-
The International Journal of...To synthesize evidence derived from systematic reviews (SRs) on different interventions for rehabilitation of the edentulous maxilla with implant-supported restorations.
PURPOSE
To synthesize evidence derived from systematic reviews (SRs) on different interventions for rehabilitation of the edentulous maxilla with implant-supported restorations.
MATERIALS AND METHODS
A protocol-oriented search was established to address the PICO question: What is the current evidence regarding rehabilitation of the edentulous maxilla with different implant-supported prostheses in terms of implant and prosthesis survival? The primary outcomes were implant and prosthesis survival rates evaluated from SRs of clinical studies including adult patients with complete edentulism of the maxilla and comparing different implant-supported rehabilitation strategies. Methodologic quality of the SRs was assessed with the AMSTAR-2 tool.
RESULTS
The final selection process led to the inclusion of 36 SRs that were grouped as: (1) addressing maxillae with sufficient bone to place implants; (2) addressing maxillae with insufficient bone to place implants; and (3) comparing different types of prosthesis, number of implants, patient-reported outcomes, and economic evaluations. The literature describes four or more implants as suitable for full-arch fixed prostheses and implant-supported overdentures; in both cases, the overall survival rate is > 95%. Mini-implants present very high short-term failure rates (> 30%). Poor description of technical complications, adjustments, and maintenance and corresponding costs precluded a cost-effectiveness analysis.
CONCLUSION
No implant-supported rehabilitation of the edentulous maxilla (fixed or removable) should be supported on fewer than four implants. A one-piece full-arch fixed dental prosthesis can be supported by a minimum of two anterior axial plus two posterior distally tilted implants or by six to eight axial implants symmetrically distributed through the posterior and anterior regions of the arch. Four to six implants is the advised number to support an overdenture. The use of mini-implants in the maxilla is inadvisable.
Topics: Adult; Dental Implants; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Follow-Up Studies; Humans; Jaw, Edentulous; Maxilla; Mouth, Edentulous; Treatment Outcome
PubMed: 33571327
DOI: 10.11607/ijp.7162 -
The Journal of Craniofacial Surgery May 2022Brown's tumor is a benign bone lesion that occurs in the setting of hyperparathyroidism and can affect the facial skeleton. It often presents as a single lesion and is... (Review)
Review
Brown's tumor is a benign bone lesion that occurs in the setting of hyperparathyroidism and can affect the facial skeleton. It often presents as a single lesion and is usually less than 3 centimeters. To our knowledge, no cases have been reported to have bilateral involvement of the maxilla and mandible with the largest dimension measuring over 7 centimeters. This report describes such a case and provides a review of the literature.
Topics: Humans; Mandible; Maxilla; Neoplasms; Ocular Motility Disorders
PubMed: 34690307
DOI: 10.1097/SCS.0000000000008308 -
International Journal of Implant... May 2023To assess the outcome [zygomatic implant (ZI) survival] and complications of the original surgical technique (OST) and an Anatomy-Guided approach (AGA) in the placement... (Review)
Review
PURPOSE
To assess the outcome [zygomatic implant (ZI) survival] and complications of the original surgical technique (OST) and an Anatomy-Guided approach (AGA) in the placement of ZI in patients with severely atrophic maxillae.
METHODS
Two independent reviewers conducted an electronic literature search from January 2000 to August 2022. The inclusion criteria were articles reporting at least five patients with severely atrophic edentulous maxilla undergoing placement OST and/or AGA, with a minimum of 6 months of follow-up. Number of patients, defect characteristics, number of ZI, implant details, surgical technique, survival rate, loading protocol, prosthetic rehabilitation, complications, and follow-up period were compared.
RESULTS
Twenty-four studies comprised 2194 ZI in 918 patients with 41 failures. The ZI survival rate was 90.3-100% in OST and 90.4-100% in AGA. Probability of complications with ZI with OST was as follows: sinusitis, 9.53%; soft tissue infection, 7.50%; paresthesia, 10.78%; oroantral fistulas, 4.58%; and direct surgical complication, 6.91%. With AGA, the presenting complications were as follows: sinusitis, 4.39%; soft tissue infection, 4.35%; paresthesia, 0.55%; oroantral fistulas, 1.71%; and direct surgical complication, 1.60%. The prevalence of immediate loading protocol was 22.3% in OST and 89.6% in the AGA. Due to the heterogeneity of studies, statistical comparison was only possible after the descriptive analysis.
CONCLUSIONS
Based on the current systematic review, placing ZI in severely atrophic edentulous maxillae rehabilitation with the OST and AGA is associated with a high implant survival rate and surgical complications within a minimum of 6 months follow-up. Complications, including sinusitis and soft tissue infection around the implant, are the most common. The utilization of immediate loading protocol is more observed in AGA than in OST.
Topics: Humans; Dental Implants; Dental Implantation, Endosseous; Maxilla; Jaw, Edentulous; Survival Rate; Treatment Outcome; Postoperative Complications; Sinusitis; Soft Tissue Infections; Orthognathic Surgical Procedures; Male; Female; Child, Preschool; Child; Adult; Middle Aged; Aged
PubMed: 37198345
DOI: 10.1186/s40729-023-00478-y -
Journal of Indian Prosthodontic Society 2021This systematic review and meta-analysis evaluated the clinical survival of axial and tilted implants in atrophic edentulous maxilla after three years of immediate... (Meta-Analysis)
Meta-Analysis Review
AIM
This systematic review and meta-analysis evaluated the clinical survival of axial and tilted implants in atrophic edentulous maxilla after three years of immediate loading and also the corresponding marginal bone loss.
SETTING AND DESIGN
This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines (PRISMA).
MATERIALS AND METHODS
The relevant studies were retrieved from MEDLINE(PubMed), the Cochrane Central Register of Controlled Trials (CENTRAL), Science Direct, Google Scholar databases. The search was limited to studies published in the English language with no date restrictions. A further hand search was conducted on individual journals and reference lists of studies. The risk of bias in included studies was assessed by using the Evidence Project risk of bias tool.
STATISTICAL ANALYSIS USED
Statistical meta-analysis was conducted using RevMan 5.4 software. The assessment for the level of evidence was done using GRADEpro software.
RESULTS
Eleven studies were finalised. All were included in the meta-analysis for implant survival, while only seven studies were included in the meta-analysis of marginal bone loss. After three years, the meta-analysis results for implant survival showed no statistical difference between axial and tilted implants, with the forest plot neither favouring axial nor tilted implants (RR = 1.00 (95% CI: 0.98-1.01); P-value = 0.59). After three years, the meta-analysis results for marginal bone showed no statistical difference between axial and tilted implants, with the forest plot neither favouring axial nor tilted implants (MD = -0.02; 95% CI; -0.09-0.06; P-value = 0.69).
CONCLUSION
In the immediately loaded rehabilitation of completely edentulous atrophic maxillae, tilting of implants did not induce any significant alteration in their survival and their corresponding marginal bone loss levels compared to conventionally placed axial implants even after three years of function.
Topics: Alveolar Bone Loss; Humans; Jaw, Edentulous; Maxilla; Mouth, Edentulous; Prostheses and Implants
PubMed: 34380808
DOI: 10.4103/jips.jips_79_21 -
Oral Surgery, Oral Medicine, Oral... Mar 2024
Topics: Humans; Maxilla
PubMed: 38171999
DOI: 10.1016/j.oooo.2023.11.008 -
Journal of Human Evolution Jul 2022Differences in morphology among modern humans and African apes are frequently used when assessing whether hominin fossils should be attributed to a single species or...
Differences in morphology among modern humans and African apes are frequently used when assessing whether hominin fossils should be attributed to a single species or represent evidence for taxic diversity. A good understanding of the degree and structure of the intergeneric, interspecific, and intraspecific variation, including aspects such as sexual dimorphism and age, are key in this context. Here we explore the variation and differences shown by the maxilla of extant hominines, as maxillary morphology is central in the diagnosis of several hominin taxa. Our sample includes adults of all currently recognized hominine species and subspecies, with a balanced species sex ratio. In addition, we compared the adults with a small sample of late juveniles. The morphology of the maxillae was captured using three-dimensional landmarks, and the size and shape were analyzed using geometric morphometric methods. Key observations are that 1) the maxillae of all extant hominine species and subspecies show statistically significant differences, but complete separation in shape is only seen at the genus level; 2) the degree of variation is not consistent between genera, with subspecies of Gorilla being more different from each other than are species of Pan; 3) the pattern of sexual shape dimorphism is different in Pan, Gorilla, and Homo, often showing opposite trends; and 4) differentiation between maxillary shapes is increased after adjustment for static intraspecific allometry. These results provide a taxonomically up-to-date comparative morphological framework to help interpret the hominin fossil record, and we discuss the practical implications in that context.
Topics: Animals; Fossils; Gorilla gorilla; Hominidae; Humans; Maxilla; Sex Characteristics
PubMed: 35617847
DOI: 10.1016/j.jhevol.2022.103210 -
The Journal of Craniofacial SurgeryThe aim of this case series was to evaluate the long-term success rate of immediate occlusal loading of extrasinus zygomatic dental implants after a 3-year follow-up....
The aim of this case series was to evaluate the long-term success rate of immediate occlusal loading of extrasinus zygomatic dental implants after a 3-year follow-up. The sample consisted of 31 patients (mean age of 64 years) with atrophic maxillae rehabilitated with 1 to 4 extrasinus zygomatic implants, placed unilaterally or bilaterally. All the patients received complete implant-supported dental prostheses with immediate loading by associating zygomatic implants with conventional implants. None of the procedures were associated with bone grafts. During the 3-year period of follow-up in the present study, all the patients attended clinical sessions and underwent radiographic exams every 6 months. In total 55 zygomatic and 69 conventional implants were placed, where 1 zygomatic and 2 conventional implants were lost, representing success rates of 98.18% and 97.20%, respectively. None of the studied patients had signs of sinusitis or changes in the maxillary sinuses. All the patients showed occlusal contact on natural antagonist teeth or implant-supported dental prostheses. Therefore, it was concluded that the use of exteriorized zygomatic implants with immediate loading represented a feasible option with high success rates for the treatment of atrophic maxilla.
Topics: Atrophy; Dental Implantation, Endosseous; Dental Implants; Dental Prosthesis, Implant-Supported; Follow-Up Studies; Humans; Jaw, Edentulous; Maxilla; Middle Aged; Treatment Outcome; Zygoma
PubMed: 34907950
DOI: 10.1097/SCS.0000000000008411 -
Clinical Oral Investigations Jan 2015We speculated that the long-term survival of narrow or conventional diameter (<5 mm) implants is higher than that of wide-diameter implants (≥ 5 mm) when placed in... (Review)
Review
OBJECTIVE
We speculated that the long-term survival of narrow or conventional diameter (<5 mm) implants is higher than that of wide-diameter implants (≥ 5 mm) when placed in posterior atrophic maxillae. The aim of this paper was to systematically review indexed literature regarding the influence of implant diameter on long-term survival of dental implants placed in posterior maxilla.
MATERIALS AND METHODS
The addressed focused question was "Does implant diameter influence long-term survival of dental implants placed in posterior maxilla?" Databases were searched from 1986 till June 2014 using the following MeSH terms: "dental implants," "dental implant-abutment design," "maxilla," and "survival." Review articles, case reports, letters to the editor, unpublished data, and studies published in languages other than English were excluded. Reference list of potentially relevant original and review studies was hand-searched.
RESULTS
The initial search yielded 51 studies. Scrutiny of the titles and abstracts reduced the number of clinical studies included in the present review to 19. Mean age of the patients ranged between 37 and 60 years. Cylindrical and tapered implants were used in 12 and 3 studies, respectively. In all studies, threaded, rough-surfaced dental implants with diameters ranging between 3.0 and 5.5 mm were used. In all studies, follow-up periods and cumulative survival rates ranged between 5 and 15 years and 80.5 and 100 %, respectively.
CONCLUSION AND CLINICAL RELEVANCE
The role of implant diameter on long-term survival of dental implants placed in posterior maxilla is secondary. A well-designed surgical protocol, achievement of sufficient primary stability at the time of implant placement, and pre- and postsurgical oral hygiene maintenance visits are critical factors that influence the long-term survival of dental implants placed in posterior atrophic maxilla.
Topics: Dental Implant-Abutment Design; Dental Implantation, Endosseous; Dental Implants; Dental Prosthesis Design; Dental Restoration Failure; Humans; Maxilla
PubMed: 25366871
DOI: 10.1007/s00784-014-1333-z -
Journal of Stomatology, Oral and... Oct 2022Dental rehabilitation of severe atrophic upper jaws remains challenging. A new generation of subperiosteally placed and rigid multi-vector bone-anchored patient-specific...
BACKGROUND
Dental rehabilitation of severe atrophic upper jaws remains challenging. A new generation of subperiosteally placed and rigid multi-vector bone-anchored patient-specific implants proposes an innovative line extension in implant dentistry. This single-center retrospective study focused on treating severely atrophic maxillae using these implants.
METHODS
All patients who were treated with a patient-specific implant (IPS Implant® Preprosthetic, KLS-Martin, Tuttlingen, Germany) at Hannover Medical School due to severe atrophy of the maxilla who had no history of malignancy, cleft lip or palate, or trauma were evaluated regarding implant stability and prosthetic restoration, as well as complications.
RESULTS
Out of a total of 58 inserted implants, 13 implants in 10 patients, which were placed to treat a severely atrophic upper jaw, were identified. The mean follow-up period was 8.2 months (1-29 months). All implants were clinically stable over the entire period. All patients with an observation period of over 2 months received prosthetics for restoration. Minor complications, screw fractures, infection, and exposure of the framework were observed, but these did not lead to failure.
CONCLUSION
This initial follow-up suggests that this new generation of implants represents a valuable treatment alternative, especially for patients with a history of failed dental implant placement. Larger numbers of cases and longer observation periods are required to confirm our findings.
Topics: Atrophy; Dental Implantation, Endosseous; Dental Implants; Dental Prosthesis, Implant-Supported; Follow-Up Studies; Humans; Jaw, Edentulous; Maxilla; Retrospective Studies; Zygoma
PubMed: 34896647
DOI: 10.1016/j.jormas.2021.12.007 -
Journal of Prosthodontics : Official... Aug 2010The purpose of this review was to highlight anatomic and biomechanical aspects of atrophic maxillae for implant possibilities. (Review)
Review
PURPOSE
The purpose of this review was to highlight anatomic and biomechanical aspects of atrophic maxillae for implant possibilities.
MATERIALS AND METHODS
A MEDLINE electronic search of the years 1966 to 2009 was conducted with the keywords "atrophic,""resorbed,""edentulous," and "maxilla."
RESULTS
Twenty papers presented the following findings: (1) previous use of a removable prosthesis is a risk factor for resorption, with flabby tissues related to the severity of resorption; (2) implants in the reconstructed maxilla (< or =5 mm) and supporting overdentures had a higher risk for bone loss based on the worse periimplant soft-tissue health observed; (3) bleeding on probing was found with pocket depths > or =5 mm in half of the zygomatic implants; (4) prevalence of bone septa is higher in atrophic maxillae, and changes on nasopalatine canal can reduce up to 44.4% of the full length of buccal bone plates; (5) female patients have less medullar bone quantity and connectivity than male patients; (6) transectioning of nutrient vessels is easier and accelerates resorption; (7) stress does not concentrate on maxillary sinus base cortical bone contiguous to trabecular bone; (8) splinted implants receive nine times less load than nonsplinted implants even under oblique loading; (9) implant stability quotient (ISQ) values for implants ranged between 60 and 65; (10) in vivo force transfer to implants is similar between fixed prostheses and overdentures; (11) inclined implants generate better biomechanical responses; (12) masticatory efficiency and bite forces improve in maxillectomized patients who receive obturators with milled bar attachments.
CONCLUSION
Sound implant-supported choices for an atrophic maxilla must be made with a thorough understanding of its anatomic and biomechanical factors.
Topics: Atrophy; Biomechanical Phenomena; Bone Resorption; Dental Implants; Female; Humans; Male; Maxilla; Maxillary Diseases; Stress, Mechanical
PubMed: 20546490
DOI: 10.1111/j.1532-849X.2010.00615.x