1,721,134 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
Clinical reliability of CAD/CAM cross-arch zirconia bridges on immediately loaded implants placed with computer-assisted/template-guided surgery: a retrospective study with a follow-up between 3 and 5 years
No full textthe purpose of this study is to retrospectively evaluate the implant and prosthetic survival and success rates of zirconia-based, implant-supported, screw-retained, cross-arch restorations up to 5 years after placement.
materials and methods
twenty-two consecutive edentulous patients (11 males and females, each; mean age 68.3 years) received 26 CAD/CAM cross-arch zirconia implant bridges (nobelproceraTM Implant Bridge zirconia; nobel biocare AG, zurich, switzerland) supported by 4 to 10 implants each. all patients were followed for at least 3 years (range 36–60 months, mean 42.3 months). clinical assessments were scheduled every 4 months during hygiene maintenance. outcomes were implant and prosthetic survival rates, prosthetic success rate, any observed clinical complications, patient satisfaction, and soft tissue parameters. fisher's exact test was used to assess associations between categorical variables.
results
no dropouts occurred. the overall implant and prostheses survival rate up to 5 years was 100%. three out of 26 restorations (five out of three hundred forty eight dental units) showed an adhesive chip-off fracture of the veneering ceramic, scoring a cumulative prosthetic success rate of 88.5% at the prosthetic level and 98.6% at the unit level. all 22 patients were functionally and aesthetically highly satisfied with their restorations. successful soft tissue parameters were found around all implants.
conclusions
industrially manufactured, zirconia-based, implant-supported, screw-retained, cross-arch restorations are a viable alternative to conventionally manufactured porcelain-fused-to-metal restorations for rehabilitating the edentulous patient
Four-implant overdenture fully supported by a CAD-CAM titanium bar: A single-cohort prospective 1-year preliminary study
No full textstatement of problem: In patients with an altered skeletal maxillomandibular relationship and bone resorption, the rehabilitation of edentulous jaws by combining 4 implants, 2 straight medially and 2 tilted distally, may be preferred to avoid a bone augmentation procedure.
purpose: the purpose of this single cohort 1-year prospective study was to evaluate the clinical performance of a 4-implant overdenture fully supported by a computer-aided designed and computer-aided manufactured (CAD-CAM) titanium bar.
material and methods: this single cohort prospective study included edentulous participants rehabilitated with a 4-implant overdenture in 1 of the 2 jaws. the outcomes were implant and prosthetic survival and success rates, any biologic and technical complications, periimplant marginal bone loss, changes in the oral health impact profile (OHIP), bleeding on probing, and the plaque index.
results: eighteen participants received 72 implants. one year after implant placement, no implants or prosthesis had failed, and no biologic or technical complications had been observed. at the 1-year follow-up, the mean marginal bone loss was 0.29 ±0.16 mm. the OHIP summary scores demonstrated a significant improvement in oral health-related quality of life. at the 1-year follow-up, positive bleeding was found in 2 participants (11.1%) around 3 implants (4.1%). Three participants (16.6%), accounting for 5 implants (6.9%), showed a slight amount of plaque.
conclusions: A 4-implant overdenture supported by a CAD-CAM titanium bar may be a reliable option for the treatment of the edentulous mandible and maxilla over a 1-year period. oral health-related quality of life significantly improved in all treated participants
Influence of plasma cleaning procedure on the interaction between soft tissue and abutments: a randomized controlled histologic study
No full textIntroduction: Plasma application can lead to an improved adhesion between soft tissue and abutments and promotes cell spreading. Objective: A triple-blinded randomized controlled clinical trial was performed to in vivo test the effect of cleaning abutment titanium surfaces with plasma of argon on cell adhesion and collagen fiber orientation at an early healing time. Material and methods: Thirty healthy patients with 30 submerged implants, at the second surgery, randomly received either a specially designed abutment with no additional treatment (as they come from industry; control group, G1) or cleaned by plasma of argon (test group, G2). Two weeks thereafter, a small biopsy including abutment and soft tissues around the abutment was performed. Abutments were analyzed using scanning electron microscopy to assess cell adhesion to the abutment surface. Outcome measures were the following: percentage of area occupied by cells, the presence or absence of cells, aspect of adhered cells, and the presence of contaminants. At the same time, the soft tissue histological analysis evaluated density and orientation of collagen fibers. Statistical analysis was performed using the Kolmogorov–Smirnov normality test and Levene variance homogeneity test. Data were analyzed using a nonparametric ranking test. The associations between the different qualitative variables were studied using Pearson's chi-squared test. The Mann–Whitney U-test (for two independent samples) was applied for quantitative variables. Results: Mean percentages of area occupied by cells were 15.14% (range 2.91–44.27) and 33.75% (range 2.37–68.4) for G1 and G2, respectively. Differences were close to significance (P = 0.089). The proportion of samples presenting adhered cells was homogeneous between the two groups (P = 0.142). In all cases, cells presented a flattened aspect, but not in three cases in the G2; in 17 cases, cells were efficiently adhered, and in 11 cases, cells presented filopodia with no statistical differences between groups (P > 0.05). No case from G2 showed contamination with cocobacteria with statistical differences between groups (P = 0.006). Collagen fiber density was higher in the basal, medial, and coronal area of G2 compared to G1 with a statistical difference in the internal area (P < 0.05). The orientation of the fibers varied according to the coordinate area with oblique fibers predominant in G2 than in G1. Conclusion: Plasma of argon may promote cell adhesion and positively influence collagen fiber orientation. A greater sample is necessary to confirm these preliminary results
Monolithic lithium disilicate full-contour crowns bonded on CAD/CAM zirconia complete-arch implant bridges with 3 to 5 years of follow-up
Full text linkThis study was carried on to assess the clinical performance of a novel restorative concept consisting in single monolithic lithium disilicate full-contour crowns bonded on computer-aided design/computer-aided manufacturing (CAD/CAM) zirconia complete-arch implant bridges, to overcome the drawbacks related to the chipping of porcelain fused to zirconia restorations. Sixteen patients received 18 implant-supported hybrid screw-cement-retained complete-arch restorations, consisting of single monolithic lithium disilicate full-contour crowns bonded on CAD/CAM zirconia frameworks. The restorations were supported by 4-8 implants. All patients were followed up for at least 3 years on function (range 36 to 60 months, mean 49.3 months). Clinical controls were scheduled every 4 months. The outcomes were implant and prosthetic survival and success rates, any complications, patient satisfaction, and soft tissue parameters. No dropouts occurred. The overall implant and prosthesis survival rates were 100%. One of 18 restorations (1 of 236 dental units) showed a chip-off fracture of the veneering ceramic that was polished intraorally without any additional treatment, scoring a cumulative prosthetic success rate of 100%, according to the California Dental Association index. All patients were functionally and esthetically highly satisfied with their restorations. Successful soft tissue parameters were found around all implants. Single monolithic lithium disilicate full-contour crowns, bonded on CAD/CAM screw-retained complete-arch zirconia frameworks, showed favorable preliminary outcomes with medium-term follow-up. However, randomized controlled studies of this technique are required for further conclusive recommendations
The Implant Biologic Pontic Designed Interface: Description of the Technique and Cone-Beam Computed Tomography Evaluation
No full textAbstract: Purpose: The study aims to evaluate clinically the thickness of the alveolar ridge mucosa underneath a zirconia implant-supported restoration with a modified ovate pontic. Materials and Methods: Sixty-five patients, 32 women and 33 men (mean age: 65.5 years; range 38-81), were included. A total of 383 implants (303 in the maxilla; 80 in the mandible), supporting 81 full or partial fixed dental prostheses (65 in the maxilla; 16 in the mandible), were either cement- or screw-retained. Three years after loading, a total of 219 pontic sites (153 in the maxilla; 66 in the mandible) were measured, and the thickness of the alveolar ridge mucosa between the prosthetic surface and the underlying bone crest were recorded. Results: The overall implant and prosthesis survival rates at 3 years were 98.7% and 100%, respectively. No implant complications were reported, scoring a cumulative implant success rate of 100%. In the maxilla, the overall mean thickness of the alveolar ridge mucosa was 2.32±0.57mm. In the mandible, the overall mean thickness of the alveolar ridge mucosa was 2.20±0.62mm. There was no statistical difference between the overall mean values in the maxilla and mandible (p=471). Conclusion: This radiologic retrospective study suggests the existence of a physiological barrier, named prosthetic biological width, underneath a novel pontic-designed restoration
Immediate loading with a novel implant featured by variable-threaded geometry, internal conical connection and platform shifting: Three-year results from a prospective cohort study
No full textpurpose: to evaluate the clinical and radiological performance of an immediately loaded novel implant design over a 3-year period.
materials and methods: this prospective study includes 54 consecutive partially edentulous patients treated between december 2010 and october 2011. outcome measures were: implant and prosthetic failures; biological and mechanical complications; marginal bone loss (MBL); sulcus bleeding index (SBI); and plaque score (PS).
results: a total of 118 (29 narrow platform, 70 regular platform and 19 wide platform) nobelreplace conical connection implants were placed in both post-extraction sockets and healed sites and immediately loaded. the mean insertion torque was 63.4 ± 7.1 Ncm. one hundred out of 118 implants (84.7%) were inserted with a torque ranging between 55 and 70 Ncm. each patient received a single prosthesis. at the 3-year follow-up, no patient dropped out and only two post-extractive implants failed (1.7%) in two patients (3.7%). the only complication (1.9%) observed was an event of periimplantitis, consisting of a mean mesiodistal peri-implant bone loss of 3.2 mm reported in a healed site of a smoker patient at the 2-year follow-up examination. no prosthesis failures were detected. the cumulative mean MBL between implant placements at the 3-year follow-up was 0.68 mm (95% CI: 0.44, 0.92). At the 3-year follow-up session, the SBI and PS were 5.7% and 15.4%, respectively.
conclusions: the nobelreplace conical connection implant can be considered as a valuable treatment option for immediate implant placement and loading in the partially edentulous patients over a 3-year period. Insertion torques ranging between 55 and 70 Ncm are not detrimental to osseointegration
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
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
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