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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 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
3.
J Prosthodont ; 29(8): 718-724, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32648318

RESUMEN

PURPOSE: To assess the accuracy of template-guided implant surgery for edentulous arches. MATERIALS AND METHODS: The stone master casts of 25 edentulous arches treated with either 4 or 6 implants with CBCT generated template-guided surgery were included in this observational cohort study. The stone casts generated from the surgical templates (group one) prior to implant placement were digitized into Standard Tesselation (STL) files with a reference scanner. For comparison, the stone master casts derived from intraoral complete-arch impressions after implant placement (group two) were also digitized. The resultant STL files were superimposed and best-fit-alignment algorithm was used to quantify the 3D deviations present between the two groups. Descriptive statistics were computed for all categorical variables. Due to the presence of nonindependent samples between maxillary and mandibular casts, a mixed-effects model was used. RESULTS: Deviations between the implant analogs of the stone casts representing digitally planned versus actually placed implants were found. The mean root-mean-square error (RMSE) between all 25 arches was found to be 0.2 mm (SD ± 0.15). The mean RMSE between presurgical and postsurgical maxillary stone casts were 0.19 ± 0.15 mm, while between mandibular stone casts were 0.21 ± 0.16 mm and were not significant (p = 0.67). The mean RMSE between presurgical and postsurgical stone casts arches with 4 versus 6 implants were found to be significant (p = 0.01). CONCLUSIONS: According to the results of the study and based on the amount of 3D deviations between the digitally planned implant positions and the actually placed implants, template-guided surgery is a safe treatment modality for implant placement in edentulous arches.


Asunto(s)
Implantes Dentales , Boca Edéntula , Cirugía Asistida por Computador , Diseño Asistido por Computadora , Técnica de Impresión Dental , Humanos , Maxilar/cirugía , Boca Edéntula/cirugía
4.
Cient. dent. (Ed. impr.) ; 17(1): 35-40, ene.-abr. 2020. ilus
Artículo en Español | IBECS | ID: ibc-189747

RESUMEN

Los implantes dentales constituyen una alternativa predecible para la rehabilitación de los maxilares edéntulos, sin embargo, el éxito del tratamiento puede ver-se comprometido cuando existen graves atrofias maxilares. Para el tratamiento de estos casos complejos, se han desarrolla-do técnicas de regeneración ósea, entre las que destacan la regeneración ósea guiada y los injertos en bloque. Dentro de estos últimos, cabe destacar la técnica de Khoury. Se trata de un procedimiento indicado para regenerar defectos horizontales y verticales, mediante la obtención de finas láminas de hueso autógeno procedentes de la línea oblicua externa mandibular. Se presenta un caso clínico de un gran defecto mandibular reconstruido con la técnica de Khoury, secundario a un fracaso implantológico que además ocasionó patología nerviosa


Dental implants constitute a predictable alternative for the rehabilitation of edentulous jaws. However, the success of the treatment can be limited when severe atrophic alveolar ridges are present. For the treatment of these complex cases, several regeneration techniques have been developed, such as guided bone regeneration and block grafts. Within the last, it should be noted the Khoury technique. It is a procedure indicated for the regeneration of horizontal and vertical defects, through the obtention of autologous graft in form of thin plates, derived from mandibular external oblique line.A clinical case is presented, that consists in a great mandibular defect which was reconstructed by the Khoury technique. The defect was secondary to an implant failure, which was also related with nervous pathology


Asunto(s)
Humanos , Masculino , Anciano , Regeneración Ósea , Atrofia/cirugía , Hipoestesia/cirugía , Fracaso de la Restauración Dental , Maxilar/cirugía , Elevación del Piso del Seno Maxilar/métodos , Procedimientos Quirúrgicos Reconstructivos/métodos , Implantes Dentales , Resorción Ósea/patología , Boca Edéntula/cirugía
5.
Shanghai Kou Qiang Yi Xue ; 29(5): 504-508, 2020 Oct.
Artículo en Chino | MEDLINE | ID: mdl-33543217

RESUMEN

PURPOSE: To evaluate the accuracy of 6D computed-derived implant guides made in China, in order to provide methods and basis for reducing deviation. METHODS: 3D rapid prototyping technique was used to fabricate implant guides for auxiliary surgical implantation in edentulous patients, and the position deviation between the preoperative design and the actual implant was measured. Sixteen edentulous patients with 172 implantation sites were measured. In 10 patients, six implants were implanted in the maxilla, 4 implants in the mandible, and 6 implants were implanted both in the maxilla and mandible of 6 patients. A total of 28 implants were tilted implant in 14 patients. Preoperative cone-beam CT(CBCT) data were imported into the 6D Dental Planning Software to design and make the implant guides. Digital guides were used to assist implant placement. Preoperative design and postoperative CBCT were imported into the software for 3D reconstruction and registration, and then exported to Geomagic Studio software for analysis to obtain the deviation between the preoperative design and the implantation, so as to analyze the accuracy of the guides. The differences were analyzed by SPSS 25.0 software package with paired t-test and single factor analysis of variance. RESULTS: The distance deviation of implant neck center point was (0.83±0.27) mm and the horizontal deviation was (0.60±0.21) mm. The distance deviation of implant bottom center point was (1.11±0.35) mm, and the vertical deviation was (0.45±0.19) mm. The angle deviation was (3.16±1.73)°. CONCLUSIONS: The 6D computed-derived implant guides made in China can improve the accuracy and efficiency of implant surgery for edentulous patients and obtain a better long-term clinical effect to meet clinical requirements well. Since the deviation is similar to other implant guide plate systems that reported aborad, it must be taken into account in the process of clinical design, in order to avoid risks and unnecessary complications. This method is worthy of wide clinical application.


Asunto(s)
Implantes Dentales , Boca Edéntula , Cirugía Asistida por Computador , China , Diseño Asistido por Computadora , Tomografía Computarizada de Haz Cónico , Implantación Dental Endoósea , Humanos , Imagenología Tridimensional , Boca Edéntula/diagnóstico por imagen , Boca Edéntula/cirugía
6.
Indian J Dent Res ; 30(1): 133-134, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30900673

RESUMEN

Total maxillectomy for patients with malignant lesions will often incapacitate the patient both functionally and aesthetically. An immediate surgical obturator prosthesis would be of utmost importance for patients in these critical situations to aid in deglutition, phonetics, respiration and effectively avoiding various post-surgical complications. This article emphasizes on utilizing circum-zygomatic wiring for retention of the immediate surgical obturator in cases of total maxillectomy or edentulous patients.


Asunto(s)
Maxilar/cirugía , Procedimientos Quirúrgicos Orales/métodos , Obturadores Palatinos , Procedimientos Quirúrgicos Reconstructivos/métodos , Hilos Ortopédicos , Trastornos de Deglución/prevención & control , Humanos , Boca Edéntula/cirugía , Complicaciones Posoperatorias/prevención & control , Trastornos Respiratorios/prevención & control , Trastorno Fonológico/prevención & control
7.
Int J Oral Maxillofac Implants ; 34(2): 529-534, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30883626

RESUMEN

PURPOSE: The purpose of this study was to evaluate whether fully digitally guided implant surgery may be performed with sufficient accuracy based on printing virtually designed templates after matching a surface scan with the magnetic resonance imaging (MRI) dataset mimicking edentulous cases based on cadaver maxillae of pigs. MATERIALS AND METHODS: The palatal mucosa of five young pig cadavers was scanned with an intraoral scanner. High-resolution MRI of the jaws was performed, and the images were exported as DICOM files and uploaded into software for implant planning. Six implant osteotomies were virtually planned in each jaw. The intraoral surface scans were fused with the volumetric MRI data based on the palatal soft tissue, and virtual templates for guided implant surgery were created and exported as STL files. These were printed and the templates were used to perform flapless guided osteotomy, with the templates fitting on the soft tissue of the jaws alone. Cone beam computed tomography (CBCT) of the jaws was performed after osteotomy. These data were fused with the virtually planned osteotomies, and the 3D crestal, apical, and axial deviations between the virtually planned and physically performed osteotomies were determined. RESULTS: Matching the surface scans with the mucosa was possible in three cases automatically; additional manual corrections were necessary in two cases. Thirty osteotomies were performed by applying the printed mucosa-supported templates. The mean angular deviation between the planned and realized cavities was 3.29 degrees (0.3 to 11.1 degrees; SD = 2.5 degrees), the mean 3D apical deviation was 1.3 mm (0.22 to 3.98 mm; SD = 0.94 mm), and the mean crestal deviation was 1.76 mm (0.39 to 3.79 mm; SD = 0.88 mm). CONCLUSION: MRI in combination with the presented workflow may be used in edentulous cases for guided implant surgery. Further studies are needed to prove the promising accuracy of this alternative approach in clinical trials.


Asunto(s)
Tomografía Computarizada de Haz Cónico , Implantación Dental Endoósea/métodos , Imagen por Resonancia Magnética , Impresión Tridimensional , Cirugía Asistida por Computador/métodos , Animales , Humanos , Imagenología Tridimensional/métodos , Arcada Edéntula/diagnóstico por imagen , Maxilar/diagnóstico por imagen , Boca Edéntula/cirugía , Programas Informáticos , Porcinos
8.
J Craniomaxillofac Surg ; 47(3): 454-460, 2019 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-30683623

RESUMEN

INTRODUCTION: In edentulous patients the form and size of the maxillary sinus vary greatly. Therefore sinus floor augmentation is a standard procedure for implantological purposes. As the sinus membrane cannot be characterized as periosteum, various augmentation materials are used. HYPOTHESIS: an artificially generated space underneath the sinus membrane in the floor of the sinus will lead to spontaneous callus forming and a stable bony consolidation without augmentation material. METHODS: Ten edentulous patients with highly atrophic maxillae were selected. Augmentation of the sinus floor was carried out in a split-mouth study design: On one side a combination of autogenous and xenogenous bone was used, and on the contralateral side a sinus membrane elevation was performed without using any substitutes. After a 6-month interval bone specimens from the test regions were harvested during implant placement. RESULTS: Clear histological evidence of new bone formation was found in all human bone specimens. An active de-novo bone formation process could be proven by the presence of Haversian systems (osteons) displaying osteoblastic and osteoclastic activity. CONCLUSION: In the maxillary sinus of edentulous patients a spontaneous callus-derived de-novo bone formation is possible by elevating the sinus membrane without using augmentation materials.


Asunto(s)
Regeneración Ósea/fisiología , Sustitutos de Huesos , Ilion/trasplante , Seno Maxilar/cirugía , Minerales , Boca Edéntula/cirugía , Elevación del Piso del Seno Maxilar/métodos , Trasplante Óseo/métodos , Callo Óseo/fisiología , Humanos , Osteogénesis/fisiología
9.
Int J Oral Maxillofac Implants ; 34(1): 31-38, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30695085

RESUMEN

PURPOSE: This in vitro study aimed to evaluate and compare the effect of different bar designs on the retention forces of implant-retained maxillary overdentures. MATERIALS AND METHODS: A maxillary edentulous acrylic resin model without alveolar undercut was fabricated. Four implant analogs were placed in the canine and second premolar regions. Overdentures were made and attached to the analogs with Dolder bar, Hader bar, and milled bar attachments. A universal testing machine was used to measure axial (resistance to vertical displacement) and nonaxial (resistance to anterior, posterior, and lateral displacement) retention forces (in Newtons). Measurements were made at the start of the experiment (initial retention) and after 540 cycles of denture insertion and removal to simulate 6 months of clinical function (final retention). RESULTS: Hader bar had the highest retention after insertions and removals, and Dolder bar had the lowest retention. Vertical displacement showed the highest retention for Dolder and milled bars, and posterior displacement showed the highest retention for Hader bar. Lateral displacement recorded the lowest retention for all bar designs. No significant difference in axial retention loss was observed between different bar designs. Dolder bar showed the highest nonaxial retention loss, and milled bar showed the lowest retention loss. CONCLUSION: Hader bar is recommended to retain maxillary implant overdentures, as it was associated with higher axial and nonaxial retention compared with Dolder and milled bars after 6 months of simulated denture wear.


Asunto(s)
Prótesis Dental de Soporte Implantado , Retención de Dentadura/instrumentación , Prótesis de Recubrimiento , Maxilar/cirugía , Resinas Acrílicas , Diente Premolar , Análisis del Estrés Dental , Humanos , Boca Edéntula/cirugía
10.
Int J Oral Maxillofac Implants ; 34(3): 726­736, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30521650

RESUMEN

PURPOSE: Different navigation markers in dynamic guided implant surgery could cause different degrees of artifacts, which would affect the accuracy and efficiency of the implant navigation system. This study aimed to quantify artifacts caused by navigation markers made of different materials and to evaluate their effects on registration accuracy under various oral conditions. MATERIALS AND METHODS: Four U-shaped tubes with different navigation markers (440c stainless steel, silicon nitride, zirconium oxide, and aluminium oxide) were produced by three-dimensional printing. Four kinds of maxillary plaster models were prepared to stimulate four tooth crown conditions. U-shaped tubes combined with different tooth models were scanned using cone beam computed tomography (CBCT). The size of artifacts from different navigation markers and registration rate were measured. Abrasion performance of navigation markers was evaluated by scanning electron microscopy (SEM) images. RESULTS: Aluminium oxide navigation markers showed the fewest artifacts. Silicon nitride markers caused fewer artifacts than zirconium oxide and 440c stainless steel ones (P < .05) and had the best registration performance under all tooth crown conditions with the lowest volume of abrasion. Registration data suggested aluminium oxide worked badly under artificial crown and natural tooth conditions for its lower radiopacity, and zirconium oxide worked undesirably in edentulous conditions. 440c stainless steel was worst in all dental conditions. CONCLUSION: Navigation markers made of silicon nitride have the best overall performance and perform the best in registration under all circumstances owing to less artifact generation, better radiopacity, and desirable abrasion resistance. Silicon nitride can be regarded as an ideal material, including but not limited to oral implant navigator-guided surgery.


Asunto(s)
Tomografía Computarizada de Haz Cónico/métodos , Implantación Dental Endoósea/métodos , Procesamiento de Imagen Asistido por Computador/normas , Cirugía Asistida por Computador/métodos , Artefactos , Coronas , Modelos Dentales , Humanos , Boca Edéntula/cirugía , Circonio
11.
J Prosthet Dent ; 121(1): 26-31, 2019 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-29961624

RESUMEN

The conversion of a denture into an interim implant-supported, screw-retained restoration has become the standard method for immediate interim restoration in patients with complete edentulism. The most critical steps of the denture conversion process are the creation of appropriate denture access holes to prevent displacement of the denture by the interim cylinders and removal of the denture flanges to facilitate both good esthetics and accessibility for oral hygiene after the denture is connected to the interim cylinders. This article presents a digital technique for designing and fabricating an interim implant-supported, fixed prosthesis for edentulous patients. The interim prosthesis has cylinder access holes that are digitally prefabricated and a denture flange part that is designed to be easily sectioned. This technique facilitates more straightforward and efficient immediate restoration for edentulous patients after implant placement.


Asunto(s)
Implantes Dentales , Diseño de Prótesis Dental , Prótesis Dental de Soporte Implantado/métodos , Dentadura Completa Inmediata , Carga Inmediata del Implante Dental , Arcada Edéntula/cirugía , Resinas Acrílicas , Diseño Asistido por Computadora , Modelos Dentales , Bases para Dentadura , Diseño de Dentadura/métodos , Dentadura Completa Inferior , Humanos , Mandíbula/patología , Mandíbula/cirugía , Boca Edéntula/cirugía , Impresión Tridimensional
12.
Int J Comput Assist Radiol Surg ; 14(2): 281-289, 2019 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-30317436

RESUMEN

PURPOSE: Surgical navigation system (SNS) has been an important tool in surgery. However, the complicated and tedious manual selection of fiducial points on preoperative images for registration affects operational efficiency to large extent. In this study, an oral and maxillofacial navigation system named BeiDou-SNS with automatic identification of fiducial points was developed and demonstrated. METHODS: To solve the fiducial selection problem, a novel method of automatic localization for titanium screw markers in preoperative images is proposed on the basis of a sequence of two local mean-shift segmentation including removal of metal artifacts. The operation of the BeiDou-SNS consists of the following key steps: The selection of fiducial points, the calibration of surgical instruments, and the registration of patient space and image space. Eight cases of patients with titanium screws as fiducial markers were carried out to analyze the accuracy of the automatic fiducial point localization algorithm. Finally, a complete phantom experiment of zygomatic implant placement surgery was performed to evaluate the whole performance of BeiDou-SNS. RESULTS AND CONCLUSION: The coverage of Euclidean distances between fiducial marker positions selected automatically and those selected manually by an experienced dentist for all eight cases ranged from 0.373 to 0.847 mm. Four implants were inserted into the 3D-printed model under the guide of BeiDou-SNS. And the maximal deviations between the actual and planned implant were 1.328 mm and 2.326 mm, respectively, for the entry and end point while the angular deviation ranged from 1.094° to 2.395°. The results demonstrate that the oral surgical navigation system with automatic identification of fiducial points can meet the requirements of the clinical surgeries.


Asunto(s)
Implantación Dental Endoósea/métodos , Marcadores Fiduciales , Procesamiento de Imagen Asistido por Computador/métodos , Maxilar/cirugía , Cirugía Asistida por Computador/métodos , Anciano , Algoritmos , Tornillos Óseos , Calibración , Femenino , Humanos , Masculino , Persona de Mediana Edad , Boca Edéntula/cirugía , Fantasmas de Imagen , Tomografía Computarizada por Rayos X/métodos
13.
BMC Oral Health ; 18(1): 219, 2018 12 18.
Artículo en Inglés | MEDLINE | ID: mdl-30563482

RESUMEN

BACKGROUND: This study evaluated full-arch rehabilitation of patients with immediately placed implants in terms of the cumulative implant survival rate, risk factors for implant failure, and patient satisfaction. METHODS: Time-to-event data of 52 completely edentulous jaws (370 implants) were collected using retrospective clinical chart review for the time period from 2008 to 2014. A conventional two stage approach for surgery was adopted to immediately placed implants in the maxilla, and immediate placement and immediate loading protocols for the mandible were followed. The study calculated the 7-year cumulative survival rates (CSR), and a Bayesian hierarchical Cox proportional hazard model was used to measure the effect of covariates. Patient satisfaction on chewing ability, esthetic appearance, and overall satisfaction was also measured with a face-to-face interview survey. RESULTS: Of the total 370 implants, 194 were immediate placement. Two delayed loading maxillary implants failed within the first year, and another one failed in the second year of loading. Two failures were recorded in the first year and one in seven years for the immediate loading mandibular implants. The 1-, 5-, and 7-year CSR of the 370 implants were 0.989 (0.979, 1.000), 0.986 (0.975, 0.998), and 0.978 (0.957, 0.999), respectively. Only the length of the implant affected implant failure (p < 0.05); other patient characteristics, systemic diseases, implant diameter, immediate loading, and immediate placement, did not have an effect on implant failure rates. Patients reported a high degree of satisfaction regardless of their age group or length of the observation period. CONCLUSIONS: Immediately placed implant had CSR as high as delayed placed implants, and 7-year CSRs of immediate loading were not significantly different from delayed loading. The procedure also had a high degree of chewing ability, esthetic appearance, and overall satisfaction. The study results suggested that the clinical procedures applied in this study to completely edentulous patients were acceptable rehabilitation procedures.


Asunto(s)
Carga Inmediata del Implante Dental , Satisfacción del Paciente/estadística & datos numéricos , Anciano , Fracaso de la Restauración Dental/estadística & datos numéricos , Femenino , Humanos , Carga Inmediata del Implante Dental/efectos adversos , Carga Inmediata del Implante Dental/psicología , Carga Inmediata del Implante Dental/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Boca Edéntula/cirugía , Estudios Retrospectivos
14.
Int J Oral Maxillofac Implants ; 33(6): 1219-1228, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30427952

RESUMEN

PURPOSE: This research aimed to propose a three-dimensional (3D) augmented reality navigation method with point cloud-based image-patient registration that could merge virtual images in the real environment for dental implants using a 3D image overlay and to evaluate its feasibility. MATERIALS AND METHODS: A total of 12 rapid prototyping mandibular models were fabricated using a 3D printing method and were divided into two groups: 3D augmented reality-guided group and traditional two-dimensional (2D) image-guided group. A point cloud-based preoperative image-to-patient registration method was introduced to replace the traditional point-to-point registration. After the registration, dental implant surgery was performed in the two model groups using an augmented reality-guided navigation method and a traditional two-dimensional image-guided navigation method. The planned and actual postoperative implant positions were compared for measuring positional implantation errors. The surgery time was also recorded and compared between the two groups. RESULTS: In the model experiment, the root-mean-square deviation of registration was 0.54 mm, and the implant surgery results showed < 1.5-mm mean linear deviation and < 5.5-degree angular deviation. The augmented reality-guided implantation showed smaller horizontal, vertical, and angular errors in the apical areas of the central incisor and the canine region. The surgery time using the augmented reality-guided navigation method was significantly shorter than that using the two-dimensional (2D) image-guided navigation method (P < .05). Moreover, the volunteer experiment demonstrated that the preoperative 3D models in situ accurately overlaid onto the surgical site. CONCLUSION: The proposed point cloud-based registration method can achieve excellent registration accuracy. Dental implant placement guided by the proposed 3D augmented reality navigation method showed better accuracy and applicability, as well as higher efficiency, than the traditional 2D image navigation method.


Asunto(s)
Implantes Dentales , Imagenología Tridimensional/métodos , Cirugía Asistida por Computador/métodos , Humanos , Mandíbula/cirugía , Boca Edéntula/cirugía , Fantasmas de Imagen , Impresión Tridimensional , Técnicas Estereotáxicas/instrumentación , Tomografía Computarizada por Rayos X/métodos , Interfaz Usuario-Computador
15.
Int J Oral Maxillofac Implants ; 33(6): 1383-1389, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30427971

RESUMEN

PURPOSE: The aim of this paired clinical study was to evaluate psychometric parameters (patient satisfaction and masticatory ability) and masticatory efficiency in elderly people before and after oral rehabilitation by a single-implant overdenture. MATERIALS AND METHODS: This study included elderly individuals with residual alveolar bone height classified as Class III or IV according to the American College of Prosthodontics, and who wore clinically unsatisfactory complete dentures. Subjects first received new maxillary and mandibular conventional complete dentures. After 2 months of patient adaptation to the new complete dentures, subjective and objective variables were measured. Satisfaction with the new complete dentures was verified by applying a visual analog scale to rate patient satisfaction with stability, comfort, ability to chew, ability to speak, ease of cleaning, esthetics, and general satisfaction of their new complete dentures. Masticatory ability was assessed by asking participants to rate on a visual analog scale their ability to chew foods with different roughness and consistencies. Masticatory efficiency was measured by the sieving method using a silicone-based artificial test food. After evaluations were completed, each participant received one implant, which was placed in the symphysis region. After 3 months of implant osseointegration, the conventional complete dentures were transitioned to mandibular single-implant overdentures through placement of a low-profile attachment on the intaglio surface of the prostheses. Subjects used the single-implant overdentures for 2 months, and then all variables were reevaluated. Parametric t test and nonparametric Wilcoxon statistical tests were used to analyze data. RESULTS: Participants reported increased satisfaction with stability of their mandibular single-implant overdentures compared with their new conventional complete dentures. However, satisfaction with the esthetics decreased when the new complete denture was converted into the single-implant overdenture (P < .05). Masticatory ability with the rehabilitation was not different between the new conventional complete dentures and the single-implant overdentures; however, transition to the single-implant overdenture greatly increased masticatory efficiency (P < .0001). CONCLUSION: Single-implant overdentures changed the patient perceptions, improving their satisfaction with stability, although decreasing satisfaction with esthetics. Despite that, masticatory efficiency of elderly individuals with decreased residual bone height was greatly improved after single-implant overdenture use.


Asunto(s)
Implantes Dentales , Prótesis Dental de Soporte Implantado , Prótesis de Recubrimiento , Masticación/fisiología , Boca Edéntula/cirugía , Satisfacción del Paciente , Psicometría , Anciano , Dentadura Completa , Estética Dental , Femenino , Humanos , Masculino , Mandíbula , Persona de Mediana Edad
16.
Medicine (Baltimore) ; 97(44): e12646, 2018 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-30383626

RESUMEN

The aim of the present study was to investigate the role of Axiom (implant diameter) ø2.8 mm narrow body implant in the clinical effect of minimally invasive implants in edentulous space.This study included 10 patients with 10 edentulous spaces less than 5 mm and received minimally invasive surgery with 10 Axiom ø2.8 mm narrow implants. Re-stabilization of all implants began 6 months after surgery to fix the partial denture. All cases were followed up for clinical and panoramic X-ray examinations.Imaging examination on these 10 pieces of narrow implants after 6 months showed that implant alveolar bone crest average absorption amount was 0.20 mm and no implant peripheral inflammation mucositis and denture with adjacent teeth gingival papilla between the fillings. All patients felt strong mastication and the reparation effect was more than up to expectation. No implant loosening and shedding were observed.Hence, <5 mm edentulous space by Axiom ø2.8 mm implant minimally invasive reparation can be used for aesthetic purposes.


Asunto(s)
Implantación Dental Endoósea/métodos , Implantes Dentales/efectos adversos , Boca Edéntula/cirugía , Adulto , Implantación Dental Endoósea/efectos adversos , Diseño de Prótesis Dental , Femenino , Humanos , Masculino , Maxilar/cirugía , Persona de Mediana Edad , Procedimientos Quirúrgicos Mínimamente Invasivos/efectos adversos , Procedimientos Quirúrgicos Mínimamente Invasivos/métodos
17.
Clin Oral Implants Res ; 29 Suppl 16: 154-183, 2018 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-30328199

RESUMEN

OBJECTIVES: The main purpose of this systematic review was to evaluate outcomes related to the number of implants utilized to support complete-arch fixed prostheses, both for the maxilla and the mandible. MATERIALS AND METHODS: This review followed the reporting guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A focused question using the PICO format was developed, questioning whether "In patients with an implant supported fixed complete dental prosthesis, do implant and prosthetic survival outcomes differ between five or more compared to fewer than five supporting implants?". A comprehensive search of the literature was formulated and performed electronically and by hand search. Two independent reviewers selected the papers and tabulated results. Primary outcomes analyzed were implant and prosthesis survival. Implant distribution, loading, and type of retention were observed as secondary outcomes, as they relate to the number of implants. A meta-analysis was performed to compare results for studies by number of implants. RESULTS: The search strategy identified 1,579 abstracts for initial review. Based on evaluation of the abstracts, 359 articles were identified for full-text evaluation. From these, 93 were selected and included in this review, being nine RCTs, 42 prospective and 42 retrospective. Of the 93 selected studies, 28 reported number of implants for the maxilla, 46 for the mandible, and 19 for both maxilla and mandible. The most reported number of implants for the "fewer than five" group is 4 for the maxilla, and 3 and 4 for the mandible, whereas for the "five or more" implants group, the most reported number of implants was 6 for the maxilla and 5 for the mandible. No significant differences in the primary outcomes analyzed were identified when fewer than five implants per arch were compared with five or more implants per arch (p > 0.05), in a follow-up time ranging from 1 to 15 years (median of 8 years). CONCLUSIONS: Evidence from this systematic review and meta-analysis suggests that the use of fewer than five implants per arch, when compared to five or more implants per arch, to support a fixed prosthesis of the completely edentulous maxilla or mandible, present similar survival rates, with no statistical significant difference at a p < 0.05 and a confidence interval of 95%.


Asunto(s)
Implantación Dental Endoósea/estadística & datos numéricos , Implantes Dentales , Prótesis Dental de Soporte Implantado , Dentadura Completa , Bases de Datos Factuales , Humanos , Mandíbula/cirugía , Maxilar/cirugía , Boca Edéntula/cirugía , Falla de Prótesis , Análisis de Supervivencia
18.
Clin Oral Implants Res ; 29 Suppl 16: 436-442, 2018 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-30328201

RESUMEN

OBJECTIVES: Working Group 5 was assigned the task to review the current knowledge in the area of digital technologies. Focused questions on accuracy of linear measurements when using CBCT, digital vs. conventional implant planning, using digital vs. conventional impressions and assessing the accuracy of static computer-aided implant surgery (s-CAIS) and patient-related outcome measurements when using s-CAIS were addressed. MATERIALS AND METHODS: The literature was systematically searched, and in total, 232 articles were selected and critically reviewed following PRISMA guidelines. Four systematic reviews were produced in the four subject areas and amply discussed in the group. After emendation, they were presented to the plenary where after further modification, they were accepted. RESULTS: Static computer-aided surgery (s-CAIS), in terms of pain & discomfort, economics and intraoperative complications, is beneficial compared with conventional implant surgery. When using s-CAIS in partially edentulous cases, a higher level of accuracy can be achieved when compared to fully edentulous cases. When using an intraoral scanner in edentulous cases, the results are dependent on the protocol that has been followed. The accuracy of measurements on CBCT scans is software dependent. CONCLUSIONS: Because the precision intraoral scans and of measurements on CBCT scans and is not high enough to allow for the required accuracy, s-CAIS should be considered as an additional tool for comprehensive diagnosis, treatment planning, and surgical procedures. Flapless s-CAIS can lead to implant placement outside of the zone of keratinized mucosa and thus must be executed with utmost care.


Asunto(s)
Diseño Asistido por Computadora , Tomografía Computarizada de Haz Cónico/métodos , Imagenología Tridimensional/métodos , Cirugía Asistida por Computador/métodos , Consenso , Bases de Datos Factuales , Implantación Dental Endoósea , Técnica de Impresión Dental , Prótesis Dental de Soporte Implantado , Humanos , Boca Edéntula/cirugía , Planificación de Atención al Paciente , Medición de Resultados Informados por el Paciente , Reproducibilidad de los Resultados , Programas Informáticos
19.
Clin Oral Implants Res ; 29 Suppl 16: 359-373, 2018 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-30328203

RESUMEN

OBJECTIVE: To systematically evaluate the scientific literature for patient-reported outcome measures (PROMs) in static computer-aided implant surgery (s-CAIS). METHODS: A PICO strategy was executed using an electronic (MEDLINE, EMBASE, CENTRAL), plus manual search up to 15-06-2017 focusing on clinical studies investigating s-CAIS with regard to patients' pain & discomfort, economics and/or intra-operative complications. Search strategy was assembled from multiple conjunctions of MeSH Terms and unspecific free-text words. Assessment of risk of bias in selected studies was made at a "trial level" applying the Cochrane Collaboration Tool and the Newcastle-Ottawa Assessment Scale, respectively. RESULTS: The systematic search identified 112 titles. Seventy abstracts were screened, and 14 full texts were included for analysis. A total of 484 patients were treated with s-CAIS for placement of 2,510 implants. Due to the heterogeneity of the included studies, meta-analyses could not be performed. CONCLUSIONS: The number of identified studies investigating s-CAIS for PROMs was low. Scientifically proven recommendations for clinical routine cannot be given at this time; however, the number of clinical complications with s-CAIS seems to be negligible and comparable to conventional implant surgery. s-CAIS may offer a beneficial treatment option in edentulous cases if a flapless approach is applicable. Nevertheless, the economic effects in terms of time efficiency and treatment costs are unclear. Clinical investigations with well-designed RCTs investigating PROMs with standardized parameters are compellingly necessary for the field of s-CAIS.


Asunto(s)
Implantación Dental Endoósea/métodos , Implantes Dentales , Medición de Resultados Informados por el Paciente , Cirugía Asistida por Computador/métodos , Bases de Datos Factuales , Humanos , Boca Edéntula/cirugía , Dolor , Cirugía Asistida por Computador/efectos adversos , Cirugía Asistida por Computador/economía , Factores de Tiempo , Resultado del Tratamiento
20.
Clin Oral Implants Res ; 29 Suppl 18: 275-294, 2018 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-30306687

RESUMEN

AIM: To investigate fully edentulous patients rehabilitated with cantilever-fixed implant-supported restorations and to analyse which complications are reported for this type of treatment. MATERIALS AND METHODS: Two operators screened the literature (MEDLINE, EMBASE) and performed a hand search on the main journals dealing with implantology and prosthetics until 31 December 2017. Only articles that considered cantilever implant-fixed restorations with at least 10 patients and with a mean follow-up of at least 5 years were selected. The outcome variables were survival of implants and prosthesis, mechanical, technical and biological complications, marginal bone loss. The review was performed according to the PRISMA statements. The risk of bias was evaluated for each article. Failure and complication rates were analysed using random effect Poisson regression models to obtain summary estimate of 5- and 10-year survival and complication rates. RESULTS: Fourteen papers for fully edentulous patients were selected. The estimated 5 to 10 years survival rate was calculated to be 99.00% and 96.7% for the implants and the prosthesis, respectively. A total of 299 complications (technical and biological) were reported with a cumulative 5-10 years complication rate of 44.41% and 39.46% for the patients and for the prosthesis, respectively. CONCLUSIONS: There is evidence that cantilever can be successful treatment in fully edentulous patients.


Asunto(s)
Prótesis Dental de Soporte Implantado , Dentadura Completa , Boca Edéntula/cirugía , Prótesis Dental de Soporte Implantado/efectos adversos , Prótesis Dental de Soporte Implantado/métodos , Fracaso de la Restauración Dental , Dentadura Completa/efectos adversos , Humanos
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