ABSTRACT
BACKGROUND: Dental implants are an important treatment option in contemporary clinical dentistry. The objective of this study was to determine trends in the prevalence of dental implants and implant-supported restorations in adults 50 years and older across demographic groups over a 20-year period. METHODS: The authors used data from the National Health and Nutrition Examination Survey collected during 1999-2004, 2009-2014, and 2015-2020 for analyses. The authors used data from 2011 through 2020 to analyze implant-supported restoration trends. Participants 50 years or older were included in the study analytic sample. The primary outcome was the presence of dental implants and implant-supported restorations. Covariates assessed included dentition status, age, sex, race and ethnicity, education, poverty status, and smoking status. The authors used population estimates, weighted percentages, SEs, and logistic regression models for study analyses. RESULTS: There was a total of 17,114 adults from 1999 through 2020 and 11,292 adults from 2011 through 2020 meeting the inclusion criteria. The prevalence (SE) of at least 1 dental implant increased over time, from 1.3% (0.22%) in 1999-2004 to 8.4% (0.68%) in 2015-2020. In general, those who were non-Hispanic Black, experiencing poverty, and had less than a college education were less likely to have implants than their counterparts. CONCLUSIONS: Although the overall prevalence of implants has increased over time, disparities in prevalence were observed among certain demographic groups. PRACTICAL IMPLICATIONS: The use of dental implants in clinical dentistry has increased over time. Future research and policy initiatives could help address disparities in implant prevalence.
Subject(s)
Dental Implants , Nutrition Surveys , Humans , United States , Middle Aged , Female , Male , Dental Implants/statistics & numerical data , Dental Implants/trends , Aged , Dental Prosthesis, Implant-Supported/statistics & numerical data , PrevalenceABSTRACT
INTRODUCTION: Approximately, 5.5 million dental implants are estimated to be surgically placed in the United States yearly, with an anticipated long-term failure rate ranging from 3% to 10%. At the Salt Lake City Dental Clinic within the Department of Veterans Affairs (VHA), specific protocols have been established to mandate that clinicians present every dental implant case for review by a committee. To understand the effectiveness of this approach, a comparative data analysis was undertaken to compare local dental implant failure data against national VHA data. METHODS: Leveraging electronic health records of veterans spanning from 2000 to 2021, we gathered procedural records related to dental implant placement or failure, demographic information, and medical history for individuals who received dental care at various dental clinics within the nationwide VHA network. Subsequently, statistical analyses were conducted using mixed-effects Poisson regression models with cluster-robust standard errors. Incident rate ratios (IRRs) for Utah-specific and nationwide cohorts were ascertained. RESULTS: The Utah VHA dental clinical data showed that there was a slightly lower prevalence of implant failure at 6.7% compared to the national cohort, which had a rate of 6.9%. The implant level failure rates were also low, with 4.20 (confidence interval [CI]: 3.68, 4.81) per 1000 implant placements per year for Utah cohorts. The adjusted IRR indicated a relative 16% reduction in risk among Utah Veterans (IRR 0.84, 95% CI [0.76-0.92]; p < 0.001). CONCLUSIONS: The stringent protocols in place at Salt Lake City, which integrate evidence-based practices and expert opinion for evaluating patient suitability for dental implant placement and subsequent care, contributed to the reduced risk among Utah Dental Clinic veterans pool compared to veterans of other states.
Subject(s)
Dental Implants , Dental Restoration Failure , Veterans , Humans , Utah , United States , Dental Implants/statistics & numerical data , Veterans/statistics & numerical data , Female , Dental Restoration Failure/statistics & numerical data , Male , Middle Aged , Aged , United States Department of Veterans Affairs/statistics & numerical data , Cohort Studies , Electronic Health Records/statistics & numerical data , AdultABSTRACT
PURPOSE: The purpose of this study was to investigate the association between possible risk factors and early implant failure. PATIENTS AND METHODS: This retrospective cohort study included consecutive patients receiving dental implant treatment in a four-year timeframe. Patient-related variables (age, sex, smoking, and systemic disease), local factors (area, reason for tooth extraction, and bone quality), surgical variables (bone augmentation, time of implant placement, staging, and antibiotic prophylaxis), and implant-related factors (brand, length, and diameter) were analyzed. Bivariate analyses and multivariate logistic regression model were used to determine the variables associated with early implant failure. RESULTS: The study group comprised 1323 implants in 738 patients with a mean of 1.8 implants/patient of which, 53 failed in 52 patients in the early stage (before final prosthetic loading). According to the multivariate model, smoking (Odds Ratio=1.836, P=0.031), posterior maxillary region (OR=2.958, P=0.006), implantation in place of teeth extracted due to periodontal problems (OR=2.531, P=0.004), bone type IV (OR=2.881, P=0.008), implant in previously augmented site (OR=2.239, P=0.014), and immediate provisional prosthesis (OR=3.418, P=0.019) were associated with a significantly higher risk of early implant failure. Narrow implants showed a significantly higher risk of early failure in bivariate analyses (P=0.012). However, the effect was no longer significant in the multivariate model (OR=2.322, P=0.068). CONCLUSION: Early implant failure would be more expected in smokers, posterior maxilla, history of periodontal problems, type IV bone, augmented bone, and immediately loaded cases.
Subject(s)
Dental Implants , Dental Restoration Failure , Humans , Retrospective Studies , Risk Factors , Female , Male , Dental Restoration Failure/statistics & numerical data , Middle Aged , Aged , Dental Implants/adverse effects , Dental Implants/statistics & numerical data , Adult , Smoking/epidemiology , Smoking/adverse effects , Dental Implantation, Endosseous/adverse effects , Dental Implantation, Endosseous/statistics & numerical data , Aged, 80 and over , Tooth Extraction/statistics & numerical data , Tooth Extraction/adverse effectsABSTRACT
In order to advance models of human oral mucosa towards routine use, these models must faithfully mimic the native tissue structure while also being scalable and cost efficient. The goal of this study was to develop a low-cost, keratinized human gingival model with high fidelity to human attached gingiva and demonstrate its utility for studying the implant-tissue interface. Primary human gingival fibroblasts (HGF) and keratinocytes (HGK) were isolated from clinically healthy gingival biopsies. Four matrices, electrospun collagen (ES), decellularized dermis (DD), type I collagen gels (Gel) and released type I collagen gels (Gel-R)) were tested to engineer lamina propria and gingiva. HGF viability was similar in all matrices except for Gel-R, which was significantly decreased. Cell penetration was largely limited to the top layers of all matrices. Histomorphometrically, engineered human gingiva was found to have similar appearance to the native normal human gingiva except absence of rete pegs. Immunohistochemical staining for cell phenotype, differentiation and extracellular matrix composition and organization within 3D engineered gingiva made with electrospun collagen was mostly in agreement with normal gingival tissue staining. Additionally, five types of dental material posts (5-mm diameter x 3-mm height) with different surface characteristics were used [machined titanium, SLA (sandblasted-acid etched) titanium, TiN-coated (titanium nitride-coated) titanium, ceramic, and PEEK (Polyetheretherketone) to investigate peri-implant soft tissue attachment studied by histology and SEM. Engineered epithelial and stromal tissue migration to the implant-gingival tissue interface was observed in machined, SLA, ceramic, and PEEK groups, while TiN was lacking attachment. Taken together, the results suggest that electrospun collagen scaffolds provide a scalable, reproducible and cost-effective lamina propria and 3D engineered gingiva that can be used to explore biomaterial-soft tissue interface.
Subject(s)
Cell Adhesion , Collagen/chemistry , Dental Implants/statistics & numerical data , Fibroblasts/physiology , Gingiva/physiology , Keratinocytes/physiology , Titanium/chemistry , Fibroblasts/cytology , Gingiva/cytology , Humans , Keratinocytes/cytology , Materials Testing , Surface PropertiesABSTRACT
RESUMEN: Comparar mediante una revisión sistemática los resultados clínicos de los procedimientos de cirugía plástica periodontal/periimplantar (CP) con injerto de tejido blando autógeno (ITB) obtenido del área lateral del paladar (ALP) versus del área de la tuberosidad (AT). Se realizó una búsqueda electrónica de ensayos clínicos en la base de datos Medline/Pubmed, Cochrane y las revistas de Periodoncia e Implantes de mayor impacto según la Web of Science, para hallar artículos publicados hasta abril del 2020. Se valoró el riesgo de sesgo de los artículos añadidos según el manual Cochrane Versión 5.1.0 para ensayos clínicos aleatorizados y la escala Newcastle-Ottawa para ensayos clínicos controlados. De una muestra inicial de 930 artículos, cuatro ensayos clínicos (tres aleatorizados) fueron incluidos en el presente estudio, donde se realizaron un total de 87 CP alrededor de piezas e implantes dentales, de las cuales 42 cirugías fueron realizadas con ITB del ALP y 45 cirugías con ITB del AT, se evaluó los resultados desde las 8 semanas hasta los 12 meses. No se hallaron diferencias estadísticamente significativas en los resultados clínicos entre ambos grupos, se mejoró el fenotipo gingival en la zona receptora para el grupo que obtuvo el ITB del AT y el nivel del dolor del sitio donador del AT fue menor en las dos primeras semanas que el sitio donante del ALP. Los estudios incluidos manifestaron un bajo riesgo de sesgo en promedio. Ambas áreas donantes de injerto de tejido blando proporcionan resultados clínicos similares, el injerto del área de la tuberosidad mejora el fenotipo gingival de la zona receptora y reduce el dolor post operatorio en las primeras semanas del sitio donador.
ABSTRACT: The objective of the study was to compare, through a systematic review, the clinical results of periodontal / peri-implant plastic surgery (CP) procedures with autogenous soft tissue graft (ITB) obtained from the lateral palate area (ALP) versus the tuberosity area (AT). We conducted an electronic search of clinical trials in the Medline/Pubmed, Cochrane database and the journals of Periodontics and Implants with the greatest impact according to the Web of Science, to find articles published until April 2020. The risk of bias of the articles added was assessed according to the Cochrane Manual Version 5.1.0 for randomized clinical trials and the Newcastle-Ottawa scale for controlled clinical trials. From the initial sample of 930 articles, four clinical trials were included (three randomized) in the present study, where a total of 87 PC were performed around dental pieces and implants, of which 42 surgeries were performed with ITB of the ALP and 45 surgeries with ITB of the AT, the results were evaluated from the 8 weeks to 12 months. No statistically significant differences were found in the clinical results between the two groups, the gingival phenotype in the receiving area was improved for the group that obtained the ITB of the AT and the level of pain at the donor site was lower in the first two weeks than the ALP donor site. The studies showed a lowrisk of bias on average. Both soft tissue graft donor areas provide similar clinical results, grafting the tuberosity area improves the gingival phenotype of the recipient area and reduces post-operative pain of the donor site in the first few weeks.
Subject(s)
Humans , Dental Implants/statistics & numerical data , Oral Surgical Procedures , Dental Implantation, Endosseous , Palate , Transplantation, Autologous , Selection Bias , Tissue Transplantation , Connective Tissue/transplantation , Gingival RecessionABSTRACT
OBJECTIVE: To describe remodeling of the mesial and distal marginal bone level around platform-switched (PS) and platform-matched (PM) dental implants that were sandblasted with large grit and etched with acid over a three-year period. MATERIALS AND METHODS: Digital periapical radiographs were obtained at the following time-points: during Stage I of the surgical placement of dental implants, before loading, immediately after loading (baseline), and one, three, six, 12, and 36 months after loading for measuring the horizontal and vertical marginal bone levels. RESULTS: Sixty implants were successfully osseointegrated during the overall observation period. Vertical marginal bone levels for the PS and PM dental implants were 0.78 ± 0.77 and 0.98 ± 0.81 mm, respectively, whereas the horizontal marginal bone levels for the PS and PM implants were 0.84 ± 0.45 and 0.98 ± 0.68 mm, respectively. During the time leading up to the procedure until 36 months after the procedure, the average vertical marginal bone level resulted in less bone loss for the PS and PM groups-0.96 ± 1.28 and 0.30 ± 1.15 mm, respectively (p < 0.05). The mean levels of the horizontal marginal bone also showed increases of 0.48 ± 1.01 mm in the PS and 0.37 ± 0.77 mm in the PM groups from the time before loading until 36 months after the procedure. However, these increases were not statistically significant (p > 0.05). CONCLUSION: PS dental implants appeared to be more effective than PM implants for minimizing the mean marginal vertical and horizontal marginal bone loss during the three-year period. Regardless of which abutment connection was used, the dental implant in the present retrospective investigation exhibited minimal marginal bone remodeling, thus indicating long-term stability.
Subject(s)
Alveolar Bone Loss/etiology , Bone-Anchored Prosthesis/statistics & numerical data , Dental Implantation, Endosseous/instrumentation , Dental Implants/statistics & numerical data , Osseointegration , Adult , Aged , Aged, 80 and over , Alveolar Bone Loss/diagnostic imaging , Bone and Bones , Bone-Anchored Prosthesis/adverse effects , Dental Implantation, Endosseous/statistics & numerical data , Dental Implants/adverse effects , Female , Humans , Male , Middle Aged , Radiography, Dental , Retrospective StudiesABSTRACT
Two-implant-retained mandibular overdentures with magnetic attachments can provide an effective treatment modality for edentulous patients. In this study, a three-dimensional finite element analysis was used to compare the biomechanical characteristics of three different types of magnetic attachments in two-implant-retained mandibular overdentures. Flat-type, dome-type, and cushion-type of the magnetic attachments were designed to retain the overdenture. Four types of load were applied to the overdenture in each model: 100 N vertical and oblique loads on the right first molar and a 100 N vertical load on the right canine and the lower incisors. The biomechanical behaviors of peri-implant bone, abutment, and mucosa were recorded. In vertical incisors, vertical right canine, and oblique molar loading condition, the flat-type group exhibited the highest levels of maximum equivalent strain/stress in the peri-implant bone. The total deformation of mucosa and the maximum equivalent strain/stress in the oblique molar loading condition are about two times as the vertical molar loading condition. These results suggested that both cushion-type and dome-type of the magnetic attachments are better choices in two-implant-retained mandibular overdentures, and oblique loading is more harmful than vertical loading.
Subject(s)
Dental Implants/statistics & numerical data , Dental Stress Analysis/statistics & numerical data , Denture, Overlay , Jaw, Edentulous/physiopathology , Jaw, Edentulous/surgery , Models, Dental , Biomechanical Phenomena , Computational Biology , Denture, Overlay/statistics & numerical data , Finite Element Analysis , Humans , Imaging, Three-Dimensional , Magnetics , Mandible/physiopathology , Mandible/surgery , Mathematical Computing , Weight-BearingABSTRACT
This multicenter study aimed to identify the different implant- and patient-related risk factors for long-term short dental implant success. Through a retrospective chart review of three centers, patient information regarding demographic variables, smoking habits, history of periodontitis, systemic diseases, and medications in addition to the parameters for short implant placement including implant manufacturer, design, anatomical location, diameter and length, and type of placement was collected. For statistical analysis, univariate regression models were used at the implant and patient levels. A total of 460 short implants placed in 199 patients followed up for up to 9 years were reviewed. Survival rates of the short implants were 95.86% and 92.96% and success rates were 90% and 83.41% for implant- and patient-based analysis, respectively. Peri-implantitis was reported as the primary cause of short dental implant failure (34/46, 73.91%). Univariate regression models revealed that female sex was strongly related to short implant success. In addition, smoking and history of periodontitis were found to have a significant negative influence on short implant success at the implant and patient levels. Taken together, these results support the use of short implants as a predictable longterm treatment option; however, smoking and history of periodontitis are suggested to be the potential risk factors for short implant success. Therefore, clinicians need to assess these potential risk factors and make treatment decisions accordingly.
Subject(s)
Dental Implants/statistics & numerical data , Dental Restoration Failure/statistics & numerical data , Adult , Age Factors , Dental Prosthesis Design , Female , Follow-Up Studies , Humans , Logistic Models , Male , Middle Aged , Retrospective Studies , Risk Factors , Sex Factors , Treatment OutcomeABSTRACT
OBJECTIVE: Anchorage reinforcement is an important issue in orthodontic treatment. There is a lack of evidence regarding the failure rate of mini-implants inserted in the retromolar (RM) area, therefore the purpose of this present study was to evaluate the failure rates of mini-implants inserted in the RM area and to evaluate the factors affecting their stability. MATERIAL AND METHODS: This retrospective cohort study of 102 patients (52 female, 55 male; mean age: 18.6years; SD: 5.2years) that had received 110 RM mini-implants for orthodontic treatment from 1.2.2012 to 1.6.2017 was conducted after IRB approval at the department of orthodontics. Clinical notes and photographic images of the patients were analysed to evaluate the dependent and independent variables. The primary outcome was mini-implant failure. Independent variables of patient related factors, mini-implant related factors, orthodontic related factors, surgical related factors, and maintenance-related factors were evaluated by logistic regression models for association to failure rates. RESULTS: A 23.2% failure rate of mini-implants inserted in the RM area was observed. The patient's right side and inflammation were significantly associated with RM mini-implant failure. The odds ratios (relative risk) for mini-implant failure in the right side, and in mini-implants with inflammation around them were 0.166 and 0.188, respectively. CONCLUSIONS: Failure rate for RM mini-implants were found to be 23.2%. To minimize RM mini-implant failure, clinicians should attempt to reduce inflammation around the mini-implants, especially for mini-implants placed on the right RM area.
Subject(s)
Bone Screws/statistics & numerical data , Dental Implantation, Endosseous/statistics & numerical data , Dental Implants/statistics & numerical data , Equipment Failure , Orthodontic Anchorage Procedures/instrumentation , Adolescent , Dental Implantation, Endosseous/instrumentation , Equipment Failure Analysis , Female , Humans , Male , Mandible/pathology , Maxilla/pathology , Molar , Orthodontic Appliance Design , Retrospective Studies , Tooth Movement Techniques/instrumentation , Young AdultABSTRACT
Abstract: This multicenter study aimed to identify the different implant- and patient-related risk factors for long-term short dental implant success. Through a retrospective chart review of three centers, patient information regarding demographic variables, smoking habits, history of periodontitis, systemic diseases, and medications in addition to the parameters for short implant placement including implant manufacturer, design, anatomical location, diameter and length, and type of placement was collected. For statistical analysis, univariate regression models were used at the implant and patient levels. A total of 460 short implants placed in 199 patients followed up for up to 9 years were reviewed. Survival rates of the short implants were 95.86% and 92.96% and success rates were 90% and 83.41% for implant- and patient-based analysis, respectively. Peri-implantitis was reported as the primary cause of short dental implant failure (34/46, 73.91%). Univariate regression models revealed that female sex was strongly related to short implant success. In addition, smoking and history of periodontitis were found to have a significant negative influence on short implant success at the implant and patient levels. Taken together, these results support the use of short implants as a predictable longterm treatment option; however, smoking and history of periodontitis are suggested to be the potential risk factors for short implant success. Therefore, clinicians need to assess these potential risk factors and make treatment decisions accordingly.
Subject(s)
Humans , Male , Female , Adult , Dental Implants/statistics & numerical data , Dental Restoration Failure/statistics & numerical data , Logistic Models , Sex Factors , Retrospective Studies , Risk Factors , Follow-Up Studies , Age Factors , Treatment Outcome , Dental Prosthesis Design , Middle AgedABSTRACT
INTRODUCTION: Loss of natural teeth is a debilitating and irreversible process, which leads to functional, cosmetic and psychological morbidities. Dental implant serves as one of the options of tooth replacement, which are stronger, functionally effective and more durable. However, public awareness regarding it has been found to be low in Asian countries. This study was designed to know the status of knowledge and awareness of dental implant. METHODS: Seventy nine patients visiting dental department of Patan Academy of Health Sciences were included in this study through non-probability sampling. Data on knowledge and awareness regarding dental implants were collected through a survey after ethical approval from Institutional Review committee of Patan Academy of Health Sciences. Data entry was done in Epidata and analyzed with the help of Statistical Package of Social Sciences version 20. RESULTS: Total 33 (41.8%) of study populations choose dental implant as alternative for replacing teeth, 22 (30.4%) choose fixed dental prosthesis. 36 (45.6%) and 32 (40.5%) of population stated that long treatment time and high cost respectively as the disadvantages of dental implants. Only 12 (15.2%) were aware that dental implants are anchored in jaw bone. The source of information about dental implants was dentists for 48 (60.8%) of the patients followed by friends, media and medical doctors. CONCLUSIONS: Within the limitations of this study, we conclude that awareness of patients attending tertiary care center of Kathmandu valley is low. Hence, there is a need of organizing dental education programs to create awareness about dental implants.
Subject(s)
Attitude to Health , Dental Implants , Health Literacy , Tertiary Care Centers/statistics & numerical data , Consumer Health Information/standards , Dental Implants/economics , Dental Implants/psychology , Dental Implants/statistics & numerical data , Female , Health Literacy/methods , Health Literacy/standards , Humans , Male , Middle Aged , Needs Assessment , Nepal , Quality ImprovementABSTRACT
INTRODUCTION: Implant therapy is an elective dental procedure of dental rehabilitative treatment. Objective of this study was to assess the knowledge, awareness, and attitude of dental interns of Nepal toward dental implants and to see associations of the responses with gender and geographic location of dental college. METHODS: It was conducted from June 2016 to June 2017 after taking ethical clearance and approval from the research committee. The sample included the interns who were present at the time of the survey. Data collection was done through a cross-sectional questionnaire survey, during clinical postings of the interns at all the dental colleges of Nepal, supervised and monitored by the investigators themselves; coded and entered in Microsoft Excel 2013 and statistical analysis was done by SPSS 20 version. RESULTS: A majority of the interns said they are moderately well informed about dental implants 141 (50.36%); main advantage of dental implants is they are conservative 164 (58.6%); most important factor for implant success is case selection 143 (51.07%); the longevity of dental implants is 10-20yrs, 162 (57.85%), 188 (67.14%) agreed that they were not provided with sufficient information and 191 (68.21%) stated that they need more information; 180 (64.3%) felt the difficulty encountered while placing implants is average and 229 (81.78%) stated that they need more hygiene care than natural teeth. There were major differences in the mindset to some other questions. Significant associations were seen with the location of college for some responses. CONCLUSIONS: A majority of interns have knowledge regarding dental implants, but the percentage of those who gave unsatisfactory answers is also large. They have a positive attitude towards gaining more information through various means.
Subject(s)
Attitude of Health Personnel , Dental Implants , Internship and Residency , Mouth Rehabilitation , Students, Dental , Cross-Sectional Studies , Dental Implants/psychology , Dental Implants/statistics & numerical data , Dental Implants/supply & distribution , Humans , Internship and Residency/methods , Internship and Residency/statistics & numerical data , Mouth Rehabilitation/methods , Mouth Rehabilitation/standards , Needs Assessment , Nepal , Quality Improvement , Students, Dental/psychology , Students, Dental/statistics & numerical data , Surveys and QuestionnairesABSTRACT
OBJECTIVES: This publication reports the EAO Workshop group-2 and consensus plenary discussions and statements on a narrative review providing the background and possible facilities and importance of a dental implant register, to allow for a systematic follow-up of the clinical outcome of dental implant treatment in various clinical settings. It should be observed that the format of the review and the subsequent consensus report consciously departs from conventional consensus publications and reports. MATERIAL AND METHODS: The publication was a narrative review on the presence and significance of quality registers regarding select medical conditions and procedures. The group discussed and evaluated the publication and made corrections and recommendations to the authors and agreed on the statements and recommendations described in this consensus report. RESULTS: Possible registrations to be included in an implant register were discussed and agreed as a preliminary basis for further development, meaning that additional parameters be included or some be deleted. CONCLUSIONS: It was agreed to bring the idea of an implant quality register, including the presented results of discussions and proposals by the group- and plenary sessions, to the EAO Board for further discussion and decision.
Subject(s)
Dental Implantation, Endosseous , Dental Implants , Registries , Dental Implantation, Endosseous/standards , Dental Implantation, Endosseous/statistics & numerical data , Dental Implants/standards , Dental Implants/statistics & numerical data , HumansABSTRACT
The Board of EAO (European Association for Osseointegration) has discussed an initiative to explore the conditions to establish a Dental Implant Register. It was suggested to bring this issue to the EAO Consensus Conference 2018 for a discussion and to possibly propose relevant and manageable parameters. This article presents some select examples from quality registers in the medical field. Based on the experience of established registers, essentially in the medical field, factors considered to be of importance, if and when establishing a Dental Implant Register are introduced and discussed.
Subject(s)
Dental Implantation, Endosseous , Registries , Dental Implantation, Endosseous/standards , Dental Implantation, Endosseous/statistics & numerical data , Dental Implants/standards , Dental Implants/statistics & numerical data , Humans , Quality of Health Care/statistics & numerical dataABSTRACT
OBJECTIVES: Working Group 2 was convened to address topics relevant to prosthodontics and dental implants. Systematic reviews were developed according to focused questions addressing (a) the number of implants required to support fixed full-arch restorations, (b) the influence of intentionally tilted implants compared to axial positioned implants when supporting fixed dental prostheses (FDPs), (c) implant placement and loading protocols, (d) zirconia dental implants, (e) zirconia and metal ceramic implant supported single crowns and (f) zirconia and metal ceramic implant supported FDPs. MATERIALS AND METHODS: Group 2 considered and discussed information gathered in six systematic reviews. Group participants discussed statements developed by the authors and developed consensus. The group developed and found consensus for clinical recommendations based on both the statements and the experience of the group. The consensus statements and clinical recommendations were presented to the plenary (gathering of all conference attendees) and discussed. Final versions were developed after consensus was reached. RESULTS: A total of 27 consensus statements were developed from the systematic reviews. Additionally, the group developed 24 clinical recommendations based on the combined expertise of the participants and the developed consensus statements. CONCLUSIONS: The literature supports the use of various implant numbers to support full-arch fixed prostheses. The use of intentionally tilted dental implants is indicated when appropriate conditions exist. Implant placement and loading protocols should be considered together when planning and treating patients. One-piece zirconia dental implants can be recommended when appropriate clinical conditions exist although two-piece zirconia implants should be used with caution as a result of insufficient data. Clinical performance of zirconia and metal ceramic single implant supported crowns is similar and each demonstrates significant, though different, complications. Zirconia ceramic FDPs are less reliable than metal ceramic. Implant supported monolithic zirconia prostheses may be a future option with more supporting evidence.
Subject(s)
Dental Implants , Dental Prosthesis, Implant-Supported , Dentistry , Prosthodontics , Ceramics/therapeutic use , Consensus , Crowns/standards , Dental Abutments , Dental Implant-Abutment Design/methods , Dental Implantation, Endosseous/standards , Dental Implants/statistics & numerical data , Dental Materials/therapeutic use , Dental Prosthesis Design/methods , Dental Prosthesis, Implant-Supported/methods , Dental Prosthesis, Implant-Supported/standards , Dental Restoration Failure , Dental Restoration, Permanent/standards , Denture, Complete/standards , Denture, Partial, Fixed/standards , Humans , Meta-Analysis as Topic , Metal Ceramic Alloys/therapeutic use , Systematic Reviews as Topic , Time Factors , Treatment Outcome , Zirconium/therapeutic useABSTRACT
RESUMEN: El objetivo de esta investigación fue analizar la etiología de las pérdidas dentales en pacientes rehabilitados con prótesis sobre implantes. Se realizó un estudio transversal con informaciones de 93 pacientes de una clínica privada que recibieron tratamiento con implantes en el período de 2000 a 2009. Los datos fueron recolectados a través de las fichas clínicas, documentaciones radiográficas y fotografías de los casos clínicos. Se levantaron datos sobre género, edad, nivel de escolaridad, hábito de fumar, tipo de diente extraído y razón de la extracción. Los resultados mostraron que la razón periodontal fue el principal motivo de las pérdidas dentales, representando el 24,7 %, seguida por las fracturas radiculares con pines metálicos (23,7 %) y caries secundarias (15,1 %). En los pacientes menores de 40 años, los traumatismos dentales y las fracturas radiculares con pino fueron responsables de la mayoría de las pérdidas. Las razones de las pérdidas dentales mostraron significancia estadística con la variable edad (p<0,05). El género, el hábito de fumar y el grado de escolaridad no mostraron asociación significativa (p>0,05) con las razones de las pérdidas dentales.
ABSTRACT: The aim of this study was to analyze the etiology of tooth loss in patients rehabilitated with dental implants. Was conducted a cross-sectional study with data from 93 patients from a private clinic who were treated with implants from the year 2000 until 2009. Data were collected through medical records, radiographic documentation and photographs of clinical cases. Data on sex, age, education level, smoking habits, teeth loss localization and extraction ratio were analyzed. The results showed that periodontal disease was the main reason for tooth loss, accounting for 24.7 %, followed by root fractures with posts (23.7 %) and secondary caries (15.1 %). In patients below 40 years, dental trauma and root fractures were responsible for most of the losses. The reasons for tooth loss showed statistical significance with the age (p<0.05). Sex, smoking habits and education showed no significant association (p>0.05) with the reasons of the tooth loss.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Dental Implants/statistics & numerical data , Tooth Loss/etiology , Dental Implantation, Endosseous/methods , Brazil , Ethics Committees , Sample SizeABSTRACT
CONTEXT: India suffers from a heavy burden of oral diseases. Dental implants (DIs) are prescribed widely by the dental practitioners to replace lost natural teeth. There is no estimate, however, to determine the number of DIs or the number of people with peri-implantitis or the failure of implants after placement. In this modeling study, we attempted to estimate the prevalence of adult Indians who would choose DI in the near future and to calculate the peri-implantitis and failure of DI. MATERIALS AND METHODS: Using the Global Burden of Disease database (2016), the number of dental caries in permanent dentition, periodontal diseases, and edentulism was obtained. Empirical assumptions of patients with anodontia in urban and rural areas who opted for DI, percentage of implants placed, the affordability factors, and mathematical models for DI were formed and executed. Peri-implantitis and survival data from literary evidence were collated. RESULTS: Based on assumptions, 909,643 Indians, (830,231-858,703) would choose DI. Estimated number of peri-implantitis would be 145,543-254,700 and estimated number of failures should be 50,940-79,412 in the near future. CONCLUSIONS: In spite of the high economic challenge and the risks or complications of peri-implantitis, DIs are gaining prominence. It is the dentists' burden to face the renewed challenges due to emerge and provide remedial measures.
Subject(s)
Cost of Illness , Dental Implantation/statistics & numerical data , Dental Implants/statistics & numerical data , Dental Restoration Failure/statistics & numerical data , Models, Theoretical , Peri-Implantitis/epidemiology , Adolescent , Adult , Aged , Dental Implantation/adverse effects , Dental Implants/adverse effects , Female , Humans , India/epidemiology , Male , Middle Aged , Peri-Implantitis/etiology , Prevalence , Prosthesis Failure , Young AdultABSTRACT
OBJECTIVE: Many studies have investigated the effect of implant number on the performance of implant-supported overdentures (ISO), but few have focused on denture movement. This in-vitro study aims to investigate the influence of implant number on the movement of mandibular ISO under biting force. METHOD AND MATERIALS: An edentulous mandibular cast and 12 overdentures (n = 12) were fabricated, and a locator attachment system with blue nylon inserts was chosen for this study. Four implant positions were simulated: anterior midline (1-ISO), bilateral canine regions (2-ISO), anterior midline and bilateral molar regions (3-ISO), and bilateral canine and molar regions (4-ISO). After positioning an overdenture on one of these four casts, vertical loads were applied to the incisor region (40 N), the left canine (55 N), or molar (100 N) regions. The movements at the loading point and the right distal edge were measured. Significance across groups was analyzed using one-way analysis of variance and post hoc Tukey honest significant difference test. P < .05 was considered statistically significant. RESULTS: On incisor loading, the 3-ISO showed the least movement, and no significant movement was detected across the other three groups. Upon canine loading, the largest displacement appeared in the 1-ISO group, at both the loading point and the right distal edge. Additionally, overdentures anchored by three or four implants, especially the 4-ISO, showed significantly smaller movement on molar loading. CONCLUSION: The implant number influences the movement of mandibular ISO, and overdentures retained with three or more implants have minimal movement.
Subject(s)
Dental Implants/statistics & numerical data , Dental Prosthesis, Implant-Supported , Denture Retention , Denture, Complete, Lower , Denture, Overlay , Bite Force , Dental Stress Analysis , Denture Design , In Vitro Techniques , Mandible , Mechanical Phenomena , MovementABSTRACT
BACKGROUND: The mandibular canal and its content represent the vital structure, which can complicate dentoalveolar surgical procedures in the posterior region of the mandible. The purpose of the present study was to determine the path the mandibular canal takes in relation to the horizontal and the vertical anatomical reference planes in edentate subjects, in order to minimize the risk of affecting its neurovascular content during various oral surgery procedures. MATERIALS AND METHODS: Morphometric evaluations were performed on 12 dried fully edentulous human mandibles and on cone-beam computed tomography (CBCT) cross-sectional images of the mandible, from 20 patients with either partial or complete edentulism. Both methods were utilized, in three target areas (corresponding to the second premolar, to the first molar and to the second molar regions), in order to measure the distance between the mandibular canal and the following reference points: (i) the lateral (buccal) surface of the mandible (MC-BS distance); (ii) the medial (lingual) surface of the mandible (MC-LS distance); (iii) the alveolar surface of the mandible (MC-AS distance). The results were statistically processed in Stata MP/13 software package using analysis of variance (ANOVA) test. RESULTS: The mandibular canal crossed the trabecular bone from the posterior towards the anterior, and from the lingual towards the buccal, reaching the premolar region, distal to the mental foramen, where it was located in the centre of the trabecular bone, main topographic pattern encountered in 27 (84.37%) of the cases. In five (15.63%) of the cases, in the premolar region, the mandibular canal was located near the buccal cortical plate. The mandibular canal descended from the second molar region towards the premolar region, main topographic pattern found in 28 (87.5%) of the cases. In four (12.5%) cases, the mandibular canal had a descending trajectory in the molar regions and it took a slightly ascending course in the premolar region. CONCLUSIONS: According to the results, the second molar region represents the highest risk area in the accidental injury to the content of the mandibular canal, during various oral surgery procedures.
Subject(s)
Dental Implants/statistics & numerical data , Mandible/anatomy & histology , Female , Humans , MaleABSTRACT
To accurately assess the long-term performance of anodized-surface implants, more data monitoring is needed outside of clinical evaluations. This retrospective study evaluated long-term implant survival and bone remodeling after up to 12 years of function. Data from 195 implants placed in 60 patients over a follow-up period ranging from 0.6 to 12.1 years were included. The implant-level survival rate was 99.0%. Marginal bone loss remained low across all follow-up cohorts. The data show that anodized-surface implants are a safe, reliable option with high implant survival rates and low levels of bone loss.