European Journal Of Oral Implantology[JOURNAL]
Sun
200 papers
Immediate, early (6 weeks) and delayed loading (3 months) of single implants: 4-month post-loading from a multicenter pragmatic randomised controlled trial.
Esposito M, Siormpas K, Mitsias M … +3 more , Bechara S, Trullenque-Eriksson A, Pistilli R
Eur J Oral Implantol · 2016 · PMID 27722223
PURPOSE: To compare the clinical outcome of single, partial and full fixed implant-supported prostheses immediately loaded (within 48 h), early loaded at 6 weeks and conventionally loaded at 3 months (delayed loading). M...
PURPOSE: To compare the clinical outcome of single, partial and full fixed implant-supported prostheses immediately loaded (within 48 h), early loaded at 6 weeks and conventionally loaded at 3 months (delayed loading). MATERIALS AND METHODS: Eighty-one patients (27 requiring single implants, 27 requiring partial fixed prostheses and 27 requiring total fixed cross-arch prostheses) were randomised in equal numbers in three private practices to immediate loading (27 patients), early loading (27 patients) and conventional loading (27 patients) according to a parallel group design with three arms. To be immediately or early loaded, implants had to be inserted with a torque superior to 40 Ncm. Implants were initially loaded with provisional prostheses and replaced after 4 months by definitive ones. Outcome measures were prosthesis and implant failures and complications. RESULTS: No patient dropped out up to 4-months post-loading. No implant or prosthesis failed or any complications occurred. CONCLUSIONS: All loading strategies were highly successful and no differences could be observed for implant survival and complications when loading implants immediately, early or conventionally. Conflict-of-interest statement: This trial was partially funded by MegaGen, the manufacturer of the implants 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 its results.
Immediate, immediate-delayed (6 weeks) and delayed (4 months) post-extractive single implants: 4-month post-loading data from a randomised controlled trial.
Felice P, Zucchelli G, Cannizzaro G … +4 more , Barausse C, Diazzi M, Trullenque-Eriksson A, Esposito M
Eur J Oral Implantol · 2016 · PMID 27722222
PURPOSE: To compare the clinical outcome of single implants placed immediately after tooth extraction with implants placed 6 weeks after tooth extraction (immediate-delayed placement), and with implants placed after 4 mo...
PURPOSE: To compare the clinical outcome of single implants placed immediately after tooth extraction with implants placed 6 weeks after tooth extraction (immediate-delayed placement), and with implants placed after 4 months of extraction and socket healing (delayed placement). MATERIALS AND METHODS: Two hundred and ten patients requiring a single implant-supported crown to replace a tooth to be extracted were randomised to receive immediate post-extractive implants (70 patients), immediate-delayed implants at 6 weeks (70 patients), and delayed implants after 4 months of healing (70 patients), according to a parallel group design. When needed, patients of the immediate and immediate-delayed group had the socket grafted with a bone substitute and covered with a resorbable membrane at implant placement. Sockets randomised to delayed implants were grafted in the same manner if poorly preserved or in the aesthetic areas (from second upper to second upper premolars). Implants inserted with at least 25 Ncm torque were left to heal unloaded for 4 months, whereas those inserted with less than 25 Ncm were left to heal unloaded for 6 months. Temporary crowns were delivered and were to be replaced by definitive ones after 4 months. Outcome measures were crown and implant failures, complications, peri-implant marginal bone level changes, aesthetics assessed using the pink esthetic score (PES) and patient satisfaction recorded by blinded assessors. RESULTS: Three patients dropped out from the immediate, five from the immediate-delayed and six from the delayed group up to 4-months post-loading. Four implants (6.0%) failed in the immediate, four (6.2%) in the immediate-delayed and one (1.6%) from the delayed group (P (chi-square test) = 0.369). Apart from the crown failures due to implant losses, no other crown had to be remade. Five immediate, six immediate-delayed and three delayed implants were affected by one complication each (P (chi-square test) = 0.601). Mean peri-implant marginal bone loss after 4 months was -0.17 ± 0.11 mm (95% CI: -0.20; -0.15) at immediate, -0.20 ± 0.09 mm (95% CI: -0.23; -0.18) at immediate-delayed, and -0.24 ± 0.12 mm (95% CI: -0.27; -0.21) at delayed placed implants (P (Kruskal Wallis test) = 0.006). At delivery of definitive crowns, 4 months after loading, the mean total aesthetic score was 12.48, 12.38 and 11.71 in the immediate, immediate-delayed and delayed groups, respectively (P (Kruskal Wallis test) < 0.001). All patients were fully satisfied with both function and aesthetics, and would undergo the same procedure again, with four exceptions (one from the immediate, one from the immediate-delayed and two from the delayed group), who were partially satisfied with the aesthetics (P = 0.785). CONCLUSIONS: No statistically significant differences for failures, complications and patient satisfaction were observed when placing single implants immediately, 6 weeks or four months after tooth extraction; nevertheless failures and complications were more frequent for immediate and immediate-delayed placed implants. Bone level changes were similar between the different procedures, but the aesthetics showed better results for immediate and immediate-delayed implants. Conflict-of-interest statement: This trial was partially funded by Nobel Biocare Services AG (code: 2010-894), the manufacturer of the implants 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.
A 10-year report from a multicentre randomised controlled trial: Immediate non-occlusal versus early loading of dental implants in partially edentulous patients.
Zuffetti F, Esposito M, Galli F … +3 more , Capelli M, Grandi G, Testori T
Eur J Oral Implantol · 2016 · PMID 27722221
PURPOSE: To compare peri-implant bone and soft-tissue levels of immediate non-occlusally loaded versus non-submerged early loaded implants in partially edentulous patients 10 years after loading. MATERIALS AND METHODS: F...
PURPOSE: To compare peri-implant bone and soft-tissue levels of immediate non-occlusally loaded versus non-submerged early loaded implants in partially edentulous patients 10 years after loading. MATERIALS AND METHODS: Fifty-two patients were randomised in five Italian private practices: 25 in the immediately loaded group and 27 in the early loaded group. To be immediately loaded, single implants had to be inserted with a torque of at least 30 Ncm, and splinted implants with a torque of at least 20 Ncm. Immediately loaded implants were provided with non-occluding temporary restorations within 48 h. After 2 months, the provisional restorations were put in full occlusion. Implants were early loaded after 2 months. Definitive restorations were provided 8 months after implant placement. Outcome measures were prosthesis failures, implant failures and complications, recorded by non-blinded assessors, and peri-implant bone and soft-tissue levels evaluated by blinded assessors. RESULTS: Fifty-two implants were loaded immediately and 52 early. Three patients with 8 implants dropped out from the immediate group versus two patients with 3 implants from the early loaded group; all remaining patients were followed for at least 10 years after loading. One single immediately loaded implant failed 2 months after placement. Three patients with immediately loaded implants and two with early loaded implants were affected by complications. There were no statistically significant differences for implant/prosthesis failures (Fisher's exact test: P = 0.294; difference = 4%, 95% CI: -16% to 24%) and complications between groups (Fisher's exact test: P = 0.574; difference = 4.5%, 95% CI: -12% to 21%). Both groups gradually lost peri-implant bone in a highly statistically significant way at 2, 8 and 14 months, and at 4, 5 and 10 years. After 10 years, immediately loaded patients lost an average of 1.34 mm and early loaded patients lost 1.42 mm of peri-implant marginal bone. At 10 years, there was a statistically significant recession (P < 0.001) of the vestibular soft tissues from baseline (delivery of the final restorations 8 months after implant placement) at both immediate (0.38 mm) and early (0.25 mm) loaded implants. There were no statistically significant differences in terms of peri-implant bone (difference = 0.08 mm, 95% CI: -0.49 to 0.65; P = 0.49) and soft-tissue level changes (difference = 0.07 mm, 95% CI: -0.48 to 0.62; P = 0.469) between the two groups at 10 years after loading. CONCLUSIONS: In well-maintained patients, complications are uncommon and healthy and stable peri-implant tissues can be maintained for 10 years around both immediate and early loaded implants. Conflict-of-interest statement: This trial was independently designed and initiated by the investigators. BIOMET 3i, the manufacturer of the implants used in this investigation, provided partial economic support at a later stage, and finally ZIMMER-BIOMET partially supported the present publication, 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.
Editorial: Some random reflections on the equal co-first authorships.
Esposito M
Eur J Oral Implantol · 2016 · PMID 27722220
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Matteo Chiapasco, SIO President, Gianluca Paniz and Grazia Tommasato present the Italian Association of Osseointegration events in 2016.
Chiapasco M
Eur J Oral Implantol · 2016 · PMID 27722218
Abstract loading — click title to view on PubMed.
Editorial: Publication of 'gray literature' in EJOI.
Esposito M
Eur J Oral Implantol · 2016 · PMID 27722217
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Solid ameloblastoma mimicking a periodontal defect: A diagnostic dilemma.
Sinha D, Dormaar T, Salvo N … +3 more , Politis C, Bornstein MM, Jacobs R
Eur J Oral Implantol · 2016 · PMID 27314127
PURPOSE: To report a rare presentation of an ameloblastoma mimicking an endo-periodontal lesion. MATERIALS AND METHODS: In this case report, we present the unusual clinical course of a 78-year-old Caucasian male patient,...
PURPOSE: To report a rare presentation of an ameloblastoma mimicking an endo-periodontal lesion. MATERIALS AND METHODS: In this case report, we present the unusual clinical course of a 78-year-old Caucasian male patient, seeking single tooth implant rehabilitation at location 42 (lower right lateral incisor), initially unsuccessfully treated at different clinics for a persistent endo-periodontal lesion associated with this tooth, by both an endodontist and a periodontologist, which finally lead to tooth loss. RESULTS: CBCT imaging of the anterior mandible region revealed a persistent radiolucency and subsequent enucleation of the lesion in the partially healed extraction socket revealed the true underlying diagnosis: a solid follicular ameloblastoma. A re-entry with biopsy was planned after radiological confirmation of lesion growth 1 year later, reconfirming the diagnosis and necessitating partial segment resection of the mandible. CONCLUSIONS: In the presence of lesions refractory to therapy, consideration towards a broader differential diagnosis and an appropriate investigation should be undertaken before the decision on implant placement.
Chronic post-surgical pain following the placement of dental implants in the maxilla: A case series.
Devine M, Taylor S, Renton T
Eur J Oral Implantol · 2016 · PMID 27314126
PURPOSE: To present ten cases of chronic post-surgical neuropathic pain (CPSP) arising after placement of maxillary dental implants, in order to raise awareness of this potential complication of treatment. MATERIALS AND...
PURPOSE: To present ten cases of chronic post-surgical neuropathic pain (CPSP) arising after placement of maxillary dental implants, in order to raise awareness of this potential complication of treatment. MATERIALS AND METHODS: Data collected from the case notes of consecutive patients presenting to the orofacial pain clinic, with neuropathic pain arising after placement of maxillary dental implants. RESULTS: Nine out of 10 patients were female, with an average age 55.4 years. Six patients had a significant medical history (depression, peripheral neuropathic pain, irritable bowel syndrome and fibromyalgia). Six patients had single implants placed, four had multiple implants. Four patients experienced pain during implant placement. Onset of pain was immediate in nine patients. Pain intensity (visual analogue scale) ranged from 2 to 9 (average 5.6). Pain was constant in all patients. Exacerbating factors included stress, tiredness, low mood and cold weather. Implants were removed in two patients however pain did not resolve. Pain management was complex; including medication (anti-epileptics and tricyclic antidepressants), Botox injections and cognitive behavioural therapy, however pain did not completely resolve in nine cases. CONCLUSIONS: Persistent pain after dental implant placement may occur with no apparent organic cause and without any neurosensory deficits. Practitioners must be aware of chronic post-surgical neuropathic pain as a possible complication of implant placement, particularly in patients with a significant medical history. Consideration should be given as to whether these patients are suitable for implant rehabilitation. Patients reporting very severe and prolonged postoperative pain following implant surgery should be considered at risk of CPSP and referred to a specialist in orofacial pain.
Foundation for Oral Rehabilitation (FOR) consensus text on "The Rehabilitation of Missing Single Teeth".
Eur J Oral Implantol · 2016 · PMID 27314125
Abstract loading — click title to view on PubMed.
Immediate loading of two flapless placed mandibular implants supporting cross-arch fixed prostheses: A 5-year follow-up prospective single cohort study.
Cannizzaro G, Felice P, Lazzarini M … +4 more , Ferri V, Leone M, Trullenque-Eriksson A, Esposito M
Eur J Oral Implantol · 2016 · PMID 27314124
PURPOSE: To evaluate the clinical outcome of two implants placed flapless in fully edentulous mandibles and immediately restored with metal-resin screw-retained cross-arch prostheses 5 years after loading. MATERIALS AND...
PURPOSE: To evaluate the clinical outcome of two implants placed flapless in fully edentulous mandibles and immediately restored with metal-resin screw-retained cross-arch prostheses 5 years after loading. MATERIALS AND METHODS: Eighty consecutive patients were recruited. To be immediately loaded, implants had to be inserted with a minimum torque of 80 Ncm. Forty-six laser-welded titanium and 34 cast silver-palladium frameworks with resin teeth were initially delivered within 8 and 48 h, respectively. Outcome measures, evaluated by two independent assessors included prosthesis and implant failures, complications, marginal bone level changes, implant stability quotient (ISQ) values and patient satisfaction. RESULTS: Five years after loading one patient did not return to the control and 10 prostheses were remade. Two implants failed early in two patients, but they were successfully replaced. Thirty-six complications occurred in 28 patients but were all successfully treated. After 5 years, mean marginal bone loss was 0.69 mm, mean ISQ values decreased from 75.4 to 73.8, and all patients were fully satisfied with the therapy. A post-hoc comparison between the outcome of laser-welded and cast frameworks showed that laser-welded frameworks were affected by significantly more complications (19 patients out of 46 and 6 patients out of 34, respectively; difference in proportion = 0.23, 95% CI: 0.03 to 0.43; Pearson's chi-square test, P = 0.032), therefore such a framework construction should be considered as a long-term temporary prosthesis and not a definitive prosthesis. CONCLUSIONS: Immediately loaded mandibular cross-arch prostheses can be supported by only two implants up to 5 years, if made with a robust cast framework. Longer follow-ups (around 10 years) are still needed to know the prognosis of this treatment modality.
Single implants in dorsal areas - A systematic review.
Moy PK, Nishimura GH, Pozzi A … +1 more , Danda AK
Eur J Oral Implantol · 2016 · PMID 27314123
AIM: This study evaluated the efficacy of replacing single missing teeth in the posterior quadrants of the maxilla and/or mandible with an implant-supported dental prosthesis. MATERIAL AND METHODS: Three scientific liter...
AIM: This study evaluated the efficacy of replacing single missing teeth in the posterior quadrants of the maxilla and/or mandible with an implant-supported dental prosthesis. MATERIAL AND METHODS: Three scientific literature databases - Medline (Pubmed), Ovid Medline and Cochrane Central Register of Controlled Trials (CENTRAL) - were used to perform a search of publications over a period from 1985 to 2014. One hundred and forty one (141) articles were reviewed; 36 articles met the inclusion criteria and were included in the final review. RESULTS: The survival rates, success rates and mean bone loss for immediate implant placement were 96.9%, 100% and 0.85 mm, respectively. The survival rates, success rates and mean bone loss for delayed implant placement were 96.8%, 94.1% and 0.55 mm respectively. The survival rate, success rate and the mean bone loss in studies comparing immediate versus delayed implant placement showed 96.8% and 96.3%, 85.8% and 93.3%, and 0.57 ± 0.57 mm and 0.55 ± 0.37 mm, respectively. CONCLUSION: The prognosis for single molar implants provides a viable treatment option for replacing a single missing tooth in the posterior quadrants of the maxilla and mandible. There does not appear to be a significant difference in the survival rates of immediately placed implants compared with delayed implant placement. However, the success rates were slightly higher with delayed loading protocols than immediate loading protocols.
A systematic review of survival of single implants as presented in longitudinal studies with a follow-up of at least 10 years.
Hjalmarsson L, Gheisarifar M, Jemt T
Eur J Oral Implantol · 2016 · PMID 27314122
BACKGROUND: Placement of single implants is one of the most common applications for implant treatment. Millions of patients have been treated worldwide with osseointegrated implants and many of these patients are treated...
BACKGROUND: Placement of single implants is one of the most common applications for implant treatment. Millions of patients have been treated worldwide with osseointegrated implants and many of these patients are treated at a young age with a long expected remaining lifetime. Therefore longterm evidence for such treatment is important. AIM: To report patient treatment, implant and implant-supported single crown survival over at least a 10-year period of follow-up. MATERIAL AND METHODS: After reviewing long-term publications, included by Jung et al (2012), a complementary PubMed search was performed using the same search strategy for the period September 2011 to November 2014. Data on implant and single implant crown treatment survival were compiled from included studies. RESULTS: Four new publications were identified from the 731 new titles. They were added to an earlier list of five manuscripts by Jung et al (2012) , which were already included. Accordingly, nine publications formed the database of available long-term evaluations. The database consisted of 421 patients altogether, provided with 527 implants and 522 single crowns. From the 367 patients that were followed-up for at least 10 years (87%), altogether 502 implants were still in function at the completion of the studies (95.3%), supporting 432 original and 33 remade single implant crowns. Based on patient level and implant level data, implant survival reached 93.8% and 95.0%, respectively. The corresponding survival rate for original crown restorations was 89.5%. CONCLUSIONS: Single implant treatment is a predicable treatment over a 10-year period of time, with no indication of obvious changes in implant failure rate between 5 and 10 years. However, replacement of new single crowns must be considered during the follow-up as part of regular maintenance. Compared to the number of treated patients worldwide, the available numbers with a follow-up of 10 years was low.
Machined versus roughened immediately loaded and finally restored single implants inserted flapless: Preliminary 6-month data from a split- mouth randomised controlled trial.
Cannizzaro G, Felice P, Loi I … +6 more , Viola P, Ferri V, Leone M, Lazzarini M, Trullenque-Eriksson A, Esposito M
Eur J Oral Implantol · 2016 · PMID 27314121
PURPOSE: To compare the outcome of immediately loaded single implants with a machined or a roughened surface. MATERIALS AND METHODS: Fifty patients had two implant sites randomly allocated to receive flaplessplaced singl...
PURPOSE: To compare the outcome of immediately loaded single implants with a machined or a roughened surface. MATERIALS AND METHODS: Fifty patients had two implant sites randomly allocated to receive flaplessplaced single Syra implants (Sweden & Martina), one with a machined and one with a roughened surface (sand-blasted with zirconia powder and acid etched), according to a split-mouth design. To be loaded immediately, implants had to be inserted with a torque superior to 50 Ncm. Implants were restored with definitive crowns in direct occlusal contact within 48 h. Patients were followed for 6 months after loading. Outcome measures were prosthetic and implant failures and complications. RESULTS: Two machined implants and four roughened implants were not loaded immediately. Six months after loading no dropout occurred. One implant loaded late, which had a rough implant surface, failed 20 days after loading (P (McNemar test) = 0.625; difference in proportions = -0.04; 95% CI: -0.15 to 0.07). Three crowns had to be remade on machined implants and four on roughened implants (P (McNemar test) = 1.000; difference in proportions = -0.02; 95% CI: -0.12 to 0.08). Three machined and five roughened implants experienced complications (P (McNemar test) = 0.625; difference in proportions = -0.04; 95% CI: -0.15 to 0.07). There were no statistically significant differences between groups for crown and implant losses as well as complications. CONCLUSIONS: Up to 6 months after loading both machined and roughened flapless-placed and immediately loaded single implants provided good and similar results, however, longer follow-ups are needed to evaluate the long-term prognosis of implants with different surfaces.
Immediate loading of two (fixed-on-2) versus three (fixed-on-3) implants placed flapless supporting cross-arch fixed prostheses: One-year results from a randomised controlled trial.
Cannizzaro G, Loi I, Viola P … +4 more , Ferri V, Leone M, Trullenque-Eriksson A, Esposito M
Eur J Oral Implantol · 2016 · PMID 27314120
PURPOSE: To evaluate the outcome of two (fixed-on-2 = FO2) versus three (fixed-on-3 = FO3) implants placed flapless in fully edentulous jaws and immediately restored with metal-resin screw-retained crossarch prostheses....
PURPOSE: To evaluate the outcome of two (fixed-on-2 = FO2) versus three (fixed-on-3 = FO3) implants placed flapless in fully edentulous jaws and immediately restored with metal-resin screw-retained crossarch prostheses. MATERIALS AND METHODS: Forty edentulous or to be rendered edentulous patients (20 in the maxilla and 20 in the mandible) were randomised to the FO2 group (20 patients: 10 in the maxilla and 10 in the mandible) and to the FO3 group (20 patients: 10 in the maxilla and 10 in the mandible) 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 periimplant marginal bone level changes evaluated up to 1-year post-loading. RESULTS: Flaps were raised in four patients and two prostheses were loaded early at 8 weeks in the FO2 group. One year after loading no dropout or implant failure occurred, however one FO2 maxillary prosthesis had to be remade because of repeated screw-loosening (risk difference = 0.05; 95% CI: -0.05 to 0.15; Fisher's exact test P = 1.000). Three FO2 patients were affected by complications versus five FO3 patients (risk difference = -0.1; 95% CI: -0.35 to 0.15; Fisher's exact test; P = 0.695). There were no statistically significant differences for prosthetic failures and complications between groups. There were no statistically significant differences for marginal peri-implant bone levels between the two groups (estimate of the difference = 0.031 mm; 95% Cl: -0.22 to 0.28; P (ancova) = 0.803), with both groups losing marginal bone in a statistically significant way (0.27 mm for FO2 patients and 0.24 mm for FO3 patients). CONCLUSIONS: These preliminary results suggest that immediately loaded cross-arch prostheses can be supported by only two or three dental implants at least up to 1-year post-loading. Longer follow-ups are needed to properly evaluate both these therapeutic options.
Guided surgery with tooth-supported templates for single missing teeth: A critical review.
Pozzi A, Polizzi G, Moy PK
Eur J Oral Implantol · 2016 · PMID 27314119
AIM: To systematically scrutinise the scientific literature to evaluate the accuracy of computer-guided implant placement for single missing teeth, as well as to analyse the eventual clinical advantages and treatment out...
AIM: To systematically scrutinise the scientific literature to evaluate the accuracy of computer-guided implant placement for single missing teeth, as well as to analyse the eventual clinical advantages and treatment outcomes. MATERIAL AND METHODS: The electronic and manual literature search of clinical studies published from January 2002 up to November 2015 was carried out using specified indexing terms. Outcomes were accuracy; implant and prosthetic failures; biological and mechanical complications; marginal bone loss (MBL); sulcus bleeding index (SBI); plaque score (PS); pink esthetic score [PES]; aesthetic and clinical outcomes. RESULTS: The search yielded 1027 relevant titles and abstracts, found during the electronic (n = 1020) and manual (n = 7) searches. After data extraction, and screening of titles, abstracts, and full-texts, 32 studies fulfilled inclusion criteria and were included in the critical review: two randomised controlled clinical trials, six prospective observational single cohort studies, one retrospective observational study, three in vitro comparative studies, 10 case reports and 10 systematic reviews. A total of 209 patients (18 to 67 years old) were treated with 342 implants using computer-guided implant surgery. The follow-up ranged from 12 to 52 months. The cumulative survival rate ranged from 96.5% to 100%. Eleven implant planning softwares and guided surgery systems were used and evaluated. CONCLUSIONS: Computer-guided surgery for single missing teeth provides comprehensive treatment planning, reliable implant positioning, favourable clinical outcomes and aesthetics. A tooth-supported template for the treatment of single missing teeth results in greater accuracy of implant positioning than with mucosa-supported or bone-supported templates. The limited scientific evidence available suggests that guided surgery leads to implant survival rates as good as conventional freehand protocols. Computer-guided surgery implies additional costs, that should be analysed in terms of cost-effectiveness, considering the reduction of surgery time, postoperative pain and swelling, as well as, the potential increased accuracy. Long-term randomised clinical trials are eagerly needed to investigate the clinical performance of guided surgery in partially edentate patients.
Dental implants with internal versus external connections: 5-year post-loading results from a pragmatic multicenter randomised controlled trial.
Esposito M, Maghaireh H, Pistilli R … +4 more , Grusovin MG, Lee ST, Trullenque-Eriksson A, Gualini F
Eur J Oral Implantol · 2016 · PMID 27314118
PURPOSE: To evaluate advantages and disadvantages of identical implants with internal or external connections. MATERIALS AND METHODS: One hundred and twenty patients with any type of edentulism (single tooth, partial and...
PURPOSE: To evaluate advantages and disadvantages of identical implants with internal or external connections. MATERIALS AND METHODS: One hundred and twenty patients with any type of edentulism (single tooth, partial and total edentulism), requiring one implant-supported prosthesis were randomly allocated in two equal groups to receive either implants with an external connection (EC) or implants of the same type with an internal connection (IC) (EZ Plus, MegaGen Implant, Gyeongbuk, South Korea), at four centres. Due to slight differences in implant design and components, IC implants were platformswitched while EC were not. Patients were followed for 5 years after initial loading. Outcome measures were prosthesis/implant failures, any complication, marginal bone level changes and clinician preference, assessed by blinded outcome assessors. RESULTS: Sixty patients received 96 EC implants and 60 patients received 107 IC implants. Three patients dropped out with four EC implants and five patients with ten IC implants, but all remaining patients were followed up to 5-year post-loading. One prosthesis supported by EC implants and two by IC implants failed (P = 0.615, difference = -0.02, 95% CI: -0.08 to 0.04). One EC implant failed versus three IC implants in two patients (P = 0.615, difference = -0.02, 95% CI: -0.08 to 0.04). Ten complications occurred in 10 EC patients versus nine complications in 9 IC patients (P = 1.000, difference = 0.01, 95% CI: -0.13 to 0.15). There were no statistically significant differences for prosthesis and implant failures and complications between the different connection types. Five years after loading, there were no statistically significant differences in marginal bone level estimates between the two groups (difference = 0.14 mm, 95% CI: -0.28 to 0.56, P (ancova) = 0.505) and both groups lost bone from implant placement in a statistically significant way: 1.13 mm for the EC implants and 1.21 mm for the IC implants. Two operators had no preference and two preferred IC implants. CONCLUSIONS: Within the limitations given by the difference in neck design and platform switching between EC and IC implants, 5-year post-loading data did not show any statistically significant differences between the two connection types, therefore clinicians could choose whichever they preferred.
Bone augmentation for single tooth implants: A review of the literature.
Friberg B
Eur J Oral Implantol · 2016 · PMID 27314117
AIM: To analyse data on bone augmentation at single-tooth implants with regard to the type of graft materials, the stability of grafts over time, reported time span towards implant placement, implant survival rates, impl...
AIM: To analyse data on bone augmentation at single-tooth implants with regard to the type of graft materials, the stability of grafts over time, reported time span towards implant placement, implant survival rates, implant marginal bone maintenance and possible complications. MATERIAL AND METHODS: A literature review resulted in 585 titles after exclusion of duplicates. Analyses of article titles and abstracts reduced the number to 93 studies, which were subsequently full-text analysed. After the final selection, a total of 24 studies were included, of which 13 reported on single implants and horizontal/vertical augmentation (onlay), 10 focused on single implants and sinus augmentation (inlay), and one study presented the outcome of single implants and distraction osteogenesis. RESULTS: All bone materials, i.e. autografts, allografts, xenografts, and alloplasts, were used with comparable satisfactory results, allowing for placement of 7 to 10 mm-long implants. Stability of bone graft volume over time was sparsely documented. Some onlay autografts tended to resorb early i.e. prior to implant placement, but minor bone resorption was also seen for other grafts over time. A continuous but small bone resorption of inlay autografts and alloplasts was seen over time for the few sites recorded. A staged approach predominated for the onlay grafts, with implants placed 3 to 6 months post-grafting, and overall a majority of these implants (347/363) were submerged. For the inlay graft procedures almost all implants were immediately inserted at the time of grafting, and the majority of these implants (253/256) were submerged. A total of five and two implant failures were registered during the various study periods for the onlays and inlays, respectively. Marginal bone conditions, around implants in grafted sites, were comparable to what has generally been reported for non-grafted sites. CONCLUSIONS: Bone augmentation for the single-tooth implant is a viable treatment option with predictable graft and implant outcomes.
Editorial: On peri-implant bone level measures: To see or not to see, that is the question.
Jacobs R, Esposito M
Eur J Oral Implantol · 2016 · PMID 27314116
Abstract loading — click title to view on PubMed.
Timing of single implant placement and long-term observation of marginal bone levels.
Schropp L, Wenzel A
Eur J Oral Implantol · 2016 · PMID 27314115
AIM: To assess the outcome of immediate or early placement of implants after tooth extraction supporting a single-tooth restoration with focus on the marginal bone level and its stability over time. MATERIAL AND METHODS:...
AIM: To assess the outcome of immediate or early placement of implants after tooth extraction supporting a single-tooth restoration with focus on the marginal bone level and its stability over time. MATERIAL AND METHODS: An electronic literature search without time restrictions was conducted of the Medline/PubMed database accompanied by a handsearch. Clinical human studies reporting on periimplant marginal bone level (BL) and/or changes in bone level (BLC) and with a follow-up period of at least 12 months were selected for the present review. RESULTS: The search strategy resulted in 816 articles and 115 relevant publications were included for full-text analysis. Only few randomised controlled trials exist comparing immediate or early implant placement with placement in healed bone (the conventional protocol). Summarising the results from prospective studies, it was found that the mean marginal bone loss around immediately or early placed implants from baseline (at implant placement or placement of restoration) to the latest followup visit (between 1 and 10 years) was less than 1.5 mm. CONCLUSION: The current literature indicates that immediate or early placement of single-tooth implants after tooth extraction may be a viable treatment with long-term survival rates and marginal bone level conditions matching those for implants placed conventionally in healed bone ridges.
The impact of immediately placed and restored single-tooth implants on hard and soft tissues in the anterior maxilla.
Weigl P, Strangio A
Eur J Oral Implantol · 2016 · PMID 27314114
AIM: The purpose of this literature review is to systematically evaluate the impact of immediate implant placement and restoration (IIPR) on hard and soft tissues and to identify clinical parameters which influence the o...
AIM: The purpose of this literature review is to systematically evaluate the impact of immediate implant placement and restoration (IIPR) on hard and soft tissues and to identify clinical parameters which influence the outcome. MATERIALS AND METHODS: An electronic search of the PubMed database was performed from January 2000 to September 2015. A further hand search was conducted in selected journals and only abstracts published in English were considered for review. Human clinical trials with at least 10 participants and which reported hard and soft tissue outcomes were assessed. Randomised controlled trials (RCT), prospective, prospective comparative and retrospective studies were considered. The effects of the following clinical parameters on hard and soft tissue outcomes were analysed: type of implant, primary stability, gingival biotype, flapless surgery, tooth extraction, spatial arrangement of the implant, socket grafting, the gap between implant surface and alveolar wall and the loading protocol. RESULTS: 17 studies (four RCT, six prospective, two comparative prospective, three controlled cohort and two retrospective studies) were included with 626 censored IIPR in 609 patients. A total of 411(65.56 %) implants were placed flapless vs 215 implants after raising a mucoperiosteal flap. Five studies defined raising a mucoperiostal flap as a mandatory part of the surgical protocol. The mean of the remaining gap in between the implant surface and the alveolar wall, the so-called "jump space", was reported for 170 implants ranging from 1.38 mm to 2.25 mm. Two hundred and one implant sites were not grafted, 405 were grafted, mostly with bone substitutes; for 20 no information was available. For 419 implants, a minimum insertion torque of ≥ 32 Ncm or an ISQ value of ≥ 60 was reached; for 53 implants an insertion torque of 25 Ncm was accepted. The implants were mostly placed palatinally of the jaw bone. The vertical position of the platform was reported either to be 0.5 to 1.0 mm below the vestibular bone crest or 3 to 4 mm apical to the adjacent cementoenamel junction of the neighbouring tooth. Post-insertion healing with a non-functional occlusion occurred for 97.8% of the implants. The final single crowns were inserted 3 to 6 months after implant placement. The IIPR resulted in a high success (97.96 %) and survival rate (98.25%) after a mean followup period of 31.2 months. The soft-tissue biotype was evaluated in 379 (60.5%) sites as thick. The mean crestal bone and the mean interproximal mucosa level changes were less than 1 mm compared to the baseline. The midfacial periimplant mucosal level change was less than 0.95 mm. This level was reached for both thin and thick soft-tissue biotypes, without a significant difference. Only in one study did the thin biotypes show a significantly higher recession. CONCLUSION: The systematic review revealed promising results for immediately placed and immediately restored implants (IIPR) in the anterior maxilla. The possible options of flapless surgery and absence of grafting of the socket allows a minimal surgical intervention. However, a strict patient selection seemed mandatory for all included clinical trials.
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