European Journal Of Oral Implantology[JOURNAL]
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200 papers
Ceramic vs composite veneering of full arch implant-supported zirconium frameworks: assessing patient preference and satisfaction. A crossover double-blind randomised controlled trial.
Merli M, Bianchini E, Mariotti G … +4 more , Moscatelli M, Piemontese M, Rappelli G, Nieri M
Eur J Oral Implantol · 2017 · PMID 28944358
PURPOSE: The objectives of this two-period, crossover, mono-centred, double-blind, randomised controlled trial (RCT) were to compare two different materials used for full arch implant-supported prosthetic restorations wi...
PURPOSE: The objectives of this two-period, crossover, mono-centred, double-blind, randomised controlled trial (RCT) were to compare two different materials used for full arch implant-supported prosthetic restorations with regard to patient preference and impact on a patient's quality of life. MATERIALS AND METHODS: Edentulous patients requesting one full arch restoration in the mandible or maxilla supported by dental implants were included in this study. Patients were randomised to receive either a full arch zirconia framework hand-veneered with ceramic, or a full arch zirconia framework hand-veneered with composite material. After 1 month, the first randomised restoration was substituted by the other, which was left in function for a further observation period of 1 month. Outcome measures were: patient preference and satisfaction (OHIP-21), complications, visual analogue scales for chewing comfort, aesthetic acceptance, phonetic comfort, full mouth plaque score (FMPS). RESULTS: Twenty-four patients were randomised to the treatments in the two periods. There was one dropout. At the end of the study, 16 patients (70%) preferred to wear ceramic prosthesis and 7 patients (30%) preferred to wear composite prosthesis (ceramic preference: 70%; 95%CI from 47 to 87%; P = 0.0605). Difference in OHIP-21 reduction between the two treatments was not significant (difference 0.5, 95%CI from -2.8 to 3.8, P = 0.7788). There was one minor complication during the ceramic period in one patient and one minor complication during the composite period in another patient (odds ratio 1.00, 95%CI from 0.06 to 15.99, P = 1.0). The difference in FMPS between treatments was not significant (0.5, 95%CI from -1.3 to 2.2, P = 0.5731). Difference in VAS between the two treatments was not significant for general satisfaction (P = 0.2067), chewing comfort (P = 0.8345) and phonetics (P = 0.9167). Difference in VAS between the two treatments was significant for aesthetic acceptance favouring the ceramic prosthesis (difference 0.9, 95%CI from 0.006 to 1.8, P = 0.0486). CONCLUSIONS: No difference between the two treatments was detected for preference, changes of OHIP-21, complications, reduction of FMPS, VAS changes regarding patient satisfaction, chewing and phonetics. Nevertheless, a slight difference was detected in the VAS regarding aesthetic acceptance favouring the ceramic material. FUNDING: The study was supported by Nobel Biocare (grant 2012-1077). Thanks to this contribution, the patients who consented to participate in this RCT were not charged for the material provided by Nobel Biocare. In addition, the patients benefited from a further back-up prosthesis that was provided to them completely free of charge.
Endodontic retreatment vs dental implants of teeth with an uncertain endodontic prognosis: 1-year results from a randomised controlled trial.
Esposito M, Tallarico M, Trullenque-Eriksson A … +1 more , Gianserra R
Eur J Oral Implantol · 2017 · PMID 28944357
PURPOSE: To ascertain whether in the presence of a previously endodontically treated tooth with a periapical pathology and/or symptoms and an uncertain prognosis, it is better to endodontically retreat it or to replace t...
PURPOSE: To ascertain whether in the presence of a previously endodontically treated tooth with a 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: Forty patients requiring the treatment of a previously endodontically treated tooth, with a periapical pathology and/or symptoms of endodontic origin and an uncertain prognosis, as judged by the recruiting investigators, were randomly allocated to endodontic retreatment (endo group; 20 patients) or tooth extraction and replacement with an implant-supported crown (implant group; 20 patients) according to a parallel group design at two different centres. Patients were followed to 1 year 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 esthetic score (PES) for the soft tissues and the white esthetic score (WES) for the tooth/crown recorded by independent assessors. RESULTS: No patient dropped out and no complications occurred during the entire follow-up; however, one endodontically retreated tooth (5%) and one implant (5%) fractured, the difference for treatment failures being not statistically significant (difference in proportions = 0; 95% CI -0.14 to 0.14; P Fisher's exact test) = 1.000). The mean marginal bone levels at endo retreatment/implant insertion were 2.34 ± 0.88 mm for the endo and 0.23 ± 0.35 mm for the implant group, which was statistically significantly different (mean difference = 2.11 mm; 95% CI: 1.68 to 2.55; P (t-test) < 0.001). One year after completion of the treatment, teeth lost on average 0.32 ± 0.53 mm and implants 0.48 ± 0.72, the difference not being statistically significant (mean difference = -0.16 mm; 95% CI: -0.58 to 0.27; P (t-test) = 0.457). One year after completion of the endodontic retreatment, of the 13 teeth that originally had a periapical radiolucency, one was lost, six showed complete healing; four a radiographic improvement; and two showed no changes/worsening. Two of the teeth originally without a lesion developed a lesion. There were no statistically significant differences for the number of patients' visits (endo = 5.2 ± 1.8; implant = 5.5 ± 1.1; mean difference = -0.03 95% CI: -1.24 to 0.64; P (t-test) = 0.522). It took significantly more days to complete the implant rehabilitation (endo = 48.9 ± 19.5; implant = 158.5 ± 67.2; mean difference = -109.60; 95% CI: -141.26 to -77.94; P (t-test) < 0.001), but less patients' chair time (endo = 405.5 ± 230.3 min; implant = 260.0 ± 154.6 min; mean difference = 45.50; 95% CI: 19.35 to 271.65; P (t-test) = 0.025). Implant treatment was significantly more expensive (endo = 1195 ± 503.7 €; implant = 1907.5 ± 232.4 €; mean difference = -712.50; 95% CI: -963.59 to -461.41; P (t-test) < 0.001). One year after treatment completion, the mean PES was 10.92 ± 1.93 and 7.07 ± 2.87 and the mean WES was 7.67 ± 1.83 and 7.60 ± 2.32 in the endo group and implant group, respectively. Soft tissues aesthetics (PES) was significantly better at endodontically retreated teeth (mean difference 3.85; 95% CI 1.94 to 5.76; P (t-test) < 0.001) whereas no significant differences were observed for tooth aesthetics (WES) (mean difference 0.07; 95% CI -1.62 to 1.76; P (t-test) = 0.936) between treatments. CONCLUSIONS: The 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. Although much larger patient populations and longer follow-ups are needed to fully answer this question, in this scenario the less invasive endodontic retreatment could be the first therapeutic option to be considered.
Two or three machined vs roughened surface dental implants loaded immediately supporting total fixed prostheses: 1-year results from a randomised controlled trial.
Cannizzaro G, Gastaldi G, Gherlone E … +4 more , Vinci R, Loi I, Trullenque-Eriksson A, Esposito M
Eur J Oral Implantol · 2017 · PMID 28944356
PURPOSE: To compare implants with machined vs roughened surfaces placed flapless in totally edentulous jaws and immediately restored with metal-resin screw-retained cross-arch prostheses. Mandibles were rehabilitated wit...
PURPOSE: To compare implants with machined vs roughened surfaces placed flapless in totally edentulous jaws and immediately restored with metal-resin screw-retained cross-arch prostheses. Mandibles were rehabilitated with two implants (Fixed-on-2 or Fo2) and maxillae with three implants (Fixed-on-3 or Fo3). MATERIALS AND METHODS: Forty edentulous or to be rendered edentulous patients (20 in the mandible and 20 in the maxilla) were randomised to the machined group (20 patients: 10 mandibles and 10 maxillae) and to the roughened group (20 patients: 10 mandibles and 10 maxillae) according to a parallel group design. To be immediately loaded implants had to be inserted with a minimum torque of 60 Ncm. Outcome measures were prosthesis and implant failures, complications and peri-implant marginal bone level changes evaluated up to 1 year post-loading. RESULTS: Flaps were raised in four patients from the machined group. Four prostheses on machined implants and three on roughened implants were delayed for loading because a sufficient insertion torque was not obtained. There were no dropouts 1 year after loading. Two maxillary machined implants were lost in two patients (difference in proportions = 0.10; 95% CI = -0.03 to 0.23; P (Fisher's exact test) = 0.487); one maxillary Fo3 prosthesis on machined implants and one mandibular Fo2 prosthesis on roughened implants had to be remade (difference in proportions = 0; 95% CI = -0.14 to 0.14; P (Fisher's exact test) = 1.000). Five patients with machined implants had six complications vs seven patients who had eight complications at roughened implants (difference in proportions = -0.10; 95% CI = -0.38 to 0.18; P (Fisher's exact test) = 0.731). There were no statistically significant differences for implant failures, prosthetic failures or complications between groups. There were no statistically significant differences for marginal peri-implant bone levels between the two groups (estimate of the difference = -0.06 mm; 95% CI = -0.23 to 0.10; P (ANCOVA) = 0.445), with both groups losing marginal bone in a statistically significant way (0.35 ± 0.23 mm for machined and 0.42 ± 0.27 mm for roughened surface). CONCLUSIONS: These preliminary results suggest that immediately loaded cross-arch prostheses can be supported by only two mandibular or three maxillary dental implants at least up to 1 year post-loading, independently of the type of implant surface used. Longer follow-ups are needed to understand whether one of the two-implant surfaces is preferable.
Wide diameter immediate post-extractive implants vs delayed placement of normal-diameter implants in preserved sockets in the molar region: 1-year post-loading outcome of a randomised controlled trial.
Checchi V, Felice P, Zucchelli G … +5 more , Barausse C, Piattelli M, Pistilli R, Grandi G, Esposito M
Eur J Oral Implantol · 2017 · PMID 28944355
PURPOSE: To compare the effectiveness of 6.0 to 8.0 mm-wide diameter implants, placed immediately after tooth extraction, with conventional 4.0 or 5.0 mm diameter implants placed in a preserved socket after a 4-month per...
PURPOSE: To compare the effectiveness of 6.0 to 8.0 mm-wide diameter implants, placed immediately after tooth extraction, with conventional 4.0 or 5.0 mm diameter implants placed in a preserved socket after a 4-month period of healing in the molar region. MATERIALS AND METHODS: Just after extraction of one or two molar teeth, and with no vertical loss of the buccal bone in relation to the palatal wall, 100 patients requiring immediate post-extractive implants were randomly allocated to immediate placement of one or two 6.0 to 8.0 mm-wide diameter implants (immediate group; 50 patients) or for socket preservation using a porcine bone substitute covered by a resorbable collagen barrier (delayed group; 50 patients), according to a parallel group design in one centre. Bone-to-implant gaps were filled with autogenous bone retrieved with a trephine drill used to prepare the implant sites for the immediate wide diameter post-extractive implants. Four months after socket preservation, one to two 4.0 or 5.0 mm-wide delayed implants were placed. Implants were loaded 4 months after placement with fixed provisional restorations in acrylic, and replaced after 4 months by fixed, definitive, metal-ceramic restorations. Patients were followed to 1 year after loading. Outcome measures were: implant failures, complications, aesthetics assessed using the pink esthetic score (PES), peri-implant marginal bone level changes, patient satisfaction, number of appointments and surgical interventions recorded, when possible, by blinded assessors. RESULTS: Three patients dropped out 1 year after loading from the immediate group vs six from the delayed group. Five implants out of 47 failed in the immediate group (10.6%) vs two out 44 (4.6%) in the delayed group, the difference being not statistically significant (difference in proportion = 6.0%, 95% CI: -8.8% to 20.8%, P = 0.436). In the immediate group 10 patients were affected by 10 complications, while in the delayed group four patients were affected by four complications. The difference was not statistically significant (difference in proportion = 12%, 95% CI: -2% to 26%, P = 0.084). At delivery of the definitive prostheses, 4 months after loading, the mean total PES score was 9.65 ± 1.62 and 10.44 ± 1.47 in the immediate and delayed groups, respectively. At 1 year after loading, the mean total PES score was 9.71 ± 2.71 and 10.86 ± 1.37 in the immediate and delayed groups, respectively. The Total PES score was statistically significantly better at delayed implants both at 4 months (mean difference = 0.79; 95% CI: 0.05 to 1.53; P = 0.03) and at 1 year (mean difference = 1.15; 95% CI: 0.13 to 2.17; P = 0.02). Marginal bone levels at implant insertion (after bone grafting) were 0.04 mm for immediate and 0.11 mm for delayed implants, which was statistically significantly different (mean difference = 0.07; 95% CI: 0.02 to 0.12; P < 0.0001). One year after loading, patients in the immediate group lost on average 1.06 mm and those from the delayed group 0.63 mm, the difference being statistically significant (mean difference = 0.43 mm; 95% CI: 0.15 to 0.61; P < 0.0001). All patients were fully or partially satisfied both for function and aesthetics, and would undergo the same procedure again both at 4 months and 1 year after loading. Patients from the immediate group required on average 7.48 ± 1.45 visits to the clinician and 2.14 ± 0.49 surgical interventions and to have their definitive prostheses delivered vs 10.30 ± 0.99 visits and 3.08 ± 0.40 surgical interventions for the delayed group, the difference being statistically significant (P < 0.001 for visits, and P < 0.001 for surgical interventions). CONCLUSIONS: Preliminary 1 year follow-up data suggest that immediate placement of 6.0 to 8.0 mm wide diameter implants in molar extraction sockets yielded inferior aesthetic outcomes than ridge preservation and delayed placement of conventional 4.0 to 5.0 mm diameter implants.
Single vs two implant-retained overdentures for edentulous mandibles: a systematic review.
Alqutaibi AY, Esposito M, Algabri R … +4 more , Alfahad A, Kaddah A, Farouk M, Alsourori A
Eur J Oral Implantol · 2017 · PMID 28944354
PURPOSE: To compare prosthesis and implant failure, patient satisfaction, prosthetic complications and peri-implant marginal bone loss of mandibular overdentures (IOD) supported by a single or two implants. MATERIALS AND...
PURPOSE: To compare prosthesis and implant failure, patient satisfaction, prosthetic complications and peri-implant marginal bone loss of mandibular overdentures (IOD) supported by a single or two implants. MATERIALS AND METHODS: Manual and electronic database (PubMed and Cochrane) searches were performed to identify randomised controlled trials, without language restriction, comparing single vs two implant supported mandibular overdentures. Two investigators extracted data independently. The Cochrane tool was used for assessing the quality of included studies. Meta-analyses were performed for the included RCTs. RESULTS: Six publications corresponding to four RCTs were identified. Three RCTs (corresponding to five publications) were included and one trial was excluded. Follow-ups in function were 1, 3 and 5 years after loading. All included studies were considered to be at a high risk of bias. The pooled result revealed more prosthesis failures at overdentures supported by two implants at 1 year (three trials) (P = 0.02; Risk Difference: -0.12, 95% CI: -0.22, -0.02), however, there were non-significant differences at 3 years (two trials) (P = 0.22; Risk Difference: -0.32, 95% CI: -0.83, 0.19) and at 5 years (one trial) (P = 0.95; Risk Difference: 0.01, 95% CI: -0.22, 0.24). Regarding implant failures, there were more implant losses in overdentures supported by two implants at 1 year (three trials) (P = 0.02; Risk Difference: -0.12, 95% CI: -0.22, -0.02) and at 5 years (one trial) (P = 0.95; Risk Difference: -0.15, 95% CI: -0.28, -0.02), however, there were non-significant difference at 3 years (two trials) (P = 0.2; Risk Difference: -0.33, 95% CI: -0.84, 0.18). After 5 years in function, meta-analyses revealed that there were non-significant differences regarding overall prosthetic complications when mandibular overdentures supported by a single implant were compared with overdentures supported by two implants (P = 0.43; RD: 0.04, 95% CI: -0.06, 0.15). CONCLUSION: Mandibular overdentures retained by a single implant have comparable results to those retained by two implants. However, this should be interpreted with caution as all the included studies were considered at a high risk of bias.
Editorial: 10 years of EJOI.
Esposito M
Eur J Oral Implantol · 2017 · PMID 28944353
Abstract loading — click title to view on PubMed.
Research in focus.
Eur J Oral Implantol · 2017 · PMID 28555211
This section presents a brief review of articles on dental implants considered of special interest to readers, in order to encourage the development of research, the interest in data analysis and the attention to scienti...
This section presents a brief review of articles on dental implants considered of special interest to readers, in order to encourage the development of research, the interest in data analysis and the attention to scientific publications. Your comments are welcome. Please contact Dr Michele Nieri at michelenieri@gmail.com.
Report of a jaw osteonecrosis possibly caused by denosumab.
Saad D, Saad P
Eur J Oral Implantol · 2017 · PMID 28555210
PURPOSE: To report a case of osteonecrosis of the jaw (ONJ) occurring in an implant area possibly related to denosumab, a relatively new antiosteoporotic agent. MATERIALS AND METHODS: Two months following the extraction...
PURPOSE: To report a case of osteonecrosis of the jaw (ONJ) occurring in an implant area possibly related to denosumab, a relatively new antiosteoporotic agent. MATERIALS AND METHODS: Two months following the extraction of both maxillary first molars, a bilateral maxillary sinus floor elevation was performed on a 64-year-old female patient under a biannual
60 mg denosumab antiosteoporotic treatment. Seven months later, two implants were inserted in a single-stage procedure in each of the grafted sinuses. After 3 months, the implants underwent prosthetic rehabilitation at one side, and a series of failures that led to an ONJ instalment at the other side. RESULTS: The ONJ persisted over 7 months and was only resolved by a surgical approach consisting of a piezoelectric osteotomy and platelet-rich fibrin with a tension-free wound closure. CONCLUSIONS: A cumulative effect of denosumab is likely to be associated with a jaw osteonecrosis, which in this case was manageable using a surgical approach with no need to interrupt the appropriate drug treatment course. Conflict of interest statement: The authors certify that they are not affiliated with, or involved in any organisation or entity with any financial or non-financial interest in the subject matter or materials discussed in this manuscript.
Characterisation of apical bone lesions: Comparison of MRI and CBCT with histological findings - a case series.
Geibel MA, Schreiber E, Bracher AK … +4 more , Hell E, Ulrici J, Sailer LK, Rasche V
Eur J Oral Implantol · 2017 · PMID 28555209
PURPOSE: The aim of this case series was to compare magnetic resonance imaging (MRI) with cone beam computed tomography (CBCT) in the representation of periapical osteolyses. Based on the histological findings, the poten...
PURPOSE: The aim of this case series was to compare magnetic resonance imaging (MRI) with cone beam computed tomography (CBCT) in the representation of periapical osteolyses. Based on the histological findings, the potential of MRI for further lesion characterisation was investigated. MATERIALS AND METHODS: Thirteen patients (average age: 41 ± 27 years) with a total of 15 periapical lesions (five molars, five premolars, and five front teeth) were examined. Lesion characterisation was based on the homogeneity/heterogeneity of the lesions, the signal intensity within the lesion compared to the surrounding tissue and differences in the signal intensities between different MRI contrast weightings. Results were compared with CBCT and histological findings. RESULTS: Although all patients presented with dental restorations, such as fixed partial dentures and filling materials, all periapical lesions could be diagnosed with either imaging modality. Histologically, 13 cysts and two apical granuloma were confirmed. In CBCT, the similar appearance of all lesions did not allow any further characterisation. In MRI, radicular cysts and granuloma could be characterised by their appearance in the MRI images with different contrast weightings. The MRI-derived characterisations were consistent with the histological findings. CONCLUSIONS: The presented study shows that the application of multi-contrast MRI may lead to better characterisation of apical lesions, thus enabling an improved patient-specific selection of the optimal treatment option. Conflict-of-interest statement: MAG, ESS, and LKS do not report any potential conflict-of-interest; EH and JU are employees of Sirona Dental Systems; VR is receiving a research grant by Sirona Dental Systems.
Comparison of immediately loaded flapless-placed one-piece implants and flapped-placed conventionally loaded two-piece implants, both fitted with all-ceramic single crowns, in the posterior mandible: 3-year results from a randomised controlled pilot trial.
Bömicke W, Gabbert O, Koob A … +2 more , Krisam J, Rammelsberg P
Eur J Oral Implantol · 2017 · PMID 28555208
PURPOSE: To compare outcomes for immediately loaded one-piece implants (OPI), placed flapless, and conventionally loaded two-piece implants (TPI), placed after two-stage flapped surgery. MATERIALS AND METHODS: Thirty-eig...
PURPOSE: To compare outcomes for immediately loaded one-piece implants (OPI), placed flapless, and conventionally loaded two-piece implants (TPI), placed after two-stage flapped surgery. MATERIALS AND METHODS: Thirty-eight participants were randomised to receive either one OPI (19 participants, OPI group) or one TPI (19 participants, TPI group) inserted in the posterior mandible with a torque of at least 35 Ncm according to a parallel group design. OPI were immediately loaded with non-occluding temporary crowns. After 3 months, TPI were exposed and implants in both groups were occlusally loaded with zirconia crowns. Outcome measures were implant failure, prosthesis failure, any complication and changes of probing pocket depth (PPD), plaque index (PI), gingiva index (GI), and peri-implant marginal bone level, recorded by unblinded assessors. RESULTS: Three years after occlusal loading, three participants dropped out from the TPI group. There were no statistically significant differences between the groups with regard to participants with implant failure (OPI group 1/19; TPI group 0/16; difference in proportions (DIP), -5.3%; 95% confidence interval (CI) -15.3 to 4.8; P = 1.000), prosthesis failure (OPI group 3/19, TPI group 5/16; DIP, 15.5%; 95% CI -12.6 to 43.5; P = 0.424), any complication (OPI group 6/19, TPI group 5/16; DIP, -0.3%; 95% CI -31.2 to 30.5; P = 1.000), or changes of PPD (P =0.174), PI (P = 0.222), or GI (P = 0.415). Veneer chipping accounted for most prosthesis failures and complications. On average OPI and TPI lost 1.34 mm and 0.67 mm of marginal bone, respectively, the difference between groups being statistically significant (mean difference, 0.66 mm; 95% CI -0.02 to 1.34; P = 0.024) in favour of TPI implants. CONCLUSIONS: Both implant procedures might be viable in the short term, but statistically significantly more bone loss might be indicative of future problems with OPI. Because of the high incidence of chipping, veneered zirconia crowns cannot be recommended on posterior implants. Conflict-of-interest statement: The authors are grateful to Nobel Biocare for providing the study materials free of charge. Money received from the manufacturer was used to reimburse participants for regular attendance at follow-up appointments and to finance data management. The authors declare no conflict of interest.
Molar replacement with 7 mm-wide diameter implants: to place the implant immediately or to wait 4 months after socket preservation? 1 year after loading results from a randomised controlled trial.
Tallarico M, Xhanari E, Pisano M … +2 more , Gatti F, Meloni SM
Eur J Oral Implantol · 2017 · PMID 28555207
PURPOSE: To test the hypothesis that there is no difference in clinical, radiographic and aesthetic outcomes positioning single post-extractive 7 mm-diameter implants or waiting 4 months after molar extraction and socket...
PURPOSE: To test the hypothesis that there is no difference in clinical, radiographic and aesthetic outcomes positioning single post-extractive 7 mm-diameter implants or waiting 4 months after molar extraction and socket preservation procedure. MATERIAL AND METHODS: Patients requiring one implant-supported single restoration to replace a failing tooth in the molar region of both maxilla and mandible were selected. Patients were randomised according to a parallel group design into two arms: implant installation in fresh extraction sockets grafted with cortico-cancellous heterologous bone and porcine derma (group A) or delayed implant installation 4 months after tooth extraction and socket preservation using the same materials (group B). Implants were submerged for 4 months. The primary outcome measures were the success rates of the implants and prostheses and the occurrence of any surgical and prosthetic complications during the entire follow-up. Secondary outcome measures were: peri-implant marginal bone level (MBL) changes, resonance frequency analysis (ISQ) and pink esthetic score (PES) values at implant placement (baseline) up to 1 year after loading. RESULTS: Twelve patients were randomised to group A and 12 to group B. No patient dropped out within 1 year after loading. No implant and prosthesis failed and no complications occurred during the entire follow-up. One year after loading, statistically significant higher mean MBL loss was experienced in group A (0.63 mm ± 0.31 mm) compared to group B (0.23 mm ± 0.06 mm); difference 0.41 mm (95% CI 0.17-0.53; P = 0.001). Six months after implant placement, mean ISQ value was 78.8 ± 2.8 for group A and 79.9 ± 3.6 for group B, showing no statistically significant difference between groups (difference 1.1; 95% CI: 0.04 to 2.96; P = 0.422). One year after loading, mean PES was 10.6 ± 1.8 [range: 8 to13] in group A and 12.2 ± 1.2 [range: 11 to 14] in group B. The difference was statistically significant (1.6 ± 2.7; 95% CI -0.55-2.55; P = 0.019) with better results for group B. CONCLUSIONS: Within the limitations of this study, both procedures achieved successful results over the 1-year follow-up period, but waiting 4 months after tooth extraction and socket preservation procedure was associated with less marginal bone loss and a better aesthetic outcome. Conflict-of-interest statement: Dr Marco Tallarico is Research Project Manager of Osstem AIC Italy. However no company supported this study and all authors declare no conflicts of interest.
A comparison of two implants with conical vs internal hex connections: 1-year post-loading results from a multicentre, randomised controlled trial.
Cannata M, Grandi T, Samarani R … +2 more , Svezia L, Grandi G
Eur J Oral Implantol · 2017 · PMID 28555206
PURPOSE: To compare the clinical and radiological outcomes of identical implants with conical or internal hex connections. METHODS: A total of 90 patients with partial edentulism requiring one implant-supported prosthesi...
PURPOSE: To compare the clinical and radiological outcomes of identical implants with conical or internal hex connections. METHODS: A total of 90 patients with partial edentulism requiring one implant-supported prosthesis were randomly allocated in two equal groups (n = 45) to receive either implants with a conical connection or implants of the same type, but with an internal hex connection at three centres. Patients were followed for 1 year after loading. Outcome measures were implant failures, any complication and marginal bone level changes. RESULTS: One patient (2.2%) belonging to the internal hex group dropped out. One implant (2.2%) failed in the conical group. There were no statistically significant differences in implant failures between the two groups (2.2% vs. 0%, difference 2.2; 95% CI: -1.3; 5.7; P = 0.315). Two complications occurred in the conical group and two in the internal hex group (P = 1.000, difference 0.00, 95% CI: -3.1; 3.1). The 12-month peri-implant bone resorption was similar in both groups: 0.56 ± 0.53 mm (95% CI 0.03; 1.09) in the conical group and 0.60 ± 0.62 mm (95% CI 0.02; 1.22) in the internal hex group (difference = 0.04 ± 0.55, 95% CI: -0.51; 0.59, P = 0.745). CONCLUSIONS: Within the limitation of this study, preliminary short-term data (1 year post-loading) did not show any statistical differences between the two internal connection types, therefore clinicians could choose whichever connection they prefer. Conflict of interest statement: Tommaso Grandi serves as consultant for J Dental Care, Modena, Italy. This study was completely self-financed and no funding was sought or obtained, not even in the form of free materials.
Conventional drills vs piezoelectric surgery preparation for placement of four immediately loaded zygomatic oncology implants in edentulous maxillae: results from 1-year split-mouth randomised controlled trial.
Esposito M, Barausse C, Balercia A … +3 more , Pistilli R, Ippolito DR, Felice P
Eur J Oral Implantol · 2017 · PMID 28555205
PURPOSE: To compare the outcome of site preparation for zygomatic oncology implants using conventional preparation with rotary drills or piezoelectric surgery with dedicated inserts for placing two zygomatic implants per...
PURPOSE: To compare the outcome of site preparation for zygomatic oncology implants using conventional preparation with rotary drills or piezoelectric surgery with dedicated inserts for placing two zygomatic implants per zygoma according to a split-mouth design. MATERIALS AND METHODS: Twenty edentulous patients with severely atrophic maxillas not having sufficient bone volume for placing dental implants and less than 4 mm of bone height subantrally had their hemi-maxillas randomised according to a split-mouth design into implant site preparation with conventional rotational drills or piezoelectric surgery. Two zygomatic oncology implants (unthreaded coronal portion) were placed in each hemi-maxilla. Implants that achieved an insertion torque superior to 40 Ncm were immediately loaded with screw-retained metal reinforced acrylic provisional prostheses. Outcome measures were: prosthesis and implant failures, any complications, time to place the implants, presence of post-operative haematoma, and patient's preference by independent assessors. All patients were followed up to 1 year after loading. RESULTS: In two patients drills had also to be used at the piezoelectric surgery side to enable implant sites to be prepared. One implant for the conventional drill group did not achieve an insertion torque superior to 40 Ncm since it fractured the zygoma. No patients dropped out and two distal oncology implants failed in the same patient (one per group), who was not prosthetically rehabilitated. Six complications occurred at drilled sites and three at piezoelectric surgery sites (two patients had bilateral complications), the difference being not statistically significant (P (McNemar's test) = 0.375; odds ratio = 4.00; 95% CI of odds ratio: 0.45 to 35.79). Implant placement with convention drills took on average 14.35 ± 1.76 min and with piezoelectric surgery 23.50 ± 2.26 min, implant placement time being significantly shorter with conventional drilling (difference = 9.15 ± 1.69 min; 95%CI: 8.36 to 9.94 min; P < 0.001). Post-operative haematomas were more frequent at drilled sites (P = 0.001), and 16 patients found both techniques equally acceptable, while four preferred piezoelectric surgery (P = 0.125). CONCLUSIONS: Both drilling techniques achieved similar clinical results, but conventional drilling required 9 min less and could be used in all instances, although it was more aggressive. These results may be system-dependent, therefore they cannot be generalised to other zygomatic systems with confidence. Conflict-of-interest statement: This study was partially supported by Southern Implants (Irene, South Africa), the manufacturer of the zygomatic implants and the conventional drills evaluated in this study. 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. Drs Felice and Pistilli developed the piezoelectric surgery zygomatic insert used in the present study.
Immediate loading of two (fixed-on-2) vs four (fixed-on-4) implants placed with a flapless technique supporting mandibular cross-arch fixed prostheses: 3-year results from a pilot randomised controlled trial.
Cannizzaro G, Felice P, Gherlone E … +5 more , Barausse C, Ferri V, Leone M, Trullenque-Eriksson A, Esposito M
Eur J Oral Implantol · 2017 · PMID 28555204
PURPOSE: To evaluate the outcome of two vs four implants placed flapless in fully edentulous mandibles and immediately restored with metal-resin screw-retained cross-arch prostheses. MATERIALS AND METHODS: A total of 60...
PURPOSE: To evaluate the outcome of two vs four implants placed flapless in fully edentulous mandibles and immediately restored with metal-resin screw-retained cross-arch prostheses. MATERIALS AND METHODS: A total of 60 patients from two different centres were randomised: 30 to the fixed-on-2 group and 30 to the fixed-on-4 group according to a parallel group design. To be immediately loaded implants had to be inserted with a minimum torque of 40 Newton/cm (Ncm). Outcome measures were prosthesis and implant failures, complications, and marginal bone level changes. RESULTS: Flaps were raised in 18 patients. Two implants in two patients did not reach the planned insertion torque and were replaced immediately by larger diameter ones. Three years after loading, two patients dropped out from the fixed-on-2 group and one from the fixed-on-4 group. No implant failure or prosthetic failure occurred. A total of 12 fixed-on-2 patients were affected by one complication each vs 13 fixed-on-4 patients. There were no statistically significant differences for complications between groups (difference in proportion = -0.03; 95% CI -29 to 0.22; P [Fisher's exact test] =1.000). There were no statistically significant differences for marginal peri-implant bone loss between the two groups (mean difference = 0.14; CI 95% -0.17 to 0.45; P [ANCOVA] = 0.356), with both groups losing marginal bone in a statistically significant way (1.70 mm for fixed-on-2 implants and 1.56 mm for fixed-on-4 implants). There were statistically significant differences between the two centres, with more bone being lost for the Bologna centre (2.18 vs 1.13 mm; P (ANCOVA) < 0.001). CONCLUSIONS: Up to 3 years after loading, these preliminary results suggest that immediately loaded mandibular cross-arch fixed prostheses can be supported by only two dental implants. Longer follow-ups (about 10 years) are needed to properly evaluate this therapeutic option. Conflict of interest statement: This study was completely self-financed and no funding from the implant manufacturers has been sought or obtained, not even in the form of free materials.
The effectiveness of systemic antibiotic prophylaxis in preventing local complications after tooth extraction. A systematic review.
Marchionni S, Toti P, Barone A … +2 more , Covani U, Esposito M
Eur J Oral Implantol · 2017 · PMID 28555203
PURPOSE: To assess the beneficial or harmful effects of systemic prophylactic antibiotics at extraction of teeth, apart from third molars, vs no antibiotic or placebo administration. Furthermore, if antibiotics are benef...
PURPOSE: To assess the beneficial or harmful effects of systemic prophylactic antibiotics at extraction of teeth, apart from third molars, vs no antibiotic or placebo administration. Furthermore, if antibiotics are beneficial, to determine which type, dosage, duration and timing of administration is the most effective. MATERIALS AND METHODS: The Cochrane Oral Health Group's Trials Register (to 30 January 2016) and MEDLINE (1 January 1950 to 30 January 2016) were searched. There were no language or date restrictions placed on the searches of the electronic databases. Randomised controlled trials (RCTs) of parallel group design, with a follow-up of at least 2 weeks, comparing the administration of various prophylactic antibiotic regimens vs no antibiotics to people undergoing extraction of teeth, not including third molars, were included. Outcome measures were postoperative complications/adverse events, post-operative pain and swelling. Screening of eligible studies, assessment of the risk of bias of the trials and data extraction were conducted in triplicate by three independent review authors. Results were to be expressed as risk ratios (RRs) using a random-effects model for dichotomous outcomes, with 95% confidence intervals (CIs). Heterogeneity, including both clinical and methodological factors, was to be investigated. RESULTS: No relevant RCT was identified. CONCLUSIONS: There is no RCT to determine if the antibiotic therapy is needed at extraction of teeth, excluding third molars. Properly designed and conducted RCTs are needed to understand the role of the antibiotic therapy for tooth extraction. Conflict-of-interest statement: This systematic review was self-funded and the authors have no conflict of interests to declare.
Editorial: The scientific plague affecting medical and dental research: from fake news to fake studies.
Esposito M
Eur J Oral Implantol · 2017 · PMID 28555202
Abstract loading — click title to view on PubMed.
Research in focus.
Eur J Oral Implantol · 2017 · PMID 28327699
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.
Accuracy and reliability of different cone beam computed tomography (CBCT) devices for structural analysis of alveolar bone in comparison with multislice CT and micro-CT.
Van Dessel J, Nicolielo LF, Huang Y … +4 more , Coudyzer W, Salmon B, Lambrichts I, Jacobs R
Eur J Oral Implantol · 2017 · PMID 28327698
OBJECTIVE: The aim of this study was to assess whether cone beam computed tomography (CBCT) may be used for clinically reliable alveolar bone quality assessment in comparison to its clinical alternatives, multislice comp...
OBJECTIVE: The aim of this study was to assess whether cone beam computed tomography (CBCT) may be used for clinically reliable alveolar bone quality assessment in comparison to its clinical alternatives, multislice computed tomography and the gold standard (micro-CT). MATERIALS AND METHODS: Six dentate mandibular bone samples were scanned with seven CBCT devices (ProMax 3D Max, NewTom GiANO, Cranex 3D, 3D Accuitomo 170, Carestream 9300, Scanora 3D, I-CAT Next generation), one micro-CT scanner (SkyScan 1174) and one MSCT machine (Somatom Definition Flash) using two protocols (standard and high-resolution). MSCT and CBCT images were automatically spatially aligned on the micro-CT scan of the corresponding sample. A volume of interest was manually delineated on the micro-CT image and overlaid on the other scanning devices. Alveolar bone structures were automatically extracted using the adaptive thresholding algorithm. Based on the resulting binary images, an automatic 3D morphometric quantification was performed in a CT-Analyser (Bruker, Kontich, Belgium). The reliability and measurement errors were calculated for each modality compared to the gold standard micro-CT. RESULTS: Both MSCT and CBCT were associated with a clinically and statistically (P <0.05) significant measurement error. Bone quantity-related morphometric indices (bone volume fraction 8.41% min to 17.90% max, bone surface density -0.47 mm-1 min to 0.16 mm-1 max and trabecular thickness 0.15 mm min to 0.31 mm max) were significantly (P <0.05) overestimated, resulting in significantly (P <0.05) closer trabecular pores (total porosity percentage -8.41% min to -17.90% max and fractal dimension 0.08 min to 0.17 max) in all scanners compared to micro-CT. However, the structural pattern of the alveolar bone remained similar compared to that of the micro-CT for the ProMax 3D Max, NewTom GiANO, Cranex 3D, 3D Accuitomo 170 and Carestream 9300. On the other hand, the Scanora 3D, i-CAT Next Generation, standard and high-resolution MSCT displayed an overrated bone quantity and aberrant structural pattern compared to other scanning devices. The calculation of morphometric indices had an overall high reliability (intraclass correlation coefficient [ICC] 0.62 min to 0.99 max), except for the i-CAT Next Generation CBCT (ICC 0.26 min to 0.86 max) and standard resolution MSCT (ICC 0.10 min to 0.62 max). CONCLUSIONS: This study demonstrated that most CBCT machines may be able to quantitatively assess alveolar bone quality, with a level of accuracy and reliability that approaches micro-CT. One may therefore propose to extrapolate this to clinical CBCT imaging, certainly when there is a need for implant rehabilitation in dentate jaw bones. Conflict-of-interest statement: There is no conflict of interest to declare. FUNDING: Fellowship support was received from Research Foundation Flanders (FWO) from the Belgian government and from the Coordination for the Improvement of Higher Education Personnel (CAPES) programme, Science without Borders, from the Brazilian government.
Seven mm long dental implants in posterior jaws: 3-year report of an ongoing prospective single cohort study.
Maló P, Nobre MA, Lopes A … +2 more , Gonçalves I, Nunes M
Eur J Oral Implantol · 2017 · PMID 28327697
PURPOSE: To report on the outcome of 7 mm long implants in the rehabilitation of posterior areas of atrophic jaws 3 years after loading. MATERIALS AND METHODS: This prospective study included 127 patients treated with 21...
PURPOSE: To report on the outcome of 7 mm long implants in the rehabilitation of posterior areas of atrophic jaws 3 years after loading. MATERIALS AND METHODS: This prospective study included 127 patients treated with 217 implants supporting 165 fixed prostheses. Final abutments were delivered at surgery stage and in the large majority of patients (n = 116) the implants (n = 199) were loaded after 4 months. Primary outcome measures were implant success and prosthetic success calculated at patient level; secondary outcome measures were complications, and marginal bone level changes calculated at patient level. RESULTS: Thirteen patients with 21 implants dropped out of the study after 3 years. Implant losses occurred in 10 of the 127 patients and 14 of the 217 implants placed failed, giving a cumulative success rate of 93.7% at 3 years, using the patient as unit of analysis. Eight prosthetic failures occurred in six patients, rendering a prosthetic success rate 95.3% at patient level. The average (standard deviation) marginal bone resorption after 3 years of follow-up was 1.46 mm (0.78 mm). Complications occurred in 13 patients (10.2%) and 15 implants (6.9%). CONCLUSIONS: Within the limitations of this study, 7 mm long implants in posterior atrophic jaws can be a viable treatment option given the good prosthetic and implant success rates, low marginal bone loss and low incidence of complications. Nevertheless, longer follow-ups are needed to validate the long-term outcome. Conflict-of-interest statement: This study was funded by grant no. 2015-1378 from Nobel Biocare Services. Paulo Maló is currently a consultant for Nobel Biocare. The remaining authors declare no conflicts of interest.
Subcrestal placement of dental implants with an internal conical connection of 0.5 mm versus 1.5 mm: Outcome of a multicentre randomised controlled trial 1 year after loading.
Gualini F, Salina S, Rigotti F … +6 more , Mazzarini C, Longhin D, Grigoletto M, Trullenque-Eriksson A, Sbricoli L, Esposito M
Eur J Oral Implantol · 2017 · PMID 28327696
PURPOSE: To evaluate whether there are some clinical benefits by placing single dental implants either 0.5 or 1.5 mm subcrestally in healed bone crests. MATERIALS AND METHODS: Sixty partially edentulous patients requirin...
PURPOSE: To evaluate whether there are some clinical benefits by placing single dental implants either 0.5 or 1.5 mm subcrestally in healed bone crests. MATERIALS AND METHODS: Sixty partially edentulous patients requiring two single implant-supported crowns had both sites randomly allocated either to 0.5 mm or 1.5 mm subcrestal implant placement according to a split-mouth design at six centres. Implants were submerged in aesthetic areas or non-submerged in non-aesthetic areas for 3 months. Provisional acrylic crowns were delivered and were replaced after 2 months by definitive metal-ceramic crowns. Patients were followed to 1 year after loading. Outcome measures were: crown and implant failures; complications; aesthetics assessed using the pink esthetic score (PES); peri-implant marginal bone level changes; and patient preference, recorded by blinded assessors. RESULTS: One patient dropped out. One patient lost both implants to infection at impression taking. Three complications affected three patients of the 0.5 mm group and two complications affected two patients of the 1.5 mm subcrestally placed implants. One patient had complications at both implants. There were no statistically significant differences for complications between group (difference of proportion = 0.02; 95% CI -0.06 to 0.09; P (McNemar test) = 1.000). At delivery of definitive crowns, 2 months after loading, the mean aesthetic score was 11.22 ± 1.91 and 11.12 ± 1.59 for the 0.5 and 1.5 mm group, respectively. At 1 year after loading, the mean aesthetic score was 12.09 ± 1.66 and 12.10 ± 1.52 for the 0.5 and 1.5 mm group, respectively. There were no statistically significant differences between the two groups at 2 months (P (paired t test) = 0.626) or at 1 year (P (paired t test) = 0.920). One year after loading, patients of the 0.5 mm lost on average 0.21 ± 0.51 mm and those of the 1.5 mm group 0.11 ± 0.36 mm, the difference being not statistically significant (difference = 0.10; 95% CI -0.01 to 0.20; P (paired t test) = 0.078). Patients did not prefer any depth of the implant placement over the other. There were no differences in outcomes between centres. CONCLUSIONS: No statistical or clinical differences were noticed when placing implants 0.5 mm or 1.5 mm subcrestally, therefore clinicians can do as they prefer. Conflict-of-interest statement: Anthogyr (Sallanches, France), the manufacturer of the implants used in this investigation, partially funded this trial and donated the implants and the prosthetic components, however data belonged to the authors and by no means did the sponsor interfere with the conduct of the trial or the publication of its results.
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