ABSTRACT
OBJECTIVES: Evaluate the 5-year safety and efficacy of a narrow-diameter (3.0 mm) implant that was immediately provisionalized with a single crown in the maxillary lateral incisor or mandibular central or lateral incisor area. MATERIALS AND METHODS: An open, prospective, single-cohort, multicenter study was conducted, in which narrow-diameter implants were placed in fresh, healed extraction, or congenitally missing sites. All patients were required to meet strict criteria for immediate loading. The primary endpoints were marginal bone levels (MBL) and MBL changes (MBLC) from implant placement to 5-year follow-up. Secondary endpoints included cumulative 5-year survival and success rates, soft tissue health, and esthetic parameters. RESULTS: A total of 91 implants were placed in 77 patients. The mean MBL remained stable from the 1-year (- 0.79 ± 0.73 mm, n = 75) to 5-year (- 0.74 ± 0.87 mm, n = 65) follow-up. A marginal bone gain of 0.11 ± 0.83 mm was observed from the 1-year to 5-year follow-up. The cumulative 5-year survival rate was 96.5%, and the cumulative 5-year success rate was 93%. The clinical parameters, including the modified plaque index, modified sulcus bleeding index, Jemt's papilla index, and pink esthetic score improved throughout the 5-year study. CONCLUSIONS: The study demonstrated that narrow-diameter implants represent a safe and predictable treatment option for subjects suitable for immediate loading and with limited bone volume or limited inter-dental space. CLINICAL RELEVANCE: Narrow-diameter implants with immediate provisionalization can be considered for use to restore missing or damaged teeth with predictable functional and esthetic outcomes. This trial was registered with ClinicalTrials.gov (NCT02184845).
Subject(s)
Crowns , Dental Prosthesis Design , Esthetics, Dental , Immediate Dental Implant Loading , Humans , Prospective Studies , Female , Male , Middle Aged , Adult , Treatment Outcome , Dental Implants, Single-Tooth , Incisor , AgedABSTRACT
OBJECTIVES: The aim of this interim analysis of a 5-year prospective multicenter study is to evaluate clinical and radiological performance of immediately provisionalized 3.0-mm-diameter tapered implants. MATERIALS AND METHODS: Patients needing implant rehabilitation of maxillary lateral incisors or mandibular lateral and central incisors were treated with 3.0-mm-diameter implants placed in extraction or healed sites and immediately provisionalized. Clinical and radiographic examinations were performed at implant insertion, 6 months thereafter, and are ongoing. Marginal bone levels and changes, complications, the papilla, plaque, and bleeding indices, and the pink esthetic score (PES) were evaluated at each follow-up visit. RESULTS: Of 112 enrolled patients, 77 patients (91 implants) met the inclusion criteria. Seventy-one patients with 82 implants completed the 1-year follow-up. Three implants failed yielding a CSR of 96.7%. All failures occurred within the first 3 months after implant insertion. Marginal bone level changes from insertion to 6 months was - 0.57 ± 1.30 mm (n = 75) and from insertion to 12 months - 0.25 ± 1.38 mm (n = 72). Fifteen non-serious complications were recorded. Papilla index score and PES improved at the 1-year follow-up. Plaque formation and bleeding-on-probing showed no statistically significant differences between the 6-month and the 1-year visit. CONCLUSIONS: This 1-year analysis demonstrated high survival, stable bone levels, and healthy soft tissue with 3.0-mm-diameter implants. CLINICAL IMPLICATIONS: Narrow diameter implants are a safe and predictable treatment option in patients with limited bone volume and/or limited interdental space and eligible for immediate loading protocols.
Subject(s)
Dental Implants, Single-Tooth , Esthetics, Dental , Immediate Dental Implant Loading/methods , Adult , Dental Prosthesis Design , Dental Restoration Failure , Female , Humans , Incisor , Male , Postoperative Complications , Prospective Studies , Treatment OutcomeABSTRACT
Although the scientific evidence supporting complete digital workflows in implant dentistry is limited, practitioners continue to show increasing interest in implementing these types of protocols into clinical practice. The digital workflow enhances the ability of surgical clinicians, restoring dentists, other specialists, and technicians to collaborate in the treatment planning process to idealize treatment outcomes and achieve truly prosthetically driven restorative outcomes. This article describes the flow of this process and reviews software applications that can be utilized to strengthen the output of the digital workflow. A step-by-step approach to the digital workflow for dentistry consisting of nine "digital touchpoints" is outlined.
Subject(s)
Dental Prosthesis Design , Workflow , Computer-Aided Design , DentistryABSTRACT
This multicenter clinical trial of platform-switched laser-microchannel implants supports findings from a previous preclinical trial. Previous information indicated that an interimplant distance narrower than 3 mm would result in decrease in the crestal bone level, but the results of this investigation suggest that a more optimistic clinical result can be anticipated for implants and abutments with a laser-microchannel surface.
Subject(s)
Alveolar Bone Loss/diagnostic imaging , Alveolar Bone Loss/prevention & control , Dental Implant-Abutment Design , Adult , Aged , Female , Humans , Lasers , Male , Middle Aged , Prospective Studies , Surface Properties , Treatment OutcomeSubject(s)
Dental Prosthesis Design , Dental Prosthesis, Implant-Supported , Esthetics, Dental , Incisor , Patient Care Planning , Alveolar Process/pathology , Alveolar Ridge Augmentation/methods , Dental Abutments , Dental Implant-Abutment Design , Dental Implantation, Endosseous/instrumentation , Dental Implantation, Endosseous/methods , Dental Prosthesis Retention , Gingiva/pathology , Humans , Immediate Dental Implant Loading , Osseointegration/physiology , Patient Care Team , Periodontal Diseases/prevention & control , User-Computer InterfaceABSTRACT
As the biological width is established around neighboring implants, there is a flattening of the interimplant bone and a change in the position of the soft tissue. As a result, a normal progression of papilla from natural teeth through the adjacent implant area is lost. This presentation describes various techniques and strategies to improve the aesthetic outcome of anterior implant restorations, together with the use of a scalloped implant designed to sustain the interdental bony peaks, and in doing so, maintain the interimplant papillae.
Subject(s)
Dental Implantation, Endosseous , Dental Implants , Dental Prosthesis Design , Gingiva/anatomy & histology , Adolescent , Crowns , Cuspid , Dental Abutments , Dental Prosthesis, Implant-Supported , Dental Restoration, Temporary , Esthetics, Dental , Female , Humans , Incisor , Maxilla , Tooth ExtractionSubject(s)
Dental Implantation, Endosseous/methods , Maxilla/surgery , Osteotomy/instrumentation , Bone Matrix/transplantation , Bone Substitutes/therapeutic use , Dental Implantation, Endosseous/instrumentation , Dental Implants , Humans , Jaw, Edentulous/rehabilitation , Jaw, Edentulous/surgery , Minerals/therapeutic useABSTRACT
High-end implant aesthetics requires precise steps from diagnosis through surgery to the restorative phase. These steps are not exclusive of each other. They are deliberate and require a clear understanding of what is possible and the skills that are required to carry out each procedure. Every small advancement will help in the initial and long-term stability of the treatment. This article will dissect implant treatment into key concepts and procedures, illustrating how these steps are crucial to a highly successful aesthetic outcome.