European Journal Of Oral Implantology[JOURNAL]
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200 papers
Immediate non-occlusal loading of immediate post-extractive versus delayed placement of single implants in preserved sockets of the anterior maxilla: 1-year post-loading outcome of a randomised controlled trial.
Felice P, Pistilli R, Barausse C … +2 more , Trullenque-Eriksson A, Esposito M
Eur J Oral Implantol · 2015 · PMID 26669546
PURPOSE: To compare the effectiveness of immediate post-extractive single implants with delayed implants placed in preserved sockets after 4 months of healing. Implants that achieved an insertion torque of at least 35 Nc...
PURPOSE: To compare the effectiveness of immediate post-extractive single implants with delayed implants placed in preserved sockets after 4 months of healing. Implants that achieved an insertion torque of at least 35 Ncm were immediately non-occlusally loaded. MATERIALS AND METHODS: Just after tooth extraction, and in the presence of less than 4 mm of vertical loss of the buccal bone in relation to the palatal wall, 50 patients requiring a single immediate post-extractive implant in the maxilla from second to second premolar were randomly allocated for either immediate implant placement (immediate group; 25 patients) or for socket preservation using an algae-derived (phycogenic) bone substitute, covered by a resorbable collagen barrier (delayed group; 25 patients), according to a parallel group design in one centre. Bone-to-implant gaps were filled with an algae-derived bone substitute. Four months after socket preservation, delayed implants were placed. Implants inserted with an insertion torque of at least 35 Ncm were immediately loaded with non-occluding provisional single crowns, then replaced, after 4 months, by definitive crowns. Patients were followed up 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 and patient satisfaction, recorded by blinded assessors. RESULTS: Nine (36%) implants were not immediately loaded in the immediate group versus 19 (76%) implants in the delayed placement group, because an insertion torque superior to 35 Ncm could not be obtained, the difference being statistically significant (difference = - 0.40, 95% CI: -0.652 to -0.148, P = 0.010). Two patients dropped out 4 months after loading in the delayed group versus none in the immediate group. Two implants failed in the immediate group (8%) versus none in the delayed group, with the difference showing no statistical significance (considering 25 and 23 patients, the difference in proportions was 8% favouring the delayed group, 95% CI: -8.4 to 26.0, P = 0.490). Three minor complications occurred in the immediate group and two in the delayed group, and this was not statistically significant (considering 25 and 23 patients, the difference in proportions was 3.3% favouring the delayed group, 95% CI: -18.2 to 24.0, P = 1.000). At delivery of definitive crowns, 4 months after loading, the mean aesthetic score was 12.42 and 12.28 in the immediate and delayed groups, respectively. At 1 year after loading, the mean aesthetic score was 12.78 and 12.22 in the immediate and delayed groups, respectively. There were no statistically significant differences at 4 months (P = 0.666) and at 1 year (P = 0.090). Marginal bone levels at implant insertion (after bone grafting) were 0.01 mm for immediate and 0.06 mm for delayed implants, which showed a statistically significant difference (mean difference = - 0.04; 95% CI: -0.08 to -0.01; P = 0.009). One year after loading, patients of the immediate group lost on average 0.13 mm marginal bone and those in the delayed group lost 0.19 mm, however the difference was not statistically significant (mean difference = 0.05; 95% CI: -0.002 to 0.110; P = 0.06). All patients were fully satisfied, both for function and aesthetics, and would undergo the same procedure again at 4 months as well as at 1 year after loading. CONCLUSIONS: No significant differences were observed between the two procedures, although the only two implant failures were for immediate post-extractive implants. It seems more difficult to obtain an implant insertion torque superior to 35 Ncm in sockets preserved with algae-derived bone substitute after a 4-month healing period than at immediate post-extractive sites.
Immediate loading of post-extractive versus delayed placed single implants in the anterior maxilla: outcome of a pragmatic multicenter randomised controlled trial 1-year after loading.
Esposito M, Barausse C, Pistilli R … +4 more , Jacotti M, Grandi G, Tuco L, Felice P
Eur J Oral Implantol · 2015 · PMID 26669545
PURPOSE: To compare the effectiveness of immediate post-extractive single implants with delayed implants, placed in preserved sockets after 4 months of healing. Implants that achieved an insertion torque of at least 35 N...
PURPOSE: To compare the effectiveness of immediate post-extractive single implants with delayed implants, placed in preserved sockets after 4 months of healing. Implants that achieved an insertion torque of at least 35 Ncm were immediately non-occlusally loaded. MATERIALS AND METHODS: Just after tooth extraction, and in the presence of less than 4 mm of vertical loss of the buccal bone in relation to the palatal wall, 106 patients requiring a single immediate post-extractive implant in the maxilla from second to second premolar were randomly allocated to immediate implant placement (immediate group; 54 patients) or to socket preservation using anorganic bovine bone covered by a resorbable collagen barrier (delayed group; 52 patients), according to a parallel group design at three different centres. Bone-to-implant gaps were to be filled with anorganic bovine bone, however this was not carried out in 17 patients (corresponding to 40% of those who should have been grafted). Four months after socket preservation, delayed implants were placed. Implants inserted with an insertion torque of at least 35 Ncm were immediately loaded with non-occluding provisional single crowns, then replaced after 4 months by definitive crowns. Patients were followed up 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 and patient satisfaction recorded by blinded assessors. RESULTS: Nineteen (35%) implants were not immediately loaded in the immediate group versus 39 (75%) implants in the delayed placement group because an insertion torque superior to 35 Ncm could not be obtained. Six patients dropped out 4 months after loading from the delayed group versus none in the immediate group. Two implants failed in the immediate group (6%) versus none in the delayed group, with the difference showing no statistical significance (difference in proportions = 0.04; 95% CI: -0.03 to 0.11; P = 0.187). Eight minor complications occurred in the immediate group and one in the delayed group, and this was statistically significant (difference in proportions = 0.13; 95% CI: 0.03 to 0.23; P = 0.028). At delivery of definitive crowns, 4 months after loading, the mean aesthetic score was 12.8 and 12.6 in the immediate and delayed groups, respectively. At 1 year after loading, the mean aesthetic score was 13.0 and 12.8 in the immediate and delayed groups, respectively. There was no statistically significant difference at 4 months (P = 0.500) and at 1 year (P = 0.615). Marginal bone levels at implant insertion (after bone grafting) were 0.10 mm for immediate implants and 0.02 mm for delayed implants, which did not have a statistically significantly difference (mean difference = 0.08; 95% CI: 0.04 to 0.12; P < 0.001). One year after loading, patients of the immediate group lost on average 0.23 mm and those in the delayed group lost 0.29 mm, the difference being statistically significant (mean difference = -0.06; 95% CI: -0.11 to -0.01; P = 0.036). Patients of both groups were equally satisfied at 4 months as well as at 1 year after loading. CONCLUSIONS: There are more complications with immediate post-extractive implants in comparison to delayed implants. It seems more difficult to obtain an implant insertion torque superior to 35 Ncm in sockets preserved with anorganic bovine bone after a 4-month healing period than with postextractive sites. The aesthetic outcome appears to be similar for both groups.
Dental implants with internal versus external connections: 1-year post-loading results from a pragmatic multicenter randomised controlled trial.
Esposito M, Maghaireh H, Pistilli R … +5 more , Grusovin MG, Lee ST, Gualini F, Yoo J, Buti J
Eur J Oral Implantol · 2015 · PMID 26669544
PURPOSE: To evaluate advantages and disadvantages of identical implants with internal or external connections. MATERIALS AND METHODS: Two hundred patients with any type of edentulism (single tooth, partial and total eden...
PURPOSE: To evaluate advantages and disadvantages of identical implants with internal or external connections. MATERIALS AND METHODS: Two hundred 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 but with an internal connection (IC) (EZ Plus, MegaGen Implant, Gyeongbuk, South Korea) at seven centres. Due to slight differences in implant design/components, IC implants were platform switched while EC were not. Patients were followed for 1 year after initial loading. Outcome measures were prosthesis/implant failures, any complication, marginal bone level changes and clinician preference assessed by blinded outcome assessors. RESULTS: One hundred and two patients received 173 EC implants and 98 patients received 154 IC implants. Six patients dropped out with 11 EC implants and 3 patients with four IC implants, but all remaining patients were followed up to 1-year post-loading. Two centres did not provide any periapical radiographs. Two prostheses supported by EC implants and one supported by IC implants failed (P = 1.000, difference = -0.01, 95% CI: -0.05 to 0.04). Three EC implants failed in 3 patients versus two IC implants in 1 patient (P = 0.6227, difference = -0.02, 95% CI: -0.07 to 0.03). EC implants were affected by nine complications in 9 patients versus six complications of IC implants in 6 patients (P = 0.5988, difference = -0.02, 95% CI: -0.10 to 0.06). There were no statistically significant differences for prosthesis/implant failures and complications between the implant systems. One year after loading, there were no statistically significant differences in marginal bone level changes between the two groups (difference = 0.24, 95% CI: -0.01 to 0.50, P = 0.0629) and both groups lost bone from implant placement in a statistically significant manner: 0.98 mm for the EC implants and 0.85 mm for the IC implants. Five 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, preliminary short-term data (1-year post-loading) did not show any statistically significant differences between the two connection types, therefore clinicians could choose whichever one they preferred.
On the era of systematic reviews: Should we put our hands up? Should we choose a side?
Nobre Mde A
Eur J Oral Implantol · 2015 · PMID 26669543
Abstract loading — click title to view on PubMed.
Editorial: Digital Dentistry.
Luongo G
Eur J Oral Implantol · 2015 · PMID 26669542
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On the scientific evidence that the sterilization of customized implant abutments is required.
Kern M
Eur J Oral Implantol · 2015 · PMID 26355174
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Inferior alveolar nerve laceration after implant site preparation: A case report.
Galli M, Barausse C, Masi I … +4 more , Falisi G, Baffone M, Tuci L, Felice P
Eur J Oral Implantol · 2015 · PMID 26355173
PURPOSE: The aim of this article is to present a referred clinical case of an inferior alveolar nerve laceration during the insertion of a dental implant in the mandible, that came to our attention after the injury. MATE...
PURPOSE: The aim of this article is to present a referred clinical case of an inferior alveolar nerve laceration during the insertion of a dental implant in the mandible, that came to our attention after the injury. MATERIALS AND METHODS: A 71-year-old female was treated by a colleague in order to be rehabilitated with a fixed implant-supported prosthesis for her missing teeth in positions 44, 45 and 46. After implant site osteotomy in region 46, the speed of the surgical motor was not changed; as a consequence, the implant was inserted at 1200 rpm and intruded into the mandibular canal, causing the laceration of the neurovascular bundle. RESULTS: During the first 2 weeks after surgery the patient complained of paresthesia in the mental and lower lip area, with labial ptosis and drooling. After 14 days, the paresthesia reduced and mucosal and gingival normosensitivity was detected; however, the patient complained about hyperesthesia of the lower inside lip. After 21 days, the lower lip tone and function were almost completely restored and the paresthesia was further reduced, however the hyperesthesia persisted. CONCLUSIONS: It is extremely important to pay attention to preventing neurological complications through proper preoperative planning, careful execution of the surgical techniques and correct management of instruments and motor speed settings. The latter procedure should be double-checked by both the operator and the assistant.
Implant site preparation using a single bur versus multiple drilling steps: 4-month post-loading results of a multicenter randomised controlled trial.
Guazzi P, Grandi T, Grandi G
Eur J Oral Implantol · 2015 · PMID 26355172
PURPOSE: To compare the clinical outcome of implants inserted in sites prepared with a simplified protocol consisting of one single drill versus multiple conventional drilling steps. MATERIALS AND METHODS: In two private...
PURPOSE: To compare the clinical outcome of implants inserted in sites prepared with a simplified protocol consisting of one single drill versus multiple conventional drilling steps. MATERIALS AND METHODS: In two private clinics, 40 patients, requiring one single implant and having a residual bone height of at least 10 mm and a thickness of at least 5 mm measured on computerised tomography (CT) scans, were randomised after flap elevation to have the implant site prepared using a single drilling step with a newly designed tapered-cylinder drill (1-drill group) or a conventional procedure with multiple drills (multiple-drill group). Implants were left to heal non-submerged for 3 months and then they were loaded with a final metal-ceramic crown. Outcome measures were: implant failure; any complications; peri-implant marginal bone level changes assessed by a blinded outcome assessor; operation time; operator preference and post-surgical pain, swelling and analgesic consumption. All patients were followed up to 4 months after implant loading. RESULTS: Twenty patients were randomised to the 1-drill group and 20 patients to the multiple-drill group. No implant failed and no complications occurred. Four months after loading, implants in the 1-drill group lost 0.54 mm of peri-implant bone versus 0.41 mm for the implants in the multiple-drill group. There were no statistically significant differences for marginal bone level changes between the two groups (difference 0.13 mm, 95% CI -0.21; 0.47, P = 0.108). Less time which was statistically significant (3.66 mins, 95% CI 2.69; 4.63, P < 0.0001) was required to place the implant with the single bur. Both operators always preferred the single bur technique. Postoperatively, patients in the 1-drill group vs patients in the multiple-drill group reported statistically significant differences for pain level (difference 27.5, 95% CI 3.3; 51.7, P < 0.0001), number of days in which the swelling persisted (difference 3.4, 95% CI 2.4; 4.4, P < 0.0001) and the number of analgesic drugs taken (difference 2.8, 95% CI 1.4; 4.2, P < 0.0001) CONCLUSIONS: Within the limits of this trial, both drilling techniques produced successful results over a 4-month post-loading follow-up period, but the single bur procedure required less surgical time and lead to less postoperative morbidity.
Comparing membranes and bone substitutes in a one-stage procedure for horizontal bone augmentation. A double-blind randomised controlled trial.
Merli M, Moscatelli M, Mariotti G … +3 more , Pagliaro U, Raffaelli E, Nieri M
Eur J Oral Implantol · 2015 · PMID 26355171
PURPOSE: The objective of this parallel randomised controlled trial is to compare two bone substitutes and collagen membranes in a one-stage procedure for horizontal bone augmentation: anorganic bovine bone (Bio-Oss) and...
PURPOSE: The objective of this parallel randomised controlled trial is to compare two bone substitutes and collagen membranes in a one-stage procedure for horizontal bone augmentation: anorganic bovine bone (Bio-Oss) and collagen porcine membranes (Bio-Gide) (BB group) versus a synthetic resorbable bone graft substitute made of pure β-tricalcium phosphate (Ceros TCP) and porcine pericardium collagen membranes (Jason) (CJ group). MATERIALS AND METHODS: Patients in need of implant treatment having at least one site with horizontal osseous defects at a private clinic in Rimini (Italy) were included in this study. Patients were randomised to receive either the BB or CJ treatment. Randomisation was computer-generated with allocation concealment by opaque sequentially numbered sealed envelopes. Patients and the outcome assessor were blinded to group assignment. The main outcome measures were implant failure, complications, clinical bone gain at augmented sites, and complete filling of the bone defect. Secondary outcome measures were chair-time, postoperative pain and peri-implant marginal bone level changes. RESULTS: Twenty-five patients with 32 implants were allocated to the BB group and 25 patients with 29 implants to the CJ group. All 50 randomised patients received the treatment as allocated and there were no dropouts up to 6-months post-loading (12 months post-surgery). There were no failures and there were three complications in the BB group and three complications in the CJ group (relative risk: 1.00, 95% CI from 0.22 to 4.49, P = 1.00). The estimated difference between treatments in the vertical defect bone gain was -0.15 mm (95% CI from -0.65 to 0.35, P = 0.5504) favouring the BB group, and the estimated difference between treatments in the horizontal defect bone gain was -0.27 mm (95%CI from -0.73 to 0.19, P = 0.3851) favouring the BB group. There was no difference in the complete filling of the defect (relative risk: 0.88, 95%CI from 0.58 to 1.34, P = 0.7688). No significant differences were detected for chair-time (P = 0.3524), for VAS pain immediately after surgery (P = 0.5644), VAS pain after 1 week (P = 0.5074) and VAS pain after 2 weeks (P = 0.6950). A slight difference (0.24 mm, 95%CI from 0.0004 to 0.47, P = 0.0464) was detected in radiographic peri-implant bone loss favouring the CJ group. CONCLUSIONS: No significant differences, except for radiographic bone loss, were observed in this randomised controlled trial comparing anorganic bovine bone with collagen porcine membranes versus synthetic resorbable bone made of pure β-tricalcium phosphate with pericardium collagen membranes for horizontal augmentation.
Short implants versus bone augmentation for placing longer implants in atrophic maxillae: One-year post-loading results of a pilot randomised controlled trial.
Esposito M, Barausse C, Pistilli R … +3 more , Sammartino G, Grandi G, Felice P
Eur J Oral Implantol · 2015 · PMID 26355170
PURPOSE: To evaluate whether short (5.0 to 8.5 mm) dental implants could be a suitable alternative to longer (at least 11.5 mm-long) implants placed in atrophic maxillae augmented with autogenous bone for supporting dent...
PURPOSE: To evaluate whether short (5.0 to 8.5 mm) dental implants could be a suitable alternative to longer (at least 11.5 mm-long) implants placed in atrophic maxillae augmented with autogenous bone for supporting dental prostheses. MATERIALS AND METHODS: Twenty-eight patients with fully edentulous atrophic maxillae, whom had 5 to 9 mm of residual crestal bone height which was at least 5 mm thick, measured using computerised tomography (CT) scans, were randomised into two groups either to receive 4 to 8 short (5.0 to 8.5 mm) implants (15 patients) or autogenous bone from the iliac crest to allow the placement of at least 11.5 mm-long implants (13 patients). Bone blocks and the windows at the maxillary sinuses were covered with rigid resorbable barriers. Grafts were left to heal for 4 months before placing implants which were submerged. After 4 months, provisional reinforced acrylic prostheses or bar retained overdentures were delivered. 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, peri-implant marginal bone level changes and patient satisfaction. Patients were followed up to 1 year after loading. RESULTS: All patients were rehabilitated with implant-supported prostheses but two patients dropped out from the augmented group. One bilateral sinus lift procedure failed for infection, although short implants could be placed. One implant failed in the augmented group versus two short implants in two patients (Fishers exact test P = 1.00; difference in proportions = 0.06; 95% CI -0.28 to 0.17). All failures occurred before loading. Significantly more complications occurred in augmented patients: eight complications occurred in 5 augmented patients (all of them complained of pain 1 month after bone harvesting from the iliac crest) versus no complications in the short implant (Fisher's exact test P = 0.013; difference in proportions = 0.38; 95% CI 0.11 to 0.65). Both groups presented a significant peri-implant marginal bone loss at 1 year after loading (P < 0.0001); -1.05 (0.20) mm for short implants and -1.01 (0.16) mm for the augmented group, respectively, with no statistically significant differences between the two groups (mean difference -0.04 mm; 95% CI -0.22 to 0.14; P = 0.59). All patients were fully satisfied with the treatment and would have it again. CONCLUSIONS: This pilot study suggests that short implants may be a suitable, cheaper and faster alternative to longer implants placed in bone augmented with autogenous bone for rehabilitating edentulous atrophic maxillae, however, these preliminary results need to be confirmed by larger trials with follow-ups of at least 5 years.
Safety and effectiveness of early loaded maxillary titanium implants with a novel nanostructured calcium-incorporated surface (Xpeed): 3-year results from a pilot multicenter randomised controlled trial.
Felice P, Grusovin MG, Barausse C … +2 more , Grandi G, Esposito M
Eur J Oral Implantol · 2015 · PMID 26355169
PURPOSE: To evaluate clinical safety and effectiveness of a novel calcium-incorporated titanium implant surface (Xpeed, MegaGen Implant Co., Gyeongbuk, South Korea). MATERIALS AND METHODS: Sixty patients were randomised...
PURPOSE: To evaluate clinical safety and effectiveness of a novel calcium-incorporated titanium implant surface (Xpeed, MegaGen Implant Co., Gyeongbuk, South Korea). MATERIALS AND METHODS: Sixty patients were randomised to receive one to six implants in the maxilla with either calcium-incorporated (Xpeed) or control resorbable blasted media (RBM) surfaces, according to a parallel group design at two centres. Implants were submerged and exposed at three different endpoints in equal groups of 20 patients, each at 12, 10 and 8 weeks, respectively. Within 2 weeks, implants were functionally loaded with provisional or definitive prostheses. Outcome measures were prosthesis failures, implant failures, any complications and peri-implant marginal bone level changes. RESULTS: Thirty patients received 45 calcium-incorporated implants and 30 patients received 42 control titanium implants. Three years after loading four patients dropped-out from the Xpeed group and one from the RBM group. No prosthesis or implant failures occurred. There were no statistically significant differences between the groups for complications (P = 0.91; difference in proportions = 0.79 %; 95% CI -0.71 to 2.29) and mean marginal bone level changes (P = 0.88; mean difference = -0.02 mm; 95% CI -0.26 to 0.22). CONCLUSIONS: Both implant surfaces provided good clinical results and no significant difference was found when comparing titanium implants with a nanostructured calcium-incorporated surface versus implants with RBM surfaces.
The effectiveness of a resorbable bone substitute with a resorbable membrane in the treatment of periodontal infrabony defect - A multicenter randomised controlled trial.
Esposito M, Grusovin MG, Lambert F … +5 more , Matos S, Pietruska M, Rossi R, Salhi L, Buti J
Eur J Oral Implantol · 2015 · PMID 26355168
PURPOSE: To evaluate the effectiveness of a bone substitute covered with a resorbable membrane versus open flap debridement for the treatment of periodontal infrabony defects. MATERIALS AND METHODS: Ninety-seven patients...
PURPOSE: To evaluate the effectiveness of a bone substitute covered with a resorbable membrane versus open flap debridement for the treatment of periodontal infrabony defects. MATERIALS AND METHODS: Ninety-seven patients with one infrabony defect, which was 3 mm or deeper and at least 2 mm wide were randomly allocated either to grafting with a bone substitute covered with a resorbable barrier (BG group) or open flap debridement (OFD group) according to a parallel group design in five European centres. Blinded outcome measures assessed tooth loss, complications, patient's satisfaction with treatment and aesthetics, changes in probing attachment levels (PAL), probing pocket depths (PPD), gingival recessions (REC), radiographic bone levels (RAD) on standardised periapical radiographs, plaque index (PI) and marginal bleeding index (MBI). RESULTS: 49 patients were randomly allocated to the BG group and 48 to the OFD group. At baseline there were more mobile teeth in the BG group (29 versus 15). One year after treatment two patients dropped out from the BG group and no teeth were lost. Three complications (minor postoperative wound dehiscence) occurred in the BG group versus none in the OFD group, where the difference was not statistically significant. The BG group obtained significantly greater statistical PAL gain (mean difference = -0.8 mm, 95% CI [-1.51; -0.03], P = 0.0428), PPD reduction (mean difference = -1.1 mm, 95% CI [-1.84; -0.19], P = 0.0165) and RAD gain (mean difference = -1.2 mm, 95% CI [-2.0; -0.4], P = 0.0058) compared to the OFD group. No statistically significant differences between the groups were observed for gingival recession, or the patient's satisfaction with the treatment and aesthetics. There were some statistically significant differences between the centres for PAL and PPD with the Italian centres reporting better outcomes. CONCLUSIONS: The use of a bone substitute covered with a resorbable membrane yielded significantly better statistical clinical outcomes than open flap debridement in the treatment of periodontal infrabony defects deeper than 3 mm, with regard to PAL gain, PPD reduction and RAD gain.
Posterior jaws rehabilitated with partial prostheses supported by 4.0 x 4.0 mm or by longer implants: Four-month post-loading data from a randomised controlled trial.
Esposito M, Barausse C, Pistilli R … +4 more , Checchi V, Diazzi M, Gatto MR, Felice P
Eur J Oral Implantol · 2015 · PMID 26355167
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...
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) mandibles having at least 12.5 mm bone height above the mandibular canal or 11.5 mm bone height 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 4-month post-loading and outcome measures were prosthesis and implant failures, any complications and peri-implant marginal bone level changes. RESULTS: No patients dropped-out before the 4-month evaluation. Three patients experienced the early failures of one 4.0 mm-long implant each, in comparison to two patients who lost one long implant each (difference in proportion = 0.01; 95% CI -0.06 to 0.09; P = 0.50). Consequently, two prostheses in each group could not be delivered as planned (difference in proportion = 0; 95% CI -0.07 to 0.07; P = 0.69), and one patient from each group is still waiting to have their prostheses delivered. Three short implant patients experienced three complications versus two long implant patients (difference in proportion = 0.01; 95% CI -0.06 to 0.09; P = 0.50). There were no statistically significant differences in prosthesis failures, implant failures and complications. Patients with short implants lost on average 0.38 mm of peri-implant bone at 4 months and patients with long mandibular implants lost 0.42 mm. There were no statistically significant differences in bone level changes up to 4 months between short and long implants (mean difference = 0.04 mm; 95% CI: -0.041 to 0.117; P = 0.274). CONCLUSIONS: Four months after loading, 4.0 x 4.0 mm implants achieved similar results as 8.5 x 4.0 mm-long or longer implants in posterior jaws, however 5 to 10 years post-loading data are necessary before reliable recommendations can be made.
The Editor's point of view: On the study on argon-plasma cleaning of customised abutments.
Esposito M
Eur J Oral Implantol · 2015 · PMID 26355166
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On Argon-plasma cleaning - some comments from regulatory and scientific perspectives.
Aronsson BO
Eur J Oral Implantol · 2015 · PMID 26355165
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Magnetic resonance imaging induced acute midfacial pain - incidental finding of a dislocated dental bur.
Voss JO, Raguse JD, Hoffmeister B … +1 more , Adolphs N
Eur J Oral Implantol · 2015 · PMID 26021229
PURPOSE: To describe the management of a patient with an initially unnoticed dislocated dental bur in the maxillary sinus that became symptomatic during a magnetic resonance imaging (MRI) scan. MATERIALS AND METHODS: A M...
PURPOSE: To describe the management of a patient with an initially unnoticed dislocated dental bur in the maxillary sinus that became symptomatic during a magnetic resonance imaging (MRI) scan. MATERIALS AND METHODS: A MRI scan provoked strong midfacial pain in a 31-year-old male patient, who exhibited ambiguous neurologic impairment consistent with multiple sclerosis. Conventional radiography revealed an opaque foreign body in close proximity to the orbital floor that most likely caused the painful symptoms during the MRI. RESULTS: After additional X-ray computed tomography (X-ray CT) scans were performed, a metal dental bur was removed by a combined transconjunctival and transnasal approach under perioperative antibiotic treatment. CONCLUSION: The disappearance of instruments during surgical procedures requires diligent investigation and immediate retrieval.
Herpes zoster ophthalmicus reactivation following maxillary sinus lift operation: A case report.
Baş B, Özden B, Özdemir M … +1 more , Yüksel EP
Eur J Oral Implantol · 2015 · PMID 26021228
PURPOSE: To present a case of Herpes Zoster Ophtalmicus (HZO), which was reactivated postoperatively after a sinus lift operation. MATERIALS AND METHODS: A 39-year-old male was referred to our clinic for implant-supporte...
PURPOSE: To present a case of Herpes Zoster Ophtalmicus (HZO), which was reactivated postoperatively after a sinus lift operation. MATERIALS AND METHODS: A 39-year-old male was referred to our clinic for implant-supported dental rehabilitation. He had maxillary missing teeth in positions 13, 14, 15 and 16 and a pneumatised right maxillary sinus with a bone height of 2 mm. Lateral sinus lifting and bone block grafting was performed before implant insertion. Twelve days after the sinus lift, the patient complained of pain and itching at the infraorbital area extending to the forehead. Clinical examination revealed no signs of infection or allergy. The patient received consultation from a dermatologist in order to rule out a possible dermatological disorder. Finally he was diagnosed with HZO. RESULTS: HZO was managed with systemic acyclovir treatment. Vesicular rashes and ptosis was seen 3 days after the medical treatment. After 1 month no postoperative skin or orbital sequela was seen. Three implants were inserted at the right posterior maxilla 5 months after sinus lift. One-year followup was uneventful. CONCLUSIONS: Dermatological diseases should always be kept in mind during the differential diagnosis of orofacial pain. In this case the proximity of the operation site and affected area gave rise to the idea that surgical trauma had a possible role in the reactivation of the virus. However, the process of reactivation is not entirely understood and requires further investigations. Early diagnosis is essential for HZO in order to avoid debilitating complications such as postherpetic neuralgia and blindness.
5-year outcome of cross-arch prostheses supported by four immediately loaded zygomatic implants: A prospective case series.
Davó R, Pons O
Eur J Oral Implantol · 2015 · PMID 26021227
PURPOSE: To evaluate the clinical outcome of maxillary prostheses supported by four immediately loaded zygomatic implants in the rehabilitation of edentulous patients with severe atrophic maxillae after 5 years of functi...
PURPOSE: To evaluate the clinical outcome of maxillary prostheses supported by four immediately loaded zygomatic implants in the rehabilitation of edentulous patients with severe atrophic maxillae after 5 years of function. MATERIALS AND METHODS: Out of a total of 17 consecutive patients with severe atrophy in the maxillae (Cawood and Howell classification C-VI and D-V or D-VI) and whom were rehabilitated using four immediately loaded zygomatic implants, three were lost during follow-up. Outcome measures were success rates of the prostheses, success rates of the zygomatic implants, complications and oral health-related quality of life (OHIP-14 questionnaire). RESULTS: In 14 patients assessed at 5 years after operation, no prosthesis or zygomatic implants failed, although one implant placed in an unfavourable position was not used. Fifty percent of the patients had complications, which included penetration of the orbital cavity during the drilling procedure (1 patient), infection followed by a fistula at one zygomatic implant (1 patient), sinusitis (2 patients), fracture of the abutment screw (1 patient) and fracture of the prostheses (2 patients). All complications were resolved without clinical consequences. At 5 years the mean score of the OHIP-14 was 3.8, which is similar to that of the general population. CONCLUSION: Results at 5 years indicate that the use of four immediately loaded zygomatic implants is a reliable approach for successful rehabilitation of edentulous patients with severely atrophied maxillae.
A controlled, cross-sectional exploratory study on markers for the plasminogen system and inflammation in crevicular fluid samples from healthy, mucositis and peri-implantitis sites.
Hall J, Pehrson NG, Ekestubbe A … +2 more , Jemt T, Friberg B
Eur J Oral Implantol · 2015 · PMID 26021226
PURPOSE: To investigate expression of gene markers for the plasminogen system, inflammation, and bone resorption/remodelling in peri-implant crevicular fluid samples from healthy subjects, subjects with mucositis and sub...
PURPOSE: To investigate expression of gene markers for the plasminogen system, inflammation, and bone resorption/remodelling in peri-implant crevicular fluid samples from healthy subjects, subjects with mucositis and subjects with peri-implantitis. A possible inhibitory effect of suppuration on the analysis of gene expression in samples from subjects with peri-implantitis was also analysed. MATERIALS AND METHODS: Peri-implant crevicular fluid (PICF) was sampled from 25 healthy subjects (H), 25 subjects with mucositis (M) and 25 subjects with peri-implantitis (P) using paper points and suction tips. The samples were analysed by quantitative polymerase chain reaction (qPCR). The following biomarkers associated with the plasminogen system, inflammation and bone resorption/ remodelling were investigated: interleukin-1 beta (IL-1β), interleukin 8 (IL-8), tissue plasminogen activator (tPA), plasminogen activator inhibitor 2 (PAI-2), tartrate-resistant acid phosphatase (TRAP) and cathepsin K (CatK). RESULTS: IL-1β and IL-8 were significantly upregulated in the P group, and tPA and PAI-2 were significantly upregulated in the M group. These four genetic markers were oppositely regulated in samples from the subjects in the mucositis compared with the peri-implantitis group. TRAP and CatK showed no differences between the groups. The presence of suppuration did not have a detectable effect on gene analysis in samples from subjects with peri-implantitis. CONCLUSIONS: Markers for the plasminogen system and inflammation could be used to distinguish between mucositis and peri-implantitis. The results suggested that the plasminogen system was sufficiently upregulated allowing for resolution of inflammation and healing at the inflamed implant site in subjects with mucositis, whereas such upregulation was insufficient resulting in impaired healing and prolonged inflammation in subjects with peri-implantitis. The combination of tissue inflammation and low levels of tPA was a strong predictor of marginal bone loss in this study. It may be an interesting candidate for the unambiguous diagnosis of mucositis and peri-implantitis independent of radiographs and could possibly constitute a powerful future tool for rapid assessment of the periimplant tissue condition and the effect of subject treatment.
Single preoperative dose of prophylactic amoxicillin versus a 2-day postoperative course in dental implant surgery: A two-centre randomised controlled trial.
Arduino PG, Tirone F, Schiorlin E … +1 more , Esposito M
Eur J Oral Implantol · 2015 · PMID 26021225
PURPOSE: To evaluate the difference between a single preoperative dose versus an additional two-day postoperative course of oral amoxicillin in patients undergoing conventional dental implant placement. MATERIALS AND MET...
PURPOSE: To evaluate the difference between a single preoperative dose versus an additional two-day postoperative course of oral amoxicillin in patients undergoing conventional dental implant placement. MATERIALS AND METHODS: Two dentists in two different private practices conducted this study. One hour prior to surgery, patients had to take a single prophylactic antibiotic dose, consisting of 2 g of amoxicillin orally; after implant placement, patients were randomly allocated to two different groups: protocol A (no other antibiotic administration) and protocol B, (1 g of amoxicillin in the evening of the day of surgery and 1 g twice a day for the 2 days after). Outcome measures were prosthetic and implant failures, adverse events and early postoperative complications. Patients were followed up to 6 months after functional loading. RESULTS: Three hundred and sixty patients were randomised and treated (192 patients in one centre and 168 in the other). Five hundred and sixty-seven implants were placed. Protocol A was applied to 180 patients (278 implants) and protocol B also to 180 patients (289 implants). Data for 17 patients, 14 from protocol A and three from protocol B, were not available. No statistically significant differences were found for the reported outcomes. Two patients of protocol B experienced a prosthetic failure, losing four implants, while no prosthetic failures were reported for protocol A (P=0.4836; difference in proportions=-0.0110; 95% CI: -0.0412 to 0.0119). Five patients (3.0%) of protocol A lost five implants versus 5 patients (2.8%) who lost eight implants in protocol B (P=1.0000; difference in proportions=0.0020; 95% CI: -0.0384 to 0.0438). Three adverse events were observed in the total population, all occurring in protocol B (1.69%), with no statistically significant differences between the two groups (P=0.1199; difference in proportions=-0.0170; 95% CI: -0.0487 to 0.0059). However, one patient experienced a severe allergic reaction requiring therapy discontinuation and hospital admission. Early postoperative complications occurred in six patients of protocol A and in four patients of protocol B, with no statistically significant differences (P=0.5170; difference in proportions=0.0130; 95% CI: -0.0254 to 0.0568). CONCLUSIONS: No statistically significant differences were observed between 2 g of preoperative amoxicillin and an additional 2-day postoperative course, although adverse events were reported only in the additional 2-day postoperative group. Based on these findings, it might be sufficient to routinely administer preoperatively 2 g of amoxicillin to patients undergoing routine dental implant placement procedures rather than administering additional postoperative doses.
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