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1.
Clin Oral Implants Res ; 35(9): 1138-1150, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-38822688

RESUMO

OBJECTIVES: To evaluate the survival rates and marginal bone loss of narrow-diameter titanium-zirconium implants supporting complete maxillary and mandibular overdentures up to 3 years after loading. MATERIALS AND METHODS: Ten completely edentulous patients who were dissatisfied with their complete dentures were enrolled. Two narrow-diameter implants were placed in the canine region of the maxilla and mandible. After second-stage surgery, implant-supported overdentures (palatal-free) attached by parallel alignable stud-attachments were placed. Patients were followed periodically for up to 36 months. Standardized radiographs were taken at baseline, 12 and 36 months to analyze mean marginal bone level changes around the implants. RESULTS: The Kaplan-Meier survival rates were 100% for mandibular and 68.0% (SE ± 10.9%) for maxillary implants at 36 months (p = .008). Six maxillary implants failed after loading; no mandibular implants were lost. Five implants failed due to loss of osseointegration. One implant fractured. The mean marginal bone level changes around the analyzed implants (n = 28, 9 patients) were -0.71 ± 0.82 mm in the mandible and -2.08 ± 1.52 mm in the maxilla at the 36-month follow-up. The difference in marginal bone level changes between the maxilla and mandible was significant (p = .019) at the 12- and 36-month follow-ups. CONCLUSION: Two narrow-diameter titanium-zirconium implants with stud-attachments showed a highly satisfactory outcome in the mandible. The maxillary implants showed a high failure rate and significantly more bone loss over time than the mandibular implants. The minimal concept of two implants and an overdenture should be limited to the edentulous mandible.


Assuntos
Prótese Dentária Fixada por Implante , Revestimento de Dentadura , Mandíbula , Titânio , Zircônio , Humanos , Projetos Piloto , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Mandíbula/cirurgia , Implantes Dentários , Maxila/cirurgia , Planejamento de Prótese Dentária , Falha de Restauração Dentária , Perda do Osso Alveolar/diagnóstico por imagem , Perda do Osso Alveolar/etiologia , Arcada Edêntula/cirurgia
2.
BMC Oral Health ; 24(1): 138, 2024 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-38281916

RESUMO

Different characteristics of bars (cross-sectional shape, diameter, distal extension etc.) lead to different biomechanical behavior (retention and stress) with implants and peri-implant tissues.Aim: To evaluate the impact of implant-supported removable prostheses bar designs in fully edentulous arch (in the maxilla and/or mandibula), with 4 implants or more, on the peri-implant soft and hard tissues.Two reviewers searched for observational studies, RCT and in vitro studies, published on five main databases and three from the grey literature, without restrictions on November 2023.Of the 3049 selected articles, four met the inclusion criteria. Four RCT evaluated peri-implant health tissues in full edentulous arches with 4 or 6 implants rehabilitated with implant bar overdentures. One prospective study with 5 years follow-up evaluated the success/survival rate of implants and implant bar overdentures. Overall, 261 subjects were enrolled in our systematic review with 1176 implants. Overdentures' survival rate was 100%. There was a trend that plaque indices and gingival indices were low in all of the studies, however no statistical analysis was done due to the lack of information.Due to the lack of information in the included studies, we cannot confirm if bar characteristics affect the peri-implant tissues health.


Assuntos
Implantes Dentários , Arcada Edêntula , Boca Edêntula , Humanos , Estudos Prospectivos , Prótese Dentária Fixada por Implante , Mandíbula , Revestimento de Dentadura , Retenção de Dentadura
3.
Gen Dent ; 72(5): 43-48, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39151081

RESUMO

This study aimed to design a new surgical guide for controlling the mesiodistal distance between implant osteotomies and adjacent teeth as well as the osteotomy depth in partially edentulous patients. The guide kit was designed with design software and milled with a CNC (computer numerical control) router. The guide consisted of 2 components-stoppers and crown guides-for determining the drilling depth and mesiodistal position, respectively. The stoppers were designed in 7.5-, 9.5-, and 11.5-mm lengths, and the crown guides were fabricated with outer diameters of 5.0, 6.0, 7.0, and 8.0 mm. The accuracy of the guide was assessed by preparing a total of 20 implant osteotomies in 4 partially edentulous models and comparing the dimensions of the actual osteotomies to the values that were predicted to occur with the use of the surgical guides. Osteotomies were prepared using the 7.5-mm stopper with either the 7.0- or 8.0-mm crown guide. Cone beam computed tomography (CBCT) was used to obtain images for analysis of osteotomy-tooth mesiodistal distances, which were predicted to be 3.0 or 5.5 mm, depending on position; interosteotomy mesiodistal distances, which were predicted to be 3.0 mm; and osteotomy depth, which was predicted to be 11.5 mm. A 1-sample t test was used to determine if there were significant differences between the predicted values and the measurements of the guided osteotomies on the CBCT images of the mandibular models, and an independent t test was conducted to compare the results of 3.0- and 5.5-mm osteotomy-tooth distances (α = 0.05). Differences between the predicted and actual values of the interosteotomy mesiodistal distance (P = 0.516) and osteotomy depth (P = 0.847) were not statistically significant. The actual osteotomy-tooth mesiodistal distances were significantly different from the predicted values of 3.0 (P = 0.000) and 5.5 mm (P = 0.001), with higher mean differences of 0.46 and 0.60 mm, respectively. The designed guide had a high accuracy in achieving optimal linear interosteotomy mesiodistal distances and osteotomy depths, and the obtained mean values were clinically acceptable.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Implantação Dentária Endóssea , Humanos , Implantação Dentária Endóssea/métodos , Técnicas In Vitro , Implantes Dentários , Osteotomia/métodos , Osteotomia/instrumentação , Cirurgia Assistida por Computador/métodos , Arcada Parcialmente Edêntula/cirurgia , Arcada Parcialmente Edêntula/diagnóstico por imagem , Desenho Assistido por Computador , Software , Modelos Dentários
4.
Medicina (Kaunas) ; 60(5)2024 Apr 26.
Artigo em Inglês | MEDLINE | ID: mdl-38792903

RESUMO

(1) Background: Recent digital workflows are being developed for full-arch rehabilitations supported by implants with immediate function. The purpose of this case series is to describe a new digital workflow for the All-on-4 concept. (2) Methods: The patients were rehabilitated using the All-on-4 concept with a digital workflow including computerized tomography scanning, intra-oral scanning, and CAD-CAM production of the temporary prosthesis, with the 3D printing of stackable guides (base guide, implant guide, and prosthetic guide). The passive fit of the prostheses and the time to perform the rehabilitations were evaluated. (3) Results: The digital workflow allowed for predictable bone reduction, the insertion of implants with immediate function, and the connection of an implant-supported prosthesis with immediate loading. The time registered to perform the full-arch rehabilitations (implant insertion, abutment connection, prosthesis connection) was below 2 hours and 30 min. No passive fit issues were noted. (4) Conclusions: within the limitation of this case series, the digital workflow applied to the All-on-4 concept using stackable base-, implant-, and prosthetic guides constitutes a potential alternative with decreased time for the procedure without prejudice of the outcome.


Assuntos
Fluxo de Trabalho , Humanos , Feminino , Masculino , Pessoa de Meia-Idade , Desenho Assistido por Computador , Idoso , Prótese Dentária Fixada por Implante/métodos , Impressão Tridimensional , Tomografia Computadorizada por Raios X/métodos , Boca Edêntula/reabilitação
5.
Artigo em Inglês, Zh | MEDLINE | ID: mdl-38832462

RESUMO

With the rapid development of implant techniques and digital technology, digital impressions have become a commonly used impression method in implant restoration. At present, the accuracy of intraoral digital impressions directly applied to implant-supported full-arch prostheses remains inadequate, which is due to the high accuracy requirement of full-arch implant impressions, while there are still technical challenges in intraoral digital impressions about recognition and stitching. In this regard, scholars have proposed a variety of scanning strategies to improve the accuracy of intraoral scan, including mucosal modifications, auxiliary devices and novel scan bodies. At the same time photogrammetry, as a new digital impression technique, has been developing steadily and exhibits promising accuracy. This article reviews the research progress on the accuracy of edentulous full-arch implant impressions and techniques which can improve the accuracy of intraoral digital impressions, to provide reference for clinical application.

6.
J Evid Based Dent Pract ; 24(1): 101933, 2024 03.
Artigo em Inglês | MEDLINE | ID: mdl-38448118

RESUMO

OBJECTIVES: Accuracy is a crucial factor when assessing the quality of digital impressions. This systematic review aims to assess the accuracy of intraoral scan (IOS) in obtaining digital impressions of edentulous jaws. METHODS: This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and was registered in the International Prospective Register of Systematic Reviews (PROSPERO ID: CRD42022382983). A thorough retrieval of 7 electronic databases was undertaken, encompassing MEDLINE (PubMed), Web of Science, EMBASE, Scopus, Cochrane Library, Virtual Health Library, and Open gray, through September 11, 2023. A snowball search was performed by tracing the reference lists of the included studies. The Population, Intervention, Comparison, and Outcome (PICO) question of this systematic review was: "What is the accuracy of intraoral scan in obtaining digital impressions of edentulous arches?" The Modified Methodological Index for Nonrandomized Studies (MINORS) was employed to assess the risk of bias. RESULTS: Among the studies retrieved from databases and manual search, a total of 25 studies were selected for inclusion in this systematic review, including 9 in vivo and 16 in vitro studies. Twenty-one of the included studies utilized the 3D deviation analysis method, while 4 studies employed the linear or angular deviation analysis method. The accuracy results of in vitro studies indicated a trueness range of 20-600 µm and a precision range of 2-700 µm. Results of in vivo studies indicated a trueness range of 40-1380 µm, while the precision results were not reported. CONCLUSION: According to the results of this study, direct digital impressions by IOS cannot replace the conventional impressions of completely edentulous arches in vivo. Edentulous digital impressions by IOS demonstrated poor accuracy in peripheral areas with mobile tissues, such as the soft palate, vestibular sulcus, and sublingual area.

7.
Clin Oral Implants Res ; 34(2): 127-136, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36461704

RESUMO

OBJECTIVE: The aim of this multicenter parallel-group randomized controlled trial is to compare, in the same clinical scenario, 6 mm short with 11 mm long implants for the rehabilitation of completely edentulous non-atrophic mandibles. MATERIALS AND METHODS: Thirty patients in three study centers received a fixed full-arch mandibular rehabilitation supported by five inter-foraminal implants, with no need for bone augmentation procedures. Patients were randomly allocated (1:1 ratio), at the time of surgery, to test (6 mm implants) or control group (11 mm implants). After 3 months, a screw-retained full-arch prosthesis was positioned (baseline). Peri-implant marginal bone level change (MBLc, primary outcome) together with implant and prosthesis survival rate, and biological/technical complications (secondary outcomes) were evaluated up to 5 years. RESULTS: Twenty seven patients were controlled at 5 years (3 drop-outs). No implant or prosthesis loss occurred. No significant intergroup difference for biological/technical complications (p > .05, Fisher's exact test) and no significant intragroup and intergroup difference in the MBLc values were registered (test -0.03 ± 0.17 mm and control -0.13 ± 0.32 mm at 5-years; p > .025, one-sided Mann-Whitney U-test). CONCLUSIONS: When used in comparable anatomic, surgical, and prosthetic conditions, no difference in the clinical and radiographic outcomes between 6-mm and 11-mm implants was observed at 5 years of follow-up. Short implants showed to be a reliable option for the rehabilitation of completely edentulous non-atrophic mandibles. There is growing clinical evidence supporting the use of short implants, even in the case of non-atrophic sites.


Assuntos
Implantes Dentários , Arcada Edêntula , Humanos , Implantação Dentária Endóssea/métodos , Planejamento de Prótese Dentária , Falha de Restauração Dentária , Mandíbula/cirurgia , Prótese Dentária Fixada por Implante , Resultado do Tratamento , Seguimentos , Arcada Edêntula/cirurgia
8.
Periodontol 2000 ; 90(1): 138-145, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-35916869

RESUMO

An increasing number of elderly people retain their natural teeth into old age and further, the prevalence of endosseous implants for supporting oral prosthesis is ever increasing. These teeth and implants now present a considerable challenge in terms of maintenance, especially when patients become dependent on care. Periodontal and peri-implant diseases are more prevalent in elderly than in younger age cohorts. There are distinct differences related to the inflammatory response between periodontal and peri-implant tissues, both in young and old age. The age-related reasons for the increase in periodontal infections may be related to poor oral hygiene because of a loss of dexterity or vision, but also to immunosenescence. This term describes the aging of the immune system and the decline of its effectiveness with age. Low-grade infections, like chronic periodontitis, may cause low-grade inflammation and subsequently increase the likelihood of developing chronic diseases. In return, treatment of periodontitis may improve general health, as demonstrated for diabetes. A second mechanism illustrating how poor oral health translates into systemic disease is the risk of developing aspiration pneumonia. The treatment options in old age should be evaluated with regard to the issues of general health and maintenance. Systematic periodontal maintenance therapy, as performed in younger age cohorts, may be difficult to implement in elderly people experiencing institutional or hospital confinement because of logistics, barriers related to patients and caregivers, or cost. The scale of periodontal disease in old age represents a public health issue.


Assuntos
Periodontite Crônica , Implantes Dentários , Peri-Implantite , Idoso , Periodontite Crônica/complicações , Implantação Dentária Endóssea/efeitos adversos , Implantes Dentários/efeitos adversos , Hospitais , Humanos , Peri-Implantite/epidemiologia , Peri-Implantite/etiologia
9.
Clin Oral Implants Res ; 33(3): 291-301, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34951501

RESUMO

OBJECTIVE: This prospective study aimed to assess the effectiveness of using a single short implant to retain a single-implant mandibular overdenture (SIMO) in participants with severely atrophic edentulous mandibles. MATERIAL AND METHODS: The study sample included 18 edentulous participants with severely resorbed mandibular ridges and limited bone height in the symphyseal region sufficient for the insertion of a 7.0-mm-height implant. First, patients received new conventional dentures or had their dentures relined, followed by the insertion of a 3.75 x 7 mm morse-taper implant, and the incorporation of a stud-type attachment and a nylon retentive insert after a 3-month healing period. Implant stability quotient (ISQ) was measured at baseline and after 3 and 12 months. Patient-reported outcomes (satisfaction with the dentures and oral health-related quality of life) were assessed before implant placement and at the 3-, 6-, and 12-month follow-ups. Clinical-radiographic outcomes and the incidence of prosthodontic events were assessed throughout the follow-up period. RESULTS: The implant survival rate was 100%. ISQ increased from baseline (72.7 ± 6.6) to the 3-month (82.0 ± 3.3) and 1-year (85.4 ± 2.9) follow-ups (p < .001). After 1 year, satisfaction with the mandibular prosthesis increased significantly, and the overall OHIP-Edent score decreased by 79.2%. No effects were found for the maxillary denture (p = .420). Due to dissatisfaction with treatment, two participants (11.1%) required additional implants after the 1-year follow-up and were considered as prosthodontic failures. CONCLUSION: Single-implant mandibular overdenture retained by a short implant showed favorable outcomes after 1 year. Further studies with larger samples and longer follow-up periods are needed to confirm the findings of this single-group prospective study. The present study was registered at the Brazilian Clinical Trials Registry (REBEC), identifier RBR-7p2xmg. The trial registry occurred during the study execution, and its final approval was delayed because of several formatting adequacies required by the platform REBEC.


Assuntos
Implantes Dentários , Revestimento de Dentadura , Prótese Dentária Fixada por Implante , Retenção de Dentadura , Humanos , Mandíbula/cirurgia , Satisfação do Paciente , Estudos Prospectivos , Qualidade de Vida , Resultado do Tratamento
10.
J Oral Implantol ; 48(6): 475-479, 2022 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-34091666

RESUMO

Severe bone atrophies are considered a challenge in the rehabilitation process. In clinical situations involving excessive vertical bone deficiency in edentulous mandibles, there is a risk of fracture and frequently the need for an approach that involves highly complex procedures. In this context, simultaneous three-dimensional bone reconstruction associated with rigid fixation is a viable alternative to optimize longevity and avoid failures in these cases. This clinical case report presents a technique for reconstruction of severely atrophic mandibles in an elderly female patient to allow the implant-supported prosthesis protocol. The placement of immediate implants was possible by using an intraoral approach for fixation of a titanium plate followed by guided bone regeneration in association with recombinant human bone morphogenetic protein-2, deproteinized bovine bone mineral, and titanium mesh in a 1-stage surgical procedure. There are no reports in the literature of this approach for treating of severely atrophic mandibles. This association of techniques was shown to be predictable after 3 years of follow-up. Therefore, this protocol provides safe supported-implant prosthesis rehabilitation for patients with severely atrophic mandible.


Assuntos
Aumento do Rebordo Alveolar , Implantes Dentários , Humanos , Feminino , Animais , Bovinos , Idoso , Implantação Dentária Endóssea/métodos , Seguimentos , Titânio , Resultado do Tratamento , Mandíbula/cirurgia , Atrofia/patologia , Prótese Dentária Fixada por Implante , Aumento do Rebordo Alveolar/métodos
11.
BMC Oral Health ; 22(1): 139, 2022 04 26.
Artigo em Inglês | MEDLINE | ID: mdl-35473637

RESUMO

INTRODUCTION: The aim of this study was to verify whether the use of short implants could optimize stress distribution of bone surrounding implants in atrophic mandibles with different bone qualities. METHODS: A three-dimensional model of the atrophic mandible with three levels of bone quality was made using computer software. Short implants (6 mm) and standard implants (10 mm) were used in four designs: Design 1 "All-On four", Design 2 "All-On-four" with two short implants, Design 3 four vertical implants with two short implants, and Design 4 six short implants. The distal short implants were placed at the first molar position. All twelve models were imported into finite element analysis software, and 110 N oblique force was loaded on the left second premolar. Maximum principal stress values of peri-implant bone and the volumes of bone with over 3000 microstrians (overload)were analyzed. RESULT: Stress values and volumes of overload bone increased in all four groups with the decline of bone quality. The highest stress values were found in the cortical bone surrounding the Design 1 inclined implant in two lower bone quality mandibles, and the lowest in Design 3. However, Design 1 had less overload bone tissue than all three designs with short implants. CONCLUSION: Short implants placed posteriorly helped decrease stress values in peri-implant bone, while bone surrounding short implants had a high resorption risk in low bone quality mandible.


Assuntos
Implantes Dentários , Prótese Dentária Fixada por Implante , Análise do Estresse Dentário/métodos , Análise de Elementos Finitos , Humanos , Mandíbula/cirurgia
12.
Int J Comput Dent ; 25(2): 221-231, 2022 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-35851358

RESUMO

BACKGROUND: Treatment of the edentulous maxilla with a fixed full-arch prosthesis on four immediately loaded implants has been discussed as a treatment option, although generally five implants are recommended for that indication. The precise transfer of the virtually planned position by 3D-guided implant placement is an essential prerequisite for delivering the prefabricated temporary restoration at the time of surgery. Three-point support on the teeth or implants ensures that the template for the guided surgery is soundly seated during the operation. CASE PRESENTATION: In the described case, the three-point support was carried out by teeth and temporary implants in the molar region inserted prior to the CBCT. The virtual implant planning determined the best prosthetic implant position while using the available bone to avoid extensive augmentation. Following this, a metal-reinforced provisional restoration was prepared using a drilling template. Four implants were placed in the planned position with the aid of a tooth-/implant-supported guide. The prosthetic axis of the angulated distal implants is balanced by 17-degree angled abutments. After transferring the implant position to the dental laboratory, the prepared restoration was finalized. The remaining teeth were extracted and the temporary restoration was delivered 3 h after implant placement. The definitive fixed full-arch zirconia restoration with micro layering was placed 9 months later in a stable situation. CONCLUSION: The remarkable accuracy of the implant placement with a surgical template generated from preoperative virtual implant planning ensures a relatively short treatment time and an uneventful and fast recovery with minimal discomfort. The immediate prosthodontic rehabilitation is a benefit, not only for the patient but also for the dental team. Micro-layered monolithic zirconia seems to be a promising option for screw-retained full-arch prostheses.


Assuntos
Implantes Dentários , Carga Imediata em Implante Dentário , Arcada Edêntula , Boca Edêntula , Implantação Dentária Endóssea , Prótese Dentária Fixada por Implante , Seguimentos , Humanos , Arcada Edêntula/cirurgia , Maxila/cirurgia , Boca Edêntula/cirurgia , Resultado do Tratamento
13.
Medicina (Kaunas) ; 58(3)2022 Feb 24.
Artigo em Inglês | MEDLINE | ID: mdl-35334520

RESUMO

Background and Objectives: Edentulism is considered to be an impediment impacting both patients' quality of life and their nutrition. Conventional complete dentures are still a preferred treatment. However, there is no consensus on the most important factors which could substantially reduce the risk of patient dissatisfaction. This study evaluated the following determinants concerning patient satisfaction with complete maxillary and mandibular dentures: sex, denture-related functional and aesthetic aspects, and the degree of bone resorption. Materials and Methods: This study included 70 patients aged 34-81 years of age. All complete dentures were made by following the same technology. Visual analogue scales were used to assess patients' overall satisfaction with dentures, comfort, ability to speak and chew, denture aesthetics, stability, and ease of prosthesis cleaning. Satisfaction with upper and lower dentures was rated separately. The degree of bone resorption was classified by using the Kalk and de Baat (1989) method. Results: The mean (SD) age of the study participants was 67.3 (10.4) years; 65.7% (n = 46) were females and 34.3% (n = 24) were males. There were no significant sex-based differences in resorption of the maxilla or mandibula. There were significant differences between maxillary and mandibular dentures, with lower mean satisfaction scores concerning chewing and maxillary complete dentures, and in regard to stability and comfort for mandibular complete dentures. There was a non-significant overall lower satisfaction with increased age. In multivariate analysis for mandibular complete dentures, aesthetics and stability significantly predicted the patient's comfort levels, and the patient's comfort significantly predicted overall satisfaction. For maxillary complete dentures, patient comfort and aesthetics significantly predicted overall patient satisfaction. Conclusions: Age, sex, and degree of resorption were not associated with patient satisfaction with complete dentures. Overall, patient satisfaction with both maxillary and mandibular complete dentures was related to their comfort level and denture aesthetics, and patient comfort itself was associated with stability of the mandibular denture.


Assuntos
Boca Edêntula , Satisfação do Paciente , Adulto , Idoso , Idoso de 80 Anos ou mais , Retenção de Dentadura , Prótese Total , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida
14.
Clin Oral Implants Res ; 32(10): 1200-1208, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34358360

RESUMO

OBJECTIVES: Resonance frequency analysis (RFA) is used to monitor implant stability. Its output, the Implant Stability Quotient (ISQ), supposedly correlates with insertion torque, a common measurement of primary stability. However, the reliability of RFA in condensed bone remains unclear. MATERIAL AND METHODS: In this human cadaver study in edentulous jaws and fresh extraction sockets, implants were inserted using a split-mouth approach into condensed or untreated bone. Mean ISQ, peak insertion torque, and pre- and postoperative bone volume fractions (BV/TV) were assessed. RESULTS: In edentulous jaws, insertion torque and ISQ correlated both in untreated (r = 0.63, p = 0.02) and in condensed (r = 0.82, p  < 0.01) bone. In extraction sockets, insertion torque and ISQ only correlated in untreated (r = 0.78, p < 0.01), but not in condensed bone (r = 0.15, p = 0.58). In all edentulous jaws, preoperative BV/TV correlated with insertion torque (r = 0.90, p < 0.0001), ISQ (r = 0.64, p < 0.001), and changes in BV/TV (r = -0.71, p < 0.01). In all extraction sockets, preoperative BV/TV did not correlate with either insertion torque (r = 0.33, p = 0.15), ISQ (r = 0.38, p = 0.09), or changes in BV/TV (r = -0.41, p = 0.09). Joint analysis identified preoperative BV/TV as a predictor of postoperative BV/TV (p < 0.001), insertion torque (p < 0.001), and ISQ (p < 0.001). CONCLUSIONS: RFA is feasible for monitoring stability after late implant placement into condensed bone, but not after immediate placement into condensed fresh extraction sites.


Assuntos
Implantação Dentária Endóssea , Implantes Dentários , Humanos , Mandíbula/cirurgia , Reprodutibilidade dos Testes , Análise de Frequência de Ressonância , Torque
15.
Int J Comput Dent ; 24(3): 303-315, 2021 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-34553895

RESUMO

BACKGROUND: Dynamic navigation has important potential advantages over the static approach for fully edentulous patients. To the best of the authors' knowledge, this is the first published case report describing the use of a dynamic implant navigation technique for a fully edentulous patient. CASE REPORT: A 55-year-old female presented for the replacement of missing teeth. Treatment with an implant-supported fixed dental prosthesis was proposed. A digital navigation implant surgery/immediate provisionalization protocol was used. An acrylic resin denture was fabricated as a radiographic guide. Digital data were obtained through the double scan technique, and a prosthetically driven 3D implant positioning was designed. Four titanium mini screws were inserted into the mandible for registration. The first implant was inserted in a freehand manner and attached to a patient tracker. After calibration and registration, the navigation system was set up. The other five implants were inserted using the navigation system. The procedure followed for the maxilla was similar. After surgery, a loading procedure was performed within 24 h. RESULTS: Following implant placement, a postoperative CBCT scan was performed. The results showed that all implants were placed precisely, in accordance with the treatment plan. CONCLUSION: From the results obtained it appears that a fully digital workflow for prosthetically driven implant navigation surgery is suitable for the treatment of fully edentulous patients requiring an implant-supported fixed restoration. High-level evidence is needed to determine the accuracy and precision of this workflow.


Assuntos
Implantes Dentários , Arcada Edêntula , Implantação Dentária Endóssea , Prótese Dentária Fixada por Implante , Feminino , Seguimentos , Humanos , Arcada Edêntula/cirurgia , Mandíbula/cirurgia , Maxila/diagnóstico por imagem , Maxila/cirurgia , Pessoa de Meia-Idade , Resultado do Tratamento , Fluxo de Trabalho
16.
Clin Oral Implants Res ; 31(1): 64-73, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31605405

RESUMO

OBJECTIVE: The aim of this multicenter parallel-group randomized controlled trial is to compare 6-mm-short with 11-mm-long implants in the rehabilitation of totally edentulous mandible in a completely comparable clinical situation, from anatomical, surgical, and prosthetic point of view. MATERIAL AND METHODS: Thirty patients were selected in three study centers to receive a fixed full-arch mandibular rehabilitation supported by five inter-foraminal implants. Patients were randomly allocated, at the time of surgery, half to the test group (6-mm-long implants) and half to the control group (11-mm-long implants). No bone augmentation procedure was performed. After 3 months, a screw-retained full-arch prosthesis with distal cantilevers was positioned (baseline). Peri-implant marginal bone level change (MBLc), implant and prosthesis survival rate, and biological/technical complications were evaluated after 1 and 3 years. RESULTS: Thirty subjects (150 implants) were evaluated after 1 year and 28 (140 implants) after 3 years. No implant or prosthesis loss occurred. No significant inter-group difference for biological/technical complications was registered. No statistically significant (p > .025) intra-group or inter-group difference in the mean MBLc values was registered. The mean MBLc was 0.01 ± 0.19 mm and -0.04 ± 0.21 mm at 1 year, and -0.10 ± 0.24 mm and 0.02 ± 0.25 mm at 3 years (test and control groups, respectively). CONCLUSIONS: 6-mm-short implants may be a reliable option when used in the rehabilitation of total edentulous mandibles. These results need to be confirmed by longer follow-up data from well-designed randomized controlled clinical trials.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Arcada Edêntula , Implantação Dentária Endóssea , Planejamento de Prótese Dentária , Prótese Dentária Fixada por Implante , Falha de Restauração Dentária , Humanos , Mandíbula , Resultado do Tratamento
17.
J Prosthodont ; 29(8): 707-711, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32557969

RESUMO

PURPOSE: The image registration of optical scans to radiographic images is essential for performing computer-guided implant surgery. This study aimed to evaluate the effect of different image matching conditions on the accuracy of image registration for computer-guided implant surgery in completely edentulous jaws. MATERIALS AND METHODS: The optical scan image of a completely edentulous study model was registered to the respective cone-beam computed tomography data using three different image matching conditions: small point (SP), large point (LP), and entire surface (ES). For the SP and LP groups, gutta-percha markers (1.0 and 3.0 mm in diameter) were attached to a base template, and a radiopaque impression material was relined on the intaglio surface of template in the ES group. Image registration was performed by 20 operators in the images obtained from each group at an interval of 2 weeks (n = 20 in each group), and the registration accuracy was assessed by calculating the aligned position of the edentulous arch image. One-way analysis of variance with Tukey post hoc tests was used to compare the results among the groups (α = 0.05). RESULTS: The mean registration error was significantly larger in the SP group (0.52 ± 0.19 mm) than in the LP group (0.29 ± 0.08 mm) and ES group (0.27 ±0.06 mm) (F = 24.689, p < 0.001). No difference was found between the LP and ES groups. The image matching discrepancy was more homogeneously distributed on the arch in the ES group than in the other groups. CONCLUSION: The accuracy of image registration is affected by the size of the congruent area shown in the optical scan and radiographic images. The entire surface-based matching method is more accurate as compared to the small point-based matching method in the image registration for implant planning in full edentulous jaws.


Assuntos
Implantes Dentários , Arcada Edêntula , Boca Edêntula , Cirurgia Assistida por Computador , Tomografia Computadorizada de Feixe Cônico , Humanos , Imageamento Tridimensional , Arcada Edêntula/diagnóstico por imagem
18.
Clin Oral Implants Res ; 30(3): 197-205, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30667092

RESUMO

OBJECTIVE: To assess the prostheses and implants survival rate and peri-implantitis rate in edentulous patients treated with full-arch screw-retained implant-supported fixed dental prostheses (FSIFDPs) and full-arch telescopic-retained implant-supported fixed dental prostheses (FTIFDPs) over an observation period of at least 5 years. MATERIALS AND METHODS: From 2004 to 2012, 696 implants were inserted into 78 patients with 102 prostheses. The FSIFDP group comprised 31 patients (37 prostheses, 232 implants), whereas the FTIFDP group comprised 47 patients (65 prostheses, 464 implants). Prosthesis and implant estimated cumulative survival rates (ECSR) and estimated cumulative peri-implantitis rates (ECPR) were assessed. The follow-up period was 5-12 years. Kaplan-Meier survival curves with the log-rank test were used to evaluate outcomes. RESULTS: The 12-year prosthesis ECSR was 96.8% (95% CI: 79.2-99.5, 36/37 prostheses) in the FSIFDP group and 96.4% (95% CI: 86.3-99.1, 63/65 prostheses) in the FTIFDP group, whereas the 12-year implant ECSR was 99.5% (95% CI: 96.4-99.9, 231/232 implants) in the FSIFDP group and 98.7% (95% CI: 96.9-99.5, 459/464 implants) in the FTIFDP group. The 12-year ECPR at the prosthesis level was 12.8% (95% CI: 12.7-47.6, 4/37 prostheses) in the FSIFDP group and 12.8% (95% CI: 11.4-24.1, 6/65 prostheses) in the FTIFDP group. The 12-year ECPR at the implant level was 4.4% (95% CI: 4.3-23.0, 6/232 implants) in the FSIFDP group and 2.2% (95% CI: 2.0-12.3, 7/464 implants) in the FTIFDP group. CONCLUSION: FTIFDPs have clinical results comparable to those of FSIFDPs. Therefore, FTIFDPs can be useful.


Assuntos
Implantes Dentários , Arcada Edêntula , Parafusos Ósseos , Planejamento de Prótese Dentária , Prótese Dentária Fixada por Implante , Falha de Restauração Dentária , Seguimentos , Humanos , Estudos Retrospectivos , Resultado do Tratamento
19.
J Prosthodont ; 28(9): 947-950, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31642562

RESUMO

Full-arch screw-retained implant-supported fixed dental prostheses have a high long-term success rate and are considered the gold standard by many clinicians. However, accurate fabrication of a passive fit long-span prosthesis can be challenging. A novel intraoral adhesion method using galvano-telescopic copings was proposed as a way of improving prosthetic fit for edentulous patients. This report describes the treatment of a 74-year-old female with a full-arch implant-supported dental prosthesis, supported by a combination of galvano-telescopic copings and screws to prevent retention loss. Four years have passed since this superstructure was placed, during this time she exhibited a good clinical course with no inflammation noted in surrounding tissues. Treatment with an implant-supported fixed dental prosthesis, retained by a combination of galvano-telescopic copings and screws, can be a useful alternative treatment for edentulous patients.


Assuntos
Implantes Dentários , Arcada Edêntula , Adaptação Psicológica , Idoso , Planejamento de Prótese Dentária , Prótese Dentária Fixada por Implante , Planejamento de Dentadura , Feminino , Humanos
20.
J Prosthodont ; 28(2): e519-e523, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29522269

RESUMO

Few studies have reported the application of digital technology for the process of impression and interocclusal recordings in edentulous patients. This article describes a digitizing system for generating digital edentulous models with a jaw relationship by taking direct digital impressions and a virtual bite registration using intraoral digital scanning. A specialized scan retractor was used to make digital impressions of edentulous jaws in patients' mouths using an intraoral scanner. Virtual bite registration was obtained with optical scanning of the buccal surfaces of both jaws at the occlusal vertical dimension. The registration was then used as a reference for aligning both jaws. Digital edentulous models that include the jaw relationship would be clinically beneficial for the fabrication of complete dentures in edentulous patients.


Assuntos
Técnica de Moldagem Odontológica , Planejamento de Dentadura , Processamento de Imagem Assistida por Computador/métodos , Registro da Relação Maxilomandibular/métodos , Desenho Assistido por Computador , Materiais para Moldagem Odontológica , Humanos , Arcada Edêntula/reabilitação , Modelos Dentários , Software
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