on this topic.
PubMed: 32878146
DOI: 10.3390/jcm9092817 -
Clinical and Experimental Dental... Dec 2023The aim of the systematic review was to compare studies on implant-supported two-unit cantilever crowns with two adjacent implant-supported crowns in the anterior...
OBJECTIVES
The aim of the systematic review was to compare studies on implant-supported two-unit cantilever crowns with two adjacent implant-supported crowns in the anterior region. The second aim was to assess in a 10-year prospective comparative pilot study, hard and soft peri-implant tissue changes in patients with a missing central and adjacent lateral upper incisor, treated with either an implant-supported two-unit cantilever crown or two single implant-supported crowns.
MATERIALS AND METHODS
Medline, Embase, and the Cochrane Central Register of Controlled Trials were searched (last search March 1, 2023). Inclusion criteria were studies reporting outcomes of two missing adjacent teeth in the esthetic region and treated with a single implant-supported two-unit cantilever fixed dental prosthesis, or with two solitary implant-supported crowns. Outcome measures assessed included implant survival (primary), changes in marginal bone and gingiva level, restoration survival, subjective and objective esthetic scores, papilla volume, mid-facial marginal mucosa level, probing depth, bleeding on probing, and biological and technical complications with ≥1-year follow-up. In addition, in a 10-year pilot study, the same outcome measures were assessed of five patients with a single implant-supported two-unit cantilever crown and compared with five patients with two adjacent single implant-supported crowns in the esthetic zone.
RESULTS
Nine articles with 11 study groups were found eligible for data extraction. Meta-analyses of implant survival rates were 96.9% (mean follow-up 3.4 ± 1.4 years) for the implant-cantilever treatment and 97.6% (mean follow-up 3.0 ± 1.8 years) for the adjacent implants treatment (p = .79). In the 10-year comparative pilot study, no clinically relevant changes in hard and soft peri-implant tissue levels occurred in both groups. Patient satisfaction was also high in both groups.
CONCLUSION
Single implant-supported two-unit crowns can be a viable alternative to the placement of two adjacent single implant crowns in the esthetic zone.
Topics: Humans; Dental Implants; Treatment Outcome; Pilot Projects; Dental Implants, Single-Tooth; Prospective Studies; Esthetics, Dental
PubMed: 37592440
DOI: 10.1002/cre2.773 -
Materials (Basel, Switzerland) Jul 2021The present review aimed to evaluate the impact of implant length on failure rates between short (<10 mm) and long (≥10 mm) dental implants. An electronic search was... (Review)
Review
The present review aimed to evaluate the impact of implant length on failure rates between short (<10 mm) and long (≥10 mm) dental implants. An electronic search was undertaken in three databases, as well as a manual search of journals. Implant failure was the outcome evaluated. Meta-analysis was performed in addition to a meta-regression in order to verify how the risk ratio (RR) was associated with the follow-up time. The review included 353 publications. Altogether, there were 25,490 short and 159,435 long implants. Pairwise meta-analysis showed that short implants had a higher failure risk than long implants (RR 2.437, < 0.001). There was a decrease in the probability of implant failure with longer implants when implants of different length groups were compared. A sensitivity analysis, which plotted together only studies with follow-up times of 7 years or less, resulted in an estimated increase of 0.6 in RR for every additional month of follow-up. In conclusion, short implants showed a 2.5 times higher risk of failure than long implants. Implant failure is multifactorial, and the implant length is only one of the many factors contributing to the loss of an implant. A good treatment plan and the patient's general health should be taken into account when planning for an implant treatment.
PubMed: 34300891
DOI: 10.3390/ma14143972 -
Journal of Oral Biology and... 2023Though, mechanical dental implant and supported prosthesis failures are considered significant, a comprehensive evaluation is lacking. A systematic review analyzing... (Review)
Review
PURPOSE
Though, mechanical dental implant and supported prosthesis failures are considered significant, a comprehensive evaluation is lacking. A systematic review analyzing different aspects related to such failures was therefore done.
METHODS
Electronic search was carried out in PubMed/MEDLINE and Cochrane Library for articles published between 1981 and 2021. Articles were selected using predefined criteria. Data extraction was based on mechanical complications associated with dental implants, prosthetic implant failures, survival rate of implants, mechanical failure of implants placed in the maxilla and mandible, and mechanical complications associated with implant supported over dentures. Quality of included studies was assessed. Meta-analysis for heterogenicity testing, publication bias and implant failure assessment was conducted using MedCalc® Statistical Software version 19.7.
RESULTS
Eighteen retrospective and prospective studies were included following PRISMA guidelines. Mechanical complications were more in the initial 9 years but reduced later. Abutment screw loosening was one of the more common mechanical complications (16.21%). Maxillary implant failure was greater compared to mandibular implant failure with an odds ratio of 4.66 (95% CI -3.21- 6.75). Failure of implant supported overdentures due to mechanical complications were 3% in the fixed effect, and 2.9% in the random effect model ( < 0.05). The overall prevalence of mechanical failure was between 5.6% and 7.7% (P < 0.05).
CONCLUSION
Mechanical failures of implant and supported prosthesis have similar prevalence to biological and esthetic failures, and therefore need to be given due credence. Identifying specific factors contributing to such failures can help reduce incidence.
PubMed: 36923071
DOI: 10.1016/j.jobcr.2023.02.009 -
Materials (Basel, Switzerland) Sep 2023The purpose of the present systematic review was to investigate the influence of bisphosphonates (BPs) on the dental implant failure rate and marginal bone loss (MBL).... (Review)
Review
The purpose of the present systematic review was to investigate the influence of bisphosphonates (BPs) on the dental implant failure rate and marginal bone loss (MBL). An electronic search was undertaken in three databases, plus a manual search of journals. Meta-analyses were performed, besides a meta-regression in order to verify how the log odds ratio (OR) was associated with follow-up time. The five- and ten-year estimated implant survivals were calculated. The review included 33 publications. Altogether, there were 1727 and 21,986 implants placed in patients taking and not taking BPs, respectively. A pairwise meta-analysis (26 studies) showed that implants in BP patients had a higher failure risk in comparison to non-BP patients (OR 1.653, = 0.047). There was an estimated decrease of 0.004 in log OR for every additional month of follow-up, although it was not significant ( = 0.259). The global estimated implant survival in patients taking BPs after 5 and 10 years was 94.2% (95% CI, 94.0-94.4) and 90.1% (95% CI, 89.8-90.3), respectively. It was not possible to make any reliable analysis concerning MBL, as only two studies reported MBL results separated by groups. There is a 65.3% higher risk of implant failure in patients taking BPs in comparison to patients not taking this class of drugs.
PubMed: 37763356
DOI: 10.3390/ma16186078 -
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 -
International Journal of Implant... Dec 2016Dental implant surgery has developed to a widely used procedure for dental rehabilitation and is a secure and predictable procedure. Local and systemic risk factors can... (Review)
Review
Dental implant surgery has developed to a widely used procedure for dental rehabilitation and is a secure and predictable procedure. Local and systemic risk factors can result in higher failure rates. Diabetes mellitus is a chronic disease that goes in with hyperglycemia and causes multifarious side effects. Diabetes as a relative contraindication for implant surgery is controversially discussed. Because the number of patients suffering from diabetes increases, there are more diabetic patients demanding implant procedures. We aimed to answer the PICO question "Do diabetic patients with dental implants have a higher complication rate in comparison to healthy controls?" by a systematic literature search based on the PRISMA statement. We identified 22 clinical studies and 20 publications of aggregated literature, which were quite heterogeneous concerning methods and results. We conclude that patients with poorly controlled diabetes suffer from impaired osseointegration, elevated risk of peri-implantitis, and higher level of implant failure. The influence of duration of the disease is not fully clear. The supportive administration of antibiotics and chlorhexidine seems to improve implant success. When diabetes is under well control, implant procedures are safe and predictable with a complication rate similar to that of healthy patients.
PubMed: 27747697
DOI: 10.1186/s40729-016-0038-2 -
Materials (Basel, Switzerland) Apr 2022The present review aimed to evaluate the impact of diabetes mellitus on dental implant failure rates and marginal bone loss (MBL). An electronic search was undertaken in... (Review)
Review
The present review aimed to evaluate the impact of diabetes mellitus on dental implant failure rates and marginal bone loss (MBL). An electronic search was undertaken in three databases, plus a manual search of journals. Meta-analyses were performed as well as meta-regressions in order to verify how the odds ratio (OR) and MBL were associated with follow-up time. The review included 89 publications. Altogether, there were 5510 and 62,780 implants placed in diabetic and non-diabetic patients, respectively. Pairwise meta-analysis showed that implants in diabetic patients had a higher failure risk in comparison to non-diabetic patients (OR 1.777, p < 0.001). Implant failures were more likely to occur in type 1 diabetes patients than in type 2 (OR 4.477, p = 0.032). The difference in implant failure between the groups was statistically significant in the maxilla but not in the mandible. The MBL mean difference (MD) between the groups was 0.776 mm (p = 0.027), with an estimated increase of 0.032 mm in the MBL MD between groups for every additional month of follow-up (p < 0.001). There was an estimated decrease of 0.007 in OR for every additional month of follow-up (p = 0.048). In conclusion, implants in diabetic patients showed a 77.7% higher risk of failure than in non-diabetic patients.
PubMed: 35591561
DOI: 10.3390/ma15093227