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1.
Int J Oral Maxillofac Implants ; 36(1): 146-153, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33600536

RESUMEN

PURPOSE: This study aimed to assess the radiographic, esthetic, and periodontal outcomes after 1 year of implant placement in compromised fresh extraction sockets in the esthetic zone using vestibular socket therapy. MATERIALS AND METHODS: Implants were placed in type 2 sockets using vestibular socket therapy, which includes immediate implant placement, vestibular incision, and cortical bone shield stabilization, along with filling the socket gap with particulate bone graft, then sealing the socket orifice with a customized healing abutment in one visit. A 6-day protocol of antimicrobial therapy for treating sockets with active infection was also described. Assessment included measuring bone height and labial plate thickness at three levels at baseline and after 1 year, in addition to pink esthetic score and periodontal parameters (modified sulcus Bleeding Index and peri-implant probing depth) after 1 year. SPSS was used to calculate descriptive statistics of outcome measures. RESULTS: All 16 implants used in the study showed success. There was a significant increase of bone height and bone thickness at the middle and crestal thirds (mean [SD] gain = 6.08 [3.07], 1.65 [0.91], and 1.18 [1.51]). The mean (SD) pink esthetic score was 12.63 (1.71), the mean (SD) modified sulcus Bleeding Index was 1.19 (0.40), and the mean (SD) peri-implant probing depth was 1.97 (0.46) mm. CONCLUSION: Vestibular socket therapy was successfully used in compromised sockets with optimum radiographic, esthetic, and periodontal outcomes in addition to minimizing treatment time and number of surgical interventions. The 6-day protocol was able to eliminate infection and prepare sockets for implant placement.


Asunto(s)
Implantes Dentales de Diente Único , Implantes Dentales , Carga Inmediata del Implante Dental , Estudios de Cohortes , Estética Dental , Humanos , Extracción Dental , Alveolo Dental/diagnóstico por imagen , Alveolo Dental/cirugía , Resultado del Tratamiento
2.
Int J Oral Maxillofac Implants ; 36(1): 165-176, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33600538

RESUMEN

PURPOSE: This study sought to define the tissue responses at different implant-abutment interfaces by studying bone and peri-implant mucosal changes using a 5-year prospective randomized clinical trial design study. The conus interface was compared with the flat-to-flat interface and platform-switched implant-abutment systems. MATERIALS AND METHODS: One hundred forty-one subjects were recruited and randomized to the three treatment groups according to defined inclusion and exclusion criteria. Following implant placement and immediate provisionalization in healed alveolar ridges, clinical, photographic, and radiographic parameters were measured at 6 months and annually for 5 years. The calculated changes in marginal bone levels, peri-implant mucosal zenith location, papillae lengths, and peri-implant Plaque Index and bleeding on probing were statistically compared. RESULTS: Forty-eight conus interface implants, 49 flat-to-flat interface implants, and 44 platform-switched implants were placed in 141 subjects. Six platform-switched interface and eight flatto- flat interface implants failed, most of them within 3 months. After 5 years, 33 conical interface, 28 flat-to-flat interface, and 27 platform-switched interface implants remained for evaluation. Calculation of marginal bone level change showed a mean marginal bone loss of -0.16 ± 0.45 (-1.55 to 0.65), -0.92 ± 0.70 (-2.90 to 0.20), and -0.81 ± 1.06 (-3.35 to 1.35) mm for conical interface, flat-to-flat interface, and platform-switched interface implants, respectively (P < .0005). The peri-implant mucosal zenith changes were minimal for all three interface designs (0.10 mm and +0.08 mm, P > .60). Only 16% to 19% of the surfaces had presence of bleeding on probing, with no significant differences (P > .81) between groups. Interproximal tissue changes were positive and similar among the implant interface designs. CONCLUSION: Over 5 years, the immediate provisionalization protocol resulted in stable peri-implant mucosal responses for all three interfaces. Compared with the flat-to-flat and platform-switched interfaces, the conical interface implants demonstrated significantly less early marginal bone loss. The relationship of marginal bone responses and mucosal responses requires further experimental consideration.


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales de Diente Único , Pérdida de Hueso Alveolar/diagnóstico por imagen , Pérdida de Hueso Alveolar/etiología , Coronas , Estética Dental , Humanos , Maxilar/diagnóstico por imagen , Maxilar/cirugía , Estudios Prospectivos
4.
Clin Implant Dent Relat Res ; 23(1): 117-130, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33528110

RESUMEN

OBJECTIVES: To study the accuracy of partially guided and fully guided templates applied to implant surgery of anterior teeth. MATERIALS AND METHODS: Sixty patients who were scheduled to receive dental implant treatment in the anterior region were enrolled and randomly assigned to one of the following study groups (n = 20 each): routine implant-supported restoration treatment (control group, 30 implants), implant-supported restoration treatment using a partially guided template (test group 1, 36 implants), and implant-supported restoration treatment using a fully guided template (test group 2, 33 implants). The depth of implant was controlled for fully guided template. After implantation, planned implants and placed implants were superimposed using digital software, and the deviations (angular, coronal, apical, depth) were analyzed. Esthetic parameters were assessed at baseline, 6 months, and 1 year after the final restoration. Pink esthetic score (PES) and white esthetic score (WES) were respectively used to evaluate the soft tissue and restoration esthetic outcome. Each parameter of PES and WES is assessed with a 0-1-2 score with 2 being the best and 0 being the worst score. RESULTS: There were significant differences in all of the deviation parameters between the control group, test group 1, and test group 2 (p < 0.001). Mean angular, coronal, apical and depth deviations were all the highest in the control group (6.61 ± 1.09°, 1.05 ± 0.17 mm, 1.36 ± 0.13 mm, and 1.02 ± 0.13 mm, respectively), and lowest in test group 2 (2.05 ± 0.45°, 0.39 ± 0.12 mm, 0.28 ± 0.09 mm, and 0.24 ± 0.06 mm, respectively). At 1 year after the final restoration, the analysis revealed mean PES values of 7.09 ± 0.56 (control group), 8.39 ± 0.54 (test group 1), and 9.04 ± 0.35 (test group 2). The WES values were 7.24 ± 0.54 (control group), 8.47 ± 0.44 (test group 1), and 8.97 ± 0.38 (test group 2). At all examinations, the mean PES and WES values were both the highest in test group 2 and lowest in the control group. The PES and WES values recorded in the control group at baseline, 6 months, and 1 year after final restoration were significantly lower than those in test groups (p < 0.001). Moreover, the PES and WES values recorded in the test group 1 at baseline, 6 months, and 1 year after final restoration were significantly lower than those in test group 2 (p < 0.05). CONCLUSIONS: Digital surgical guides can improve the accuracy of the three-dimensional position of implants in the maxillary esthetic zone, the fully guided template has higher precision than that of the partially guided template, and plays an important role in obtaining the ideal esthetic outcome for maxillary anterior teeth.


Asunto(s)
Implantes Dentales de Diente Único , Implantes Dentales , Coronas , Estética Dental , Humanos , Maxilar , Resultado del Tratamiento
5.
Quintessence Int ; 52(2): 132-137, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33433079

RESUMEN

The extraction of a tooth with root resorption can be a complicated procedure and can result in the removal of a significant amount of alveolar bone. In the anterior maxilla, esthetic rehabilitation of damaged sites with implant-supported crown could require multiple surgeries. Patients often ask for an alternative, and minimally invasive treatments are generally preferred. In this paper, a clinical case of implant-supported crown in a site affected by root resorption is described. Immediate implant was placed leaving some root fragments in the osteotomy site, thus avoiding invasive extractive surgeries. A minimally invasive flapless technique with a computer-guided implant placement procedure was used. After ?8 years, clinical and radiologic data were stable, gingival tissues around the implant appeared healthy, no dark translucency appeared through marginal gingiva around the implant, and there was no pathologic probing pocket depth ?or bleeding on probing. In the presence of root resorption and ankylosis, computer-guided surgery could be helpful to prepare a precise implant site through various tissues, such as partially resorbed root remnants. (Quintessence Int 2021;52:132-137; doi: 10.3290/j.qi.a45432).


Asunto(s)
Implantes Dentales de Diente Único , Implantes Dentales , Carga Inmediata del Implante Dental , Computadores , Coronas , Implantación Dental Endoósea , Prótesis Dental de Soporte Implantado , Estética Dental , Humanos , Maxilar/cirugía , Extracción Dental , Resultado del Tratamiento
6.
Compend Contin Educ Dent ; 42(1): 38-42, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33481625

RESUMEN

Implants used to replace molar teeth present issues of space distribution and crown contours that are unique to these sites. Because the diameter of the implant typically is smaller than that of the tooth being replaced, and the circular shape of the implant does not replicate the anatomy of the tooth, a large gingival embrasure area between the implant platform and adjacent tooth often results. Upon the review of radiographs of molar implants placed over an 11-year period in one private practice, the authors identified an unusually high incidence of approximal, cervical, and root caries on teeth adjacent to these implants. This retrospective radiographic study investigated the incidence of decay as related to: (1) the horizontal distance from the implant to the adjacent tooth (ie, the implant-tooth distance, or ITD) as measured at the alveolar crest, (2) the vertical distance from the apical portion of the prosthetic contact area to the implant platform, and (3) the presence of an existing restoration on the adjacent tooth. Of the three variables examined, both the horizontal distance of the implant to a natural tooth (ITD) and the presence of an existing restoration on an adjacent tooth proved to be significantly correlated with the incidence of decay. Results showed that incidence of decay ranges from 7.4% when the ITD is less than 2 mm to 40% when the ITD is ≥6 mm. The mean ITD in cases in which decay was found was 4.1 mm, and it was 3.5 mm in cases that showed no decay (P = .005). It is therefore suggested that the horizontal threshold of 4 mm be considered as the "critical ITD." The results also indicated that the presence of a previous restoration on an adjacent tooth increases the incidence of decay to a statistically significant degree with an odds ratio of 2.25 at a 95% confidence level. This information may prove useful in diagnosis and treatment planning for molar implant replacement.


Asunto(s)
Implantes Dentales de Diente Único , Implantes Dentales , Incidencia , Diente Molar/diagnóstico por imagen , Diente Molar/cirugía , Estudios Retrospectivos
7.
Artículo en Inglés | MEDLINE | ID: mdl-33348644

RESUMEN

Aim: (PRIMARY) Assess the changes in bone level (6 and 12 months after implant placement) between the test (definitive abutment (DEF)) and control (healing abutment (HEA)) groups. (SECONDARY) Assess the changes in bone level (6 and 12 months after implant placement) between the 1 mm high abutment group and 2 mm abutment group. Evaluate changes in implant stability recorded with analysis of the resonance frequency (RFA) Osstell system, at 6 and 12 months after implant placement, between the control group (HEA) and test (DEF). For the DEF group, the abutment was placed at the time of the surgery and was never removed. For the HEA group, the abutment was removed three times during the manufacture of the crowns. The abutments used were 1 mm high (Subgroup A) and 2 mm high (Subgroup B). Materials and methods: A total of 147 patients were selected between 54.82 ± 11.92 years old. After implant placement, patients were randomly distributed in the DEF and HEA group. After the implant placement, a periapical radiograph was taken to assess the peri-implant bone level; the same procedure was carried out 6 and 12 months post-placement. To compare the qualitative variables between the groups (HEA/DEF), the Chi-square test was used; for quantitative (MANOVA). Results: After a year, the accumulated bone loss was 0.48 ± 0.71 mm for the HEA group and 0.36 ± 0.79 mm for the DEF group, without statistical significance. Differences were only found due to timing (time) between 0 and 6 months (=0.001) and 0 and 12 months (0.001), with no differences attributable to the study groups (DEF and HEA). The accumulated bone loss (1 year) was 0.45 ± 0.78 mm for the 1 mm abutment group and 0.41 ± 0.70 mm for the 2 mm abutment group (p = 0.02). No differences were observed in implant stability between groups. Conclusions: The "One Abutment-One Time" concept does not reduce peri-implant bone loss compared to the connection-disconnection technique. The height of the abutment does influence bone loss: the higher the abutment, the lower the bone loss.


Asunto(s)
Pérdida de Hueso Alveolar/diagnóstico , Pilares Dentales , Implantes Dentales de Diente Único , Adulto , Anciano , Diseño de Implante Dental-Pilar , Implantación Dental Endoósea , Femenino , Humanos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias , Estudios Prospectivos , Resultado del Tratamiento
8.
Artículo en Inglés | MEDLINE | ID: mdl-33327506

RESUMEN

The aim of this retrospective study was to evaluate implant survival, marginal bone loss and peri-implant complications in 326 short and ultra-short implants. Implants were placed in the maxillary and mandibular posterior regions of 140 patients with (PP) and without (NPP) a history of periodontal disease. Clinical and radiographic examinations were performed at 3-year recall appointments. The 8.0, 6.0 and 5.0 mm-length implants placed in PP and NPP were respectively 43.75% and 38.46%, 35.10% and 34.19%, 21.15% and 27.35%; 325 implants (one early failure) were rehabilitated with single crowns in 139 patients. Overall implant survival after 3 years of follow-up was 97.55%, 98.08% and 96.61% for PP and NPP (p = 0.46). Crestal bone level variations were not statistically different among PP and NPP; 15.41% of implants presented signs of mucositis, 14.71% and 16.67% in PP and NPP (p = 0.64). Setting the threshold for bone loss at 2 mm after 36 months, peri-implantitis prevalence was 2.2%, 1.96% and 2.63% in PP and NPP (p = 0.7). Overall implant success was 82.39%, 83.33% and 80.7% for PP and NPP (p = 0.55). Short-term outcomes suggest that short and ultra-short locking-taper implants can successfully be restored with single crowns in the posterior jaws both in PP and NPP.


Asunto(s)
Pérdida de Hueso Alveolar , Coronas , Implantes Dentales de Diente Único , Enfermedades Periodontales , Pérdida de Hueso Alveolar/epidemiología , Pérdida de Hueso Alveolar/etiología , Coronas/normas , Coronas/estadística & datos numéricos , Implantes Dentales de Diente Único/efectos adversos , Implantes Dentales de Diente Único/normas , Implantes Dentales de Diente Único/estadística & datos numéricos , Femenino , Estudios de Seguimiento , Humanos , Masculino , Enfermedades Periodontales/complicaciones , Prevalencia , Estudios Retrospectivos
9.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(11): 819-824, 2020 Nov 09.
Artículo en Chino | MEDLINE | ID: mdl-33171553

RESUMEN

In addition to restoring oral function, stable aesthetic outcome has become the goal of oral implant therapy. To ensure the harmonious appearance of the restoration and the natural tooth and to obtain the ideal hard and soft tissue structure, clinicians should have a clear understanding of the factors that influence the success of aesthetics and apply different technique accordingly. In view of the recent progress in the field of oral implant, the factors affecting the aesthetic outcome of implant treatment were discussed including neck design of implant, design of customized abutment, tissue regeneration and gingival papilla height, so as to provide clinical reference to improving the aesthetic outcome of oral implant treatment.


Asunto(s)
Implantes Dentales de Diente Único , Implantes Dentales , Coronas , Pilares Dentales , Implantación Dental Endoósea , Estética Dental , Encía , Resultado del Tratamiento
10.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(11): 831-837, 2020 Nov 09.
Artículo en Chino | MEDLINE | ID: mdl-33171555

RESUMEN

Objective: To compare and evaluate the clinical outcome of immediate implant therapy in patients with limited buccal bone wall dehiscence and in patients with intact buccal bone wall. Methods: This prospective cohort study included patients intended to receive immediate implant treatment in upper anterior esthetic region in the Department of Implantology, Hospital of Stomatology, Wuhan University from August to December, 2018. Patients with buccal bone wall dehiscence limited to the coronal half were attributed to experimental group to conduct flap implant surgery (indicating to less than coronal half of the buccal bone wall length from the alveolar bone crest to the implant tip), whereas patients with intact buccal bone wall were attributed to control group to conduct flapless implant surgery. Buccal bone wall resorptions in height and thickness were evaluated 6 months after implant placement. Implant survival rate, pink/white esthetic score and post-operation complications were also analyzed 12 months after implant placement. Paired t-test and two-sample t-test were adopted to analyze the differences of different points within one group and differences between groups, respectively. Results: A total of 38 patients with the age of (39.2±5.8) years (range 19-45 years) and 38 upper anterior single tooth implants were included,in which 19 patients were attributed to experimental group [12 male and 7 female, the age was (37.6±5.3) years], and 19 patients were attributed to control group [9 male and 10 female, the age was (40.8±6.7) years]. Over the 12 months' observation after implant placement, the overall implant survival rate was 97% (37/38), and 18/19 in control group and 19/19 in experimental group. Only one implant lost in control group and no other complications were reported. Buccal bone resorption in thickness and height occurred in both groups within 6 months after implant placement. The thickness and height of buccal bone decreased significantly in both groups within 6 months after implant placement (P<0.05). Thickness decreases in experimental group were (1.32±0.74), (0.53±0.89) and (0.36±0.70) mm in coronal, middle and apical part of implant in experimental, and (1.24±0.57), (0.83±0.46) and (0.38±0.72) mm in coronal, middle and apical part of implant in control group. While the buccal bone height decreases were (0.24±0.15) mm in experimental group and (0.25±0.23) mm in control group. There were no statistical differences between the corresponding spots in the two groups (P>0.05). Upon the final restoration, both group got ideal pink esthetic scores [experimental group (10.92±1.13),control group (10.92±1.26)] and white esthetic scores [experimental group (7.61±0.78), control group (7.40±0.71)], the differences in both groups were not statistically significant (P>0.05). Conclusions: Clinical results of immediate implant to patients with buccal bone wall dehiscence limited to the coronal half are comparable to the results of patients with intact buccal bone wall.


Asunto(s)
Implantes Dentales de Diente Único , Implantes Dentales , Carga Inmediata del Implante Dental , Implantación Dental Endoósea , Estética Dental , Femenino , Humanos , Masculino , Maxilar/cirugía , Estudios Prospectivos , Alveolo Dental/cirugía , Resultado del Tratamiento
11.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(11): 851-856, 2020 Nov 09.
Artículo en Chino | MEDLINE | ID: mdl-33171558

RESUMEN

Objective: To further improve socket shield technique. The treatment outcome and the key related factors in Asian population are evaluated by measuring the root fragment and alveolar crest parameters in immediate implant placement cases with socket shield. Methods: A total of 18 patients, with 21 implants placed using socket shield technique were included in this retrospective study. Fourteen implants of 11 cases were recruited from West China Hospital of Stomatology, Sichuan University, 7 implants of 7 cases were recruited from Stomatological Hospital of Chongqing Medical University. The relationship between the thickness of the root fragment, the vertical height of the root fragment and the dimensional changes of buccal alveolar bone in 6 months was analyzed respectively. The pink-white esthetic scores were evaluated. The complications were recorded, analyzed and preventive measures were put forward. Results: There is a negative correlation between the vertical height of tooth fragment and the buccal crest height reduction (r=-0.458, P=0.037). There were negative correlations between the thickness of the tooth fragment with the vertical dimensional changes (r=-0.574, P=0.007) and horizontal dimensional changes (r=-0.619, P=0.003) of buccal alveolar bone. Three cases with internal exposure were recorded during the treatment. No severe complications were observed. Every case achieved a satisfying pink-white esthetic outcome according to the existing treatment protocols. Conclusions: Rigorous case screening, delicate surgical procedures, and maintaining adequate thickness of the root are the key to achieve a good esthetic outcome of implant treatment with socket shield technique.


Asunto(s)
Implantes Dentales de Diente Único , Carga Inmediata del Implante Dental , China , Implantación Dental Endoósea , Estética Dental , Humanos , Estudios Retrospectivos , Extracción Dental , Alveolo Dental/cirugía , Resultado del Tratamiento
12.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(11): 857-863, 2020 Nov 09.
Artículo en Chino | MEDLINE | ID: mdl-33171559

RESUMEN

Objective: To compare the difference of soft and hard tissue changes between immediate implant and early implant placement in maxillary anterior region, so as to provide the basis for the selection of implant timing and surgical method for patients in clinical maxillary anterior dental esthetic zone. Methods: From January 2016 to January 2019, 89 patients [48 males and 41 females, aged (38.0±13.3) years] with dentition defect and single tooth implant restoration in the Department of Oral Implantology, Dalian Stomatological Hospital were retrospectively collected. The patients were divided into three groups according to different implant timing and operation methods: immediate implant flapless group (26 cases), immediate implant flap group (30 cases) and early implant group (33 cases, early implant 4-8 weeks after tooth extraction). The operation time, intraoperative and postoperative complications were compared among the three groups. Cone-beam CT was taken before operation, immediately after operation and 6 months after operation. The bone plate thickness immediately after implantation, bone plate thickness at 6 months after operation and absorption amount of bone plate thickness at labial side (immediately after operation minus 6 months after operation) were measured, and the absorption rate of labial bone plate was calculated. Three dimensional quantitative analysis was performed on the lip bone increment, residual bone volume (6 months after operation minus preoperative), and bone volume absorption rate of the three groups immediately after operation by using GuideMia, PlastyCAD and Geomagic engineering software. The pink and white esthetic indexes of the three groups were evaluated at 9 months and 15 months after implant placement. The implant stability quotient (ISQ) value was measured at 6 months after implantation, and the patients' satisfaction with the whole treatment process was investigated at 6 months after implantation. Results: The operation time of immediate implant flapless group was the shortest, the median (lower quartile, upper quartile) was 36.5 (33.3, 38.5) min. At 9 months after operation, PES was relatively high [8.5 (8.0, 9.0)], and the final patient satisfaction was 8.0 (7.3, 8.8), and the difference was statistically significant compared with the other two groups (P<0.05). There was no significant difference in the incidence of intraoperative and postoperative complications among the groups (P>0.05). At 6 months after operation, the thickness of labial bone plate in early group was 3.09 (3.00, 3.25) mm, which was greater than that in the immediate non flap group [1.90 (1.72, 2.33) mm] and that in the immediate implant flap group [2.39 (2.05, 3.06) mm], and the difference was statistically significant (P<0.05). The absorption of labial bone thickness in immediate implant flapless group [0.61 (0.35, 0.98) mm] was significantly lower than that in the immediate implant flap group [1.13 (0.97, 1.53) mm] and that in the early implant group [1.23 (1.07, 1.37) mm] (P<0.05). After 6 months, the residual bone volume of immediate flapless group was 38.7 (31.2, 54.6) mm3 and was significantly different from that in early implant group [109.1 (85.6, 263.1) mm3] (P<0.05), and there was no significant difference in the residual bone volume between immediate implant flapless group and immediate implant flap group (P>0.05). Conclusions: Immediate implant can reduce the treatment time with equal esthetic outcome of implant supported restoration of anterior teeth, and patients prefer it more. The bone volume of lip side was not significantly increased after immediate flap operation, and the bone absorption was less after immediate flap operation. Early implant placement can better maintain the three-dimensional bone mass, and the three groups can obtain good clinical results in the short term, but the long-term effect needs further follow-up study.


Asunto(s)
Implantes Dentales de Diente Único , Implantes Dentales , Carga Inmediata del Implante Dental , Adulto , Implantación Dental Endoósea , Estética Dental , Femenino , Estudios de Seguimiento , Humanos , Masculino , Maxilar/cirugía , Persona de Mediana Edad , Estudios Retrospectivos , Resultado del Tratamiento , Adulto Joven
13.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(11): 885-890, 2020 Nov 09.
Artículo en Chino | MEDLINE | ID: mdl-33171563

RESUMEN

Objective: To observe the changes of peri-implant tissue around the individualized abutment that was grinded from zirconia provisional crown in one year. Methods: In this research, a prosthodontic-driven virtual implant planning and immediate provisionalization were conducted in computer assisted design software. And computer-aided design/computer-aided manufacturing (CAD/CAM) techniques were used to fabricate the zirconia provisional crown and surgical guide template before surgery. The implant was accurately placed with the surgical guide, and the zirconia provisional crown was immediately delivered after surgery. Three months later, the implant osseointegration was completed, and zirconia provisional crown was prepared intraorally to generate customized zirconia abutment for final prosthesis. The study included 30 patients with single anterior tooth loss, including 18 males and 12 females, aged from 26 to 50 years old, and the mean age was (36.2±6.1) years old. The patients were from the Center of Oral Implantology, The First Affiliated Hospital of Zhejiang University Medical College from January 2017 to February 2018. After cementation of the final prosthesis, the cases were followed up at 6 and 12 months time intervals. Implant survival rate, probing depth, bleeding on probing, marginal bone level loss and papilla index score (PIS) were recorded in every appointment. Results: The survival rate of 30 implants was 100%, and the probing depths were less than 5 mm. The bone resorption at 6 and 12 months follow-up after the final delivery was 0 (0, 0) mm and 0 (-0.2, 0) mm, respectively, and the difference was not statistically significant (P>0.05). The PIS was 3.0 (2.0, 4.0), 3.0 (2.8, 4.0) and 3.0 (3.0, 4.0) on the final delivery, 6 and 12 months after final delivery, respectively. Conclusions: Marginal bone level and bone loss were stable with this new implant clinical protocol at the one-year follow-up.


Asunto(s)
Implantes Dentales de Diente Único , Implantes Dentales , Adulto , Coronas , Prótesis Dental de Soporte Implantado , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Resultado del Tratamiento , Circonio
14.
Artículo en Inglés | MEDLINE | ID: mdl-33151193

RESUMEN

This article aims to evaluate the effect of anatomically designed, single-unit provisional restorations on soft tissue preservation following immediate implant placement. Patients in need of a single-tooth replacement in the esthetic area were recruited for this study. An immediate provisional restoration with a transmucosal area anatomically designed to support the soft tissue was used for every patient. The horizontal volumetric tissue changes and the presence and amount of vertical recession were measured at baseline (T0) and after 1 month (T1), 3 months (T2), and 6 months (T3). Sixty-three patients received 66 implants that were placed into fresh extraction sites. The average follow-up time was 48 months (range: 24 to 60 months). All implant restorations were successful, and the cumulative implant survival rate and success of restorations was 100%. After 6 months, the mean horizontal ridge measured midbuccally had increased by 0.10 ± 0.10 mm at 1 mm from the free gingival margin, had decreased by 0.09 ± 0.10 mm at 3 mm, and had decreased by 0.20 ± 0.10 mm at 5 mm. In addition, the mean recession at the midbuccal surfaces was 0.04 ± 0.37 mm. Measurements were made clinically and compared to measurements made on the casts. According to the results of this study, the use of customized anatomically designed immediate provisional restorations following single-tooth extraction and immediate implant placement appeared to minimize the loss of tissue volume that results from postextraction bone remodeling, thus optimizing the final esthetic result.


Asunto(s)
Implantes Dentales de Diente Único , Carga Inmediata del Implante Dental , Estética Dental , Humanos , Estudios Prospectivos , Conservación de Tejido , Extracción Dental , Resultado del Tratamiento
15.
Int J Esthet Dent ; 15(4): 390-400, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33089256

RESUMEN

The socket-shield technique shows promising results in the esthetic zone. It is a technically challenging procedure but is effective in maintaining the buccal plate after tooth extraction and avoiding tissue collapse. Therefore, it could be considered a valid option in the immediate implant scenario. A careful shield preparation and handling are paramount for the success of the treatment and to minimize complications. Raising a flap can improve visibility and simplify the procedure. This article reports on a case in which a small crestal approach is used to visualize the root and the buccal plate, combined with a buccal semilunar flap, to gain access to the apical area. This surgical management is especially indicated when long roots are involved, in order to determine the correct axis for cutting and sectioning the root and to remove the apex if conventional drills are not long enough. Possible esthetic complications of raising a flap are also discussed.


Asunto(s)
Implantes Dentales de Diente Único , Carga Inmediata del Implante Dental , Estética Dental , Humanos , Extracción Dental , Alveolo Dental/cirugía
16.
Shanghai Kou Qiang Yi Xue ; 29(3): 287-292, 2020 Jun.
Artículo en Chino | MEDLINE | ID: mdl-33043346

RESUMEN

PURPOSE: To analyze 8-year cone-beam CT (CBCT) data of early, delayed and late implantation around maxillary area of patients with single dental implant after tooth extraction, and to investigate the effect of implantation at different times on implants, in order to provide valuable information for correct selection of appropriate implant timing after tooth extraction. METHODS: Clinical data of 68 patients who received single-tooth implant after tooth extraction in our hospital from January 2010 to December 2010 were retrospectively analyzed. According to different implantation times, the patients were divided into three groups: group A (n=25), group B (n=24) and group C (n=19). All patients were followed up for 8 years, and the buccal bone defects were recorded. The adjacent bone level and bone defects were analyzed based on CBCT images and posteroanterior(PA) radiographs. The data were processed with SPSS 18.0 software package. RESULTS: The success rate of mini-implants was 92.59%(150/162). Univariate analysis of variance showed that there was significant difference in the success rate of implantation among three groups(P<0.05). Paired comparison showed that the success rate of implantation among three groups was the highest in group C, followed by group B and group A (P<0.05). 8-year CBCT image data of 51 patients included 16 in group A, 20 in group B and 15 in group C. The adjacent bone levels showed no significant difference between CBCT and PA images(P>0.05). Insertion torque and pullout torque showed no significant difference among three groups(P>0.05). Implant timing, insertion torque and pullout torque were the high-risk factors affecting implant success rate(P<0.05). After 8 years of implant placement, there was no significant difference in bone level among three groups (P>0.05). In the second stage of operation, bone defect rate of group C was significantly less than that of group A and B (P<0.05). The average maxillary bone level of implants with no bone defects was lower than that of implants with dehiscence-type defects (P<0.05). CONCLUSIONS: Implant placement time after extraction has no impact on adjacent bone level, but different implant times can affect the success rate of implant; moreover, the indication of immediate implant should be strictly controlled.


Asunto(s)
Implantes Dentales de Diente Único , Implantes Dentales , Humanos , Maxilar/diagnóstico por imagen , Maxilar/cirugía , Estudios Retrospectivos , Extracción Dental
17.
Compend Contin Educ Dent ; 41(8): e16-e20, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32870703

RESUMEN

The replacement of missing teeth is more complex than simply placing a dental implant and restoring it, especially when a single implant site is involved. Implants have a round cross-section, whereas natural teeth do not but instead have crestal cross-sections that vary in shape from ovoid to triangular to rectangular depending on which tooth is being replaced. When this factor is combined with the zone between the crestal bone and adjacent proximal contacts, an emergence profile presents that will govern the esthetics of the restoration. The emergence profile will also guide and maintain the soft tissue, preventing potential food accumulation areas interproximally. This article defines an emergence profile and reviews the importance of establishing it and how to develop it based on the tooth being replaced to achieve natural-appearing restorations.


Asunto(s)
Implantes Dentales de Diente Único , Implantes Dentales , Implantación Dental Endoósea , Estética Dental
18.
Int J Oral Implantol (Berl) ; 13(3): 241-252, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32879929

RESUMEN

PURPOSE: Implant primary stability has long been considered a prerequisite for successful osseointegration. However, achieving stability may be difficult when placing implants in wide postextractive bone defects. The purpose of this study was to conduct a clinical and radiographic investigation of bone modifications at porous-structured implants inserted with or without primary stability. MATERIALS AND METHODS: Fifty porous-structured implants were inserted in the posterior sockets of 50 consecutive patients 2 months after tooth extraction, combined with allogeneic bone and a resorbable membrane. The implants were divided into two groups according to insertion torque: spinner (spinning at 35 Ncm, n = 23) and stable (stable at 35 Ncm, n = 27). Implant stability was assessed by resonance frequency analysis from baseline to 6-month function. Follow-up took place 3 years after implant placement. RESULTS: At baseline, the implant stability quotient was undetectable in the spinner group and averaged 75.07 ± 5.84 in the stable group. At uncovering, the implant stability quotient increased to 71.33 ± 4.42 and 77.97 ± 3.30 in the spinner and stable group, respectively (P < 0.001). After 6 months of loading, no between-group difference in implant stability quotient was found (P = 0.13). Marginal bone level changes were similar between groups at all follow-ups, averaging -0.41 ± 0.77 mm and -0.15 ± 0.53 mm at 36-month follow-up in the spinner and stable group, respectively (P = 0.35). No implant failed throughout the observation period. Neither biological nor mechanical complications occurred. CONCLUSION: Implants with a moderately rough surface and a porous-structured body may osseointegrate even without primary stability.


Asunto(s)
Implantes Dentales de Diente Único , Implantes Dentales , Implantación Dental Endoósea , Estética Dental , Humanos , Porosidad , Alveolo Dental/cirugía
19.
Int J Oral Implantol (Berl) ; 13(3): 269-277, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32879931

RESUMEN

PURPOSE: To compare the short-term clinical and radiographic outcomes of angulated screw-retained and cemented implant crowns following flapless immediate implant placement. MATERIALS AND METHODS: The study was designed as a prospective cohort study with 1-year follow-up. Eligible patients were divided into two groups according to restoration type: the angulated screw group (AG) and the cemented group (CG). Implant survival, marginal bone loss, mechanical complications, probing depth, bleeding on probing% and pink aesthetic score were evaluated. RESULTS: After 1 year of loading, the implant survival rate was 100% in both groups (AG, n = 23; CG, n = 20). A significantly lower bleeding on probing% was found in the AG than in the CG (11.6 ± 19.1% vs. 33.3 ± 33.8%, P = 0.04). No significant differences in marginal bone loss, probing depth and mechanical complication rates were found between the two groups (P = 0.53, 0.48, 0.41, respectively). The overall pink aesthetic score value was 8.96 ± 0.88 in the AG and 8.98 ± 0.62 in the CG at 1-year examination (P = 0.96). The percentage of excellent pink aesthetic scores (≥ 9) value increased from 48% at baseline to 83% at 1 year in the AG, and from 45% at baseline to 85% at 1 year in the CG. CONCLUSION: Based on the 1-year results, both treatment options provide high implant survival, a stable marginal bone level and excellent aesthetic outcomes in the short term. Angulated screw-retained crowns might benefit the long-term peri-implant conditions.


Asunto(s)
Implantes Dentales de Diente Único , Implantes Dentales , Tornillos Óseos , Coronas , Estética Dental , Estudios de Seguimiento , Humanos , Estudios Prospectivos
20.
Int J Prosthodont ; 33(5): 487-492, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32956429

RESUMEN

PURPOSE: The aim of the present study was to assess the perceptibility and acceptability threshold values for color differentiation at the restoration and mucosa levels. MATERIALS AND METHODS: One restored single-tooth implant and the contralateral reference tooth were spectrophotometrically assessed in 20 patients. Perceptibility and acceptability were evaluated by dentists, dental technicians, and laypeople. RESULTS: Dental technicians had the highest sensitivity in the perception of tooth color differences (ΔE = 2.7), followed by dentists (ΔE = 3.3) and laypeople (ΔE = 4.4). Acceptability threshold values were generally higher than perceptibility threshold in all groups. Dental technicians exhibited the highest sensitivity in the perception of mucosa color differences (50% perceptibility at ΔE = 2.65), followed by dentists (ΔE > 3.7) and laypeople (ΔE > 6). CONCLUSION: Color differences were tolerated with varying degrees among the three groups. Laypeople accepted higher color differences at the mucosa level.


Asunto(s)
Implantes Dentales de Diente Único , Diente , Color , Percepción de Color , Humanos , Membrana Mucosa
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