Evaluation of the Treatment of Partially Edentulous Patients With Bone Level Tapered Implants: 24-Month Clinical and Radiographic Follow-Up.

The aim of this case series was to assess, over a period of 24 months, the clinical and radiographic outcomes in partially edentulous patients receiving bone-level tapered implants. In total, 33 partially edentulous patients and 50 implants were evaluated. Patients received single or multiple implants in the posterior maxilla. Clinical and radiographic measurements of vertical bone levels were assessed at surgery, at loading, and 6, 12, and 24 months after surgery. The success and survival rates of the implants were also evaluated. Within the 24-month follow-up, only 1 implant failed (2.0%). Other biological or technical complications were not observed. The mean insertion torque was 34 ± 5.3 Ncm. Bone-level changes of 0.35 ± 0.23 mm were found between surgery and 12 months after surgery, and changes of 0.03 ± 0.05 mm were found between 12 months and 24 months after surgery. The overall change from surgery to 24 months after implant placement was 0.38 ± 0.24 mm. Most of the bone loss occurred between surgery and 3 months (0.28 ± 0.19 mm; P < .001); thereafter, the loss was minimal and statistically nonsignificant. Bone-level tapered implants yielded a high survival and success rate with minimal bone-level changes. Tapered implants could be considered as a predictable treatment option for partially edentulous patients with different types of bone qualities and loading protocols.

Prosthetic maintenance of different mandibular implant overdentures: A systematic review.

STATEMENT OF PROBLEM: Different factors can affect prosthetic maintenance requirements for mandibular implant overdentures (IODs). However, the literature shows a high level of disagreement concerning the effect of each factor on maintenance needs. PURPOSE: The purpose of this systematic review was to address the focus question: "In the clinical studies published since 2004 of adult patients with totally edentulous mandibles treated by IODs with a variable number of implants and different designs, what were the maintenance types, frequencies, and complications?" MATERIAL AND METHODS: A search of MEDLINE and PubMed databases was performed targeting papers in English on prosthetic maintenance of mandibular IODs published between 2004 and June 2015, aiming at recognizing the needs for adjustment, repair, and renewal. The recorded data were divided into 6 categories, and a percentage value was attributed to each. RESULTS: From a total of 130 articles, 33 studies met the specified inclusion criteria for the review (14 randomized controlled trials, 8 prospective clinical trials, 3 retrospective studies, and 4 systematic reviews). These articles provided evidence that a mean complication rate was impossible to determine because of the multiplicity of contributing factors. No clear identification of the causes of mechanical complications was found, nor was there any clear evidence of superiority of one implant and/or attachment design over another. CONCLUSIONS: Prosthetic complications with IODs are unavoidable. However, they can be reduced to an expected level if a close follow-up protocol is implemented aiming at anticipating risks of unexpected complications. Further clinical studies are needed to achieve a constructive meta-analysis that accounts for different parameters such as opposite arch, attachment functional variety, connection method, and prosthesis quality.

Strategic extraction protocol: Use of an image-fusion stereolithographic guide for immediate implant placement.

Increasingly, patients are demanding a smooth transition from a hopeless dentition to a fixed implant-supported prosthesis without the use of an interim removable denture. This raises new challenges in adapting computer-aided design and computer-aided manufacturing (CAD-CAM) techniques to patients whose treatment plan includes immediate implant placement in fresh extraction sockets. To facilitate this conversion to a rehabilitated dentition, a strategic extraction protocol (SEP) can be applied. The SEP consists of selecting strategic, remaining, hopeless teeth as abutments to stabilize an image-fusion stereolithographic guide and to allow the immediate placement of sufficient implants to support an immediately loaded fixed prosthesis. The remaining supporting teeth are extracted in the same surgical session before the placement of the interim prosthesis.

Use of narrow-diameter implants in the posterior jaw: a systematic review.

STATEMENT OF PROBLEM: Evidence is limited on the efficacy of narrow-diameter implants (NDIs) in the posterior jaw. PURPOSE: The purpose of this systematic review was to assess the survival of NDIs and provide guidelines for their safe use. MATERIALS AND METHODS: Electronic search of the English-language literature enriched by hand search to identify suitable publications was made. Only peer-reviewed clinical studies published from January 1990 through March 2014 were included. RESULTS: Seventeen studies with a total of 1644 implants met the inclusion criteria, with an observation period from 1 up to 12 years. The mean survival rate of 98.6% was reported. Technical and other complications were observed. CONCLUSION: Short-term clinical data suggest that NDIs may serve in the posterior jaw as an alternative to standard-diameter implants. However, certain clinical conditions must be observed to assure long-term success.

Mini-lateral windows for minimally invasive maxillary sinus augmentation: case series of a new technique.

OBJECTIVES: The purpose of this article was to introduce a new technique for minimally invasive lateral window sinus augmentation, developed to maximize the amount of residual lateral wall after the procedure. MATERIALS AND METHODS: Fourteen consecutive patients requiring maxillary sinus augmentation by a lateral approach and delayed implant placement were treated using standardized mini-lateral windows. Before the procedure, the remaining height of alveolar bone was determined; 6 months after the procedure, the augmented height and augmented width were measured. The extent of the antrostomy was calculated using a gauge and compared with a conventional window size. RESULTS: A total of 15 maxillary sinus augmentation procedures were performed in 14 patients using this technique. Every patient received the planned implant treatment 6 months after the sinus augmentation procedure. The average residual bone height was 2.1 ± 1.1 mm, the average augmented height was 13.4 ± 3.4 mm, and the average augmented width was 19.0 ± 5.5 mm. The average total area of the antrostomy was calculated to be 59.2 ± 12.8 mm. CONCLUSIONS: The results of this case series study suggest that this technique allows for the achievement of a similar result as with conventional size windows, but with a significantly smaller total window area.

Revisiting implant-retained mandibular overdentures: planning according to treatment needs.

Increasingly popular, implant-retained mandibular overdentures have a highly predictable success rate and provide many options in terms of design and attachment systems. General dentists may have some difficulties in choosing the appropriate system. This paper provides a general overview of the various options that are available, taking into consideration the specifications and challenges of each.