European Journal Of Oral Implantology[JOURNAL]
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200 papers
Preoperative radiological evaluation of missing single teeth: A review.
Horner K, Shelley AM
Eur J Oral Implantol · 2016 · PMID 27314113
AIMS: Missing single teeth can be treated in several ways and preoperative radiological evaluation varies accordingly. The main area of controversy relates to the need for cross-sectional imaging in the context of implan...
AIMS: Missing single teeth can be treated in several ways and preoperative radiological evaluation varies accordingly. The main area of controversy relates to the need for cross-sectional imaging in the context of implant treatment. In this context, the aim of the systematic component of this review was to determine whether the use of additional cross-sectional imaging has any impact on diagnostic thinking, treatment planning or outcome, compared with conventional imaging alone. An additional aim was to present information relating to diagnostic efficacy, dose of radiation, economic aspects of imaging and selection criteria. MATERIALS AND METHODS: PubMed/MEDLINE, OVID/Embase and the Cochrane central register of controlled trials were searched up to and including June 2015. Studies were eligible for inclusion if they compared the impact of conventional and cross-sectional imaging when placing implants. Quality assessment of studies was performed. Synthesis was qualitative. RESULTS: Twelve studies were included, all of which had a 'before-after' design. Only three of these were limited to single implant treatments with none limited to immediate implants. There were methodological problems with most of the studies and results were sometimes contradictory regarding the impact of cross-sectional imaging. CONCLUSIONS: It is tentatively suggested that cross-sectional imaging may not be required in straightforward, unchallenging, cases of missing single teeth being considered for implant treatment. Beyond this, no strong evidence exists to inform the choice of imaging. Existing guidelines on preoperative imaging for missing single teeth are not unanimous in their recommendations, either for implant or non-implant treatments.
Single implant and crown versus fixed partial denture: A cost-benefit, patient-centred analysis.
Goodacre CJ, Naylor WP
Eur J Oral Implantol · 2016 · PMID 27314112
Single implants and their crowns have high survival rates that exceed the survival rates for fixed partial dentures on teeth and most but not all publications have determined single implants are more cost-effective than...
Single implants and their crowns have high survival rates that exceed the survival rates for fixed partial dentures on teeth and most but not all publications have determined single implants are more cost-effective than 3-unit fixed partial dentures. Both initial root canal treatment and retreatment are more cost-effective than tooth extraction and rehabilitation with a single implant and crown.
Patient information on treatment alternatives for missing single teeth - Systematic review.
Edelmayer M, Woletz K, Ulm C … +2 more , Zechner W, Tepper G
Eur J Oral Implantol · 2016 · PMID 27314111
AIM: This study systematically evaluates existing evidence-based literature covering the topic of patient information about different treatment alternatives for missing single teeth, in order to summarise current evidenc...
AIM: This study systematically evaluates existing evidence-based literature covering the topic of patient information about different treatment alternatives for missing single teeth, in order to summarise current evidence. MATERIAL AND METHODS: Three scientific databases - Pubmed, OvidSP and Scopus - were searched for publications up to July 2015, relating to patient information on treatment options for missing single teeth. References of publications and the google scholar database were screened additionally leading to a total of 183 journal articles written in English. Following the selection criteria, 33 articles were included. Twenty-nine questionnaire- based publications were compared by descriptive analysis of six key parameters - awareness of treatment options, source of information, knowledge, attitude to treatment, preference of treatment option and reason for refusal. RESULTS: Included studies consisted of data from 23,702 responding participants and which were performed in 16 countries. Mean values and standard deviations revealed variations between and within countries. The level of awareness and attitude to treatment in most countries is acceptable. Insufficient knowledge as well as a high demand for knowledge was found. Clinicians are the most important source of information followed by media, family and friends. Dental Implants and FPDs were preferred and high costs would be the major reason for refusal. CONCLUSION: Clinicians play an important role in improving awareness and knowledge of patients about treatment alternatives. Non-uniform study designs could lead to variations in results. This systematic review can be considered in further studies, in order to standardise methods using key parameters and a representative study population.
Outcome of bonded vs all-ceramic and metal- ceramic fixed prostheses for single tooth replacement.
Karl M
Eur J Oral Implantol · 2016 · PMID 27314110
AIM: The conventional treatment of a single missing tooth is most frequently based on the provision of a fixed dental prosthesis (FDPs). A variety of designs and restorative materials are available which have an impact o...
AIM: The conventional treatment of a single missing tooth is most frequently based on the provision of a fixed dental prosthesis (FDPs). A variety of designs and restorative materials are available which have an impact on the treatment outcome. Consequently, it was the aim of this review to compare resin-bonded, all-ceramic and metal-ceramic FDPs based on existing evidence. MATERIALS AND METHODS: An electronic literature search using "metal-ceramic" AND "fixed dental prosthesis" AND "clinical, all-ceramic" AND "fixed dental prosthesis" AND "clinical, resin-bonded" AND "fixed dental prosthesis" AND "clinical, fiber reinforced composite" AND "clinical, monolithic" AND "zirconia" AND "clinical" was conducted and supplemented by the manual searching of bibliographies from articles already included. RESULTS: A total of 258 relevant articles were identified. Metal-ceramic FDPs still show the highest survival rates of all tooth-supported restorations. Depending on the ceramic system used, all-ceramic restorations may reach comparable survival rates while the technical complications, i.e. chipping fractures of veneering materials in particular, are more frequent. Resin-bonded FDPs can be seen as long-term provisional restorations with the survival rate being higher in anterior locations and when a cantilever design is applied. Inlay-retained FDPs and the use of fiber-reinforced composites overall results in a compromised long-term prognosis. Recently advocated monolithic zirconia restorations bear the risk of low temperature degradation. CONCLUSIONS: Several variables affect treatment planning for a given patient situation, with survival and success rates of different restorative options representing only one factor. The broad variety of designs and materials available for conventional tooth-supported restorations should still be considered as a viable treatment option for single tooth replacement.
Treatment options for congenitally missing lateral incisors.
Kiliaridis S, Sidira M, Kirmanidou Y … +1 more , Michalakis K
Eur J Oral Implantol · 2016 · PMID 27314109
AIM: The aim of this systematic review was to identify studies that examined maxillary lateral incisor agenesis treatment, by either orthodontic space closure by canine mesial repositioning and reshaping, or by a prostho...
AIM: The aim of this systematic review was to identify studies that examined maxillary lateral incisor agenesis treatment, by either orthodontic space closure by canine mesial repositioning and reshaping, or by a prosthodontic intervention, in order to compare the biological, functional and aesthetic outcomes of these two approaches. MATERIALS AND METHODS: An electronic MEDLINE search was conducted by two independent reviewers in order to isolate English language articles, published in scientific journals between January 1975 and March 2015, reporting on treatment of agenesis of maxillary lateral incisors, accomplished either by canine orthodontic repositioning or prosthodontic intervention. The search terms were categorised into the four groups comprising the PICO (problem, intervention, comparison and outcome) question. Supplementary manual searches of published reviews and other full-text articles were also performed. RESULTS: The initial database search produced 8,453 titles. After careful examination and discussion, 12 articles were selected for inclusion, where 5 of them compared the two therapeutic options directly. No randomised controlled trials were identified. CONCLUSIONS: Definitive conclusions cannot be drawn, since randomised controlled trials and more prospective and retrospective studies directly comparing the two therapeutic options are required. According to this systematic review, both therapeutic options are effective. However, it seems that the orthodontic space closure, whenever this is possible, is advantageous over the prosthodontic rehabilitation.
Guest Editorial.
Wagner W, van Steenberghe D
Eur J Oral Implantol · 2016 · PMID 27314108
Abstract loading — click title to view on PubMed.
Editorial.
Esposito M, Jacobs R, Nieri M
Eur J Oral Implantol · 2016 · PMID 27314107
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Outcome of dental implants in diabetic patients with and without cardiovascular disease: A 5-year post-loading retrospective study.
Nobre Mde A, Maló P, Gonçalves Y … +2 more , Sabas A, Salvado F
Eur J Oral Implantol · 2016 · PMID 27022640
PURPOSE: To investigate the outcome of immediate function of dental implant rehabilitations in diabetic patients with and without coexisting cardiovascular diseases (CVD). MATERIALS AND METHODS: This retrospective study...
PURPOSE: To investigate the outcome of immediate function of dental implant rehabilitations in diabetic patients with and without coexisting cardiovascular diseases (CVD). MATERIALS AND METHODS: This retrospective study included 70 diabetic patients (33 females and 37 males, average age: 59 years old), rehabilitated with 352 implants and divided into two groups (CVD: 38 patients; non-CVD: 32 patients). Diabetes mellitus was defined as fasting plasma glucose ≥ 7.0 mmol/l (126 mg/dl) or 2 h plasma glucose ≥ 11.1mmol/l (200 mg/dl). The data was retrieved from patient records. Primary outcome measures were prosthesis and implant survival; secondary outcome measures were marginal bone loss and complications (biological or mechanical). The follow-up was 5 years after loading for all patients. RESULTS: Seven patients (10%) were lost to follow-up (one patient in the CVD group; and six patients in the non-CVD group). One prosthesis failed in the non-CVD group, rendering a 97.4% survival rate, compared to 100% in the CVD group (non-significant difference between groups; P = 0.359). Ten implants failed in 7 patients: CVD group with eight implant failures in 5 patients (86.7% cumulative survival rate) versus two implants in 2 patients in the non-CVD group (93.8% cumulative survival rate) with a non-significant difference between both groups (P = 0.365). The average (95% confidence interval) marginal bone loss at 1- and 5-years was 0.95 mm (0.66 mm; 1.23 mm) and 1.52 mm (1.20 mm; 1.88 mm), respectively in the CVD group; and 0.78 mm (0.40 mm; 1.16 mm) and 1.54 mm (0.86 mm; 2.31 mm), respectively for the non-CVD group; with no significant differences between groups at 1 year (P = 0.979) and 5 years (P = 0.300). Complications occurred in 38 patients (CVD group: 21 patients; non-CVD group: 16 patients); with a non-significant difference between both groups (P = 0.660). CONCLUSIONS: Implant rehabilitations represent a valid treatment for diabetic patients with or without coexisting CVD, with a good risk/benefit ratio.
Is a high level of total cholesterol a risk factor for dental implants or bone grafting failure? A retrospective cohort study on 227 patients.
Tirone F, Salzano S, D'orsi L … +2 more , Paola P, Rodi D
Eur J Oral Implantol · 2016 · PMID 27022639
PURPOSE: This study aims to verify the effect of hypercholeresterolaemia on implant and bone augmentation failures. MATERIALS AND METHODS: A retrospective cohort study was conducted on 268 sequential patients scheduled f...
PURPOSE: This study aims to verify the effect of hypercholeresterolaemia on implant and bone augmentation failures. MATERIALS AND METHODS: A retrospective cohort study was conducted on 268 sequential patients scheduled for implant and bone augmentation surgery under conscious sedation in a private practice. Total serum cholesterol (TC) levels were assessed via blood tests before surgery. Patients were divided into two groups: TC < 200 mg/dl and TC > 200 mg/dl. A 6-month post-loading follow-up was scheduled both for implants and grafts. The outcomes considered were implant failure (removal) and graft infection/failure. The effect of cholesterol on early implant and grafting failure was investigated according to a logistic regression model. RESULTS: Two hundred and twenty-seven patients fulfilled inclusion criteria; 139 had hypercholesterolemia. The 6-month post-loading overall implant failure rate was 6.25% at patient level (2.00% at implant level). Partial or total graft infection rate was 10.2%. High TC increased by 7.48 times the odds of the grafting failure (P = 0.047; 95% CI: -0.94 to 59.23), whilst it did not modify the odds of implant failure (P = 0.749; 95% CI: 0.28 to 2.49). CONCLUSIONS: High total serum cholesterol levels tend to increase graft failure rates whilst it did not influence implant failures.
Immediate loading of bimaxillary total fixed prostheses supported by five flapless-placed implants with machined surfaces: A 6-month follow-up prospective single cohort study.
Cannizzaro G, Felice P, Loi I … +5 more , Viola P, Ferri V, Leone M, Collivasone D, Esposito M
Eur J Oral Implantol · 2016 · PMID 27022638
PURPOSE: To evaluate the clinical outcome of fully edentulous patients rehabilitated with immediately loaded bimaxillary screw-retained metal-resin prostheses supported by five implants placed flapless: two in the mandib...
PURPOSE: To evaluate the clinical outcome of fully edentulous patients rehabilitated with immediately loaded bimaxillary screw-retained metal-resin prostheses supported by five implants placed flapless: two in the mandible and three in the maxillae. MATERIALS AND METHODS: Twenty-five consecutively treated patients were recruited. To be immediately loaded, implants had to be inserted with a minimum torque of 80 Ncm. Outcome measures were prosthesis and implant failures, and complications. RESULTS: Six months after loading no patients dropped out and no prosthesis or implant failed. Two maxillary prostheses were loaded early at 8 weeks because implants were inserted with a torque inferior to 45 Ncm. Three complications occurred in two patients but they were all successfully treated. CONCLUSIONS: Six months after loading, immediately loaded bimaxillary cross-arch prostheses can be supported by only two mandibular and three maxillary flapless-placed dental implants. Longer follow-ups of approximately 10 years are needed to understand the prognosis of this treatment modality.
A low dose of subperiosteal anaesthesia injection versus a high dose of infiltration anaesthesia to minimise the risk of nerve damage at implant placement: A randomised controlled trial.
Sánchez-Siles M, Camacho-Alonso F, Salazar-Sánchez N … +3 more , Aguinaga-Ontoso E, Muñoz JG, Calvo-Guirado JL
Eur J Oral Implantol · 2016 · PMID 27022637
PURPOSE: To evaluate whether a low-dose subperiosteal anaesthesia is effective in minimising risks of inferior alveolar nerve damage at implant placement when compared to high-dose infiltration anaesthesia. MATERIAL AND...
PURPOSE: To evaluate whether a low-dose subperiosteal anaesthesia is effective in minimising risks of inferior alveolar nerve damage at implant placement when compared to high-dose infiltration anaesthesia. MATERIAL AND METHODS: One hundred and twenty patients requiring the placement of a single implant in order to replace a missing first mandibular were randomly allocated to two groups: group A (awake hemilip) subperiosteal crestal injection equal to 0.9 ml of articaine with 0.5% epinephrine and group B (numb hemilip) infiltration equal to 7.2 ml of articaine with 0.5% epinephrine in the vestibular fundus. Intraoperative sensory control using sensory tests was carried out in all patients. Outcome measures were neurological complications, intraoperative and postoperative visual analogue scale (VAS) scores for pain and swelling, and a questionnaire evaluating patient satisfaction. Patients were followed for 1 week postoperatively. RESULTS: There were no cases of nerve injury. Seven days after surgery the postoperative VAS score for pain and swelling was lower in group A in a statistically significant manner (difference = -3.41%; 95% CI: -5.57, -1.26; P = 0.002 and difference = -3.33%; 95% CI: -5.41, -1.25; P = 0.002, respectively). CONCLUSIONS: No nerve damage occurred using either anaesthesia types, therefore the choice of type of anaesthesia is a subjective clinical decision, however it may be preferable to use a low dose (0.9 ml) of subperiosteal anaesthesia, since it is unnecessary to deliver 7.2 ml of articaine to anaesthetise a single mandibular molar implant site.
Immediate occluding definitive partial fixed prosthesis versus non-occluding provisional restorations - 4-month post-loading results from a pragmatic multicenter randomised controlled trial.
Heinemann F, Grufferty B, Papavasiliou G … +4 more , Dominiak M, García JJ, Trullenque-Eriksson A, Esposito M
Eur J Oral Implantol · 2016 · PMID 27022636
PURPOSE: To compare the clinical outcome of dental implants restored with definitive occluding partial fixed prostheses within 1 week, after implant placement with immediate non-occluding provisional restorations, which...
PURPOSE: To compare the clinical outcome of dental implants restored with definitive occluding partial fixed prostheses within 1 week, after implant placement with immediate non-occluding provisional restorations, which were to be replaced by definitive prostheses after 4 months. MATERIALS AND METHODS: Fifty partially edentulous patients treated with one to three dental implants, at least 8.5 mm long and 4.0 mm wide inserted with a torque of at least 35 Ncm, were randomised in two groups of 25 patients each, to be immediately loaded with partial fixed prostheses. Patients of one group received one definitive screw-retained metal-ceramic prosthesis in occlusion within 1 week after placement. Patients of the other group received one non-occluding provisional acrylic reinforced prosthesis within 24 h after implant placement. Provisional prostheses were replaced after 4 months by definitive ones. The follow-up for all patients was 4-months post-loading. Outcome measures were prosthesis and implant failures, any complications, peri-implant marginal bone level changes, aesthetic evaluation by a clinician, patient satisfaction, chair time and number of visits at the dental office from implant placement to delivery of definitive restorations. RESULTS: No patient dropped out. Two immediately occlusally loaded implants with their related definitive prostheses (8%) failed early (difference in proportions = 0.08; 95% CI: -0.03 to 0.19; P = 0.490). Four complications occurred in the occlusal group versus one in the non-occlusal group; (difference in proportions = 0.12; 95% CI: -0.04 to 0.28; P = 0.349). Four months after loading, patients subjected to non-occlusal loading lost an average of 0.72 mm of peri-implant bone versus 0.99 mm of patients restored with occluding definitive partial fixed prostheses. There were no statistically significant differences for marginal bone level changes between the two groups (mean difference = -0.27 mm; 95% CI: -0.84 to 0.30; P = 0.349). The differences for aesthetic scores showed no statistical significance (8.26 versus 7.58; P = 0.445); the same was seen for aesthetics evaluated by patients (Mann-Whitney U test: P = 0.618). Patients in the non-occlusal group were significantly more satisfied with the function of their implant-supported prostheses (Mann-Whitney U test: P = 0.039). Significantly less chair time (mean difference = -28.4 min; 95% CI: -48.82 to -7.99; P = 0.007) and the number of visits (mean difference = -1.88; 95% CI: -2.43 to -1.33; P < 0.001) were required for the immediate definitive prosthesis group. CONCLUSION: This study did not provide a conclusive answer but may suggest that provisional prostheses non-occlusally immediately loaded may increase patient functional satisfaction, chair time and the number of visits, with respect to definitive prostheses immediately loaded in functional occlusion.
Posterior jaws rehabilitated with partial prostheses supported by 4.0 x 4.0 mm or by longer implants: One-year post-loading results from a multicenter randomised controlled trial.
Felice P, Checchi L, Barausse C … +5 more , Pistilli R, Sammartino G, Masi I, Ippolito DR, Esposito M
Eur J Oral Implantol · 2016 · PMID 27022635
PURPOSE: To evaluate whether 4.0 x 4.0 mm dental implants could be an alternative to implants at least 8.5 mm long, which were placed in posterior jaws, in the presence of adequate bone volumes. MATERIALS AND METHODS: On...
PURPOSE: To evaluate whether 4.0 x 4.0 mm dental implants could be an alternative to implants at least 8.5 mm long, which were placed in posterior jaws, in the presence of adequate bone volumes. MATERIALS AND METHODS: One hundred and fifty patients with posterior (premolar and molar areas) jaws having at least 12.5 mm bone height above the mandibular canal or 11.5 mm below the maxillary sinus, were randomised according to a parallel group design, in order to receive one to three 4.0 mm-long implants or one to three implants which were at least 8.5 mm-long, at three centres. All implants had a diameter of 4.0 mm. Implants were loaded after 4 months with definitive screw-retained prostheses. Patients were followed up to 1-year post-loading and outcome measures were prosthesis and implant failures, any complications and peri-implant marginal bone level changes. RESULTS: Seventy-five patients were randomly allocated to each group. One patient dropped out after the 4-month post-loading evaluation from the long implant group. Up to 1-year post-loading, 3 patients lost one 4.0 mm-long implant each in comparison to 2 patients who lost one long implant each (difference in proportion = 0.013; 95% CI: -0.058 to 0.087; P = 0.506). All failures occurred before loading, the failed implants were replaced and the delivery of two prostheses in each group was delayed for several months (difference in proportion = 0.0004; 95% CI: -0.068 to 0.069; P = 0.685). Three short implant patients experienced three complications versus 2 long implant patients (difference in proportion = 0.013; 95% CI: -0.058 to 0.087; P = 0.506). There were no statistically significant differences in prosthesis failures, implant failures and complications. Patients with short implants lost on average 0.53 mm of peri-implant bone and patients with longer implants lost 0.57 mm. There were no statistically significant differences in bone level changes up to 1 year between short and long implants (mean difference = 0.038 mm; 95% CI: -0.068 to 0.138; P = 0.198). CONCLUSIONS: One year after loading 4.0 mm-long implants achieved similar results as 8.5 mm-long or longer implants in posterior jaws, however 5- to 10-year post-loading data are necessary before reliable recommendations can be made.
Bone augmentation at implant dehiscences and fenestrations. A systematic review of randomised controlled trials.
Merli M, Merli I, Raffaelli E … +3 more , Pagliaro U, Nastri L, Nieri M
Eur J Oral Implantol · 2016 · PMID 27022634
PURPOSE: To evaluate the efficacy of the bone augmentation procedure at dehiscence or fenestration defects in one-stage implant insertion and to evaluate which is the most effective procedure. MATERIALS AND METHODS: A sy...
PURPOSE: To evaluate the efficacy of the bone augmentation procedure at dehiscence or fenestration defects in one-stage implant insertion and to evaluate which is the most effective procedure. MATERIALS AND METHODS: A systematic review of articles selected from MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL) and Google Scholar was performed. Additional studies handsearched and found in printed versions of the principal dental implant journals were included. Only randomised controlled trials (RCTs) were included. Outcome variables considered were implant failure, complications, aesthetic and functional satisfaction, complete fill of the defect, clinical and radiological bone level variation, and vestibular peri-implant recession. Independent data extraction by two authors using predefined data fields, including study quality indicators, was completed. All pooled analyses were based on random effects models. RESULTS: A total of 65 full-text articles were examined in detail. Forty-six of the 65 articles did not meet the inclusion criteria. Nineteen articles involving 15 trials were identified for inclusion in the review. Only one study was considered to be at a low risk of bias. The included studies involved 396 patients and 535 implants. Comparing the test group using membranes with the control without membranes, a statistically significant difference was obtained for vertical variation of the peri-implant defect; the difference was 1.64 mm (three RCTs, 95% CI from 0.47 to 2.80 mm; P = 0.006, I2 = 0%) favouring the use of a membrane. Non-resorbable polytetrafluoroethylene (ePTFE) membranes obtained a complete clinical fill of defects more frequently than resorbable polylactide/polyglycolide (PLGA) membranes. The odds ratio was 0.15 (two RCTs, 95% CI from 0.04 to 0.64 mm; P = 0.01, I2 = 0%), favouring the use of ePTFE membranes. No differences were observed comparing nonresorbable ePTFE membranes and resorbable collagen membranes. The comparison between crosslinked membranes and collagen native membranes yielded a very high heterogeneity for vertical variation of the peri-implant defect (two RCTs, I2 = 91%, P = 0.001). Dehiscence complications were more frequent using cross-linked membranes but the odds ratio was not significant (three RCTs, odds ratio 0.44, 95% CI from 0.18 to 1.10; P = 0.08, I2 = 4%). CONCLUSIONS: Overall, the evidence is not sufficiently robust to determine if any treatment is needed and which is the best treatment for dehiscence or fenestration defects at one-stage implant placement. Only 15 trials were included and the majority are of limited sample size, have short follow-ups as well as having a high risk of bias. The use of a membrane can contribute to the regeneration of the hard tissue in horizontal one-stage augmentation. The complete fill of the defect was obtained more frequently when a non-resorbable ePTFE membrane was used compared to a resorbable PLGA membrane. No differences were observed comparing non-resorbable ePTFE membranes and resorbable collagen membranes. No substantial differences were obtained using different non-resorbable membranes and grafts, and the results were positive for the variables examined. A high result of heterogeneity was observed in studies dealing with cross-linked membranes.
Editorial: Randomised controlled trials of factorial design alias on how to speed up research on effectiveness of interventions without compromising its validity.
Esposito M, Nieri M
Eur J Oral Implantol · 2016 · PMID 27022633
Abstract loading — click title to view on PubMed.
European Journal of Oral Implantology. Guidelines for authors.
Eur J Oral Implantol · 2015 · PMID 26669551
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Dramatic course of osteomyelitis in a patient treated with immediately placed dental implants suffering from uncontrolled diabetes: A case report.
Doll C, Hartwig S, Nack C … +3 more , Nahles S, Nelson K, Raguse JD
Eur J Oral Implantol · 2015 · PMID 26669550
PURPOSE: To report a rare and dramatic complication following immediate dental implant placement in a heavy smoker, who had a delayed diagnosis of uncontrolled diabetes. MATERIALS AND METHODS: In this case report we pres...
PURPOSE: To report a rare and dramatic complication following immediate dental implant placement in a heavy smoker, who had a delayed diagnosis of uncontrolled diabetes. MATERIALS AND METHODS: In this case report we present the dramatic course of a 64-year old female patient treated with five immediate post-extractive dental implants in the mandible, who developed osteomyelitis, which manifested initially as local peri-implant inflammation and progressed into a spontaneous jaw fracture, despite repeated surgical interventions and antibiotic courses over a 3-year period, until diabetes was diagnosed. RESULTS: A symptom-free status could be achieved only after partial mandibulectomy, treatment of diabetes and reconstruction with a microvascular fibula free flap. CONCLUSION: In the presence of mandibular osteomyelitis refractory to therapy, yet undiagnosed underlying pathologies, such as diabetes, should be investigated and treated urgently.
The Smile Esthetic Index (SEI): A method to measure the esthetics of the smile. An intra-rater and inter-rater agreement study.
Rotundo R, Nieri M, Bonaccini D … +11 more , Mori M, Lamberti E, Massironi D, Giachetti L, Franchi L, Venezia P, Cavalcanti R, Bondi E, Farneti M, Pinchi V, Buti J
Eur J Oral Implantol · 2015 · PMID 26669549
PURPOSE: To propose a method to measure the esthetics of the smile and to report its validation by means of an intra-rater and inter-rater agreement analysis. MATERIALS AND METHODS: Ten variables were chosen as determina...
PURPOSE: To propose a method to measure the esthetics of the smile and to report its validation by means of an intra-rater and inter-rater agreement analysis. MATERIALS AND METHODS: Ten variables were chosen as determinants for the esthetics of a smile: smile line and facial midline, tooth alignment, tooth deformity, tooth dischromy, gingival dischromy, gingival recession, gingival excess, gingival scars and diastema/missing papillae. One examiner consecutively selected seventy smile pictures, which were in the frontal view. Ten examiners, with different levels of clinical experience and specialties, applied the proposed assessment method twice on the selected pictures, independently and blindly. Intraclass correlation coefficient (ICC) and Fleiss' kappa) statistics were performed to analyse the intra-rater and inter-rater agreement. RESULTS: Considering the cumulative assessment of the Smile Esthetic Index (SEI), the ICC value for the inter-rater agreement of the 10 examiners was 0.62 (95% CI: 0.51 to 0.72), representing a substantial agreement. Intra-rater agreement ranged from 0.86 to 0.99. Inter-rater agreement (Fleiss' kappa statistics) calculated for each variable ranged from 0.17 to 0.75. CONCLUSION: The SEI was a reproducible method, to assess the esthetic component of the smile, useful for the diagnostic phase and for setting appropriate treatment plans.
Immediately loaded machined versus rough surface dental implants in edentulous jaws: One-year postloading results of a pilot randomised controlled trial.
Esposito M, Felice P, Barausse C … +3 more , Pistilli R, Grandi G, Simion M
Eur J Oral Implantol · 2015 · PMID 26669548
PURPOSE: To compare the effectiveness of immediately loaded total prostheses supported by implants with a roughened surface versus implants with a machined/turned surface. MATERIALS AND METHODS: Fifty edentulous or to-be...
PURPOSE: To compare the effectiveness of immediately loaded total prostheses supported by implants with a roughened surface versus implants with a machined/turned surface. MATERIALS AND METHODS: Fifty edentulous or to-be-rendered edentulous patients requiring an implant-supported cross-arch prosthesis, were randomised either to receive four to eight implants with a roughened surface (25 patients) or with a machined/turned surface (25 patients). Provisional metal-reinforced acrylic prostheses were delivered 48 h after implant placement. Provisional prostheses were replaced after 4 months, by definitive screw-retained metal-resin cross-arch restorations. Outcome measures were prosthesis and implant failures, any complications and peri-implant marginal bone level changes. Patients were followed 1 year after loading. RESULTS: One year after loading no patient dropped out. No prosthesis failed, but two machined implants were found to be mobile at definitive impression taking in 1 patient (Fisher's exact test: P = 0.312; difference in proportions = 4%; 95% Cl: -10 to 18). No complications occurred. Both groups presented a significant peri-implant marginal bone loss at 1 year after loading (P < 0.0001), -0.64 ± 0.20 mm for rough implants and -0.68 ± 0.23 mm for turned implants, respectively, with no statistically significant differences between the two groups (P = 0.482; mean difference = 0.04 mm; 95% Cl: -0.17 to 0.25). CONCLUSIONS: Up to 1 year after immediate loading, both implant surfaces provided good and similar results, however, the only two implants which failed early in the same patient had a machined surface. These preliminary results must be confirmed by larger trials with longer follow-ups.
Short implants as an alternative to crestal sinus lift: A 1-year multicentre randomised controlled trial.
Felice P, Pistilli R, Barausse C … +3 more , Bruno V, Trullenque-Eriksson A, Esposito M
Eur J Oral Implantol · 2015 · PMID 26669547
PURPOSE: To evaluate the efficacy of short (5 or 6 mm-long) dental implants versus 10 mm or longer implants placed in crestally-lifted sinuses. MATERIALS AND METHODS: Twenty partially edentulous patients having 5 to 7 mm...
PURPOSE: To evaluate the efficacy of short (5 or 6 mm-long) dental implants versus 10 mm or longer implants placed in crestally-lifted sinuses. MATERIALS AND METHODS: Twenty partially edentulous patients having 5 to 7 mm of residual crestal height and at least 7 mm thickness below the maxillary sinuses as measured on computerised 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 (Endobon). Implants were left to heal submerged for 4 months and loaded with reinforced acrylic provisional prostheses, and then replaced after 4 months, by definitive provisionally cemented or screw-retained metal-ceramic or metal-resin 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 1 year after loading. RESULTS: No patient dropped out, no failures or complications occurred. Short implants lost 0.70 ± 0.19 mm of peri-implant marginal bone and long implants lost 0.87 ± 0.21 mm of periimplant marginal bone 1 year after loading, the difference between the two groups showing no statistical significance (difference = -0.17 mm; 95% CI: -0.35 to 0.02; P = 0.078). CONCLUSIONS: Both techniques achieved excellent results and no differences were observed between prostheses supported by one to two implants, 5 to 6 mm-long or 10 mm-long in the posterior atrophic maxillae up to 1-year after loading, therefore it is up to the clinicians to decide which procedure to use, although longer follow-ups are needed to understand if one of these procedures could be more effective in the long-term.
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