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1.
Artículo en Inglés | MEDLINE | ID: mdl-33528448

RESUMEN

The aim of this article is to propose a simplified digital protocol for the treatment of the fully edentulous patient, using an immediate implant and immediate loading protocol to deliver a polymethyl methacrylate metal-reinforced hybrid prosthesis. Ten consecutive patients were treated with this approach. At the end of 1 year, there was an implant survival rate of 97.8% and a prosthetic success rate of 100%. Based on the responses to the quality of life questionnaire, patients had a high acceptance rate for this treatment protocol. Within the limits of this case series, the proposed simplified digital protocol could be utilized for reconstruction in the fully edentulous patient and for delivering an implant-supported prosthesis immediately after implant placement.


Asunto(s)
Implantes Dentales , Carga Inmediata del Implante Dental , Arcada Edéntula , Boca Edéntula , Implantación Dental Endoósea , Prótesis Dental de Soporte Implantado , Estudios de Seguimiento , Humanos , Arcada Edéntula/cirugía , Boca Edéntula/cirugía , Calidad de Vida , Resultado del Tratamiento
2.
Int J Prosthodont ; 34: s8-s20, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33571323

RESUMEN

The tasks of Working Groups 1 to 6 at the 4th Consensus Meeting of the Oral Reconstruction Foundation were to elucidate clinical recommendations for implant-supported full-arch rehabilitations in edentulous patients. Six systematic/narrative reviews were prepared to address the following subtopics: (1) the influence of medical and geriatric factors on implant survival; (2) the prevalence of peri-implant diseases; (3) the influence of material selection, attachment type, interarch space, and opposing dentition; (4) different interventions for rehabilitation of the edentulous maxilla; (5) different interventions for rehabilitation of the edentulous mandible; and (6) treatment choice and decision-making in elderly patients. Consensus statements, clinical recommendations, and implications for future research were determined based on structured group discussions and plenary session approval.


Asunto(s)
Implantes Dentales , Arcada Edéntula , Boca Edéntula , Anciano , Consenso , Prótesis Dental de Soporte Implantado , Humanos , Maxilar
3.
Int J Prosthodont ; 34: s63-s84, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33571327

RESUMEN

PURPOSE: To synthesize evidence derived from systematic reviews (SRs) on different interventions for rehabilitation of the edentulous maxilla with implant-supported restorations. MATERIALS AND METHODS: A protocol-oriented search was established to address the PICO question: What is the current evidence regarding rehabilitation of the edentulous maxilla with different implant-supported prostheses in terms of implant and prosthesis survival? The primary outcomes were implant and prosthesis survival rates evaluated from SRs of clinical studies including adult patients with complete edentulism of the maxilla and comparing different implant-supported rehabilitation strategies. Methodologic quality of the SRs was assessed with the AMSTAR-2 tool. RESULTS: The final selection process led to the inclusion of 36 SRs that were grouped as: (1) addressing maxillae with sufficient bone to place implants; (2) addressing maxillae with insufficient bone to place implants; and (3) comparing different types of prosthesis, number of implants, patient-reported outcomes, and economic evaluations. The literature describes four or more implants as suitable for full-arch fixed prostheses and implant-supported overdentures; in both cases, the overall survival rate is > 95%. Mini-implants present very high short-term failure rates (> 30%). Poor description of technical complications, adjustments, and maintenance and corresponding costs precluded a cost-effectiveness analysis. CONCLUSION: No implant-supported rehabilitation of the edentulous maxilla (fixed or removable) should be supported on fewer than four implants. A one-piece full-arch fixed dental prosthesis can be supported by a minimum of two anterior axial plus two posterior distally tilted implants or by six to eight axial implants symmetrically distributed through the posterior and anterior regions of the arch. Four to six implants is the advised number to support an overdenture. The use of mini-implants in the maxilla is inadvisable.


Asunto(s)
Implantes Dentales , Arcada Edéntula , Boca Edéntula , Adulto , Prótesis Dental de Soporte Implantado , Fracaso de la Restauración Dental , Estudios de Seguimiento , Humanos , Maxilar/cirugía , Resultado del Tratamiento
4.
Int J Oral Maxillofac Implants ; 36(1): 21-29, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33600519

RESUMEN

PURPOSE: To assess the postoperative complications and outcome (implant survival) of quad zygomatic implants inserted in patients with edentulism and severely atrophic maxillae. MATERIALS AND METHODS: Two independent reviewers conducted an electronic search of the literature (PubMed, Scopus, EBSCO, Web of Science) from January 2000 to February 2019. The inclusion criteria were articles published in English reporting data of at least five patients with severely atrophic edentulous maxillae undergoing placement of four zygomatic implants without additional insertion of standard implants, with a minimum of 6 months of follow-up. Data extracted included number of patients, characteristics of the maxillary defect, number of zygomatic implants, implant details, surgical procedure, prosthetic rehabilitation, postoperative complications, survival rate, and length of follow-up after definitive prosthesis delivery. RESULTS: Eleven studies with 166 patients were included. The heterogeneity among studies was not significant. The pooled incidence rates of complications were as follows: sinusitis 12% (95% confidence interval [CI]: 4% to 23%), malposition and surgical guiding failure 11% (95% CI: 3% to 21%), local infection/injury 10% (95% CI: 3% to 18%), and prosthetic complications 5% (95% CI: 0% to 13%). The implant survival rate ranged between 95.8% and 100%, and the pooled implant survival rate in the meta-analysis was 98% (95% CI: 97% to 99%). CONCLUSION: Quad zygomatic implants inserted in patients with severely atrophic edentulous maxillae have a high implant survival rate, but the incidence of complications should not be underestimated.


Asunto(s)
Implantes Dentales , Arcada Edéntula , Implantación Dental Endoósea/efectos adversos , Implantes Dentales/efectos adversos , Prótesis Dental de Soporte Implantado , Estudios de Seguimiento , Humanos , Arcada Edéntula/cirugía , Maxilar/cirugía , Resultado del Tratamiento , Cigoma/cirugía
5.
Compend Contin Educ Dent ; 42(1): S1-S4, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33481628

RESUMEN

The treatment of the moderate to advanced resorbed edentulous maxilla with a fixed prosthesis is complicated due to the presence of pneumatized maxillary sinuses posteriorly and the nasal aperture in the premaxilla. To treat patients with this condition using endosseous implants to support a functional prosthesis, grafting procedures have been advocated. The multiple surgical steps involved in the reconstruction of the resorbed maxilla, however, can be a significant barrier to patient acceptance of grafting treatment protocols. The success of graftless concepts using tilted and zygomatic implants has led to a higher case acceptance as the treatment can be accomplished in one appointment. Over the past two decades, the experience clinicians have gained using zygomatic implants has resulted in a redesign of the implant aimed at addressing the challenges associated with the treatment of patients with moderate to advanced resorbed maxillae to better serve these patients.


Asunto(s)
Implantes Dentales , Arcada Edéntula , Enfermedades Periodontales , Implantación Dental Endoósea , Prótesis Dental de Soporte Implantado , Estudios de Seguimiento , Humanos , Arcada Edéntula/cirugía , Rayos Láser , Maxilar/cirugía
6.
Dent Clin North Am ; 65(1): 135-165, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33213707

RESUMEN

More patients are requesting fixed prosthesis to replace missing teeth. More than 5 million dental implants are placed annually in the United States. This number will decrease in 2020 owing to the coronavirus disease-19 pandemic. The edentulous patient has a decreased quality of life. Prosthodontic rehabilitation/reconstruction of edentulism improves overall quality of life. Patient-reported outcome measures are subjective reports of patients' perceptions of their oral health status and the impact that it has on their quality of life. This chapter contains a variety of prosthodontic principles for the reader to help satisfy the needs and expectations of the patient.


Asunto(s)
Infecciones por Coronavirus , Coronavirus , Implantes Dentales , Arcada Edéntula , Pandemias , Neumonía Viral , Betacoronavirus , Prótesis Dental de Soporte Implantado , Prótesis de Recubrimiento , Humanos , Pandemias/prevención & control , Calidad de Vida
7.
Niger J Clin Pract ; 23(12): 1767-1771, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33355833

RESUMEN

Alveolar bone loss subsequent to long-term edentulism and trauma may be severe and treatment plan is always an esthetic and functional challenge. Implant supported hybrid prosthesis is widely regarded as an effective treatment option for patients with excessive and irregular bone loss. However, implant placement is occasionally impossible without surgical procedures in such cases. This case report presents rehabilitation of 19-year-old maxillary anterior edentulous male patient with maxillary anterior bone defect and excessive cross-bite anterior closure with multidisciplinary approach. The patient was rehabilitated with implant supported hybrid prosthesis with Malo Bridge design following autogeneous iliac bone augmentation, teeth leveling with orthodontic treatment, and surgical placement of three implants. Esthetics, pleasing phonetics and function were achieved as desired with this treatment option and no complications were observed.


Asunto(s)
Pérdida de Hueso Alveolar , Aumento de la Cresta Alveolar , Implantes Dentales , Arcada Edéntula , Procedimientos Quirúrgicos Reconstructivos , Adulto , Pérdida de Hueso Alveolar/cirugía , Trasplante Óseo , Prótesis Dental de Soporte Implantado , Humanos , Arcada Edéntula/cirugía , Masculino , Maxilar/cirugía , Resultado del Tratamiento , Adulto Joven
8.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(11): 845-850, 2020 Nov 09.
Artículo en Chino | MEDLINE | ID: mdl-33171557

RESUMEN

Objective: To evalute the accuracy and clinical outcome of a real-time navigation system for the placement of quad zygomatic implants. Methods: Twenty-four patients [9 males and 15 females, mean age was (50.8±14.7) years old], from January 2015 to December 2019, with 96 zygomatic implants placed under a real-time navigation system in Department of Second Dental Center and Department of Oral Implantology of Ninth People's Hospital, Shanghai Jiaotong University School of Medicine were included in the study. The preoperative and the postoperative multislice CT or cone-beam CT were fused to measure and record the entry, exit and angle deviation between the planned and placed implants. The implants were divided into groups according to implant insertion approach (real-time navigation and free-hand), implant length (<47.5 mm and ≥47.5 mm) and implant position (proximal and distal implant). And the differences of implant accuracy were analyzed. The intraoperative and postoperative complications were also recorded. The implant survival rate was evaluated after 6 months follow-up. A P value<0.05 indicates statistical significance. Results: The mean entry, exit and angle deviation of zygomatic implants were (1.49±0.64) mm, [2.03(1.58, 2.40)] mm and (2.49°±1.12°), respectively. The average entry, exit and angle deviation of the navigation guided implant insertion group were (1.45±0.60) mm, (1.96±0.44) mm and (2.66±1.13°) respectively, while those of the free-hand group were (1.50±0.64) mm, (2.04±0.79) mm and (2.50°±1.13°) respectively. There was no significant difference between the two groups (P>0.05). The average entry, exit and angle deviation of the group with length<47.5 mm were (1.42±0.60) mm, (2.13±0.60) mm and (2.61°±1.08°) respectively and those of the group with length ≥ 47.5 mm were (1.52±0.65) mm, (1.98±0.82) mm and (2.43°±1.14°) respectively. No significant difference was found between the two groups (P>0.05). In proximal implant group, the average entry, exit and angle deviation were (1.55±0.69) mm, (2.05±0.92) mm and (2.48°±1.16 °) respectively while those of distal implant group were (1.43±0.57) mm, (2.01±0.57) mm and (2.49°±1.10°), respectively. No significant difference was detected between the two groups (P>0.05). All zygomatic implants were placed uneventfully. There were no intra-operative complications, and post-operative reversible complications developed in 3 patients. Two zygomatic implants were lost and the overall zygomatic implant survival rate was 97.9% (94/96) within a follow-up of 6 months. Conclusions: Quad zygomatic implant placement can be achieved with high accuracy and predictable clinical outcome under guidance of a real-time navigation system.


Asunto(s)
Implantes Dentales , Arcada Edéntula , Cirugía Asistida por Computador , Adulto , Anciano , China , Implantación Dental Endoósea , Femenino , Humanos , Arcada Edéntula/cirugía , Masculino , Maxilar/cirugía , Persona de Mediana Edad , Cigoma/cirugía
9.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(11): 864-870, 2020 Nov 09.
Artículo en Chino | MEDLINE | ID: mdl-33171560

RESUMEN

Objective: To evaluate long-term clinical outcome of implant-supported fixed prosthesis with the guidance of computer-aided design/computer-aided manufacturing (CAD/CAM) surgical template in old patients. Methods: Fifteen 50-67(58.6±5.3) year-old patients (11 males and 4 females) who received the digital implant surgery with the guidance of CAD/CAM surgical template and implant-supported fixed prosthesis in Department of Oral Implantology, Yantai Stomatological Hospital Affiliated to Binzhou Medical College from August, 2013 to Janurary, 2016 were included. There are 15 edentulous maxillas, 8 edentulous mandibles on which 145 implants were placed in total. After the placement of implant, the accuracy of CAD/CAM surgical template was assessed by comparing the post-operative 3-dimensional location of implant with the pre-operative design. The 5-year survival rate of implant and prosthesis was recorded, and marginal bone loss around implants and the development of complication were evaluated by radiological and clinical examination respectively. Results: The result on accuracy of CAD/CAM surgical template showed that deviations in neck and apex of implants were (0.78±0.59) and (1.38±0.63) mm respectively, depth deviation was (0.65±0.35) mm and angle deviation was 4.12°±2.77°. The 5-year cumulative survival rate of implants was 98.6%(143/145). In all 145 implants, the prevalence of implant-related biological complication was 4.1%(6/145). The prosthesis-related mechanical complication rate was 57%(13/23). After 5-year function, mean peri-implant bone loss was (0.69±0.35) mm. Conclusions: This 5-year follow-up retrospective study showed that implant-supported fixed prosthesis with the guidance of CAD/CAM surgical template in middle aged and elderly patients could achieve good long-term clinical outcome and patient satisfaction.


Asunto(s)
Implantes Dentales , Arcada Edéntula , Cirugía Asistida por Computador , Anciano , Diseño Asistido por Computadora , Implantación Dental Endoósea , Prótesis Dental de Soporte Implantado , Femenino , Humanos , Arcada Edéntula/cirugía , Masculino , Persona de Mediana Edad , Estudios Retrospectivos
10.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(11): 891-896, 2020 Nov 09.
Artículo en Chino | MEDLINE | ID: mdl-33171564

RESUMEN

Objective: To evaluate the clinical outcomes of digital technique-aided occlusal rehabilitation based on implant-supported fixed prostheses (ISFP), and to provide some information for clinical application of digital technique. Methods: Retrospectively reviewed the cases which had used neuromuscular system and condylar movement tracing device to reconstruct occlusion in one or double jaw fully edentulous ISFP from January, 2013 to January, 2020. A total of 6 eligible patients were enrolled in the present study with 56 implants and 8 ISFP, including 4 male patients and 2 female patients, aged from 43 to 74 years. The clinical outcomes were evaluated in four aspects, including implant survival rate, implants success rate, marginal bone loss and the occurrence of prosthesis complications. Results: The follow-up time was (4.0±2.2) years (1-7 years). The implant survival rate was 100% (56/56) and the implant success rate was 98% (55/56), with an average missal and distal marginal bone loss of (0.04±0.11) mm/year. Veneer chipping occurred at incisal edge of 2 adjacent incisors in only one prosthesis 3 years after rehabilitation. Conclusions: Combination of digital techniques of neuromuscular system and condylar movement tracing device to assist occlusal rehabilitation based on ISFP showed a high implant success rate. The complication seldom happened. Long and stable occlusion has been observed. The clinical outcomes were favorable.


Asunto(s)
Implantes Dentales , Arcada Edéntula , Boca Edéntula , Adulto , Anciano , Implantación Dental Endoósea , Diseño de Prótesis Dental , Prótesis Dental de Soporte Implantado , Fracaso de la Restauración Dental , Femenino , Estudios de Seguimiento , Humanos , Arcada Edéntula/cirugía , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Resultado del Tratamiento
11.
Int J Prosthodont ; 33(5): 565-571, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32956438

RESUMEN

This case history report describes a comprehensive digital workflow for implant treatment and occlusal reconstruction to provide a systematic protocol for implant-supported restorations in edentulous patients. In this case, a restoration-oriented surgical protocol was created using an oral implant planning and design software. The implant surgery was completed under the guidance of a fully guided surgical template. This is the first report of the combined application of computer-aided diagnosis axiograph and neuromuscular evaluation systems in implant-supported occlusal reconstruction. Digital technologies can increase the accuracy, efficiency, and comfort of implant treatment and achieve satisfactory occlusal reconstruction outcomes in edentulous patients.


Asunto(s)
Implantes Dentales , Arcada Edéntula/cirugía , Cirugía Asistida por Computador , Diseño Asistido por Computadora , Implantación Dental Endoósea , Prótesis Dental de Soporte Implantado , Humanos , Mandíbula , Flujo de Trabajo
12.
Niger J Clin Pract ; 23(9): 1328-1331, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32913176

RESUMEN

It is possible to rehabilitate fully edentulous patients with implantsupported fixed or removable prostheses; however, implantsupported fixed prostheses are the gold standard for patients who not prefer to use removable dentures. This case report, prosthetic rehabilitation of a completely edentulous young patient with an implantsupported fixed hybrid prosthesis using the "Malo Bridge" technique is described. A 18 years old male patient was referred to the clinic with complaints of tooth loss, aesthetics, function, and phonetic. A total of 5 implants were placed in both the jaws. Considering that screw holes may cause aesthetic problems due to the Class III occlusion, these problems have been solved with the implant-supported hybrid prosthesis called Malo bridge. With the Malo Bridge design, the patient's aesthetic, functional and phonetic loss was eliminated, patient comfort and quality of life were improved, and patient expectations were met. It is a viable treatment option to rehabilitate completely edentulous jaws with a cross relationship and increase interarch distance using Malo Bridge to support a fixed prosthesis.


Asunto(s)
Implantes Dentales , Prótesis Dental de Soporte Implantado , Arcada Edéntula/rehabilitación , Maxilar/cirugía , Calidad de Vida , Pérdida de Diente/psicología , Adolescente , Diseño de Prótesis Dental , Retención de Dentadura/instrumentación , Humanos , Arcada Edéntula/cirugía , Masculino , Fonética , Radiografía Panorámica , Resultado del Tratamiento
13.
Int J Oral Maxillofac Implants ; 35(5): 995-1004, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32991651

RESUMEN

PURPOSE: To describe the prevalence of alveolar bone atrophy in edentulous arches of elderly individuals in relation to insertion of dental implants and the eventual need for bone grafting procedures. MATERIALS AND METHODS: Computed tomography scan files of 228 edentulous arches of elderly patients (ages 65 to 100 years) were evaluated in relation to implant placement. Six measurements per arch were taken on cross-sectional reconstructions. Bone atrophy categories were described, in relation to implant placement, for the anterior and posterior sections of the arches. Six bone sections per arch were evaluated and allocated to the predetermined categories. Prevalence of each type of atrophy was calculated. RESULTS: In the maxilla, only 5.0% of the patients showed a bone anatomy capable of receiving implants without any augmentation both in the posterior and anterior regions; 64.4% showed the need for major reconstruction in both areas. In the mandible, 17.3% of the patients did not require any augmentation in both regions; 9.4% were in need of major reconstruction in both areas. The anterior part of the arches could eventually be treated without any bone augmentation in 10.9% of the maxillae and 72.4% of the mandibles, while minor augmentation was needed in 16.8% of maxillae and 15.8% of mandibles. CONCLUSION: Most edentulous elderly patients show some degree of alveolar bone atrophy. It is often feasible to insert implants in the anterior mandible to support a restoration. In most maxillary cases, alveolar atrophy calls for augmentation procedures in both the anterior and posterior areas. In elderly individuals, the anterior maxilla often shows bone deficiency interfering with simple implant placement procedures, thus also limiting the use of tilted implants.


Asunto(s)
Implantes Dentales/efectos adversos , Arcada Edéntula/diagnóstico por imagen , Arcada Edéntula/cirugía , Boca Edéntula/diagnóstico por imagen , Boca Edéntula/cirugía , Anciano , Anciano de 80 o más Años , Estudios Transversales , Implantación Dental Endoósea/efectos adversos , Humanos
14.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(8): 555-564, 2020 Aug 09.
Artículo en Chino | MEDLINE | ID: mdl-32842347

RESUMEN

Objective: To evaluate the outcomes of immediate rehabilitation of the edentulous and potential edentulous jaws with implant-supported full-arch prostheses and analyse the risk factors of the complications. Methods: This retrospective study included 273 patients treated with immediate rehabilitation of the edentulous and potential edentulous jaws with implant-supported full-arch prostheses from April 2008 to December 2018 in Department of Implantology, Peking University School and Hospital of Stomatology. The patients' sex, age, place of residence, jaw position, opposing dentition, number of implants, diameter and length of implants, abutment height and abutment angle were recorded. The survival rate of implants and marginal bone loss were calculated and analyzed. Cox proportional hazards ratio model was adopted to analyze the potential risk factors of prosthetic complications. Results: A total of 225 patients (288 jaws) and 1 260 implants were included, with 126 males and 99 females, aged (57.3±11.0) years, with a following time of (5.04±3.08) years. The 1-year cumulative survival rate of implants was 98.0% (1 235/1 260). Forty-eight implants were lost during the follow-up, with 39 implants in the maxillae and 9 implants in the mandible. The risk of implant failure of the maxillae ï¼»7.2% (39/541)] is significantly higher than that of the mandible ï¼»1.3% (9/719)] (P<0.01). Average marginal bone loss at 1 and 5 years was (0.7±0.2) mm and (1.1±0.3) mm. One hundred and twenty patients experienced prosthetic complications including screw/abutment loosening (44 cases), screw/abutment fracture (2 cases) and artificial tooth/denture base fracture (99 cases). The possibility of immediate prosthesis fracture within 6-8 months was high but declined over the following years with the final prosthesis delivered. Cox regression analysis showed that the use of 17° abutments in the anterior region was significantly related to the prosthetic complications (hazard ratio=1.797, P=0.002). Conclusions: Immediate rehabilitation of the edentulous jaws with implant-supported full-arch prostheses can be a predictable technique. The immediate prosthetic mechanical complication prevalence was high. The use of 17° abutments in the anterior region may increase the risk of screw/abutment loosening. It is necessary to review in time.


Asunto(s)
Implantes Dentales , Carga Inmediata del Implante Dental , Arcada Edéntula/cirugía , Boca Edéntula , Anciano , Prótesis Dental de Soporte Implantado , Fracaso de la Restauración Dental , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Resultado del Tratamiento
15.
Av. odontoestomatol ; 36(2): 63-70, mayo-ago. 2020. ilus
Artículo en Español | IBECS | ID: ibc-194687

RESUMEN

Se presenta un caso clínico en el que se rehabilita a una paciente con maxilar superior atrófico mediante una combinación de implantes cigomáticos, colocados mediante una aproximación exteriorizada, e implantes anteriores convencionales palatinizados. Se realizó un procedimiento de regeneración ósea guiada alrededor de los implantes cigomáticos para obtener un mayor grosor de la cortical vestibular y palatina alrededor de los implantes del maxilar superior y mejorar el pronóstico. A un año de la carga protésica, el hueso periimplantario se mantiene estable


A clinical case is presented in which a patient with atrophic upper jaw is rehabilitated by a combination of zygomatic implants, placed using an exteriorized approach, and conventional palatalized anterior implants. A guided bone regeneration procedure is performed around the zygomatic implants to obtain a greater thickness of the facial bone and improve the prognosis. One year after loading, the peri-implant bone remains stable


Asunto(s)
Humanos , Femenino , Anciano , Regeneración Ósea , Atrofia/diagnóstico por imagen , Implantes Dentales , Implantación Dental Endoósea/métodos , Arcada Edéntula/cirugía , Cigoma/cirugía , Atrofia/cirugía , Maxilar/anomalías , Maxilar/cirugía , Cigoma/diagnóstico por imagen
16.
Av. odontoestomatol ; 36(2): 81-88, mayo-ago. 2020. ilus, tab
Artículo en Español | IBECS | ID: ibc-194689

RESUMEN

INTRODUCCIÓN: La implantología oral puede constituir una modalidad terapéutica en el tratamiento prostodóncico de los pacientes con compromiso médico. El estudio muestra la evaluación del tratamiento con implantes en pacientes con diabetes comparados con pacientes sin diabetes. MÉTODOS: 48 pacientes edéntulos totales (24 pacientes diabéticos y 24 no diabéticos) fueron tratados con 96 implantes con superficie arenada y grabada Galimplant ® en la mandíbula para su rehabilitación prostodóncica con sobredentaduras mandibulares. 2 implantes fueron insertados en cada paciente. Los implantes fueron cargados funcionalmente tras un periodo de tiempo de 6 semanas con retenedores de fricción. Los hallazgos clínicos (implantológicos y prostodóncicos) se han seguido durante 7 años. RESULTADOS: Los resultados indican una supervivencia de los implantes del 95,8%. Durante el periodo de seguimeinto clínico se perdieron 4 implantes (dos implantes en cada grupo). La pérdida de hueso marginal media fué de 0,7 mm en ambos grupos. El 100% de los pacientes fueron tratados mediante una sobredentadura implantorretenida con anclajes de fricción. En 14 pacientes se realizaron cambios en los componentes plásticos de los ataches. El seguimiento clínico medio fue de 82,5 meses (60-102 meses). CONCLUSIONES: Los resultados del presente estudio indican que el tratamiento con implantes dentales en pacientes diabéticos es una terapéutica exitosa sin diferencias entre los pacientes diabéticos y no diabéticos


INTRODUCTION: Implant dentistry can to constitute a therapeutic modality in the prosthodontic treatment of medically compromised patients. This study reports the evaluation of treatment with implants in patients with diabetes compared with patients without diabetes. METHODS: 48 edentulous patients (24 diabetic patients and 24 non-diabetic patients) were treated with 96 Galimplant ® sand-blasted and acid-etched surface implants for prosthodontic rehabilitation with mandibular overdentures. Two implants were inserted in each patient. Implants were loaded after a healing free-loading period between 6 weeks with locator attaches. Clinical findings (implant and prosthodontics) were followed during at 7 years. RESULTS: Clinical results indicate a survival rate of implants of 95.8% in both groups. Four implant was lost during the follow-up period (two implants in each group). Media marginal bone loss was 0.7 mm in both groups. 100% of patients were treated with overdentures retained with 2 implants with locator attaches. Changes in plastic components of attaches were reported in 14 patients. The media follow-up was of 82.5 months (60-102 months). CONCLUSIONS: Clinical results of this study indicate that treatment with dental implants in diabetic patients is a successful implant treatment without differences with nondiabetic patients


Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Implantes Dentales , Arcada Edéntula/cirugía , Diabetes Mellitus , Prótesis de Recubrimiento , Prostodoncia/métodos , Tomografía Computarizada por Rayos X/métodos , Profilaxis Antibiótica/métodos , Clorhexidina/uso terapéutico , Tejido Periapical/diagnóstico por imagen , Tejido Periapical/patología , Análisis de Varianza
17.
Quintessence Int ; 51(9): 722-731, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32696032

RESUMEN

OBJECTIVE: To investigate bone loss in the anterior edentulous maxilla restored with maxillary complete dentures and opposed by mandibular two-implant-supported overdentures (2-IODs) or complete dentures. METHOD AND MATERIALS: A systematic search was conducted using the Ovid MEDLINE, Embase, Web of Science, CINAHL, and Cochrane databases for studies investigating bone loss in the anterior edentulous maxilla with mandibular 2-IODs or complete dentures. Two reviewers assessed the eligibility of studies and risk of bias assessment was conducted according to the Newcastle-Ottawa Scale. A meta-analysis was performed using statistical software to estimate weighted mean difference in bone loss with 95% confidence interval (CI). The level of significance was defined as P value (< .05). RESULTS: A total of 2,510 studies were identified through electronic and manual searching. Six studies were selected and compounded for quantitative synthesis of 163 patients. Bone loss in the anterior edentulous maxilla was greater with 2-IODs than with complete dentures. The total estimate of weighted mean difference between 2-IODs and complete dentures was -1.40 (95% CI -3.12 to 0.31). However, the difference was not statistically significant (P = .11). The data were heterogenous across the studies based on chi-square statistics (χ2 [df = 7] = 52.75, P < .0001; τ2 = 5.53, I2 = 95.21%). In addition, the impact of implant splinting on bone loss was not significant (P > .29). None of the included studies were considered to be at high risk of bias. CONCLUSION: Within the limitations of the current systematic review and meta-analysis, the estimate of bone loss in the anterior edentulous maxilla was greater with 2-IODs than with complete dentures. However, the difference was not statistically significant. A well-designed randomized clinical study needs to be conducted to validate the results of this systematic review.


Asunto(s)
Prótesis de Recubrimiento , Arcada Edéntula , Prótesis Dental de Soporte Implantado , Dentadura Completa , Humanos , Mandíbula , Maxilar
18.
Int J Oral Maxillofac Implants ; 35(4): 750-756, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32724927

RESUMEN

PURPOSE: The aim of this study was to evaluate 141 zygomatic implants for the reconstruction of severely atrophic maxillae. MATERIALS AND METHODS: In this retrospective case series study, zygomatic implants were placed under general anesthesia. Inclusion criteria were as follows: ASA I or ASA II, age older than 18 years, inadequate bone for restoration with conventional implants, alternative augmentation procedures considered either inappropriate or contraindicated, absence of a medical condition related to implant failure, and providing written consent. Zygomatic implants used in the study consisted of three different brands: NobelZygoma, Southern Implants System, and Implantswiss. RESULTS: The study included 45 patients, in whom 141 zygomatic implants were placed. The mean age of the patients was 51.76 (range: 23 to 72) years. Three patients were rehabilitated with removable prostheses, 19 patients with fixed prostheses, and 23 patients with hybrid prostheses. The overall complication rate was 5.67% (two zygomatic implants developed infection [1.4%], one zygomatic implant developed peri-implantitis [0.7%], three zygomatic implants developed sinusitis [2.1%], and two zygomatic implants showed unsuccessful prosthetic rehabilitation [1.4%]). The follow-up period ranged from 6 to 36 months. CONCLUSION: Clinical complications of zygomatic implants are acceptable, and their survival rates are similar to those of endosteal implants. Zygomatic implants can contribute to prosthetic rehabilitation.


Asunto(s)
Implantes Dentales , Arcada Edéntula/cirugía , Adulto , Anciano , Implantación Dental Endoósea , Prótesis Dental de Soporte Implantado , Estudios de Seguimiento , Humanos , Maxilar/cirugía , Persona de Mediana Edad , Estudios Retrospectivos , Adulto Joven , Cigoma/cirugía
19.
Int J Prosthodont ; 33(4): 393-400, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32639699

RESUMEN

PURPOSE: To evaluate the first-choice treatment options proposed to edentulous patients and the rationale behind them using an internet-based survey conducted among a sample of French dental clinicians. MATERIALS AND METHODS: From July to December 2018, an internet-based survey was conducted among a sample of 2,000 dental practitioners in order to assess first-choice treatment options proposed to edentulous patients. A total of 349 responses were received, and 310 questionnaires were included for analysis. RESULTS: The majority of clinicians proposed a maxillary complete denture (CD) (59.7%) and mandibular implant overdenture (45.2%) for edentulous patients. Almost 30% of practitioners proposed a CD as the first-choice option for mandibular edentulous patients. Binary logistic regression showed that the likelihood of proposing implant therapy in the maxilla was significantly increased for male practitioners (OR = 2.041, 95% CI = 1.231 to 3.385, P < .05) and for clinicians who had further training in implantology (OR = 2.301, 95% CI = 1.354 to 3.917, P < .05). In the mandible, the likelihood was significantly increased for clinicians who graduated 10 to 19 years ago (OR = 5.312, 95% CI = 1.331 to 21.208, P < .05), had further training in implantology (OR = 2.246, 95% CI = 1.121 to 4.500, P < .05), had expectations of comfort and stability (OR = 11.810, 95% CI =5.289 to 26.372, P < .001), and proposed the treatment according to national and international recommendations (OR = 3.252, 95% CI = 1.208 to 8.755, P < .05). CONCLUSION: The research results suggest that proposing either a CD or implant restorations for treatment of edentulous patients depends on training and specific skills in implantology.


Asunto(s)
Implantes Dentales , Arcada Edéntula , Prótesis Dental de Soporte Implantado , Odontólogos , Prótesis de Recubrimiento , Humanos , Internet , Masculino , Mandíbula , Rol Profesional , Encuestas y Cuestionarios
20.
Compend Contin Educ Dent ; 41(7): 368-376; quiz 377, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32687381

RESUMEN

Dental implant therapies must be planned and executed to meet both the immediate and longer-term expectations of patients. The early developmental success of dental implants was dependent on the quality and quantity of a patient's bone. Implants were commonly placed into the parasymphyseal mandibular and anterior maxillary bone. Building on this success, bone grafting allowed patients lacking sufficient bone to obtain implant-supported prosthetic solutions for treatment of partial or complete edentulism. More recently, several nongrafting solutions for implant therapy, including pterygoid implants, zygomatic implants, tilted implants, and short implants, have reported success. This article will consider the rationale for graftless solutions in implant therapy as well as the data supporting the use of various graftless protocols as alternatives to grafting and conventional dental implant therapy. It will discuss factors concerning graftless versus grafted approaches to treatment of patients with limited bone volume and will describe the use of short dental implants as a graftless solution in the edentulous maxilla.


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales , Arcada Edéntula/cirugía , Implantación Dental Endoósea , Diseño de Prótesis Dental , Prótesis Dental de Soporte Implantado , Fracaso de la Restauración Dental , Humanos , Maxilar/cirugía , Resultado del Tratamiento
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