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Journal of Periodontology Jun 2016Multiple variables have been shown to affect early marginal bone loss (MBL). Among them, the location of the microgap with respect to the alveolar bone crest, occlusion,... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Multiple variables have been shown to affect early marginal bone loss (MBL). Among them, the location of the microgap with respect to the alveolar bone crest, occlusion, and use of a polished collar have traditionally been investigated as major contributory factors for this early remodeling. Recently, soft tissue thickness has also been investigated as a possible factor influencing this phenomenon. Hence, this study aims to further evaluate the influence of soft tissue thickness on early MBL around dental implants.
METHODS
Electronic and manual literature searches were performed by two independent reviewers in several databases, including Medline, EMBASE, and Cochrane Oral Health Group Trials Register, for articles up to May 2015 reporting soft tissue thickness at time of implant placement and MBL with ≥12-month follow-up. In addition, random effects meta-analyses of selected studies were applied to analyze the weighted mean difference (WMD) of MBL between groups of thick and thin peri-implant soft tissue. Metaregression was conducted to investigate any potential influences of confounding factors, i.e., platform switching design, cement-/screw-retained restoration, and flapped/flapless surgical techniques.
RESULTS
Eight articles were included in the systematic review, and five were included in the quantitative synthesis and meta-analyzed to examine the influence of tissue thickness on early MBL. Meta-analysis for the comparison of MBL among selected studies showed a WMD of -0.80 mm (95% confidence interval -1.18 to -0.42 mm) (P <0.0001), favoring the thick tissue group. Metaregression of the selected studies failed to demonstrate an association among MBL and confounding factors.
CONCLUSION
The current study demonstrates that implants placed with an initially thicker peri-implant soft tissue have less radiographic MBL in the short term.
Topics: Alveolar Bone Loss; Alveolar Process; Bone Diseases, Metabolic; Dental Implantation, Endosseous; Dental Implants; Humans; Surgical Flaps
PubMed: 26777766
DOI: 10.1902/jop.2016.150571 -
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 -
Journal of Clinical Periodontology Nov 2022To test whether the emergence profile (CONVEX or CONCAVE) of implant-supported crowns influences the mucosal margin stability up to 12 months after insertion of the... (Randomized Controlled Trial)
Randomized Controlled Trial
AIM
To test whether the emergence profile (CONVEX or CONCAVE) of implant-supported crowns influences the mucosal margin stability up to 12 months after insertion of the final restoration.
MATERIALS AND METHODS
Forty-seven patients with a single implant in the anterior region were randomly allocated to one of three groups: (1) CONVEX (n = 15), implant provisional and an implant-supported crown both with a convex profile; (2) CONCAVE (n = 16), implant provisional and an implant-supported crown both with a concave profile; (3) CONTROL (n = 16), no provisional (healing abutment only) and an implant-supported crown. All patients were recalled at baseline, 6, and 12 months. The stability of mucosal margin along with clinical, aesthetic, and profilometric outcomes as well as time and costs were evaluated. To predict the presence of recession, multivariable logistic regressions were performed and linear models using generalized estimation equations were conducted for the different outcomes.
RESULTS
Forty-four patients were available at 12 months post-loading. The frequency of mucosal recession amounted to 64.3% in group CONVEX, 14.3% in group CONCAVE, and 31.4% in group CONTROL. Regression models revealed that a CONVEX profile was significantly associated with the presence of recessions (odds ratio: 12.6, 95% confidence interval: 1.82-88.48, p = .01) compared with the CONCAVE profile. Pink aesthetic scores amounted to 5.9 in group CONVEX, 6.2 in group CONCAVE, and 5.4 in group CONTROL, with no significant differences between the groups (p = .735). Groups CONVEX and CONCAVE increased the appointments and costs compared with the CONTROL group.
CONCLUSIONS
The use of implant-supported provisionals with a CONCAVE emergence profile results in a greater stability of the mucosal margin compared with a CONVEX profile up to 12 months of loading. This is accompanied, however, by increased time and costs compared with the absence of a provisional and may not necessarily enhance the aesthetic outcomes.
TRIAL REGISTRATION
German Clinical Trials Register; DRKS00009420.
Topics: Crowns; Dental Implants; Dental Implants, Single-Tooth; Dental Prosthesis, Implant-Supported; Esthetics, Dental; Humans
PubMed: 35817419
DOI: 10.1111/jcpe.13696 -
Periodontology 2000 Feb 2022Implant therapy aims at providing the patient with a functional and esthetically pleasing rehabilitation in a long-term perspective. The loss of an implant constitutes a... (Review)
Review
Implant therapy aims at providing the patient with a functional and esthetically pleasing rehabilitation in a long-term perspective. The loss of an implant constitutes a major complication, which may have an impact on the treatment plan and/or jeopardize the longevity of the restoration. Implant loss may occur during the phase of osseointegration (early) or at a later time when the previously achieved osseointegration is lost (late). The present work evaluates the evidence on the occurrence of both events and discusses etiology, risk factors, and consequences.
Topics: Alveolar Bone Loss; Dental Implantation, Endosseous; Dental Implants; Dental Prosthesis, Implant-Supported; Humans; Osseointegration
PubMed: 35103324
DOI: 10.1111/prd.12408 -
Advanced Drug Delivery Reviews Aug 2023Unlike orthopedic implants, dental implants require the orchestration of both osseointegration at the bone-implant interface and soft-tissue integration at the... (Review)
Review
Unlike orthopedic implants, dental implants require the orchestration of both osseointegration at the bone-implant interface and soft-tissue integration at the transmucosal region in a complex oral micro-environment with ubiquitous pathogenic bacteria. This represents a very challenging environment for early acceptance and long-term survival of dental implants, especially in compromised patient conditions, including aged, smoking and diabetic patients. Enabling advanced local therapy from the surface of titanium-based dental implants via novel nano-engineering strategies is emerging. This includes anodized nano-engineered implants eluting growth factors, antibiotics, therapeutic nanoparticles and biopolymers to achieve maximum localized therapeutic action. An important criterion is balancing bioactivity enhancement and therapy (like bactericidal efficacy) without causing cytotoxicity. Critical research gaps still need to be addressed to enable the clinical translation of these therapeutic dental implants. This review informs the latest developments, challenges and future directions in this domain to enable the successful fabrication of clinically-translatable therapeutic dental implants that would allow for long-term success, even in compromised patient conditions.
Topics: Humans; Aged; Dental Implants; Nanotechnology; Osseointegration; Bacteria; Dental Implantation; Titanium; Surface Properties
PubMed: 37263543
DOI: 10.1016/j.addr.2023.114900 -
Pulmonology 2022
Topics: Dental Implants; Foreign Bodies; Humans; Respiration Disorders
PubMed: 35135740
DOI: 10.1016/j.pulmoe.2022.01.003 -
Journal of Oral Science Oct 2022The purpose of this review is to search for complications of dental implant superstructures and consider the issues involved. This narrative review was performed by... (Review)
Review
The purpose of this review is to search for complications of dental implant superstructures and consider the issues involved. This narrative review was performed by searching through PubMed databases and review articles that were published after 1990. Misfitting of the superstructure can result in loosening of screws, reduced preload, and in some cases, significant stress around the implant. External connection modalities and single implant prostheses have been reported to have more loose or broken abutment screws. In addition, when zirconia abutment was used for platform shifting, the rate of fracture of the abutment was considered to be high. Additionally, it was reported that men were significantly at an increased risk of abutment fracture. As for the retention mechanism of implant overdenture, stud attachment (Locator type) should receive more attention to wear and damage of retention parts than other attachments. The causes of the complications of implant superstructures have not been clarified in some cases, and further verification is required. Verification of complications is considered important to obtain a long-term prognosis for superstructures of implants. It will be necessary to further verify complications of implants in the future.
Topics: Dental Abutments; Dental Implants; Dental Prosthesis, Implant-Supported; Dental Stress Analysis; Denture, Overlay; Humans; Male
PubMed: 35989295
DOI: 10.2334/josnusd.21-0534 -
International Journal of Molecular... Apr 2010Among various dental materials and their successful applications, a dental implant is a good example of the integrated system of science and technology involved in... (Review)
Review
Among various dental materials and their successful applications, a dental implant is a good example of the integrated system of science and technology involved in multiple disciplines including surface chemistry and physics, biomechanics, from macro-scale to nano-scale manufacturing technologies and surface engineering. As many other dental materials and devices, there are crucial requirements taken upon on dental implants systems, since surface of dental implants is directly in contact with vital hard/soft tissue and is subjected to chemical as well as mechanical bio-environments. Such requirements should, at least, include biological compatibility, mechanical compatibility, and morphological compatibility to surrounding vital tissues. In this review, based on carefully selected about 500 published articles, these requirements plus MRI compatibility are firstly reviewed, followed by surface texturing methods in details. Normally dental implants are placed to lost tooth/teeth location(s) in adult patients whose skeleton and bony growth have already completed. However, there are some controversial issues for placing dental implants in growing patients. This point has been, in most of dental articles, overlooked. This review, therefore, throws a deliberate sight on this point. Concluding this review, we are proposing a novel implant system that integrates materials science and up-dated surface technology to improve dental implant systems exhibiting bio- and mechano-functionalities.
Topics: Biocompatible Materials; Dental Implants; Dental Materials; Elastic Modulus; Humans; Metals; Oxides; Surface Properties
PubMed: 20480036
DOI: 10.3390/ijms11041580 -
Medicina (Kaunas, Lithuania) Apr 2023: This project was developed from anecdotal evidence of varied practices around antibiotic prescribing in dental procedures. The aim of the study was to ascertain if... (Meta-Analysis)
Meta-Analysis Review
: This project was developed from anecdotal evidence of varied practices around antibiotic prescribing in dental procedures. The aim of the study was to ascertain if there is evidence to support whether antibiotic (AB) use can effectively reduce postoperative infections after dental implant placements (DIPs). : Following PRISMA-P© methodology, a systematic review of randomised controlled clinical trials was designed and registered on the PROSPERO© database. Searches were performed using PubMed, Science Direct and the Cochrane© Database, plus the bibliographies of studies identified. The efficacy of prophylactic antibiotics, independent of the regimen used, versus a placebo, control or no therapy based on implant failure due to infection was the primary measured outcome. Secondary outcomes were other post-surgical complications due to infection and AB adverse events. : Twelve RCTs were identified and analysed. Antibiotic use was reported to be statistically significant in preventing infection ( < 001). The prevention of complications was not statistically significant ( = 0.96), and the NNT was >5 (14 and 2523 respectively), which indicates that the intervention was not sufficiently effective to justify its use. The occurrence of side effects was not statistically significant ( = 0.63). NNH was 528 indicating that possible harm caused by the use of ABs is very small and does not negate the AB use when indicated. : The routine use of prophylactic antibiotics to prevent infection in dental implant placement was found to be not sufficiently effective to justify routine use. Clear clinical assessment pathways, such as those used for medical conditions, based on the patients' age, dental risk factors, such as oral health and bone health, physical risk factors, such as chronic or long-term conditions and modifiable health determinants, such as smoking, are required to prevent the unnecessary use of antibiotics.
Topics: Humans; Anti-Bacterial Agents; Antibiotic Prophylaxis; Dental Implants
PubMed: 37109671
DOI: 10.3390/medicina59040713 -
JPMA. the Journal of the Pakistan... Feb 2022To identify top 30 studies related to dental implant failures based on bibliometric analysis. (Review)
Review
OBJECTIVE
To identify top 30 studies related to dental implant failures based on bibliometric analysis.
METHODS
The bibliometric study was conducted at Aga Khan University, Karachi from April 2021 to June 2021 and comprised database search on Google Scholar used key words "dental implant failures" for studies published between 1990 and 2020. The selected studies were reviewed based on citation count for which the cut-off date was June 1, 2021.
RESULTS
The top 30 papers on dental implant failures had median citation count of 153 (range: 41-1583. Most of the studies were retrospective 11(36.7%), followed by literature reviews 6(20%). The top three contributing journals were the 'International Journal of Oral Maxillofacial Implants' 6(20%), the 'Clinical Oral Implants Research' 5(16.7%) and 'Clinical Implant Dentistry and Related Research' 3(10%). Goteborg University, Sweden, contributed the maximum number of most cited papers 8(26.7%).
CONCLUSIONS
Most of the papers in the top-cited on dental implant failures were retrospective studies, and there was only one clinical trial.
Topics: Bibliometrics; Dental Implants; Dental Restoration Failure; Humans; Retrospective Studies
PubMed: 35202375
DOI: 10.47391/JPMA.AKU-15