European Journal Of Oral Implantology[JOURNAL]
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200 papers
From the maxillary sinus to the stomach: a rare case report of a displaced fragment of dental implant.
Park JH, Kim HY, Kim SJ
Eur J Oral Implantol · 2018 · PMID 30515486
PURPOSE: To present a rare clinical case of migration of a displaced implant fragment from the maxillary sinus to the stomach. MATERIALS AND METHODS: A 66-year-old man was referred from a local dental clinic to remove a...
PURPOSE: To present a rare clinical case of migration of a displaced implant fragment from the maxillary sinus to the stomach. MATERIALS AND METHODS: A 66-year-old man was referred from a local dental clinic to remove a displaced implant apical fragment in the left maxillary sinus. After 15 days from the displacement, no foreign body was seen in the maxillary sinus or in any other craniofacial cavity. Thoracic and abdominal radiographs were taken, and a 3 × 3 mm radiopaque object, which corresponded to the piece of implant fragment, was detected within the patient's stomach. RESULTS: Follow-up radiographs were taken to monitor the progress after 1 week, and it was found that the radiopaque object had disappeared. CONCLUSIONS: A displaced dental implant fragment in the maxillary sinus can migrate and exit from the maxillary sinus within a few days. Since it presents a potential risk for swallowing or aspiration, displaced implants or other objects in the maxillary sinus should be removed immediately. Before removal, additional radiographs are recommended to confirm the current position of the implant.
Non-surgical mechanical treatment of peri-implant mucositis: the effect of sub-mucosal mechanical instrumentation following supra-mucosal plaque removal. A 7-month prospective single cohort study.
Serino G, Wada M
Eur J Oral Implantol · 2018 · PMID 30515485
PURPOSE: To evaluate the effect of sub-mucosal mechanical instrumentation following supra-mucosal plaque removal in the treatment of peri-implant mucositis. MATERIALS AND METHODS: A total of 44 patients, 27 from a specia...
PURPOSE: To evaluate the effect of sub-mucosal mechanical instrumentation following supra-mucosal plaque removal in the treatment of peri-implant mucositis. MATERIALS AND METHODS: A total of 44 patients, 27 from a specialist clinic in Sweden, and 17 from a Japanese one, were included. The 44 patients had a total of 175 implants of which 84 (48%) had clinical signs of mucositis (bleeding on probing [BoP]) and no radiographic bone loss. At baseline, the 44 patients received professional supra-mucosal plaque removal and oral hygiene instruction and motivation. Following the 1-month examination, sub-mucosal instrumentation was initiated using ultrasonic and hand instruments. Patients were then examined at 4 and 7 months. Presence of plaque, marginal bleeding, BoP and probing pocket depth (PPD) changes were recorded at each examination in an unblinded manner. RESULTS: One month following supra-mucosal plaque removal, the number of treated implants with BoP was reduced from 84 to 44 (48% reduction) with a concomitant decrease of the mean PPD of 0.6 mm (95% CI: -0.5 to -0.7), from 4.4 ± 1.0 mm (mean ± SD) to 3.8 ± 1.0 mm, P < 0.0001. Following sub-mucosal instrumentation, a further reduction of 9% (from 44% to 36%) of BoP was recorded, with a concomitant reduction of the mean PPD of 0.3 mm (95% CI: -0.1 to -0.4) at the 7-month examination. CONCLUSIONS: The improvement of the clinical condition (absence of marginal bleeding, BoP and PPD reduction at treated implants) following non-surgical treatment of mucositis appeared to be in great part because of supra-mucosal plaque removal, while the sub-mucosal instrumentation seemed to have only a minor additional effect. Deep implant position compared to neighbouring teeth/implant was associated with persisting mucositis following treatment. The presence of deep pockets following treatment was associated with BoP, screw-retained prostheses without abutment and sub-mucosal crown margins.
Comparing membranes and bone substitutes in a one-stage procedure for horizontal bone augmentation. Three-year post-loading results of a double-blind randomised controlled trial.
Merli M, Moscatelli M, Mariotti G … +3 more , Pagliaro U, Raffaelli E, Nieri M
Eur J Oral Implantol · 2018 · PMID 30515484
PURPOSE: The objective of this 3-year post-loading parallel randomised controlled trial is to compare two bone substitutes and resorbable membranes in a one-stage procedure for horizontal bone augmentation: anorganic bov...
PURPOSE: The objective of this 3-year post-loading parallel randomised controlled trial is to compare two bone substitutes and resorbable membranes in a one-stage procedure for horizontal bone augmentation: anorganic bovine bone and porcine collagen membranes (BB group) versus synthetic resorbable bone graft substitute made of pure β-tricalcium phosphate and porcine pericardium collagen membranes (CJ group). MATERIALS AND METHODS: Patients in need of implant treatment having at least one site with horizontal osseous defect at a private clinic in Rimini, Italy, were included in this study. Patients were randomised to receive either BB or CJ in a one-stage procedure for horizontal bone augmentation in a submerged approach. Randomisation was computer-generated with allocation concealment by opaque sequentially numbered sealed envelopes. Patients and the outcome assessor were blinded to group assignment. The abutment connection was made after 6 months of healing. The application of the provisional prosthesis was performed after abutment connection and a definitive metal-ceramic prosthesis was placed 6 months post-loading. The patients were followed-up to 3 years post-loading. Primary outcome measures were: implant failure, complications and peri-implant margin bone level changes. Secondary outcome measures were: visual analogue scale (VAS) for functional and aesthetic satisfaction and pink aesthetic score (PES). RESULTS: Twenty-five patients with 32 implants were randomly allocated to the BB group and 25 patients with 29 implants to the CJ group. All 50 randomised patients received the treatment as allocated and there were 7 drop-outs in the BB group and 11 drop-outs in the CJ group up to 3 years' post-loading. There were no implant failures. There were six complications in five patients of the BB group and three complications in three patients of the CJ group (relative risk: 1.32, 95% CI from 0.37 to 4.64, P = 1.0000). Radiographic bone loss was 1.61 mm for the BB group and 1.02 mm for the CJ group (difference 0.54 mm, 95% CI from -0.53 to 1.60, P = 0.3100). The functional VAS was 9.0 for the BB group and 9.6 for the CJ group (difference 0.6, 95% CI from -0.4 to 1.5, P = 0.2393). The aesthetic VAS was 9.4 for the BB group and 9.6 for the CJ group (difference 0.2, 95% CI from -0.5 to 0.8, P = 0.6141). PES was 8.7 for the BB group and 8.5 for the CJ group (difference -0.1, 95% CI from -2.9 to 2.7, P = 0.9360). CONCLUSIONS: No significant differences were observed in this randomised controlled trial comparing anorganic bovine bone with porcine collagen membranes versus synthetic resorbable bone made of pure β-tricalcium phosphate with pericardium collagen membranes for horizontal augmentation.
Endodontic retreatment versus dental implants of teeth with an uncertain endodontic prognosis: 3-year results from a randomised controlled trial.
Esposito M, Trullenque-Eriksson A, Tallarico M
Eur J Oral Implantol · 2018 · PMID 30515483
PURPOSE: To ascertain whether in the presence of a previously endodontically treated tooth with periapical pathology and/or symptoms and an uncertain prognosis, it is better to endodontically retreat it or to replace the...
PURPOSE: To ascertain whether in the presence of a previously endodontically treated tooth with periapical pathology and/or symptoms and an uncertain prognosis, it is better to endodontically retreat it or to replace the tooth with a single-implant-supported crown. MATERIALS AND METHODS: Twenty patients requiring the treatment of a previously endodontically treated tooth, with periapical pathology and/or symptoms of endodontic origin and an uncertain prognosis, as judged by the recruiting investigator, were randomly allocated to endodontic retreatment (Endo group, 10 patients) or tooth extraction and replacement with an implant-supported crown (Implant group, 10 patients) according to a parallel-group design at a single centre. Patients were followed to 3 years after completion of the treatment. Outcome measures were: failure of the procedure, complications, marginal bone level changes at both teeth and implants, endodontic radiographic success (teeth only), number of patients' visits and days to complete the treatment, patients' chair time, costs, aesthetics assessed using the pink aesthetic score (PES) for the soft tissues and the white aesthetic score (WES) for the tooth/crown recorded by independent assessors. RESULTS: No patient dropped out. One endodontically retreated tooth fractured and another had a crown loosening. There were no statistically significant differences for treatment failure or complications (difference in proportions = 0.10; 95% CI: -0.09 to 0.29; P (Fisher exact test) = 1.000). The mean marginal bone levels at endodontic retreatment/implant insertion were 2.10 ± 0.66 mm for the Endo group and 0.05 ± 0.15 mm for the Implant group. Three years after completion of the treatment, teeth lost on average 0.23 ± 0.82 mm and implants 0.62 ± 0.68 mm, the difference not being statistically significant (mean difference = -0.39 mm; 95% confidence interval [CI]: -1.12 to 0.33; P (t test) = 0.267). Three years after completion of the endodontic retreatment, of the four teeth that originally had a periapical radiolucency, one was lost, two showed complete healing, and one showed radiographic improvement. There were no statistically significant differences for the number of patients' visits (Endo = 6.67 ± 0.71; Implant = 6.10 ± 0.74; mean difference = 0.57; 95% CI: -0.14 to 1.27; P (t test) = 0.106). It took significantly more days to complete the implant rehabilitation (Endo = 61 ± 12.97; Implant = 191.40 ± 75.04; mean difference = -130.40; 95% CI: -184.45 to -76.35; P (t test) < 0.001) but less patients' chair time (Endo = 629.44 ± 43.62 min; Implant = 326 ± 196.99 min; mean difference = 303.44; 95% CI: 160.87 to 446.02; P (t test) = 0.001). Implant treatment was significantly more expensive (Endo = €1,588.89 ± 300.81; Implant = €2,095 ± 158.90; mean difference = €-506.11; 95% CI: -735.41 to -276.82; P (t test) < 0.001). Three years after treatment completion, mean PES were 11.11 ± 1.97 and 6.50 ± 2.46 and mean WES were 7.78 ± 1.30 and 6.80 ± 2.39 in the Endo group and Implant group, respectively. Soft tissues aesthetics (PES) were significantly better at endodontically retreated teeth (mean difference 4.61; 95% CI: 2.44 to 6.78; P (t test) < 0.001) whereas no significant differences were observed for tooth aesthetics (WES) (mean difference 0.98; 95% CI: -0.89 to 2.85; P (t test) = 0.281) between treatments. CONCLUSIONS: The present preliminary results suggest that both endodontic retreatment and replacement of previously endodontically treated teeth with persisting pathology and a dubious endodontic prognosis provided similar short-term success rates. Aesthetics of the soft tissues and time needed to complete treatment were in favour of endodontic retreatment whereas implant rehabilitation required half of the chair time than endodontic retreatment, but was significantly more expensive. Much larger patient populations and longer follow-ups are needed to fully answer this question; however, in this scenario the less invasive endodontic retreatment could be the first therapeutic option to be considered.
Immediate non-occlusal versus delayed loading of mandibular first molars. Five-year results from a randomised controlled trial.
Meloni SM, Baldoni E, Duvina M … +3 more , Pisano M, De Riu G, Tallarico M
Eur J Oral Implantol · 2018 · PMID 30515482
PURPOSE: To compare outcomes of immediate non-occlusal loading with delayed implant loading in the bilateral replacement of mandibular first molars. MATERIALS AND METHODS: This study was designed as a split-mouth, random...
PURPOSE: To compare outcomes of immediate non-occlusal loading with delayed implant loading in the bilateral replacement of mandibular first molars. MATERIALS AND METHODS: This study was designed as a split-mouth, randomised controlled trial. Twenty patients with bilaterally missing mandibular first molars randomly received immediately or conventionally loaded single implants. One molar was restored with a non-occlusal temporary crown within 24 hours after implant placement (immediate loading group, IL) while the contralateral molar was restored with a definitive crown 4 to 5 months later (delayed loading group, DL). A total of 40 implants were installed. All implants were inserted in healed bone with an insertion torque between 35 and 45 Ncm. Outcome measures were implant failure, complications, radiographic marginal bone level changes, probing pocket depths (PPDs) and bleeding on probing (BOP). Clinical data were collected at implant placement, and after 6, 12 and 60 months. RESULTS: No patients dropped out and no implant failed. Only minor prosthetic complications were observed (two provisional acrylic crown fractures in the IL group and four ceramic chipping in the DL group). Two patients had bilateral peri-implant mucosal inflammation with BOP after 6 months. The differences between groups were not statistically significant (OR = 0.500; 95% CI: 0.045 to 3.489; P = 0.6831). At the 1-year follow-up examination, the mean marginal bone level was 0.83 ± 0.16 mm (95% CI: 0.75 to 0.91) in the IL group and 0.86 ± 0.16 mm (95% CI: 0.78 to 0.94) in the DL group, with no statistically significant differences between groups (difference = 0.03 ± 0.15 mm; 95% CI: -0.07 to 0.07; P = 0.53). After 5 years, mean marginal bone level was 1.06 ± 0.38 mm (95% CI: 0.97 to 1.15) in the IL group and 1.07 ± 0.32 mm (95% CI: 0.95 to 1.16) in the DL group, with no statistically significant differences between groups (difference = 0.01 ± 0.22 mm; 95% CI: -0.10 to 0.10; P = 0.96). The mean marginal bone loss after 5 years was 0.62 ± 0.45 mm in the IL group and 0.69 ± 0.33 mm in the DL group (difference = 0.07 ± 0.32 mm; 95% CI: -0.10 to 0.18; P = 0.567). At the 5-year follow-up the mean PPD and BOP values were 2.82 ± 0.65 mm and 1.17 ± 0.92 in the IL group, and 2.85 ± 0.53 mm and 1.17 ± 0.86 in the DL group, respectively. No significant differences were found (difference = 0.03 ± 0.15 mm; 95% CI: -0.15 to 0.21; P = 0.990; and 0.01 ± 0.07; 95% CI: -0.06 to 0.08; P = 1.000, respectively). CONCLUSIONS: Within the limitations of this study, the present data seem to confirm the hypothesis that the clinical outcome of immediate versus delayed loading of implants in mandibular fist molar sites is comparable.
Do we need abutments at immediately loaded implants supporting cross-arch fixed prostheses? Results from a 5-year randomised controlled trial.
Todisco M, Sbricoli L, Ippolito DR … +1 more , Esposito M
Eur J Oral Implantol · 2018 · PMID 30515481
PURPOSE: To compare the clinical outcome (in particular of marginal peri-implant bone level changes) between immediately loaded straight implants which had definitive abutments placed at implant placement and never remov...
PURPOSE: To compare the clinical outcome (in particular of marginal peri-implant bone level changes) between immediately loaded straight implants which had definitive abutments placed at implant placement and never removed versus implants which had no intermediate abutments. MATERIALS AND METHODS: Thirty-two edentulous patients had one of their jaws rehabilitated with a provisional screw-retained resin reinforced cross-arch fixed prosthesis supported by four immediately loaded implants: two central straight implants and two either tilted or straight distal implants. The two central straight implants were randomly allocated in two equal groups to receive or not an intermediate abutment (Multi-Unit Abutment, MUA) according to a parallel group design. To be immediately loaded implants had to be inserted with a minimum torque of 30 Ncm, which was achieved by all implants. After 4 months, definitive screw-retained metal-ceramic prostheses were delivered and patients were followed-up to 5 years after loading. Prostheses were removed every 8 months to facilitate professionally delivered maintenance. Outcome measures were prosthesis and implant failures, complications, peri-implant marginal bone level changes and bleeding on probing (BoP). RESULTS: Five-years after loading one patient dropped out from each group. No implant or prosthetic failure occurred. Three patients of the abutment group versus one of the no-abutment group were affected by complications (risk difference = 0.125; 95% CI: -0.13 to 0.37; Fisher exact test, P = 0.600). At 5 years, both groups lost marginal bone in a statistically significant way (0.32 ± 0.40 mm for patients of the abutment group and 0.35 ± 0.29 mm for patients of the no-abutment group), with no difference in bone loss between groups at patient levels (difference = 0.03 mm; 95% CI: -0.23 to 0.29 mm; P = 0.809). At 5 years, BoP was significantly higher in the no-abutment group than in the abutment group (difference between medians = 25%; 95% CI: 12.5% to 25%; P < 0.001). By considering only the average of the two central study implants per patient with and without intermediate abutments, there were no differences in bone loss (difference: -0.05 mm; 95% CI: -0.41 to 0.31 mm; P = 0.763), while marginal bleeding was significantly higher in the no-abutment group (difference between medians = 25%; 95% CI: 0% to 50%; P = 0.004). CONCLUSIONS: The present results suggest that intermediate abutments may not be needed at immediately loaded cross-arch screw-retained prostheses, unless there is the necessity to correct implant angulation.
Short implants versus longer implants in vertically augmented posterior mandibles: result at 8 years after loading from a randomised controlled trial.
Felice P, Barausse C, Pistilli R … +2 more , Ippolito DR, Esposito M
Eur J Oral Implantol · 2018 · PMID 30515480
PURPOSE: To evaluate whether 6.6-mm long implants could be a suitable alternative to longer implants placed in vertically augmented atrophic posterior mandibles. MATERIALS AND METHODS: Sixty partially edentulous patients...
PURPOSE: To evaluate whether 6.6-mm long implants could be a suitable alternative to longer implants placed in vertically augmented atrophic posterior mandibles. MATERIALS AND METHODS: Sixty partially edentulous patients having 7 to 8 mm of residual crestal height and at least 5.5-mm thickness measured on computed tomography scans above the mandibular canal were randomly allocated according to a parallel-group design either to receive one to three submerged 6.6-mm long implants or 9.6-mm or longer implants (30 patients per group) placed in vertically augmented bone. Bone was augmented with interpositional anorganic bovine bone blocks fixed with titanium plates and covered with resorbable barriers. Grafts were left to heal for 5 months before implant placement. Four months after implant placement, provisional acrylic prostheses were delivered, replaced, after 4 months, by definitive metal-ceramic prostheses. Outcome measures were: prosthesis and implant failures, complications, and radiographic peri-implant marginal bone level changes. Patients were followed up to 8 years after loading. RESULTS: Eight years after loading 12 patients dropped out, five from the short implant group and seven from the augmented group. The augmentation procedure failed in two patients and only 6.6-mm long implants could be inserted. There were no statistically significant differences for prosthesis and implant failures. Four prostheses failed in three patients of the short implant group versus three prostheses in three patients of the augmented group (Fisher exact test P = 1.000; difference in proportions = 0.01; 95% CI: -0.19 to 0.22). Five short implants failed in three patients versus three long implants in three patients (Fisher exact test P = 1.000; difference in proportions = 0.01; 95% CI: -0.19 to 0.22). There were statistically more complications in augmented patients (27 complications in 22 augmented patients versus 9 complications in 8 patients of the short implant group) (Fisher exact test P < 0.001; difference in proportions = 0.64; 95% CI: 0.38 to 0.79). Both groups gradually lost peri-implant bone in a statistically significant way. Eight years after loading, short implant group patients lost an average of 1.58 mm of peri-implant bone compared with 2.46 mm in the augmented group. Short implants experienced statistically significantly less bone loss (0.88 mm, 95% CI: 0.50 to 1.26 mm) than long implants. CONCLUSIONS: When residual bone height over the mandibular canal is between 7 and 8 mm, 6.6-mm short implants are an interesting alternative to vertical augmentation in posterior atrophic mandibles since the treatment is faster, cheaper and associated with less morbidity.
Editorial: The European Journal of Oral Implantology becomes the International Journal of Oral Implantology Editorial.
Esposito M
Eur J Oral Implantol · 2018 · PMID 30515479
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Research in focus.
Eur J Oral Implantol · 2018 · PMID 30246189
This section presents a brief review of articles on dental implants considered of special interest for the reader, in order to encourage the developing of research, the interest for data analysis and the attention to sci...
This section presents a brief review of articles on dental implants considered of special interest for the reader, in order to encourage the developing of research, the interest for data analysis and the attention to scientific publications. Your comments are welcome. Please contact Dr Michele Nieri at michelenieri@gmail.com.
A controlled study on the accuracy and precision of intraoral radiography in assessing interproximal bone defect morphology around teeth and implants.
Christiaens V, De Bruyn H, De Vree H … +3 more , Lamoral S, Jacobs R, Cosyn J
Eur J Oral Implantol · 2018 · PMID 30246188
PURPOSE: The primary objective of the present controlled study was to determine the accuracy and precision of intraoral radiography in assessing interproximal bone defect morphology in patients suffering from periodontal...
PURPOSE: The primary objective of the present controlled study was to determine the accuracy and precision of intraoral radiography in assessing interproximal bone defect morphology in patients suffering from periodontal disease as well as in patients with peri-implantitis. A secondary objective was to evaluate the possible impact of clinical experience on accuracy and precision. MATERIALS AND METHODS: The study sample comprised a total of 99 interproximal bony defects (40 patients) needing surgical treatment. Forty-nine defects were periodontal (17 patients), while the remaining 50 were peri-implant defects (23 patients). Following reflection of a mucoperiosteal flap and removal of granulation tissue, the type of bone defect as classified by Goldman and Cohen (1958) was determined. This intrasurgical registration was considered the true bone defect morphology. An intraoral radiograph was taken for each interproximal site. Twenty clinicians determined the bone defect morphology on each intraoral radiograph twice, with a washout period of 3 months. RESULTS: Using the Goldman and Cohen (1958) classification, the overall accuracy of intraoral radiography in assessing interproximal bone defect morphology was slight for teeth/implants (κ = 0.132; 95% CI: 0.091 to 0.173/κ = 0.126; 95% CI: 0.091 to 0.162). Duplicate evaluation indicated fair precision (κ = 0.369; 95% CI: 0.308 to 0.430/κ = 0.355; 95% CI: 0.230 to 0.414). Pooling one-, two- and three-wall defects into one category had a positive impact on accuracy (κ = 0.254; 95% CI: 0.201 to 0.307/κ = 0.387; 95% CI: 0.340 to 0.435), as well as on precision (κ = 0.504; 95% CI: 0.423 to 0.584/κ = 0.560; 95% CI: 0.463 to 0.657). A significant difference between experienced clinicians and trainees was not found (P ≥ 0.285). CONCLUSIONS: Intraoral radiography lacks accuracy for assessing interproximal bone defect morphology around teeth and implants. Clinical experience does not seem to influence this.
1-year results from a split-mouth randomised controlled pilot trial comparing implants with 0.75 mm of machined collar placed at bone level or supracrestally.
Meloni SM, Baldoni E, Pisano M … +3 more , Tullio A, De Riu G, Tallarico M
Eur J Oral Implantol · 2018 · PMID 30246187
PURPOSE: The present study evaluated the hypothesis that implants inserted at bone level or supracrestally have different outcomes in single tooth replacements against the alternative hypothesis of no difference. MATERIA...
PURPOSE: The present study evaluated the hypothesis that implants inserted at bone level or supracrestally have different outcomes in single tooth replacements against the alternative hypothesis of no difference. MATERIALS AND METHODS: This study was designed as a randomised, split-mouth, controlled pilot trial. Ten patients, each missing two bicuspids or molars, were treated with 20 implants featuring 0.75 mm of machined collar. Each patient randomly received one implant inserted at bone level (BL) and one inserted 0.75 mm to 1 mm above the alveolar crest (SC), measured with a periodontal probe during surgery. All the implants were inserted into healed healthy bone with an insertion torque ranging between 35 Ncm and 45 Ncm. Both implants were loaded with screw-retained acrylic-resin temporary crowns 3 months after implant insertion and 3 months later with screw-retained zirconia-ceramic definitive crowns. Outcome measures were implant/crown failures, biological and prosthetic complications, radiographic marginal bone level changes (MBL), probing pocket depth (PPD) and bleeding on probing (BOP). Clinical data were collected at baseline (implant insertion) and 1 year after implant placement (9 months after initial loading). RESULTS: After 1 year of follow-up, no patients dropped out, no implants failed, and no complications occurred. The mean MBL at the 1-year follow-up was 0.28 ± 0.21 mm in the SC group and 0.93 ± 0.37 mm in the BL group. While the difference in MBL was statistically significant between the two treatment groups (difference 0.65 ± 0.34; 95% CI = 0.59 to 1.01; P = 0.0001), the soft-tissue parameters were not statistically different. The mean PPD was 2.63 ± 2.4 in the SC group and 2.40 ± 0.70 in the BL group (P = 0.419) and mean BOP was 0.50 ± 0.71 in the SC group and 0.40 ± 0.70 in the BL group (P = 0.754). CONCLUSIONS: The smooth-collar implants inserted supracrestally showed 0.7 mm less radiographic marginal bone loss compared with implants inserted at the bone level 9 months after loading.
Immediate vs conventional loading of variable-thread tapered implants supporting three- to four-unit fixed partial dentures in the posterior maxilla: 1-year interim results of a split-mouth randomised controlled trial.
Abi-Aad H, Daher F, Dimassi H … +2 more , Cordioli G, Majzoub Z
Eur J Oral Implantol · 2018 · PMID 30246186
PURPOSE: To compare the outcome of immediately loaded and one-stage conventionally loaded variable-thread tapered implants in the posterior maxilla. MATERIALS AND METHODS: This study was designed as a split-mouth randomi...
PURPOSE: To compare the outcome of immediately loaded and one-stage conventionally loaded variable-thread tapered implants in the posterior maxilla. MATERIALS AND METHODS: This study was designed as a split-mouth randomised controlled trial. Twenty-six patients missing teeth bilaterally in the posterior maxilla received three to four implants in each of the posterior sextants. Bone quality was recorded based on Misch criteria (D1-D4) and insertion torque values were measured using a manual wrench. The implants on one side were immediately loaded with a temporary resin fixed partial denture on definitive multi-unit abutments. The implants in the contralateral side received definitive multi-unit abutments according to the one-stage unloaded protocol. Three to 3.5 months following implant placement, the implants were restored with metal-ceramic fixed prostheses. Outcome measures were implant and prosthesis failure rates, complications, and peri-implant bone level changes at 1 year following delivery of the definitive prostheses. RESULTS: Two patients dropped out prior to the delivery of definitive prostheses. Four implants supporting a four-unit immediately loaded prosthesis failed in one patient, 3 months following delivery of the definitive prostheses. None of the conventionally loaded implants or prostheses failed. There were no significant differences in the proportions of implant and prosthesis failures (difference = 4.2%; 95% CI -4.2 to 12.6%; P = 0.999). In the immediately loaded group, four early prosthetic complications occurred during the provisionalization phase (three small resin chippings and one prosthetic screw loosening). No other complications were reported. The difference in the rate of complications between the two interventions was not statistically significant (difference = 16.7%; 95% CI -1.2% to 35.6%; P = 0.125). The 1-year peri-implant marginal bone level changes were evaluated in 23 patients (77 immediately loaded and 76 conventionally loaded implants). On average, patients lost 0.42 mm at the immediately loaded and 0.46 mm at the conventionally loaded implants, the difference being statistically not significant (difference = 0.044 mm; 95% CI -0.27 to 0.18 mm; P = 0.701). CONCLUSIONS: Immediate loading of 3- to 4-unit fixed partial prostheses supported by variable-thread implants in the posterior maxilla can yield good and similar 1-year results to one-stage conventionally loaded implants.
Immediate loading of three (fixed-on-3) vs four (fixed-on-4) implants supporting cross-arch fixed prostheses: 1-year results from a multicentre randomised controlled trial.
Cannizzaro G, Cavallari M, Lazzarini M … +6 more , Purello D'ambrosio G, Scialpi G, Audino S, Velasco-Ortega E, Ippolito DR, Esposito M
Eur J Oral Implantol · 2018 · PMID 30246185
PURPOSE: To evaluate the outcome of three (fixed-on-3 = Fo3) vs four (fixed-on-4 = Fo4) implants immediately restored with metal-resin screw-retained cross-arch prostheses in fully edentulous jaws. MATERIALS AND METHODS:...
PURPOSE: To evaluate the outcome of three (fixed-on-3 = Fo3) vs four (fixed-on-4 = Fo4) implants immediately restored with metal-resin screw-retained cross-arch prostheses in fully edentulous jaws. MATERIALS AND METHODS: Forty-eight edentulous or to be rendered edentulous patients were randomised in six centres (eight patients per centre) to the Fo3 group (24 patients: 12 maxillae and 12 mandibles) and to the Fo4 group (24 patients: 12 maxillae and 12 mandibles) according to a parallel group design. To be immediately loaded, implants had to be inserted with a minimum torque of 40 Ncm. Outcome measures were prosthesis and implant failures, complications and peri-implant marginal bone level changes evaluated up to 1 year post-loading. RESULTS: One maxillary prosthesis per group was delayed loaded because implants could not be placed with a torque of at least 40 Ncm. Ten patients in the Fo3 group and four in the Fo4 group had implants placed flapless. One year after loading no drop out occurred. One patient of the Fo3 group lost three implants vs three patients of the Fo4 group who lost four implants, the difference being no statistically significant (risk difference = -0.08; 95% CI: -0.27 to 0.10; Fisher's exact test P = 0.609). One mandibular Fo3 and one maxillary Fo4 prosthesis failed. Six Fo3 patients were affected by complications vs three Fo4 patients (risk difference = 0.12; 95% CI: -0.10 to 0.34; Fisher's exact test; P = 0.461). Both groups lost marginal bone in a statistically significant way (0.22 ± 0.20 mm for Fo3 patients and 0.40 ± 0.21 mm for Fo4 patients), with Fo3 group showing less marginal peri-implant bone loss than Fo4 group (estimate of the difference = -0.18 (standard error: 0.06) mm; 95% CI: -0.30 to -0.06; P = 0.005). There were no differences in clinical outcomes between the six operators. CONCLUSIONS: These preliminary results suggest that immediately loaded cross-arch prostheses of both jaws can be supported by only three dental implants at least up to 1 year post-loading, though longer follow-ups are definitively needed.
Immediate loading of occluding definitive partial fixed prostheses vs non-occluding provisional restorations - 3-year post-loading results from a pragmatic multicentre randomised controlled trial.
Esposito M, Grufferty B, Papavasiliou G … +3 more , Dominiak M, Trullenque-Eriksson A, Heinemann F
Eur J Oral Implantol · 2018 · PMID 30246184
PURPOSE: To compare the clinical outcome of dental implants restored with definitive occluding partial fixed prostheses within 1 week after implant placement with immediate non-occluding provisional restorations to be re...
PURPOSE: To compare the clinical outcome of dental implants restored with definitive occluding partial fixed prostheses within 1 week after implant placement with immediate non-occluding provisional restorations to be replaced by definitive prostheses after 4 months. MATERIALS AND METHODS: Forty partially edentulous patients treated with one to three dental implants, at least 8.5 mm long and 4.0 mm wide, inserted with a torque of at least 35 Ncm, were randomised in two groups of 20 patients each, to be immediately loaded with partial fixed prostheses. Patients in one group received one definitive screw-retained, metal-ceramic prosthesis in occlusion within 1 week after placement. Patients in the other group received one non-occluding provisional acrylic reinforced prosthesis within 24 h of implant placement. Provisional prostheses were replaced by definitive ones after 4 months. The follow-up for all patients was 3 years post-loading. Outcome measures were prosthesis and implant failures, any complications, peri-implant marginal bone level changes, aesthetic evaluation by a dental practitioner, patient satisfaction, chair time and number of visits at the dental office from implant placement to delivery of definitive restorations. RESULTS: Three patients dropped out, one from the non-occlusal group and two from the occlusal group. Two immediately occlusally loaded implants with their related definitive prostheses failed early (difference in proportions = 0.10; 95% CI = -0.03 to 0.23; P = 0.488). Five patients from the occlusally loaded group were affected by six complications vs three patients (three complications) in the non-occlusally loaded group. The difference in proportions was not statistically significant (difference in proportions = 0.08; 95% CI = -0.17 to 0.34; P = 0.697). Three years after loading, patients subjected to occlusal loading lost an average of 1.13 mm of peri-implant bone vs 1.03 mm of patients restored with non-occluding definitive partial fixed prostheses. There were no statistically significant differences for marginal bone level changes between the two groups (mean difference = 0.10 mm; 95% CI -0.62 to 0.82; P = 0.779). No significant were the differences for pink aesthetic scores (7.09 vs 6.90; P = 0.873); for aesthetics evaluated by patients (Mann-Whitney U test P = 0.799) and function satisfaction (Mann-Whitney U test P = 0.578). Significantly less chair time (mean difference -38.00; 95% CI -58.96 to -17.04; P = 0.001) and number of visits (mean difference -2.15; 95% CI -2.77 to -1.53; P < 0.001) were required for the immediate definitive prosthesis group. CONCLUSIONS: This study did not provide a conclusive answer, but suggests that immediate occlusal loading by manufacturing immediate definitive partial fixed prostheses decreases chair time and number of visits.
Immediate loading of fixed cross-arch prostheses supported by flapless-placed 5 mm or 11.5 mm long implants: 5-year results from a randomised controlled trial.
Cannizzaro G, Felice P, Ippolito DR … +2 more , Velasco-Ortega E, Esposito M
Eur J Oral Implantol · 2018 · PMID 30246183
PURPOSE: To compare the outcome of cross-arch prostheses supported either by 5 mm long or 11.5 mm long implants placed flapless and immediately restored with a metal-resin screw-retained cross-arch prostheses. MATERIALS...
PURPOSE: To compare the outcome of cross-arch prostheses supported either by 5 mm long or 11.5 mm long implants placed flapless and immediately restored with a metal-resin screw-retained cross-arch prostheses. MATERIALS AND METHODS: Thirty patients with edentulous or to-be- rendered edentulous mandibles, and 30 with edentulous maxillas, having sufficient bone to allow the placement of four and six implants respectively, of at least 11.5 mm long, were randomised according to a parallel group design into two equal groups and received either 5 mm or 11.5 mm long implants at one centre. Implants had a diameter of 5 mm, were to be placed flapless, and with an insertion torque of at least 50 Ncm. Mandibles received four implants between the mental foramina. Implants were to be immediately loaded with metal-resin definitive prostheses the same day as implant placement. Patients were followed to 5 years post-loading and the outcome measures were: prosthesis and implant failures, complications, and peri-implant marginal bone level changes. RESULTS: Four patients per group dropped out. Two prostheses were remade, one on short maxillary implants and one on long mandibular implants (difference in proportions = 0; 95% CI: -0.15 to 0.15; P = 1.000). Three patients lost six short implants vs three patients who lost four long implants (difference in proportions = 0; 95% CI: -0.19 to 0.19; P = 1.000). Four short implant patients were affected by complications vs five patients with long implants (difference in proportions = 0.04; 95% CI: -0.17 to 0.25; P = 1.000). There were no statistically significant differences for prostheses failures, implant failures and complications. Patients with mandibular short implants lost on average 0.22 mm of peri-implant bone at 5 years while patients with long mandibular implants lost 0.83 mm. Patients with maxillary short implants lost on average 0.30 mm of peri-implant bone at 5 years and patients with long maxillary implants lost 0.89 mm. Short implants showed less bone loss when compared with long implants and the differences up to 5 years were statistically significant both in maxillae (mean difference = 0.59 mm, 95% CI: 0.33 to 0.86 mm, P < .0001) and in mandibles (mean difference = 0.61 mm, 95% CI: 0.36 to 0.86 mm, P < 0.0001). CONCLUSIONS: Flapless-placed 5 mm long implants achieved similar results as 11.5 mm long implants when supporting immediately loaded cross-arch prostheses both in maxillae and mandibles up to 5 years after loading. These results must be confirmed by other trials, and 10 years post-loading data is necessary before making reliable recommendations.
6 mm vs 10 mm-long implants in the rehabilitation of posterior jaws: A 10-year follow-up of a randomised controlled trial.
Storelli S, Abbà A, Scanferla M … +2 more , Botticelli D, Romeo E
Eur J Oral Implantol · 2018 · PMID 30246182
PURPOSE: The aim of this study was to compare survival and success rates of 6 mm-long and 10 mm-long implants in partially edentulous posterior areas. MATERIALS AND METHODS: Twenty-four patients with a partially edentulo...
PURPOSE: The aim of this study was to compare survival and success rates of 6 mm-long and 10 mm-long implants in partially edentulous posterior areas. MATERIALS AND METHODS: Twenty-four patients with a partially edentulous area were included in the study. Patients were randomly allocated according to a parallel group design to receive 6 mm or 10 mm-long implants. A total of 54 implants were placed (26 × 6 mm implants). Patients were followed for 10 years after prosthetic loading. Outcome measures were prosthesis and implant survival, marginal bone level changes and complications. RESULTS: After 10 years, 17 patients (eight with 6 mm implants and nine with 10 mm implants) were available: three 6 mm and four 10 mm patients were lost to follow-up. One 6 mm implant failed during the healing period and its related prosthesis could not be placed. No implants were lost after loading. Nine patients in the 6 mm group registered a total of 15 complications: two mucositis, six decementations and seven chippings. Ten patients in the 10 mm group registered a total of 13 complications: five mucositis, two decementations and six chippings. Overall the difference for complications between the two groups was not statistically significant (P = 0.22; difference in proportion = -0.02; 95% CI: -0.31 to 0.27). Decementations in the 6 mm group were statistically significant higher than the 10 mm group (P = 0.04; difference in proportion = 0.39; 95% CI: 0.03 to 0.74). Marginal bone loss at 10 years was 0.84 and 0.37 mm with the 6 mm and 10 mm groups, respectively (difference between the two groups 0.49 mm; 95% CI -0.31; 1.29; not statistically significant: t test P = 0.22). CONCLUSIONS: Rehabilitations supported by 6 mm or 10 mm-long implants showed similar clinical outcomes in terms of survival and success rates, although 6 mm implants had more decementations.
Implant prosthetic rehabilitation in partially edentulous patients with bone atrophy. An umbrella review based on systematic reviews of randomised controlled trials.
Merli M, Moscatelli M, Pagliaro U … +3 more , Mariotti G, Merli I, Nieri M
Eur J Oral Implantol · 2018 · PMID 30246181
PURPOSE: To summarise systematic reviews that assess the effects of different interventions for implant prosthetic rehabilitation in partially edentulous patients with the presence of bone atrophy. MATERIALS AND METHODS:...
PURPOSE: To summarise systematic reviews that assess the effects of different interventions for implant prosthetic rehabilitation in partially edentulous patients with the presence of bone atrophy. MATERIALS AND METHODS: Only systematic reviews of randomised controlled trials (RCTs) dealing with partially edentulous adult patients presenting bone defects were included. Treatments of interest were bone augmentation procedures, use of short, tilted or zygomatic implants, sinus lift and transposition of the inferior alveolar nerve. Outcome variables considered were: prosthetic and implant failure, complications, radiological and clinical peri-implant bone level variation, aesthetic and functional satisfaction, and vestibular peri-implant soft tissue recession. A search of systematic reviews of RCTs selected from MEDLINE, the Cochrane Database of Systematic Review, and the Prospero register published in the past 5 years (May 2012 - May 2017) was performed. Systematic reviews were also manually searched. Independent data extraction by two authors using predefined data fields, including ROBIS risk of bias, was executed. RESULTS: A total of 12 systematic reviews of RCTs were identified for inclusion in the overview. Eight reviews were considered at low risk of bias. Short implants (≤ 8 mm) were associated with a notable decrease in complications compared to long implants with bone augmentation procedures. Many trials compared different sinus lift procedures and different bone augmentation techniques. None of these indicated that one procedure could reduce prosthetic or implant failures when compared to the other. The use of a membrane can contribute to the regeneration of the hard tissue in horizontal augmentation. Different membranes or bone substitutes did not give substantially different results. No data are available regarding comparisons involving zygomatic implants or tilted implants or transposition of the alveolar nerve. CONCLUSIONS: Overall, the evidence is not sufficiently robust to determine the best treatment for implant prosthetic rehabilitation in partially edentulous patients presenting bone atrophy. In terms of vertical defects, if the short implants can be used they should be used because the number of complications are reduced compared to longer implants with sinus lift or bone augmentation. Nevertheless, caution should be exercised because long-term follow-up studies were not available. No conclusions can be drawn regarding the comparison between different vertical bone augmentation techniques in atrophic posterior mandible because quantitative meta-analyses were not performed. With regards to horizontal defects, the use of a membrane appears to increase the regeneration of the hard tissue but no differences were detected in prosthesis or implant failures or in complications.
Editorial: Overviews and umbrella reviews.
Esposito M
Eur J Oral Implantol · 2018 · PMID 30246180
Abstract loading — click title to view on PubMed.
Surgical experience, workload and learning curve vs postoperative outcome.
Jerjes W, Hopper C
Eur J Oral Implantol · 2018 · PMID 30109307
AIM: In this review, we look at the factor of the surgical experience and surgical workload in a variety of surgical disciplines and its effect on the intraoperative and postoperative complications rate. MATERIALS AND ME...
AIM: In this review, we look at the factor of the surgical experience and surgical workload in a variety of surgical disciplines and its effect on the intraoperative and postoperative complications rate. MATERIALS AND METHODS: An extensive systematic electronic search was carried out on the relevant databases. Two independent reviewers were engaged in selecting appropriate articles in line with the protocol. RESULTS: It was very interesting to see that only 52 studies could be identified as per the inclusion criteria and search keywords. This included studies from 1990 onwards, spanning all surgical disciplines. Six studies were identified in third molar surgery, one of the most common surgeries practiced across all surgical disciplines. Seven appropriate oral implant surgery studies were identified, covering two-stage implants and immediately loaded implants. The evidence was overwhelming that the surgeon's experience positively correlates with the level of osseointegration and implant success. An interesting study from general surgery highlighted the fact it is not unusual to see senior surgeons selected to operate on complex patients or carry out complex surgical procedures than their junior colleagues. In face, this may explain why a number of studies identified no difference in the surgical complications between seniors and juniors. CONCLUSIONS: Despite the fact that experience matters, many factors can influence the outcome of the surgery. If the surgeon, despite his/her lack of seniority, manages to utilise experience appropriately then there will be a beneficial outcome for the patient.
Material-related complications in implant-supported fixed dental restorations. A systematic review.
Papia E, Larsson C
Eur J Oral Implantol · 2018 · PMID 30109306
AIM: A large variety of dental materials are available for the production of implant-supported fixed restorations. Materials with different properties are likely to behave differently during clinical function, which may...
AIM: A large variety of dental materials are available for the production of implant-supported fixed restorations. Materials with different properties are likely to behave differently during clinical function, which may result in different prevalence and types of complications. The aim of the present review was to summarise, analyse and discuss the prevalence and types of complications or failures related to dental materials in implant-supported restorations. MATERIALS AND METHODS: A strategy was set up using the PICO format and the search was performed using the PubMed database, including a hand search of reference lists. Two independent reviewers selected papers based on a set of criteria. The number of events of complications was summarised. RESULTS: The initial search produced 2764 titles. After application of criteria, 47 publications were selected for analysis. Seventeen studies reported on 1447 single crowns and 30 studies reported on 2190 fixed dental prostheses. The most common complications were fracture or chipping of the veneer material, loss of retention and lost access hole fillings. Due to the heterogeneity of studies, and large variation in number of restorations per material group, no conclusive correlation between type of material and type of technical complication and/or failure could be established. CONCLUSIONS: The review did not succeed in providing convincing evidence to answer the question concerning a possible relationship between restoration materials and prevalence of technical complications in implant-supported restorations.
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