European Journal Of Oral Implantology[JOURNAL]
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200 papers
Flapless vs flapped implant insertion in patients with controlled type 2 diabetes subjected to delayed loading: 1-year follow-up results from a randomised controlled trial.
Agrawal KK, Rao J, Anwar M … +2 more , Singh K, Himanshu D
Eur J Oral Implantol · 2017 · PMID 29234747
PURPOSE: To compare the outcome of dental implants placed following full-thickness flap surgery with flapless surgery in controlled type 2 diabetic patients. MATERIALS AND METHODS: A total of 92 controlled type 2 diabeti...
PURPOSE: To compare the outcome of dental implants placed following full-thickness flap surgery with flapless surgery in controlled type 2 diabetic patients. MATERIALS AND METHODS: A total of 92 controlled type 2 diabetic patients, who needed missing mandibular first molars to be replaced by implants, were selected for a single-centre, parallel group, double-blinded randomised controlled trial. Patients were randomly allocated into two groups: flap (46 patients) vs flapless (46 patients) implant placement. Implants were loaded with metal-ceramic crowns, 4 months after placement in both groups. OUTCOME MEASURES: Implant and crown success, complications, post-operative pain and swelling, plaque index, sulcular bleeding index, pocket depth and HbA1c level. Follow up examinations were made after 24 h, and on the third and seventh days for soft tissue healing, pain and swelling evaluation; then at 6 months and 12 months (after loading) for dental plaque, sulcular bleeding, pocket depth, and HbA1c level evaluation. RESULTS: After 16 months of implant placement, no dropouts occurred. Five implants failed, two in the flap group and three in the flapless group (4.34% vs 6.52%, McNemar test P = 1, difference = 0.4457, 95% CI of difference = 4.554 to 47.234). Seven prosthesis failures occurred, three in the flap group and four in the flapless group (McNemar test P = 1; difference = 0.4239; 95% CI of difference = 29.95 to 3.86). Two patients in each group were affected by complications. There were statistically insignificant differences in the incidence of complications between the groups (McNemar test P = 1; difference = 0.457; 95% CI of difference = 90.75 to 5.33). After 24 h, the flapped group patients showed significantly greater pain compared with the flapless group (24 h: P = 0.017, difference = 0.37 and 95% CI = 0.673 to -0.067). After the third and seventh postoperative days, the mean pain level in both groups decreased linearly after the treatments (third day: P = 0.183, difference = 0.19 and 95% CI = -0.472 to 0.092; seventh day: P = 0.225, difference = 0.09 and 95% CI = -0.237 to 0.056). The frequency of post-operative swelling "some + a lot" at the third day was significantly higher in the full thickness flap group compared with the flapless group (P = 0.002, difference = 0.1835 and 95% CI = -0.0409 to 0.4079). Most of the cases in either of the study groups demonstrated no swelling (P =1.00, difference = 0.00 and 95% CI = -0.3034 to 0.3034) on the seventh post-operative day. The mean plaque index (6 months: 1.00 ± 0.47 vs 0.83 ± 0.79, P = 0.230, difference = 0.17 and 95% CI = -0.450 to 0.110 and 12 months: 1.30 ± 0.67 vs 1.04 ± 0.86, P = 0.123, difference = 0.26 and 95% CI = 0.593 to 0.073), mean sulcular bleeding index (6 months: 1.40 ± 0.52 vs 1.04 ± 0.83, P = 0.018, difference = 0.36 and 95% CI = 0.658 to 0.062 and 12 months: 1.90 ± 0.48 vs 1.17 ± 0.57, P = < 0.001, difference = -0.73 and 95% CI = -0.958 to -0.503) and pocket depth (6 months: 1.30 ± 0.26 vs 1.17 ± 0.25, P = 0.021, difference = -0.13 and 95% CI = - 0.240 to- 0.012 and 12 months: 1.95 ± 0.28 vs 1.56 ± 0.17, P = < 0.001, difference = -0.39 and 95% CI = -0.490 to -0.290) in both groups increased after the treatment and the increase was evident higher in full thickness flap group than flapless group. CONCLUSIONS: On the basis of these results, it was concluded that flapless surgical technique could be considered for dental implant placement in type 2 diabetic patients to reduce post-operative pain and swelling.
Short implants as an alternative to crestal sinus lift: a 3-year multicentre randomised controlled trial.
Gastaldi G, Felice P, Pistilli R … +3 more , Barausse C, Trullenque-Eriksson A, Esposito M
Eur J Oral Implantol · 2017 · PMID 29234746
PURPOSE: To evaluate the efficacy of short (5 or 6 mm long) dental implants vs 10 mm or longer implants placed in crestally lifted sinuses. MATERIALS AND METHODS: Twenty partially edentulous patients with 5 to 7 mm of re...
PURPOSE: To evaluate the efficacy of short (5 or 6 mm long) dental implants vs 10 mm or longer implants placed in crestally lifted sinuses. MATERIALS AND METHODS: Twenty partially edentulous patients with 5 to 7 mm of residual crestal height and at least 7 mm thickness below the maxillary sinuses as measured on computed tomography scans were randomised according to a parallel group design to receive either one to two 5 or 6 mm long implants (10 patients) or 10 mm long implants (10 patients) after crestal sinus lifting and grafting with anorganic bovine bone. Implants were left to heal submerged for 4 months and were loaded with reinforced acrylic provisional prostheses, replaced, after 4 months, by definitive provisionally cemented or screw-retained metal-ceramic or metal-composite prostheses. Outcome measures were: prosthesis and implant failures, any complications, radiographic peri-implant marginal bone level changes, and patient's satisfaction assessed by blinded assessors, when possible. All patients were followed up to 3 years after loading. RESULTS: Two patients from the augmented group dropped out after the 1-year follow-up. No implant or prosthesis failure occurred. One short implant patient was affected by two complications vs one complication in the long implant group. There was no difference for patients experiencing complications between the two groups (difference in proportions = -0.03 %; 95%CI: -0.32 to 0.27; P = 1.000). Short implants lost 0.89 ± 0.25 mm and long implants lost 1.08 ± 0.29 mm of peri-implant marginal bone 3 years after loading, the difference between the two groups being not statistically significant (difference = -0.19 mm; 95%CI: -0.46 to 0.09; P = 0.165). All patients were fully or partially satisfied with function and fully satisfied with aesthetics. CONCLUSIONS: Both techniques achieved excellent results and no differences were observed between prostheses supported by one to two 5 or 6 mm long implants vs 10 mm long in posterior atrophic maxillae up to 3 years after loading; therefore it is up to clinicians to decide which procedure to use, although longer follow-ups with larger patient populations are needed to better understand if one of these procedures could be more effective in the long-term. Conflict of interest statement: this study was partially supported by Zimmer Biomet. However, data property belonged to the authors, and by no means did the manufacturer interfere with the conduct of the trial or the publication of its results.
The influence of repeated abutment changes on peri-implant tissue stability: 3-year post-loading results from a multicentre randomised controlled trial.
Bressan E, Grusovin MG, D'Avenia F … +4 more , Neumann K, Sbricoli L, Luongo G, Esposito M
Eur J Oral Implantol · 2017 · PMID 29234745
PURPOSE: To evaluate the influence of at least three abutment disconnections in conventional loaded implants against placement of a definitive abutment in immediately non-occlusal loaded implants on hard and soft tissue...
PURPOSE: To evaluate the influence of at least three abutment disconnections in conventional loaded implants against placement of a definitive abutment in immediately non-occlusal loaded implants on hard and soft tissue changes. A secondary aim was to evaluate whether the presence of less than 2 mm of keratinised mucosa is associated with increased peri-implant marginal bone loss and soft tissue recessions. MATERIALS AND METHODS: Eighty patients requiring one single crown or one fixed partial prosthesis supported by a maximum of three implants were randomised, after implants were placed with more than 35 Ncm, according to a parallel group design to receive definitive abutments that were loaded immediately (definitive abutment or immediate loading group) or transmucosal abutments, which were delayed loaded after 3 months and removed at least three times: 1. At impression taking (3 months after implant placement); 2. When checking the zirconium core on titanium abutments at single crowns or the fitting the metal structure at prostheses supported by multiple implants; 3. At delivery of the definitive prostheses (repeated disconnection or conventional loading group). Patients were treated at four centres and each patient contributed to the study, with only one prosthesis followed for 3 years after initial loading. Outcome measures were: prosthesis failures, implant failures, complications, pink aesthetic score (PES), buccal recessions, patient satisfaction, peri-implant marginal bone level changes and height of the keratinised mucosa. RESULTS: Forty patients were randomly allocated to each group according to a parallel group design. Six patients from the definitive abutment group dropped out or died, and one left from the repeated disconnection group. One implant, from the repeated disconnection group, fractured (difference = 3%; CI 95%: -2%, 8%; P = 1). Four provisional crowns and one definitive single crown had to be remade because of poor fitting, and one definitive crown and one definitive prosthesis because of ceramic and implant fracture, respectively, in the repeated disconnection group vs one provisional prosthesis from the definitive abutment group due to frequent debondings (difference = 15%; CI 95%: 2%, 28%; P = 0.060). Five patients from the definitive abutment group and four patients from the repeated disconnection group were affected by complications (difference = 4%; CI 95%: -11%, 20%; P = 0.725). PES scores assessed at 3 years post-loading were 11.7 (standard deviation = 1.8) mm for the definitive abutment group and 11.3 (1.5) mm for the repeated abutment changes group (difference = 0.4; CI 95%: -0.4, 1.2; P = 0.315). However, there was a difference of 0.26 out of a maximum score of 2 in favour of the definitive abutment group for soft tissue contour only. Buccal recessions at 3 years post-loading amounted to -0.1 (0.8) mm for the definitive abutment group and -0.1 (1.2) mm for the repeated abutment changes group (it was actually a soft tissue gain; difference = 0.01 mm CI 95%: -0.48, 0.50; P = 0.965). All patients declared being very satisfied or satisfied with the function and aesthetics of the prostheses and said they would undergo the same procedure again, with the exception of one patient from the repeated disconnection group who was uncertain regarding function. Mean peri-implant marginal bone loss 3 years after loading was 0.07 (0.18) mm for the definitive abutment group and 0.50 (0.93) mm for the repeated abutment changes group (difference = 0.43 mm; CI 95%: 0.13, 0.74; P = 0.007). The height of keratinised mucosa at 3 years post-loading was 2.8 (1.3) mm for the definitive abutment group and 2.8 (1.6) mm for the repeated abutment changes group (difference = 0.03; CI 95%: -0.67, 0.73; P = .926). Up to 3 years after initial loading there were no statistically significant differences between the two procedures, with the exception of 0.4 mm more marginal bone loss at implants subjected to three abutment disconnections. There were no significantly increased marginal bone loss (difference = 0.1 mm, CI 95%: -0.3, 0.5, P = 0.590) or buccal recessions (difference = 0.1 mm, CI 95%: -0.4, 0.7, P = 0.674) at implants with less than 2 mm of keratinised mucosa at loading. CONCLUSIONS: Three-year post-loading data showed that repeated abutment disconnections significantly increased bone loss of 0.43 mm, but this difference may not be considered clinically relevant; therefore clinicians can use the procedure they find more convenient for each specific patient. Immediately non-occlusally loaded dental implants are a viable alternative to conventional loading and no increased bone loss or buccal recessions were noticed at implants with less than 2 mm of keratinised mucosa. Conflict of interest statement: This trial was partially funded by Dentsply Sirona Implants, the manufacturer of the implants and other products evaluated in this investigation. However, data belonged to the authors and by no means did the manufacturer interfere with the conduct of the trial or the publication of the results, with the exception of rejecting a proposal to change the protocol, after the trial was started, allowing the use of indexed abutments.
Editorial: Congratulations and thank you.
Wolters J
Eur J Oral Implantol · 2017 · PMID 29234744
Abstract loading — click title to view on PubMed.
Performance of CAD/CAM monolithic ceramic Implant-supported restorations bonded to titanium inserts: A systematic review.
Conejo J, Kobayashi T, Anadioti E … +1 more , Blatz MB
Eur J Oral Implantol · 2017 · PMID 28944374
AIMS: This review assessed the available evidence on the performance of CAD/CAM monolithic implant-supported restorations bonded to titanium (Ti) inserts and bases, which has become a popular concept. MATERIALS AND METHO...
AIMS: This review assessed the available evidence on the performance of CAD/CAM monolithic implant-supported restorations bonded to titanium (Ti) inserts and bases, which has become a popular concept. MATERIALS AND METHODS: An electronic and manual search of PubMed databases was conducted to identify studies published in English between 2000 and 2016 on the performance of monolithic ceramic implant restorations with Ti inserts. RESULTS: The initial search revealed 505 titles. Full-text screening was carried out for 70 studies, yielding 25 articles that met the inclusion criteria. No clinical studies could be identified regarding the performance of monolithic ceramic restorations bonded to Ti inserts. Laboratory studies on selected aspects and studies on similar prosthetic designs indicate that Ti inserts improve the overall fracture strength of ceramic abutments and crowns, protect the implant connection from wear, and offer a better marginal fit when compared with all-ceramic abutments. CONCLUSIONS: While laboratory studies and evaluations of similar designs indicated promising outcomes, clinical studies that evaluate the performance of CAD/CAM monolithic implant-supported restorations bonded to Ti inserts and bases are needed.
Misfit of implant prostheses and its impact on clinical outcomes. Definition, assessment and a systematic review of the literature.
Katsoulis J, Takeichi T, Sol Gaviria A … +2 more , Peter L, Katsoulis K
Eur J Oral Implantol · 2017 · PMID 28944373
BACKGROUND AND AIM: Compromised fit between the contact surfaces of screw-retained implant-supported fixed dentures (IFDs) is thought to create uncontrolled strains in the prosthetic components and peri-implant tissues,...
BACKGROUND AND AIM: Compromised fit between the contact surfaces of screw-retained implant-supported fixed dentures (IFDs) is thought to create uncontrolled strains in the prosthetic components and peri-implant tissues, thus evoking biological and technical complications such as bone loss, screw loosening, component fractures and, at worst, loss of implants or prostheses. The aim of this systematic review was to evaluate the impact of marginal misfit on the clinical outcomes of IFDs, and to elucidate definition and assessment methods for passive fit. MATERIALS AND METHODS: A systematic review of the literature was conducted with a PICO question: "For partially or complete edentulous subjects with screw-retained IFDs, does the marginal misfit at the implant-prosthesis interfaces have an impact on the clinical outcomes?". A literature search was performed electronically in PubMed (MEDLINE) with the help of Boolean operators to combine key words, and by hand search in relevant journals. English written in vivo studies published before August 31, 2016 that reported on both clinical outcome and related implant prosthesis misfit (gap, strains, torque) were selected using predetermined inclusion criteria. RESULTS: The initial search yielded 2626 records. After screening and a subsequent filtering process, five human and five animal studies were included in the descriptive analysis. The selected studies used different methods to assess misfit (linear distortion, vertical gap, strains, screw torque). While two human studies evaluated the biological response and technical complications prospectively over 6 and 12 months, the animal studies had an observation period < 12 weeks. Four human studies analysed retrospectively the 3 to 32 years' outcomes. Screw-related complications were observed, but biological sequelae could not be confirmed. Although the animal studies had different designs, bone adaptation and implant displacement was found in histological analyses. Due to the small number of studies and the heterogenic designs and misfit assessment methods, no meta-analysis of the data could be performed. CONCLUSIONS: The current literature provides insufficient evidence as to the effect of misfit at the prosthesis-implant interface on clinical outcomes of screw-retained implant-supported fixed dentures. Marginal gaps and static strains due to screw tightening were not found to have negative effects on initial osseointegration or peri-implant bone stability over time. Based on two clinical studies, the risk for technical screw-related complications was slightly higher. While the degree of tolerable misfit remains a matter of debate, the present data do not imply that clinicians neglect good fit, but aim to achieve the least misfit possible. Conflict of interest statement: The authors declare no conflict of interest. The review was conducted as part of the 2016 Foundation of Oral Rehabilitation Consensus Conference on "Prosthetic Protocols in Implant-based Oral Rehabilitation".
Accuracy of digital implant impressions with intraoral scanners. A systematic review.
Rutkūnas V, Gečiauskaitė A, Jegelevičius D … +1 more , Vaitiekūnas M
Eur J Oral Implantol · 2017 · PMID 28944372
AIM: The use of intraoral scanners (IOS) for making digital implant impressions is increasing. However, there is a lack of evidence on the accuracy of IOS compared with conventional techniques. Therefore, the aim of this...
AIM: The use of intraoral scanners (IOS) for making digital implant impressions is increasing. However, there is a lack of evidence on the accuracy of IOS compared with conventional techniques. Therefore, the aim of this systematic review was to collect evidence on the accuracy of digital implant impression techniques, as well as to identify the main factors influencing the accuracy outcomes. MATERIALS AND METHODS: Two reviewers searched electronic databases in November, 2016. Controlled vocabulary, free-text terms, and defined inclusion and exclusion criteria were used. Publications in English language evaluating the accuracy outcomes of digital implant impressions were identified. Pooled data were analysed qualitatively and pertinent data extracted. RESULTS: In total, 16 studies fulfilled the inclusion criteria: one in vivo and 15 in vitro studies. The clinical study concluded that angular and distance errors were too large to be acceptable clinically. Less accurate findings were reported by several in vitro studies as well. However, all in vitro studies investigating the accuracy of newer generation IOS indicated equal or even better results compared with the conventional techniques. Data related to the influence of distance and angulation between implants, depth of placement, type of scanner, scanning strategy, characteristics of scanbody and reference scanner, operator experience, etc were analysed and summarised. Linear deviations (means) of IOS used in in vitro studies ranged from 6 to 337 µm. Recent studies indicated small angle deviations (0.07-0.3°) with digital impressions. Some studies reported that digital implant impression accuracy was influenced by implant angulation, distance between the implants, implant placement depth and operator experience. CONCLUSIONS: According to the results of this systematic review and based on mainly in vitro studies, digital implant impressions offer a valid alternative to conventional impressions for single- and multi-unit implant-supported restorations. Further in vivo studies are needed to substantiate the use of currently available IOS, identify factors potentially affecting accuracy and define clinical indications for specific type of IOS. Data on Data on accuracy OF digital records, as well as accuracy of printed or milled models for implant-supported restorations, are of high relevance and are still lacking. Conflict-of-interest and funding statement: The authors state there is no conflict of interest.
Prosthetic protocols in implant-based oral rehabilitations: A systematic review on the clinical outcome of monolithic all-ceramic single- and multi-unit prostheses.
Spitznagel FA, Horvath SD, Gierthmuehlen PC
Eur J Oral Implantol · 2017 · PMID 28944371
AIM: The purpose of this systematic review was to assess the clinical performance of implant-supported monolithic all-ceramic single- and multi-unit restorations. MATERIALS AND METHODS: The electronic databases of MEDLIN...
AIM: The purpose of this systematic review was to assess the clinical performance of implant-supported monolithic all-ceramic single- and multi-unit restorations. MATERIALS AND METHODS: The electronic databases of MEDLINE via PubMed, the Cochrane Library (CENTRAL) and EMBASE were searched for clinical studies on monolithic all-ceramic single and multi-unit implant-supported fixed dental prostheses. Human studies with a mean follow-up of at least 2 years and published in English or German language peer-reviewed journals up until August 2016 were included. Two independent examiners conducted the literature search and review process. RESULTS: The search resulted in 2510 titles and of these, 57 studies were selected for full-text evaluation. Three studies were included on the basis of the pre-determined criteria. Two articles reported on monolithic lithium disilicate implant-supported single crowns (SC) and revealed a survival rate of 97,8 and 100% after 3 years. One study investigated implant- supported monolithic zirconia SCs and fixed partial dentures (FPD) and showed a survival rate of 100% after 5 years. No studies could be identified on the clinical performance of monolithic resin matrix ceramic restorations. Clinical studies are lacking on the long-term outcome of implant-supported monolithic all-ceramic single- and multi-unit restorations. CONCLUSIONS: Preliminary clinical data indicate high short-term survival for implant-supported monolithic lithium disilicate and zirconia single- and multi-unit restorations. Randomised clinical studies and observations with a longer duration are necessary to validate the broad application of this therapy. Conflict-of-interest statement: The authors declare no conflict of interest.
Immediate loading of zygomatic implants: A systematic review of implant survival, prosthesis survival and potential complications.
Tuminelli FJ, Walter LR, Neugarten J … +1 more , Bedrossian E
Eur J Oral Implantol · 2017 · PMID 28944370
STATEMENT OF PROBLEM: Zygomatic implants have been utilised for the treatment of the severely atrophic maxilla since 1998. However, few articles exist as to the success of zygomatic implants and immediate loading of its...
STATEMENT OF PROBLEM: Zygomatic implants have been utilised for the treatment of the severely atrophic maxilla since 1998. However, few articles exist as to the success of zygomatic implants and immediate loading of its prosthesis. AIM: To systematically review the outcome of immediate loaded zygomatic implants. MATERIALS AND METHODS: An electronic PubMed search was performed to identify case reports, prospective and retrospective studies of immediately loaded zygomatic implants with a mean follow-up of 12 months. Assessment of the identified studies was performed using the Delphi method. Reviewers independently assessed the articles for inclusion, with a facilitator coordinating responses. A consensus was reached on the articles that were included. RESULTS: The search provided 236 titles for immediately loaded zygomatic implants and resulted in 106 abstracts for analysis. Full-text analysis was performed on 67 articles, resulting in the inclusion of 38 articles for this systematic review. CONCLUSION: Based on the present systematic review, the authors report that immediately loading zygomatic implants for the restoration of the severely atrophic maxilla presents a viable alternative for treatment of the atrophic maxilla.
Influence of implant abutment fabrication method on clinical outcomes: a systematic review.
Long L, Alqarni H, Masri R
Eur J Oral Implantol · 2017 · PMID 28944369
AIM: The aim of this systematic review was to evaluate and synthesise the existing evidence on the effect of the prosthetic implant abutment design and fabrication process on mechanical, biological and aesthetic clinical...
AIM: The aim of this systematic review was to evaluate and synthesise the existing evidence on the effect of the prosthetic implant abutment design and fabrication process on mechanical, biological and aesthetic clinical outcomes. MATERIALS AND METHODS: Two electronic databases (PubMed and Embase) were searched in August 2016 to identify clinical studies evaluating the clinical outcomes of CAD/CAM abutments. The studies were screened and two reviewers used the full text to extract data independently. A qualitative synthesis was performed on the extracted data and summary tables were prepared. Due to heterogeneity in the studies included, no meta-analysis was performed. RESULTS: Twenty-four studies were included in this review. Of these, 13 studies focused solely on CAD/CAM abutment and did not include a control group, or a comparison with conventional implant abutments. Eleven studies compared clinical outcomes of CAD/CAM abutments with conventional abutments. There were only three clinical trials and the majority of the studies were observational or case series studies. The most commonly reported clinical outcomes measured were soft tissue volume and aesthetic scores, survival and success rates, and marginal bone levels. CONCLUSION: The results of the review demonstrate that CAD/CAM abutments had overall good survival and success rates and that they provide comparable, if not better, clinical outcomes when compared with conventional abutments. However, existing evidence is weak as few randomised control trials were conducted and follow-up periods were, in general, short. Conflict-of-interest and funding statement: The authors report no financial or other relationships that might lead to a conflict of interest. This systematic review was conducted as a part of the 2016 Foundation of Oral Rehabilitation Consensus Conference on "Prosthetic Protocols in Implant-based Oral Rehabilitation". The authors received no funding to conduct the systematic review, but received reimbursement to participate in the Consensus Conference.
Impact of prosthetic material on mid- and long-term outcome of dental implants supporting single crowns and fixed partial dentures: A systematic review and meta-analysis.
Abou-Ayash S, Strasding M, Rücker G … +1 more , Att W
Eur J Oral Implantol · 2017 · PMID 28944368
AIM: The impact of prosthetic material selection on implant survival is not clear. The current criteria for choosing a prosthetic material seem to be based on clinician preferences. This systematic review aims to evaluat...
AIM: The impact of prosthetic material selection on implant survival is not clear. The current criteria for choosing a prosthetic material seem to be based on clinician preferences. This systematic review aims to evaluate the impact of restorative materials on the mid- and long-term survival of implants supporting single crowns and fixed partial dentures. MATERIALS AND METHODS: Hand and MEDLINE searches were performed to identify relevant literature for single crowns (SC) and fixed partial dentures (FPD). Further inclusion criteria were a mean follow-up period of at least 3 years, the inclusion of at least 10 patients in a relevant study cohort, and a clear description of prosthesis type and prosthetic material. RESULTS: A total of 63 studies for the SC group and 11 studies for the FPD group were included. Full arch restorations were not included. The materials utilised in the SC group were metal-ceramic (precious and non-precious), lithium-disilicate, veneered zirconia, veneered alumina, and nanoceramics. The materials used in the FPD group were metal-ceramic (precious), veneered titanium, metal-resin (precious), and veneered zirconia. No significant impact on the prosthetic material relating to mid- or long-term implant survival was identified. Furthermore, there were no statistically significant differences between the survival rates of the dental prostheses made from different materials (SC and FPD group). Single crowns made of nanoceramics showed a higher risk for decementation relative to other materials (0.80, 95% CI [0.67; 0.89]; P < 0.0001), whereas metal-resin FPDs showed a higher risk for chipping (0.36, 95% CI [0.23; 0.52]; P = 0.0072). CONCLUSION: The current evidence suggests that prosthetic material selection has no influence on mid- and long-term survival of implants restored with single crowns and fixed partial dentures. Similarly, the prosthetic material seems to have no significant impact on prosthetic survival rates. Further research is required to provide more evidence regarding the impact of the prosthetic material on long-term outcome. Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Clinical outcomes of full arch fixed implant-supported zirconia prostheses: A systematic review.
Bidra AS, Rungruanganunt P, Gauthier M
Eur J Oral Implantol · 2017 · PMID 28944367
AIM: The primary aim of this systematic review was to study the clinical outcomes of one-piece fixed complete dentures (complete arch fixed implant-supported prostheses) made of zirconia for edentulous patients. The seco...
AIM: The primary aim of this systematic review was to study the clinical outcomes of one-piece fixed complete dentures (complete arch fixed implant-supported prostheses) made of zirconia for edentulous patients. The secondary aim was to compare the clinical outcomes of monolithic zirconia vs zirconia veneered with porcelain (conventional, minimal or gingival) for fixed complete dentures. MATERIALS AND METHODS: Two investigators conducted an independent electronic search of the literature, using PubMed and Scopus search engines from January 1, 2000, to August 31, 2016. After application of pre-determined inclusion and exclusion criteria, the final list of articles was reviewed to meet the aims of this review. RESULTS: A total of 12 observational studies were identified that satisfied the inclusion criteria of this systematic review. Short-term results from a combined 223 patients with 285 one-piece zirconia fixed complete dentures showed a mean failure rate of 1.4% due to the fracture of four prostheses. Prosthetic complications occurred in 46 prostheses (16.1%). Out of these, 42 prostheses (14.7%) had minor complications exclusive to fracture of veneered porcelain. CONCLUSIONS: Current evidence indicates that zirconia fixed complete dentures have a very low failure rate in the short term, but have a substantial rate of minor complications related to chipping of veneered porcelain. Use of monolithic zirconia with only gingival stains, or zirconia that is veneered only at the gingiva may offer promising results, but will need to be validated by future long-term studies. Conflict-of-interest statement: All authors report no conflict of interest.
Fixed vs removable complete arch implant prostheses: A literature review of prosthodontic outcomes.
Goodacre C, Goodacre B
Eur J Oral Implantol · 2017 · PMID 28944366
AIM: To compare implant fixed complete dentures with implant overdentures relative to prosthodontic outcomes. MATERIAL AND METHODS: An electronic Medline (PubMed) with MeSH terms, and Cochrane library search was performe...
AIM: To compare implant fixed complete dentures with implant overdentures relative to prosthodontic outcomes. MATERIAL AND METHODS: An electronic Medline (PubMed) with MeSH terms, and Cochrane library search was performed, focusing on studies that included implant fixed complete dentures and implant overdentures in the same study, with the results based on studies that included both types of prostheses. RESULTS: The following six categories of comparative studies were identified in the literature: 1) Implant and prosthesis survival; 2) Prosthesis maintenance/complications; 3) Bone changes; 4) Patient satisfaction and quality of life; 5) Cost-effectiveness; and 6) Masticatory performance. It was determined that both the fixed and removable treatments were associated with high implant survival rates. However, both types of prostheses were impacted by the need for post-placement mechanical maintenance or prosthetic complications. More maintenance/complications occurred with implant overdentures than with fixed complete dentures. Residual ridge resorption was greater with implant overdentures. Patient satisfaction was high with each prosthesis, with three studies revealing higher satisfaction with fixed complete dentures and five studies finding no difference. All but one study on cost-effectiveness indicated implant overdentures were more cost-effective. Based on two studies, it appears the masticatory performance of implant fixed complete dentures and implant overdentures is comparable. CONCLUSIONS: Multiple factors must be considered when determining whether an implant-fixed complete denture or implant overdentures are best suited for patients with completely edentulous jaws. Conflict-of-interest statement: The authors declare they have no conflicts of interest.
Foundation for Oral Rehabilitation (FOR) Consensus Text on "Prosthetic Protocols in Implant-Based Oral Rehabilitations".
Eur J Oral Implantol · 2017 · PMID 28944365
Abstract loading — click title to view on PubMed.
Guest Editorial.
Goodacre CJ, Blatz MB
Eur J Oral Implantol · 2017 · PMID 28944364
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Editorial.
Esposito M, Jacobs R, Nieri M
Eur J Oral Implantol · 2017 · PMID 28944363
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Research in focus.
Eur J Oral Implantol · 2017 · PMID 28944362
This section presents a brief review of articles on dental implants considered of special interest for the reader, in order to encourage the development of research, the interest for data analysis and the attention to sc...
This section presents a brief review of articles on dental implants considered of special interest for the reader, in order to encourage the development 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.
Cone-beam computed tomography with ultra-low dose protocols for pre-implant radiographic assessment: An in vitro study.
Liljeholm R, Kadesjö N, Benchimol D … +2 more , Hellén-Halme K, Shi XQ
Eur J Oral Implantol · 2017 · PMID 28944361
PURPOSE: To evaluate the ultra-low dose scanning protocols of a newly developed CBCT for pre-implant radiographic assessment. MATERIALS AND METHODS: A total number of 32 CBCT scans were exposed at 90 kV using ProMax 3D's...
PURPOSE: To evaluate the ultra-low dose scanning protocols of a newly developed CBCT for pre-implant radiographic assessment. MATERIALS AND METHODS: A total number of 32 CBCT scans were exposed at 90 kV using ProMax 3D's standard (GS) and three ultra-low dose scanning protocols: high, mid and low definition (UL-HD, UL-MD and UL-LD) on eight human dry skulls with simulated soft tissue. The mAs values and the voxel size were 96mAs/200 µm, 28mAs/150 µm, 22.4mAs/200 µm and 7.5mAs/400 µm for scanning protocols GS, UL-HD, UL-MD and UL-LD, respectively. The overall image quality and the precision of anatomical landmarks were assessed on a 4-rank ordinal scale by seven observers. Logistic regression analysis and post-hoc Scheffé test were applied to analyse possible differences in image quality and recognition of the anatomical structures for the three ultra-low dose protocols, compared with the standard protocol. Additionally, observers performed bone quality assessment and bone quantity measurement at 96 predefined 2D cross-sectional images. A Pearson Chi-square test and a paired t-test were used to analyse assessed bone quality and quantity using the four scanning protocols respectively. RESULTS: For the CBCT unit, ProMax 3D, UL-LD was not diagnostically acceptable for pre-implant assessment, whereas the UL-HD and UL-MD were diagnostically acceptable regarding overall image quality, visibility of most anatomical structures and bone quality assessment. However, to recognise the border of mandibular canal and the border of maxillary sinus, standard protocol may be indicated for some cases. No statistically significant differences in bone height measurement were found when applying standard protocol and the three ultra-low dose protocols. CONCLUSIONS: Low-dose scanning protocols may be applied for pre-implant radiographic assessment, although image quality can be hampered if the radiation exposure is too low and the voxel size too large.
Immediate loading of fixed prostheses in fully edentulous jaws - 1-year follow-up from a single-cohort retrospective study.
Giordano F, Esposito M
Eur J Oral Implantol · 2017 · PMID 28944360
PURPOSE: To evaluate the clinical outcome of four to five implants immediately restored with metal-resin screw-retained cross-arch fixed prostheses in edentulous jaws 1 year after loading. MATERIALS AND METHODS: In total...
PURPOSE: To evaluate the clinical outcome of four to five implants immediately restored with metal-resin screw-retained cross-arch fixed prostheses in edentulous jaws 1 year after loading. MATERIALS AND METHODS: In total, 104 consecutive patients received four 11 × 4.5 mm implants with a torque superior to 35 Ncm. If one implant did not reach a torque superior to 35 Ncm a fifth implant was added. If two implants did not reach a torque superior to 35 Ncm, loading was postponed after 3 months. A total of 127 metal-resin screw-retained fixed prostheses (59 mandibular and 68 maxillary) were to be delivered within 3 days. Outcome measures, evaluated by the treating clinician, were: prosthesis and implant failures, as well as complications. RESULTS: In total, 549 implants were placed (195 immediate post-extractive implants). Twelve maxillary prostheses were delayed loaded, whereas all others were loaded immediately. One year after loading, six patients dropped out, 12 implants failed in eight patients (two patients lost three implants each), and 87 prostheses were remade in 68 patients, one because of three implant failures and then again in the recall programme (replaced twice), one because of tree implant failures and five prosthesis fractures, 10 because of prostheses fractures and 74 in a recall programme for prosthesis replacement. All patients were wearing the planned fixed prostheses at the end of the first year in function. Ninety-eight complications occurred in 66 patients, but all were successfully solved. CONCLUSIONS: Immediately loaded cross-arch prostheses supported by four to five implants are a viable therapeutic option, if prostheses are made with resistant frameworks.
Crestal sinus lift using an implant with an internal L-shaped channel: 1-year after loading results from a prospective cohort study.
Tallarico M, Cochran DL, Xhanari E … +4 more , Dellavia C, Canciani E, Mijiritsky E, Meloni SM
Eur J Oral Implantol · 2017 · PMID 28944359
PURPOSE: To evaluate the clinical and radiographic outcomes of a one-stage crestal sinus elevation procedure using a self-tapping endosseous implant system (iRaise, Maxillent, Herzliya, Israel) developed for sinus augmen...
PURPOSE: To evaluate the clinical and radiographic outcomes of a one-stage crestal sinus elevation procedure using a self-tapping endosseous implant system (iRaise, Maxillent, Herzliya, Israel) developed for sinus augmentation, 1 year after loading. MATERIALS AND METHODS: Patients needing restoration in the posterior maxilla with a residual alveolar crest of 3 to 8 mm in height and 5 mm in width distal to the canine as measured on CBCT scan were treated using the iRaise sinus lift system. Outcome measures were: implant and prosthetic failures, any complications, increased bone height (iBH), marginal bone loss (MBL), implant stability quotient (ISQ), radiographic tissue remodelling patterns using the sinus grafting remodelling index (SGRI), volumetric measurements of sinus graft, patient self-reported post-surgical swelling, consumption of pain medication and histological analysis. RESULTS: A total of 30 consecutive participants with a mean age of 54.2 ± 9.4 years underwent a transcrestal elevation of the sinus membrane, insertion of bone graft, and implant placement. A total of 50 implants were placed (30 iRaise system implants and 20 adjunctive iSure implants, Maxillent). The mean follow-up was 15.8 ± 2.1 months after implant loading. One patient dropped out at the 1-year after loading follow-up examination. No implants and no prostheses failed during the entire follow-up. One patient experienced a small membrane tear. Before implant insertion, the mean residual alveolar ridge height was 4.64 ± 0.86 mm (range: 3.4-6.4 mm; 95% CI: 4.39-5.01 mm). One year after loading, the bone height was 16.86 ± 3.13 mm (95% CI 15.83-18.07 mm). At the 1-year after loading follow-up, the mean MBL was 0.19 ± 1.05 mm (95% CI 0.02-0.78 mm). The mean ISQ at implant placement was 65.2 ± 5.4 (95% CI 63.6-67.4) and increased during the healing period reaching the mean value of 73.6 ± 3.7 (95% CI 73.1-75.9; range 62-79). The difference was statistically significant (8.4 ± 5.3; 95% CI 5.9-39.7; P = 0.0000). One year after loading, SGRI score was evaluated in 23 implants. Overall, the mean SGRI value was 2.29 ± 2.41 mm (95% CI 1.22-2.98 mm). Bone volume at implant placement was 2.41 ± 0.25 CC (95% CI 2.22-2.48 CC). During the 6-month, submerged healing period, a slight bone contraction of 11.3% were observed. (2.13 ± 0.24 CC;95% CI 2.02-2.26; difference = 0.27 ± 0.25 CC; 95% CI 0.10-0.36; P = 0.0011). At the first year post-loading period, the bone graft remained stable (2.11 ± 0.22 CC; 95% CI 2.02-2.24). The difference was not statistically significant (0.02 ± 0.07 CC; 95% CI 0.01-0.04; P = 0.2166). From the patient's point of view, the mean pain value was 0.52 ± 0.74 (range 0-3); mean swelling value was 0.27 ± 0.52 (range 0-2); and the mean consumption of analgesic was 0.87 ± 4.94 tablets (range 0-4) 3 days after surgery. Morphological and histomorphometric analyses showed that all the samples had a normal structure without inflammatory infiltrate, six months after healing. The following fractions (%) were found: bone (immature bone + mature bone): 44.07 ± 4.91; residual biomaterial: 23.98 ± 2.64; medullary spaces: 31.95 ± 3.16. CONCLUSIONS: Sinus floor augmentation can be successfully accomplished with a transcrestal approach using a dedicated implant system. A physiologic contraction of 11.3% of the original volume of the bone graft was experienced during the first 6 months of healing; afterwards, no additional graft volume reduction was observed. Long-term clinical studies are needed to confirm these preliminary results.
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