1,721,071 research outputs found
Retrospective analysis on survival rate, template-related complications, and prevalence of peri-implantitis of 694 anodized implants placed using computer-guided surgery: Results between 1 and 10 years of follow-up
No full textPurpose: To report survival rate, early surgical template-related complications, and prevalence of periimplantitis of dental implants placed in private practices using computer-guided, template-assisted surgery and followed between 1 and 10 years. Materials and Methods: The present retrospective multicenter study evaluated data collected from fully or partially edentulous patients, with anodized-surface implants placed using computer-guided, template-assisted surgery between January 2006 and December 2015. The outcome measures were implant cumulative survival rate (CSR), early surgical complications involving the surgical template, and prevalence of peri-implantitis. Results: A total of 694 implants were placed in 141 patients. Ten patients (7.1%) with 48 implants (6.9%) dropped out during the study period. One hundred seventeen patients, who received 121 surgical and prosthetic procedures, were treated according to a double-scan protocol, while the remaining 24 patients were treated by using the integrated treatment workflow. Most of the implants were immediately loaded (528 implants, 76.1%; 112 patients, 79.4%). Overall, 107 complete full-arch restorations (supported by four to eight implants each) were delivered in 103 patients (73%) with 595 implants (85.7%), while 13 single and 30 partial restorations (two to five implants each) were delivered in 38 patients (27%) with 99 implants (14.3%). Patients were followed for up to 10 years (mean: 58.2 months, range: 12 to 120 months). Implant- and patient-level CSR (Kaplan-Meier estimation) at the 10-year follow-up was 97.4% (95% CI: 1.0309 to 0.9161) and 92.1% (95% CI: 1.1575 to 0.6836), respectively. All failed implants were lost before definitive prosthesis delivery (early failure). Ten (7.1%) minor template-related complications were experienced and resolved chairside. Over the entire follow-up period, four patients (2.8%) with 12 implants (1.7%) showed signs of peri-implantitis at the 1- (four implants), 2- (four implants), and 4-year (four implants) visits. Conclusion: High long-term survival rates and low complications and prevalence of peri-implantitis were observed for a large cohort of anodized-surface implants placed in private practices. Further studies are needed to confirm these preliminary results
FUNCTIONAL-AESTHETIC GUIDED IMPLANT PLACEMENT WITH DOUBLE TEMPLATE IN ASSOCIATION WITH ONE-STAGE COMPUTER-GUIDED BONE REGENERATION PROCEDURE FOR AESTHETIC PURPOSES: 18-MONTH OUTCOMES IN A PROSPECTIVE CASE SERIES
No full textPURPOSE. To evaluate the outcomes of a new computer-guided surgical approach for prosthetically-and aesthetically-driven implant insertion in horizontally atrophic ridges using a double template concept and one-stage guided bone regeneration (GBR) procedure at 1 year and half after loading. MATERIALS AND METHODS. This study was designed as a prospective case series. Patients in need of rehabilitation with an implant-supported restoration between the up-per premolars, Cawood-Howell Class III defects and residual horizontal bone width of less than 6 mm and more than 4 mm were treated with computer-guided implant placement using two templates and simultaneous GBR, and, in cases of bone fenestration with autologous bone, anorganic bovine bone arranged in layers, or in cases of thin buccal bone, using a mix of 20% autologous bone and 80% anorganic bovine bone pro-tected with a resorbable collagen membrane. After 6 months of healing, implants were fitted with temporary screw-retained acrylic resin crowns, and 6 months later perma-nent screw-retained zirconia-ceramic crowns were delivered. Outcome measures were: implant and prosthesis failures, complications, marginal bone level (MBL) changes, periodontal parameters, and pink aesthetic score (PES). RESULTS. Twenty-one consecutive patients (mean age 39.2 years) received one compu-ter-guided GBR procedure each, with contemporary placement of 25 conical-connection implants. No patient dropped-out, no implants or prostheses failed, and only two minor complications were observed. Mean marginal bone loss from implant placement up to 18 months after loading was 0.71±0.23 mm (95% CI 0.59 to 0.83 mm), mean BoP was 2.37±5.95 (95% CI-0.17 to 4.92)percent of sites, mean PPD was 2.54±0.49 mm (95% CI 2.35 to 2.73 mm), and mean PES was 11.2±1.2 (95% CI 10.3 to 12.1). CONCLUSIONS. Acknowledging the limitations of this study, the high survival rate and PES seem to validate the use of a double-template approach in association with one-stage GBR and implant placement in atrophic aesthetic areas. Randomised controlled trials are needed to properly evaluate the utility of this technique versus simple free-hand implant placement with no augmentation procedures
COMPUTER-GUIDED VERTICAL AND HORIZONTAL BONE REGENERATION WITH RESORBABLE CUSTOMIZED BONE LAMINAS FILLED WITH 100% PARTICULATE AUTOLOGOUS BONE: A CASE REPORT
No full textPURPOSE. To describe a case of novel computer-guided bone regeneration (CGBR) tech-nique used for vertical and horizontal reconstruction of atrophic edentulous maxilla with customized rigid bone laminas filled with 100% particulate bone. MATERIALS AND METHODS. A healthy female requested an implant-supported fixed prosthesis for rehabilitation of a completely edentulous maxilla. The patient reported pain and discomfort with her complete removable denture, due to severe bone atrophy, and presented a horizontal and vertical bone defect. After virtual prosthetic planning, a 3D bone augmentation procedure was planned. Bone reconstruction was performed using two separate customized bone laminas filled with 100% autologous bone. Nine months after healing, six implants were installed, and three months later a full gingival graft was performed on the maxilla. A titanium resin screw-retained prosthesis was then fitted, and bone volume and linear dimensional changes were measured. RESULTS. Seven months after augmentation, part of the left lamina had become exposed, albeit with no graft infection. However, one year after loading no implant had failed and the prosthesis was deemed successful. The mean volumetric bone augmentation was 1.583 cm3. Mean horizontal bone augmentation was 6.3 mm, while mean vertical bone augmentation was 5.5 mm. CONCLUSIONS. The stable results one year after loading should prompt randomized controlled trials to verify the potential clinical advantages of the approach described
Mucosa thickness and peri-implant crestal bone stability: A clinical and histologic prospective cohort trial
No full textTo correlate soft tissue thickness and peri-implant bone remodeling of platform-switching implants. Materials and Methods: This comparative prospective trial evaluated, for up to 3 years after implant loading, the influence of soft tissue thickness on changes in peri-implant marginal hard tissue levels. Any patient who was partially edentate in the mandible and required at least two adjacent implant-supported restorations was recruited at the University of Valencia in Spain. A 3-mm tissue punch biopsy, which corresponded to a diameter slightly smaller than the coronal diameter of the implants, was performed using a circular mucotome. Afterward, implants with a length of 10 to 13 mm and a diameter of 3.8 mm were inserted. Outcome measures were implant and prosthesis survival rates, marginal hard tissue changes, any complications, and results of morphologic and histomorphometric analyses. Correlation between mucosa width components (epithelium, connective tissue, and epithelium and connective tissue) and radiographic bone loss at 1 and 3 years after loading was performed at the patient level. Statistical significance was set at P =.05. Results: A total of 26 samples in 26 patients with 68 implants were analyzed. The specimens were divided into two groups: group 1 (16 patients, 40 implants), with thin mucosa (≤ 2 mm), and group 2 (10 patients, 28 implants), with thick mucosa (> 2 mm). Two dropouts (two specimens) were recorded at the 3-year follow-up. None of the implants or definitive prostheses failed during the healing period, resulting in an overall implant and prosthesis cumulative survival rate of 100%. No major biologic or mechanical complications were recorded. The mean (standard deviation, SD) epithelium thickness was 430.33 (250.21) μm; the mean (SD) connective tissue thickness was 1,324.31 (653.46) μm, and the mean (SD) mucosa thickness was 1,751.29 (759.53) μm. Comparisons of radiographic bone loss between group 1 and group 2 failed to show any statistically significant differences at the 1-year (P =.290) or 3-year (P =.090) follow-up examinations. Conclusion: The initial mucosa thickness surrounding a bone-level platform-switching implant seems not to influence the pattern of physiologic marginal bone loss
Ameloblastic fibro-odontoma. Case report and review of the literature
No full textAmeloblastic fibro-odontoma (AFO) is defined by the World Health Organization (WHO) as a neoplasm composed of proliferating odontogenic epithelium. It is a benign, slow-growing, expansive tumour that clinically appears as a well-encapsulated, benign lesion. Histologically, AFO has been classified as an ameloblastic fibroma or odontoma. Despite numerous efforts, however, there is still considerable confusion concerning the nature, the histology and the therapy of these lesions. This paper reports an additional case of a large AFO and reviews the relevant literature regarding the clinical and pathologic features of this lesion. (C) 2009 European Association for Cranio-Maxillo-Facial SurgeryAmeloblastic fibro-odontoma (AFO) is defined by the World Health Organization (WHO) as a neoplasm composed of proliferating odontogenic epithelium. It is a benign, slow-growing, expansive tumour that clinically appears as a well-encapsulated, benign lesion. Histologically, AFO has been classified as an ameloblastic fibroma or odontoma. Despite numerous efforts, however, there is still considerable confusion concerning the nature, the histology and the therapy of these lesions. This paper reports an additional case of a large AFO and reviews the relevant literature regarding the clinical and pathologic features of this lesion. © 2009 European Association for Cranio-Maxillo-Facial Surgery
Management of midcheek masses and tumors of the accessory parotid gland
No full textTumors of the lateral wall of the mouth have different origins and behaviors. These lesions often arise from salivary tissues, such as the accessory parotid gland, but tumors can also originate from the muscles, buccal fat pad, or other structures. Surgical approaches are limited in this region by the presence of the facial nerve and the Stensen's duct. In this article, we present 9 cases of midcheek masses that were operated on via extra- or intraoral approaches. We discuss the problems related to the diagnosis of such tumors, as well as the indications and rationales for different treatment approaches. © 2011 Mosby, Inc
Platform switching versus regular platform implants: 3-year post-loading results from a randomised controlled trial
No full textPurpose: To test the hypothesis that platform switching and regular platform implants would have different outcomes in single-tooth replacement against the alternative hypothesis of no difference. Material and methods: This study was designed as a randomised controlled split-mouth trial. Eighteen patients with bilaterally missing single premolars or molars to be restored with implantsupported single crowns, were consecutively enrolled. Implant sites were randomly assigned to be treated according to the platform switching concept (PS group), or with matching implant-abutment diameters (RP group). A total of 36 Nobel Replace Tapered Groovy implants were installed. All the implants were inserted in healed bone, with an insertion torque between 35 and 45 Ncm, according to a one-stage protocol. Both implant types were loaded with a screw-retained temporary crown 3 months after implant insertion. Definitive screw-retained single crowns were delivered 2 months later. Outcome measures were implant and prosthetic survival rates, biological and prosthetic complications, radiographic marginal bone level (MBL) changes, pocket probing depth (PPD) and bleeding on probing (BOP). Clinical data was collected at implant placement (baseline), and at 3, 9 and 36 months after loading. Results: No patients dropped out and no implant failed. No prosthetic complications were recorded. One patient experienced mucosal inflammation with positive BOP (RP group) after 3 months, three patients had bilateral peri-implant mucosal inflammation with positive BOP at 6, 24 and 30 months after loading, respectively. There were no statistically significant differences between groups for complications (3/18 versus 4/18; P = 1.0; Odds Ratio = 1.333; 95% CI: 0.3467 to 5.1272). Nine months after loading, the mean MBL was 0.93 ± 0.26 mm in the RP group and 0.84 ± 0.23 mm in the PS group, with no statistically significant differences between groups (mean difference = 0.09 mm, 95% CI: -0.22 to 0.04, P = 0.18). Three years after loading, mean MBL was 1.09 ± 0.31 mm in the RP group and 1.06 ± 0.24 mm in the PS group, with no statistically significant differences between groups (mean difference = 0.02 mm, 95% CI: -0.06 to 0.10, P = 0.70). Marginal bone level changes between 3 years and baseline were 0.72 ± 0.28 mm in the RP group and 0.71 ± 0.27 mm in the PS group, with no statistically significant differences between the groups (mean difference = -0.00 mm, 95% CI: -0.07 to 0.07, P = 0.89). Mean PPD was 2.70 ± 0.52 mm in the RP group and 2.46 ± 0.69 mm in the PS group at 36 months after loading, with no statistically significant differences between the groups (mean difference = 0.23 mm, 95% CI: -0.05 to 0.35, P = 0.43). Mean BOP was 0.83 ± 0.96 mm in the RP group and 0.89 ± 0.99 mm in the PS group at 36 months after loading, with no statistically significant differences between the groups (mean difference = 0.07 mm, 95% CI: -0.03 to 0.17, P = 0.77). Conclusions: The clinical and radiographic outcomes of implants restored according to the platformswitching concept versus implants restored with the matching implant-abutment diameters are comparable, 3 years after loading
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