Purpose: To compare the pen-implant bone surrounding a new abutment-free tissue-level implant design with classic tissue-level implants restored with titanium-base (Ti-base) abutments. Materials and Methods: A retrospective cohort study was conducted between 2018 and 2022 in patients requiring dental implants. A total of 53 patients received either a novel abutment-free tissue-level implant (n(1) = 50 sites) or a conventional tissue-level implant (n(2) = 50 sites). Patients were monitored for 1 year after prosthetic loading, with the primary endpoint being any change in hard tissue around the implant. Bone resorption was evaluated using CBCT. Statistical analyses included Fisher exact test for categorical variables and Student t test for continuous variables. Longitudinal outcomes were assessed using linear mixed models to account for within-patient correlations over time. The models incorporated treatment group, time, and their interaction, with statistical significance evaluated using Wald tests. Non-inferiority was assessed with one-sided P values < .025, while two-sided P values <.05 indicated statistical significance. Results:No significant differences in patient demographics or complications were found between abutment-free and conventional implants. However, abutment-free implants exhibited less buccal bone loss than traditional implants. The abutment-free implant group had significantly lower palatal/lingual bone loss (P = .041) and alveolar ridge width reduction (P = .040) after 1 year of follow-up. Conclusions: The results of this study suggest that abutment-free dental implants offer advantages in reducing buccal bone loss compared to conventional implants, potentially due to their ability to mitigate risks to pen-implant tissues. Further research is warranted to evaluate their long-term efficacy and safety.
PURPOSE:To develop an online tool based on an evidence-based predictive model that allows clinicians to accurately predict the risk of peri-implantitis in candidates for dental implant therapy. MATERIALS AND METHODS:A retrospective study of patients attending the University Hospital Leuven in Leuven, Belgium, was performed at the Implant Review Clinic. The presence of peri-implantitis and related risk factors were recorded, and a predictive model for peri-implantitis was then developed based on this data. RESULTS:A total of 460 patients with 1,432 implants were included. Peri-implantitis was reported in 78 (17%) patients. For partially edentulous patients (n = 350; 60% female; average age 64.1 years), susceptibility to periodontitis (odds ratio [OR] = 0.48 [0.24;0.94]; P = .03), the number of sites with a probing pocket depth (PPD) of ≥ 5 mm (OR = 0.2 [0.10;0.40]; P < .01), and smoking (OR = 0.25 [0.09;0.66]; P < .01) were significantly associated with peri-implantitis. For fully edentulous patients (n = 50; 72% female; average age 72.2 years), implants placed in the maxilla displayed a greater risk (OR = 0.15 [0.02;0.87]; P = .03) of developing peri-implantitis. A predictive model for the development of peri-implantitis was created based on eight patient-related risk factors for partially edentulous patients (sensitivity = 90.2%; specificity = 55.0%) and four risk factors for fully edentulous patients (sensitivity = 100%; specificity = 51.3%). CONCLUSIONS:The predictive model can be used for a preoperative risk assessment of partially edentulous patients. Further validation and refinement of the model with additional data could enable its use for fully edentulous patients and will improve its predictive power, thereby increasing its reliability.
PURPOSE:To evaluate the effect of the electrolytic cleaning method on the mechanical properties of dental implants. MATERIALS AND METHODS:A total of 90 dental implants were studied, of which 30 were control, 30 were treated with GalvoSurge (Dental Implant Cleaning System GS 1000, Straumann), and 30 were treated with concentrated hypochlorous acid. The amount of hydrogen in the titanium (Ti) interior was determined for each of the samples via spectroscopy to obtain an elemental analysis of hydrogen TCH600 LECO. Electrochemical corrosion tests were performed on 30 dental implants to determine the corrosion potentials and corrosion intensity for the different treatments. One important factor for the fatigue behavior is residual stress, which was studied by Bragg-Bentano X-ray diffraction. Fatigue tests were performed using a servohydraulic machine that determines the S-N curves by performing triaxial tests (tension-compression and 5-degree torsion) at different loads to simulate human mastication. A study of the dental implant fractures was carried out by scanning electron microscopy, and the samples were observed by transmission electron microscopy to see the possible appearance of hydrides in the Ti microstructure. RESULTS:The results showed that the electrolytic technique reduces the presence of hydrogen in the dental implant and the acid treatment increases it, causing the presence of hydrides at the grain boundaries of the Ti. It has been shown that galvanic treatments do not affect the corrosion resistance of dental implants. However, attacks with hypochlorous acid increase the corrosion rate due to the fact that acid attack on a Ti surface favors pitting points. Fatigue tests show that dental implants treated with GalvoSurge have a longer fatigue life than the control due to the lower hydrogen content. It was shown that the increase of hydrogen in the acid-treated implants reduces the fatigue life of the dental implant. CONCLUSIONS:The formation of hydrogen via electrolysis does not cause a diffusion of this element to Ti nor does it affect corrosion resistance, but it reduces the level of hydrogen, which favors its mechanical properties in the long term.
PURPOSE:To investigate the effect that clinical experience has on implant primary stability using insertion torque (IT) and resonance frequency analysis (RFA) from two different drilling protocols: (1) implant-specific osteotomy protocol and (2) conventional drilling. MATERIALS AND METHODS:A total of 60 tri-oval and 60 parallel-walled implants were placed in fresh bovine ribs by three clinicians (B.K., M.Ç., and M.A.D), who were classified according to the total number of implants they had previously placed. Tri-oval implants were placed with an implant-specific osteotomy protocol, and parallel implants were placed with conventional drilling. The ITs of the implants were measured by the same clinician who performed the operation. An independent examiner (O.G.) measured the RFA of all implants after placement via a resonance frequency analyzer. RESULTS:In the IT evaluation, no statistical significance was observed between the clinicians and both tri-oval implants and parallel implants (P = .293 and P = .98, respectively); in all experience levels, the ITs were significantly lower in parallel implants. Additionally, across all experience levels, tri-oval implants demonstrated greater RFA values than parallel implants (P = .001). Within-group comparisons of RFA by experience level for the tri-oval implants did not show a statistically significant difference (P = .950). However, in parallel implants, there was a significant difference between the moderately experienced and inexperienced groups (P = .019). CONCLUSIONS:The implant-specific osteotomy procedure with tri-oval implants offers greater primary stability compared to conventional osteotomy with parallel-walled implants, regardless of the clinician's experience.
PURPOSE:To estimate and compare the effect of two different nonreconstructive surgical techniques for treating periimplantitis. MATERIALS AND METHODS:An electronic search was performed in PubMed, Web of Science, Embase, Scopus, Ovid Medline, and the Cochrane Library of the Cochrane Collaboration (CENTRAL) for articles published until September 2023. Studies evaluating surgical nonreconstructive techniques for the treatment of peri-implantitis were included. The primary outcomes were changes in pocket probing depth (PPD) and bleeding on probing (BoP). Secondary outcomes included marginal bone levels (MBLs) and plaque index (PI) changes. Meta-analysis and meta-regression were performed. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to determine the quality of evidence. Results were grouped according to their treatment techniques: (1) flap surgeries and (2) osseous resective surgeries (nonreconstructive). RESULTS:The final stage of screening included 15 clinical trials. At 12 months, the flap group had a mean PPD reduction of 1.27 mm (95% CI: 0.67-1.87; I2 = 95.9%), and the osseous resective group had a PPD reduction of 1.88 mm (95% CI: 1.39-2.37; I2 = 97.1%), showing no significant differences (P = .119). Regarding BoP, there were no significant differences between the two techniques at 3, 6, or 12 months. For MBL, at 12 months, the flap group showed less bone loss than the osseous resective group (mean difference = 0.73 mm; P < .001). CONCLUSIONS:Both nonreconstructive surgical interventions were effective in managing peri-implantitis. Moderate-quality evidence suggested that flap surgeries may provide a slight advantage in maintaining MBLs compared to osseous resective surgery.
PURPOSE:To compare the clinical and radiographic outcomes of patients receiving two different healing strategies for their guided bone regeneration (GBR) procedures using a novel collagen membrane to support the implant placement. MATERIALS AND METHODS:A total of 20 patients (27 implants) were included. They received either transmucosal (10 patients, 11 teeth) or submerged (10 patients, 16 teeth) GBR procedures. A standardized CBCT scan protocol was performed immediately posttreatment and in a follow-up visit at 4 to 6 months posttreatment. The distance from the implant shoulder to the first bone-to-implant contact on the sides of the implant (distance from implant to bone [DIB]), the horizontal dimension of the buccal alveolar crests, the quality of newly formed bone in the submerged group, the complication rate, and the pain score were reported. RESULTS:Healing at all implant sites was uneventful, with mild swelling and inflammation within normal postoperative limits. The between-group quantitative analysis of CBCT images obtained immediately postoperatively (CBCT1) and 4 to 6 months postoperatively (CBCT2) showed no statistical difference in any parameter. Facial bone wall thickness at 1, 3, and 5 mm below the implant shoulder significantly decreased in both submerged and transmucosal procedure participants in CBCT2 compared to CBCT1. CONCLUSIONS:Outcomes of GBR treatment were consistent with established clinical and preclinical evidence for the safety and performance of collagen barrier membranes in either submerged or transmucosal GBR procedures. In addition, these two different healing strategies exhibited similar clinical and radiographic outcomes.
PURPOSE:To compare the patient's quality of life (QoL) after free gingival graft (FGG) application around teeth and implants and to evaluate the factors affecting it. MATERIALS AND METHODS:A total of 32 participants were included in the study, with FGG performed on 27 natural teeth in 16 patients (T-FGG group) and 24 implants in 16 patients (I-FGG group). QoL was assessed using the General Oral Health Assessment Index (GOHAI) at the following time points: preoperatively (T0), 7 days postoperatively (T7), and 1 month (T30) postoperatively. Patient satisfaction was evaluated at T30. Graft dimensions (height, width, thickness) and the operation time were recorded. Keratinized tissue width (KTW) was measured at baseline (T0) and at T30. Graft volume (GV) and vertical collapse rate (VCR) were also calculated for analysis. RESULTS:The GOHAI-total (GOHAI-T) scores were found to be higher at T7 and T30 in the I-FGG group than in the T-FGG group. Behavioral impact (GOHAI-BI) and functional limitation (GOHAI-FL) subscores were found to be significantly higher in the I-FGG than T-FGG group at 6 days postoperatively (T6) and T7. According to multiple linear regression analysis, the GOHAI score of female patients was 8.749 points higher than male patients at T7. Patients in the I-FGG group had a GOHAI score 5.488 points higher than that of the T-FGG group at T30 (P < .05). The VCR for the T-FGG and I-FGG groups was found to be 23.57% and 28.92%, respectively, and there was no statistically significant difference between the two (P > .05). VCR was positively correlated with GOHAI-BI for the T-FGG group and negatively correlated with GOHAI-FL for the I-FGG group at T30 (P < .05). CONCLUSIONS:The negative effect of implant experience and female sex on QoL after FGG seems to be a stronger predictor than other clinical and intraoperative variables after the first month; however, the relationship with VCR and potential confounding factors still requires clarification.
Purpose:To evaluate implant success rates and facial mucosal profile changes in maxillary single immediate implant placement and provisionalization with the socket-shield (IIPP+SS) technique and without the socket-shield (IIPP-SS) technique. Materials and methods:A total of 30 dental implants in 25 patients were assigned to either the IIPP-SS group (15 implants) or the IIPP+SS (15 implants) group. Clinical and radiographic outcomes were collected preoperatively (T0) as well as at 2-week (T1), 6-month (T6), and 12-month (T12) postoperative follow-ups. The implant success rate, marginal bone level changes, facial mucosal level changes, and papilla level changes were evaluated at different time points. Facial mucosal profile changes were assessed individually for hard and soft tissue zones and as a whole using volumetric analysis. Results:Two implants were excluded (one patient dropped out and one implant failed) from the data analysis in this study, resulting in an overall implant success rate of 96.6% (28/29) after 1 year. Fewer facial mucosal profile changes were noted in the IIPP+SS group than in the IIPP-SS group; however, the difference was only marginally statistically significant (P = .06). No statistically significant difference was found in the facial mucosal level changes (P = .18) and papilla level changes (P = .67 for the mesial papilla level, P = .41 for the distal papilla level) between the IIPP-SS and IIPP+SS groups. Conclusions:Within the limitations of this 1-year randomized controlled clinical trial, the IIPP+SS group appeared to maintain the implant facial mucosal profile slightly better than IIPP alone. Both treatment modalities provide clinically satisfactory outcomes biologically, functionally, and esthetically.
PURPOSE:To explore the association between specific implant site locations and early and late implant failure when replacing single teeth and to investigate possible local and systemic risk factors that could influence these failures. MATERIALS AND METHODS:The study design was a retrospective cohort study. A chart review was conducted based on records of patients who had received implants replacing single teeth at the University of Toronto, Faculty of Dentistry, between January 2005 and December 2021. In addition to implant location, systemic, local, and prosthetic factors were evaluated as potential risk factors contributing to implant failure. RESULTS:A total of 78 (2.3%) implant failures were identified from a total of 3,460 single implants. The prevalence of early implant failure (1.4%) was significantly higher than late implant failure (0.9%; z = 2.05) (P = .040). The maxillary lateral incisor location (12/22) demonstrated the highest site-specific early implant failure rate (3.4%) relative to all other locations (Fisher exact test; P = .026). All implants placed in the anterior region of the jaw (2.3%), especially those placed in the maxilla (2.4%), had significantly higher rates of early failure when compared to posterior sites (1.1%; χ²[1] = 6.21) (P = .013). Early implant failures were significantly associated with patients whose health history was positive for a systemic condition other than type 2 diabetes (Fisher exact test, P = .034). There was a significantly higher late implant failure rate in mandibular implants (1.3%) compared to maxillary implants (0.6%; χ²[1] = 5.17) (P = .023). There was a significant association of late implant failures with wide-platform sites (≥ 4.6 mm) (χ²[2] = 11.57; P = .003) or wider-diameter implants (4.51 ± 0.6 mm) (t[76] = 3.19, P = .002). CONCLUSIONS:The prevalence of implant failure was 2.3%, with maxillary lateral incisor sites demonstrating the highest rate of site-specific early implant failure. Early implant failures were associated with patients with a systemic medical condition, whereas late implant failures were associated with healthy individuals, mandibular implants overall, and in sites with wide-diameter implants.
PURPOSE:To compare survival rates and the marginal bone loss (MBL) of implants placed in patients with one-stage or two-stage maxillary sinus augmentation via the lateral window approach (MSALW) using only deproteinized bovine bone mineral (DBBM). MATERIALS AND METHODS:The dental records and radiologic data of patients who had implants placed with MSALW were collected. The patients were divided according to the one-stage and two-stage MSALW, and the survival rate of each group was measured using the Kaplan-Meier method. The MBL of each group was measured through periapical radiographs at each defined time period. Statistical analysis of the differences between groups was conducted through the log-rank test and one-way analysis of variance (ANOVA). Univariate and multivariate regression tests wereperformed to analyze the degree of influence the interested variables had on the implant survival rate. RESULTS:There was no significant difference in the 5-year cumulative survival rates between the one-stage and two-stage MSALW at the implant level (91.0% and 90.6%, respectively; P = .201) or at the patient level (89.7% and 89.7%, respectively; P = .330). There was a slight difference in MBL at the initial time point, but there was no significant difference for the total period (P = .289). Diabetes was found to have a negative effect on implant survival (P = .015; hazard ratio [HR] = 3.669). CONCLUSIONS:There was no significant difference in the 5-year cumulative survival rate or the 2-year MBL of implants between the one-stage and two-stage MSALW using DBBM.
Purpose: To identify the top-cited articles in the field of sinus augmentation and to analyze the different bibliometric variables that impacted the citation of articles. Materials and Methods: A search was conducted in the Web of Science database and sorted to find articles that were cited at least 100 times. The articles were then screened by two independent investigators (S.S. and K.C.M.) for inclusion. The included articles were analyzed to generate (1) keyword and title word maps using the VOS viewer program, (2) author timelines and contributions using Bibliometrix, and (3) citation analysis data using the HistCite software (Informer Technologies). Then the data were analyzed for individual variables affected by citation counts using Quasi-Poisson regression, Wilcoxon signed-rank test, and Fisher's exact test. Results: A total of 162 articles were included in the analysis. The number of references in each article was directly proportional and the journal impact factor and number of pages in the included articles were inversely proportional to the number of citations (P < .05). Note that authors from the USA had the highest number of publications within the collection. Conclusions: The top-publishing authors, countries, keywords, and title words were identified. It was observed that the number of references, the journal impact factor, and the number of pages of the included articles significantly impacted citation counts obtained by a given article,
PURPOSE:To provide clinicians with information to develop a treatment plan to use short implants as either single or splinted restorations. MATERIALS AND METHODS:The study design was an analytical review of articles that reported clinical data with at least a 1-year follow-up. PubMed was the main source of information, and the years reviewed included 1990 to 2023. The inclusion criteria for this analytical analysis included retrospective and prospective studies. The predictor variable was the use of short implants for fixed restorations. The primary outcome variable was implant status coded as survived or failed. The covariates were the type of restoration using either splinted short implants or short implants used as single-tooth replacements, and time to failure was either less than 1 year or at least 1 year. Bivariate statistics assessed the association between splinting or single implants and failure with a significance of P < .05. RESULTS:A total of 50 articles were collated and summarized to answer specific clinical situation questions. Of those, 18 articles had retrospective or prospective data available for analysis, 11 articles were found for single-implant restorations, and 7 articles were found for splinted implant restorations. After applying the exclusion criteria, the sample size was 1,683 implants as reported in these articles: 853 single implants (50.7%) and 830 splinted implants (49.3%). A total of 62 (7.3%) single short implants failed compared to 36 of 830 (4.3%) splinted short implants. There were 565 implants that were > 8 mm in length, with 11 (1.9%) implant failures. The comparison between splinted and single-implant restorations for short and long implants was significant (P < .05) for all comparisons except for splinted versus single long implants. The comparison of the covariates single and splinted for both short and long implants separating failure < 1 year to longer loading indicated that short implants had more failure after loading (P < .05). The longer implants had nonsignificant differences comparing early failure to failures after longer loading. CONCLUSIONS:Short implants, when splinted together, have similar success rates compared to longer implants based on evidence from the refereed reports. Single short implants did have an increased risk for failure.
PURPOSE:To evaluate the effect of gradually and nongradually surface-roughened dental implants with identical macro designs and anodized surface topography on osteogenic differentiation in vitro in 3D cell culture. MATERIALS AND METHODS:This study compared two groups of implants: (1) gradually (TiUltra) and (2) nongradually (TiUnite) anodized implant surfaces. Mouse-derived bone marrow stem cells (MSCs) were cultivated up to passage three. Subsequently, the GelXA BONE bioink (Cellink), which had been homogeneously combined with the cells, was transferred into polylactic acid cages that had been previously rinsed in phosphate-buffered saline. To assess cell viability and proliferation, metabolic activity was measured. The adhesion of cells was evaluated through the use of a DNA-binding probe. The expression of osteogenic differentiation genes was analyzed through quantitative polymerase chain reaction (qPCR) analysis on days 7, 14, and 21. The osteogenic gene expression markers were type 1 collagen, fibronectin, alkaline phosphatase (ALP), osteopontin (OSP), and osteocalcin (OC), with β-actin serving as the housekeeping gene. RESULTS:No statistically significant differences were observed in cell viability and proliferation values. Nevertheless, the qPCR values for osteogenic differentiation markers were notably elevated in the TiUltra group compared to both the TiUnite group and the control group (P < .05). ALP values were significantly lower in the TiUltra group (P < .05). CONCLUSIONS:It can be concluded that the TiUltra surface demonstrated higher osteogenic gene expression than the TiUnite surface. However, further experimental and clinical studies are required.
PURPOSE:To investigate and compare the survival rate and the success rate of single-tooth implants placed and restored immediately after extraction in non-infected, acutely infected, and chronically infected sites in the maxillary anterior area. MATERIALS AND METHODS:Patients requiring a single-tooth replacement in the maxillary central incisor, lateral incisor, canine, or premolar region were included in the study. Implant sites were divided into three groups based on the presence or absence of an infection: group 1 (control)-non-infected sites (healthy periodontal and endodontic conditions); group 2 (test 1)-acutely infected sites (presence of a periodontal or endodontic or combined abscess and/or fistula); and group 3 (test 2)-chronically infected sites (presence of a periodontal pocket or a periapical lesion with no signs of acute inflammation). The applied protocol was as follows: flapless extraction, thorough debridement of the alveolus, immediate placement of the implant, placement of particulate graft material around the implant, resorbable membrane placement in the facial aspect of the implant for all those cases in which the buccal plate was compromised, and immediate placement of a screw-retained provisional FDP out of occlusion. The following periodontal and endodontic initial conditions were evaluated: gingival recession, probing depth, presence of an abscess and/or a fistula, reason for extraction, presence of a periapical lesion, alveolar buccal wall integrity, distance between the gingival margin (GM) and the alveolar bone crest midbuccally, and implant insertion torque. Implant conditions at the last follow-up included survival rate and marginal bone loss (MBL). Periodontal conditions such as recession, probing depth, and gingival index (GI) and the final esthetic results (pink esthetic score) were also evaluated. Statistical analysis was also performed. RESULTS:After a mean follow-up of 7 years (range 2 to 12 years), a total of 127 patients were treated and 143 single-tooth implants were placed and immediately restored with a provisional FDP. There were a total of 47 implants in group 1, 56 implants in group 2, and 40 implants in group 3. The survival rate for group 1 was 97.8%, 96.4% for group 2, and 95% for group 3, with no statistical difference between groups (P = .8). A total of five implants failed-one in group 1, two in group 2, and two in group 3-resulting in a cumulative implant survival rate of 96.5%. CONCLUSIONS:The results of this study showed a comparable implant survival rate for single-tooth implants placed and restored immediately in non-infected, acutely infected, and chronically infected sites.
PURPOSE:To conduct a radiologic and clinical evaluation of patients who underwent fixed rehabilitation involving subperiosteal implants and to define not only the criteria for failure but also the criteria for survival and success. MATERIALS AND METHODS:Patients suffering from severe atrophy of the maxilla and/or mandible underwent immediate loading with fixed full-arch prostheses supported by custom-made 3D-printed subperiosteal implants. The evaluated outcomes included the success and survival rates of subperiosteal implant prosthetic therapy, surgical complications, and the 3D positions of osteosynthesis screws and sleeves used for implant adhesion to the bone. The Stability, Inflammation, and Offset (SIO) criteria were used for evaluating the success, survival, or failure of subperiosteal implant-prosthetic rehabilitation. Success required no clinical mobility, asymptomatic soft tissues without recession, and no intraoperative deviations from virtual implant planning, whereas survival allowed transient micromovements, tissue recession without inflammation, and minimal postsurgical implant modifications. Persistent micromotion and implant removal due to esthetic dissatisfaction or fabrication of a new implant were classified as failures. Nonparametric tests were applied to the datasets with a significance level of P = .01. RESULTS:A total of 18 patients were followed up for 2 years; 11 implants were placed in the maxilla and 15 in the mandible. Temporary instability was observed in four subperiosteal implants, accounting for a survival rate of 84.6% (based on the stability criterion). Two patients suffered from peri-implant soft tissue recession at 2 years (inflammation criterion). Preoperative virtual implant positions and the achieved postoperative position of 189 titanium osteosynthesis screws and sleeves were analyzed: 98 buccal, 69 linguopalatal, and 22 in other areas. The overall linear sleeve misalignment was 1.66 ± 0.99 mm. Horizontal misalignment (1.46 ± 1.03 mm) was approximately three times greater than vertical misalignment (0.59 ± 0.21 mm), with a significant difference (P = .0004). One patient exhibited horizontal and overall misalignments exceeding the maximum threshold suitable for implant success (approximately 5 mm), resulting in 25 successful implants and only 1 surviving implant (offset criterion). No prostheses failed during the entire follow-up time, and no mechanical or functional complications were recorded. The cumulative survival rate was 100% at the 2-year follow-up. CONCLUSIONS:The proposed SIO criteria defined success, survival, and failure for subperiosteal implant rehabilitation. Transient movements or infection events were classified as survival indicators, while negative offset results led implant survival but not success. The present virtual design and planning approach achieved a 73.1% success rate over 2 years, according to the SIO classification.
PURPOSE:To evaluate the frequency, timing, and financial implication of regenerative hard or soft tissue augmentation procedures (ReP) before and after implant placement, alongside the influence of systemic conditions on the need for additional interventions. MATERIALS AND METHODS:This cohort included patients who received implants with or without ReP at the University of Michigan Graduate School of Dentistry from 2011 to 2023. Data on demographics and systemic health conditions were collected and analyzed using univariate and multivariate logistic regression. RESULTS:A total of 4,803 patients (10,247 implants) were included-48.9% of the patients and 21.7% of the implants received at least one ReP, and ancillary ReP was needed for 14.7% of the implants. The most common of these was alveolar ridge augmentation (ARA) simultaneous with implant placement (42.1%) and alveolar ridge preservation (ARP) (26.4%). Patients with diabetes showed significantly higher odds of repeating procedures preoperatively (OR = 5.47; P = .016) and required more frequent hard tissue augmentations after implant placement (OR = 3.58; P = .006). The cost analysis revealed that ReP constituted 12.9% of the total implant procedure cost. Notably, the mandibular anterior area was the most likely to undergo ReP (OR = 2.08; P = .001). CONCLUSIONS:One of every two patients received an ReP, and almost half of these patients received ARA (simultaneous or staged), whereas one-fourth received ARP. Diabetic patients exhibited significantly higher odds of requiring hard tissue augmentation pre-implant site preparation (pre-ISP) and post-implant site preparation (post-ISP). Trends showed a shift toward soft tissue augmentation over hard tissue procedures for managing peri-implant deficiencies.
PURPOSE:To report the implant survival rates and clinical and radiographic outcomes of patients with a short-span fixed partial denture (FPD) supported by two immediately placed implants in the anterior mandible after 5+ years in function. MATERIALS AND METHODS:A total of 100 individuals who had a short-span FPD supported by two immediately placed implants (n = 200) in the lateral incisor region of the mandible for long-term functional life with different loading protocols were chosen for this study. The participants were divided into the following three groups according to loading protocol after implant placement: group 1-immediate implant placement with loading protocol type A; group 2-immediate implant placement with loading protocol type B; and group 3-immediate implant placement with loading protocol type C. Plaque index (PI), bleeding on probing (BOP), probing depth (PD), radiographic crestal bone level (CBL), and implant survival rate were evaluated. RESULTS:Three implants failed out of 200. The implants were in function an average of 7 years, and the overall survival rate was 98.5%. The mean PI was 24.86 in group 1, 24.45 in group 2, and 24.77 in group 3. Group 1 had a mean BOP of 29.48, group 2 had a mean BOP of 29.03, and group 3 had a mean BOP of 29.12. Group 1 had a mean PD of 2.03, group 2 had a mean PD of 2.09, and group 3 had a mean PD of 2.11. Additionally, group 1 had a mean radiographic CBL of 1.69 mm, group 2 had 1.56 mm, and group 3 had 1.57 mm. There was no significant difference among the three groups regarding PI, BOP, PD, CBL, or implant survival. CONCLUSIONS:Within the limitations of this retrospective study, immediate loading for immediately placed dental implants in the mandibular lateral incisor region is a reliable dental rehabilitation option and represents a valid alternative to traditional delayed loading. Immediate implant placement with immediate loading can be advantageous for both patients and physicians. It can save cost and treatment time, and it might be a good alternative for patients who have high esthetic standards for their anterior mandible.
PURPOSE:To investigate the effect of the number of basis images and metal artifact reduction (MAR) on an artifact's expression and trabecular bone architecture assessment in a medullary bone area close to a zirconia (Zr) implant placed in different mandibular regions on CBCT. MATERIALS AND METHODS:CBCT volumes were acquired using the Picasso Trio unit with a Zr implant placed individually in either the anterior or posterior mandibular region, both with and without MAR, under two scanning modes: normal (450 basis images) and high (720 basis images). To measure the SD of gray values, a region of interest was placed mesial to the Zr implant site for artifact assessment. For trabecular bone architecture analysis, a volume of interest was established in the same area. The fractal dimension (FD), connectivity density (ConnD), trabecular thickness (TbTh), and trabecular spacing (TbSp) were calculated. RESULTS:The Zr implant increased the SD of gray values, especially in the posterior region without MAR, while activating MAR reduced these values regardless of the scanning mode (P < .05). The number of basis images generally had no impact on SD (P > .05), except in the posterior region without MAR, where the normal scanning mode showed higher SD values (P < .05). Implant presence reduced FD and ConnD in the posterior region; however, this effect was less pronounced with MAR enabled (P < .05). In the control group, the overall high scanning mode reduced FD and ConnD (P < .05), with a minimal effect on TbTh and TbSp (P > .05). CONCLUSIONS:The Zr implant increased artifact expression, particularly in the posterior mandibular region without MAR, which also resulted in decreased FD and ConnD. While increasing the number of basis images had little effect on the parameters, MAR minimized artifact expression and the reductions in FD and ConnD values.
PURPOSE:To examine and compare the strain distribution around long and short implants retaining mandibular overdentures via either by ball or self-aligning stud (Positioner) attachments. MATERIALS AND METHODS:Two completely edentulous mandibular models made of epoxy resin were used with implants placed equidistant in the canine region. In the first model, two long implants were placed, while two short implants were placed in the second model. Two attachment mechanisms were examined for each model. A total of 24 identical mandibular overdentures were constructed and divided into two groups for each model (n = 12). Each model had two subgroups: ball attachments (n = 6) and Positioner attachments (n = 6). Two linear strain gauges were bonded to the epoxy at their corresponding prepared sites around each implant, where the microstrain was measured under bilateral and unilateral vertical loads of 100 N. One-way analysis of variance (ANOVA) with post-hoc pairwise comparison and an independent t-test were used to analyze the microstrain value data (α = .05). RESULTS:When comparing ball and Positioner attachments, the Positioner showed significantly higher microstrain than the ball attachment (P < .001) for both bilateral and unilateral loading. When long and short implants were compared, no statistically significant difference was found in bilateral loading (P = .22) or unilateral loading (P = .19; P = .16) on both loading and nonloading sides. CONCLUSIONS:A higher strain distribution around implants was induced by the Positioner attachment than the ball attachment, regardless of the implant length. Increasing the implant length was not advantageous. Thus, the use of short implants for retaining mandibular overdentures can be a viable alternative treatment option.
