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Systematic review of the survival rate and the biological, technical, and aesthetic complications of fixed dental prostheses with cantilevers on implants reported in longitudinal studies with a mean of 5 years follow-up
No full textOBJECTIVE:
A systematic review was carried out to evaluate the success and survival rate of implants supporting cantilever prosthesis, as well as the incidence of technical and biological complications.
MATERIAL AND METHODS:
A MEDLINE search was conducted up to December 2011 for studies with a mean follow-up of 5 years or more. Two independent reviewers screened the retrieved articles and extracted the data independently. Data on survival, failure, mechanical/technical and biological complications were analyzed.
RESULTS:
One-hundred and sixty articles were selected as abstract. Only 18 underwent a full-text analysis and only six were included in the study. The estimated cumulative survival rate of implants supporting cantilevered prosthesis was 98.9% (95% CI: 97.4-99.5%), whereas ICFDP survival was estimated to be about 97.1% (95% CI: 90.1-99.2%). Implant failures before prosthetic delivery were not considered. Biological complications were estimated to be 5.7% (95% CI: 4.2-7.6%) at implant level after 5 years. Technical complications were analyzed: the most common complications were veneer fractures (5-year estimate: 10.1%; 95% CI: 3.7-16.5%) and abutment screw fractures (5-year estimate: 1.6%; 95% CI: 0.8-3.5%). Decementation and screw loosening were estimated to be at 5 years 5.9% (95% CI: 1.7-16.8%) and 7.9% (95% CI: 3.2-18.2%), respectively. Implant fracture was rare (5-year estimate: 0.7%; 95% CI: 0.1-4.7%); no framework fracture was reported. Radiographic bone level changes did not yield statistically significant differences. No aesthetic outcome was reported.
CONCLUSIONS:
ICFDPS can be considered a reliable treatment: the systematic review assessed that there is no increase in complication rate due to the presence of the cantilever
Rehabilitation of a dentate mandible requiring a full arch rehabilitation. Immediate loading of a fixed complete denture on 8 implants placed with a bone-supported surgical computer-planned guide : a case report
No full textThe use of technologies that merge computerized tomography X-ray imaging and 3-dimensional (3D) planning software allow the surgeon to digitally elaborate on the computer the position, length, and diameter of every implant to be placed. Following this approach, the placement is guided in a 3D digital model, and the implants are placed in the final position avoiding eventual anatomic structures. In this case report, the patient's remaining mandibular teeth were extracted, and the patient received 8 implants with the help of a computer surgical guide. The case was planned using SimPlant and a bone-supported guide. Because of the high precision of the planning, it was possible to realize a provisional rehabilitation before the actual surgery. The planning allows placement of parallel implants to optimize the prosthetic procedure and outcome. An immediate provisional implant was fixed with a flow composite on the temporary abutments and then refined in the dental laboratory. The patient received the provisional rehabilitation the same day of the surgery. After 6 weeks of healing, the final impression was taken and the prosthesis was finalized with a computer-aided design/computer-aided manufacturing titanium full-arch screwed framework with composite veneering. A 6-month follow-up showed good integration of the prostheses and success of all 8 implants. The use of surgical computer-guided planning changes the surgeon's approach: whereas before the use of conventional guides permitted a certain degree of offset from what was planned, the use of computer guides allows the implant to be inserted in a far more precise way. It is obvious that careful planning is the key factor to avoid implant misplacemen
SVILUPPI NORMATIVI, QUALITA' DI PRODOTTO, PROVE E TEST
Full text linkPARTE PRIMA
Cultura Normativa e Ausili per Disabili:
esperienze, risultati e prospettive
PREMESSA
Questo documento viene redatto in seno al progetto “Cultura e rappresentanza normativa”, della
Camera di Commercio di Padova.
Esso rappresenta la sintesi del lavoro di un lavoro avviato nel 2008 con il supporto della Camera di
Commercio di Padova e della CNA di Padova, in collaborazione prima con il Dipartimento di Inge-
gneria Meccanica ed ora con il Dipartimento di Ingegneria Industriale dell'Università di Padova,
con l'obiettivo di coinvolgere i produttori di ausili del territorio e di rinnovare l'attenzione e la parteci-
pazione ai lavori di normazione in atto a livello internazionale.
Le imprese del settore hanno avuto la possibilità di essere presenti nelle discussioni tecniche, di te-
stare i propri ausili con le attrezzature e le metodologie sviluppate presso il Dipartimento
dell'Università di Padova, di essere propositive nelle soluzioni di prova e di conseguenza reattive
nel mercato conoscendo in anticipo le modalità di prova ed i requisiti di sicurezza
Six-mm versus 10-mm long implants in the rehabilitation of posterior edentulous jaws : a 5-year follow-up of a randomised controlled trial
No full textTo compare the clinical outcome of 6-mm and 10-mm long implants in partially edentulous posterior areas.
MATERIALS AND METHODS:
Twenty-four patients, with a partially edentulous area in the jaws with a height and width allowing the positioning of 2 to 3 adjacent 10 × 4.1 mm implants without any augmentation procedure, were randomly allocated according to a parallel group design to receive 6-mm long or 10-mm long implants. A total of 54 implants were placed (26 × 6 mm and 28 × 10 mm implants). Patients were restored 8 weeks after surgery and were followed for 5 years. Outcome measures were prosthesis and implant survival, as well as marginal bone level changes and complications.
RESULTS:
After 5 years, 18 patients were available. One 6 mm implant failed during the healing period and its related prosthesis could not be placed. No implants were lost after loading. The 6 mm group registered 5 complications (1 mucositis, 3 prosthesis decementations and 1 chipping), while only 3 were registered in the 10 mm group (2 decementations and 1 chipping). The difference in complications between the two groups was not statistically significant (P = 0.39). Marginal bone loss at 5 years was 0.43 and 0.24 mm with the 6 mm and 10 mm groups, respectively (not statistically significant; difference between the two groups 0.19 mm; SD 0.23 mm; 95% CI -0.34;0.73; t test P = 0.42) CONCLUSIONS: Implant and prosthetic survival and success rates were similar between prostheses supported by 6-mm or 10-mm long implants. Conflict-of-interests statement: The present study was supported by grant 369_2004 from ITI, Basel, Switzerland used to provide free implants and prosthetic components to the patient. Authors declare no conflict of interest
Clinical peri-implant sounding accuracy in the presence of chronic inflammation of peri-implant tissues. Clinical observation study
No full textAIM: The aim of this study was to assess if the probing pocket depth is a reliable clinical parameter in the evaluation of the depth of the peri-implant sulci. In case of chronic inflamed peri-implant tissues, this evaluation is useful for understanding the level of bone resorption. METHODS: The study enrolled 22 patients. All of them were diagnosed for a peri-implantitis and were scheduled for a resective surgery with implantoplasty. During the surgery, a full thickness flap was raised and resective surgery was performed as well as an implantoplasty procedure. Peri-implant probing values before the surgery (PAL) were recorded, as were values of bone resorption after flap elevation (DIB), at all four sites around each implant (88 sites). RESULTS: The mean value of PAL calculated for all 88 sites was 5.67 mm (+/-1.46); the correspondent value of DIB was 6.37 mm (+/-1.81). In 52 sites out of 88 (59.1%) the values of PAL and DIB were exactly the same (maximum difference 0.5 mm). In only 10 cases (11.3%) the difference between PAL and DIB was >2 mm. The mean values for PAL and DIB were not statistically different. CONCLUSIONS: Authors have concluded that in case of chronic inflammation of peri-implant tissues, the probe reaches the bone pick, allowing the clinician to have reliable information on the actual bone resorptio
Guarigione intraorale di tre differenti tipi di suture odontoiatriche e morfologia al SEM della colonizzazione batterica dei fili
No full textStratification of prosthetic complications by manufacturer in implant-supported restorations with a 5 years’ follow-up: systematic review of the literature
No full textINTRODUCTION:
Prosthetic complications on implant-supported restorations have been documented in several papers published in the literature. Several manufacturers are present on the market but results are often cumulated and may thus be misleading. The objective of the present review is to assess the prosthetic complications of implant-supported restorations with particular interest of the results obtained with prostheses from different manufacturers.
EVIDENCE ACQUISITION:
A manual search of Medline/PubMed was carried out up to June 2016, yielding a total of 6832 articles, which were narrowed down to 1450, then 347 abstracts to include 55 papers after full text reading. Papers with at least 5 years of follow-up reporting on prosthetic complications of single and fixed partial prosthesis were included. Prosthetic complications were divided into mechanical and technical complications, and reported in a table.
EVIDENCE SYNTHESIS:
Overall 14.4% of prosthetic complication was found for a total of 6623 restorations followed for an average of 7.4 years (range 5-16 years). Results where then sorted and compared. Single crowns were affected by 1.4% of mechanical complications and 10.9% of technical complications after a mean of 7.4 years. Fixed partial prosthesis were affected by 2.5% of mechanical complications and 18% of technical complications. Screw-retained and cemented restorations were calculated to have a 5 years rate of complications of 21.2% and 9.3%, respectively, which demonstrated a statistically difference with fisher exact test with P<0.1. Only 3 manufacturers presented more than 10 articles and were directly compared with Fisher's exact test with P<0.1. The incidence of overall complications was estimated to be after 5 years of 11.2%, 10.8% and 13.8% for Straumann, Nobel, and Astratech, respectively, but dividing results in mechanical and technical complications, gave different results. Straumann was estimated to have less mechanical complications after 5 years in respect to Nobel and Astratech, but the three were similar for technical complications.
CONCLUSIONS:
although studies present very different material and methods and do not report all data, some conclusions can be made. The difference between mechanical complications lead the authors to suppose that there might be a difference in results obtained by different implant abutment connections. It is also noticed that all papers were published by expert clinicians and universities research centers that apply rigid surgical and prosthetic protocols and use original abutments
Severe case of osteonecrosis following implant placement in a patient in therapy with bisphosphonates : a case report
No full textOsteonecrosis of the jaw is a rare complication that has been associated with the use of bisphosphonates. A 77-year-old patient presented in April 2013 asking for a consultation. She reported that in May 2009, she underwent an implant rehabilitation with 8 implants and an immediately loaded fixed prosthesis in the maxilla. After a few months the patient started to report pain and purulent secretions that were neglected by the clinician for several years. She decided to refer to the Dental Clinic after another acute pain episode. Once the fixed prosthesis was removed, exposed necrotic bone was found in relation to the implants. The patient reported having taken oral alendronic acid to treat osteoporosis since before 2006. The patient underwent a functional endoscopic sinus surgery and a removal of necrotic bone blocks. Three years of follow-up showed healed tissues with no recurrence, although the alveolar crest appeared irregular on radiographs
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