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1.
Artículo en Inglés | MEDLINE | ID: mdl-33151184

RESUMEN

This investigation was designed to evaluate the reestablishment of bone-to-implant contact on infected dental implant surfaces following decontamination with an erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser and reconstructive therapy. Three patients presenting with at least one failing implant each were enrolled and consented to treatment with the Er,Cr:YSGG laser surface decontamination and reconstruction with a bone replacement allograft and a collagen membrane. The laser treatment was carried out at a setting of 1.5 W, air/water of 40%/50%, and pulse rate of 30 Hz. At 6 months, all three patients returned for the study. En bloc biopsy samples of four implants were obtained and analyzed. Two patients had excellent clinical outcomes, while one patient with two adjacent failing implants experienced an early implant exposure during the follow-up period. There was histologic evidence of new bone formation with two implant specimens and less bone gain with the others. Despite the small sample size, these were optimistic findings that suggested a positive role of Er,Cr:YSGG laser in debridement of a titanium implant surface to facilitate subsequent regenerative treatment. This investigation provides histologic evidence as well as encouraging clinical results that use of the Er,Cr:YSGG laser can be beneficial for treatment of peri-implantitis, but further long-term clinical studies are needed to investigate the treatment outcome obtained.


Asunto(s)
Implantes Dentales , Láseres de Estado Sólido , Implantes Dentales/efectos adversos , Erbio , Humanos , Láseres de Estado Sólido/uso terapéutico , Titanio , Itrio
2.
Int J Periodontics Restorative Dent ; 40(6): e211-e227, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33151185

RESUMEN

For decades, the histologic evidence about osseointegration and the bone-implant interface has been discussed in the literature. In this review, the effectiveness of dental implants retrieved for different causes was evaluated. A literature search was performed in databases for papers about implants retrieved from humans published by the Implant Retrieval Center of the University of Chieti-Pescara, Italy. Sixty-eight articles were selected into categories based on topics. The data indicated high level of bone-to-implant contact, lamellar bone close to the surface, roughness related to an increased bone response, organized and remodeled bone after loading, and peri-implant interfaces subjected to a continuous dynamic function.


Asunto(s)
Implantes Dentales , Huesos , Implantación Dental Endoósea , Humanos , Italia , Oseointegración , Estudios Retrospectivos , Propiedades de Superficie
3.
Artículo en Inglés | MEDLINE | ID: mdl-33151186

RESUMEN

This study presents the histomorphometric results of the Wafer Technique, which is based on guided bone regeneration and onlay grafts for 3D bone augmentation. This two-stage technique utilizes autogenous cortical bone plates and collagen membranes, forming a barrier containing a mixture of deproteinized bovine bone matrix, autologous blood, and bone grafted from intraoral sites. Twelve patients were treated. At 6 months postsurgery, histologic analysis of the regenerated areas revealed the presence of compact newly formed bone with no sign of inflammation. The percentages of new bone and native bone (mineralized tissue) were 16.4% (95% CI: 9.5% to 23.2%) and 42.6% (95% CI: 28.2% to 57.0%), respectively. Twenty-five implants were placed. The procedure has been proven to be safe and reliable, and only one transient complication was observed.


Asunto(s)
Aumento de la Cresta Alveolar , Sustitutos de Huesos , Implantes Dentales , Animales , Regeneración Ósea , Trasplante Óseo , Bovinos , Implantación Dental Endoósea , Regeneración Tisular Guiada Periodontal , Humanos , Membranas Artificiales
4.
Int J Periodontics Restorative Dent ; 40(6): e229-e233, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33151189

RESUMEN

A link between periodontitis and cardiovascular disease has been reported in the literature. For this systematic review, the keywords "cardiovascular disease" (CVD) were combined with "periodontitis" and "peri-implantitis" and were used to search for literature published on MEDLINE and PubMed between 1990 and 2020. Hand searching was also performed. A total of 206 articles were identified, 51 of which were reviewed. A link between periodontal disease and CVD can be explained by both the infection and inflammatory pathways. Interventional studies on the treatment of periodontal disease related to CVD have shown conflicting results. Therefore, based on published studies, CVD should presently be considered a comorbidity of periodontitis (with an association but no direct cause and effect documented). The association of CVD with peri-implantitis has too few studies to draw any conclusions. More studies are necessary before any conclusions can be made between CVD and periodontitis and CVD and peri-implantitis regarding possible links and the extent of association.


Asunto(s)
Enfermedades Cardiovasculares , Implantes Dentales , Periimplantitis , Enfermedades Periodontales , Periodontitis , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/etiología , Implantes Dentales/efectos adversos , Humanos , Periimplantitis/epidemiología , Periimplantitis/etiología , Enfermedades Periodontales/complicaciones , Enfermedades Periodontales/epidemiología , Periodontitis/complicaciones , Periodontitis/epidemiología
5.
Artículo en Inglés | MEDLINE | ID: mdl-33151192

RESUMEN

Oral cancer treatment involving the maxilla and/or mandible often results in esthetic and functional deficits that can diminish the patient's quality of life. As a result, expeditious reconstruction of the defect and dental rehabilitation is desirable. Dental rehabilitation shortly after reconstruction with an osteocutaneous free flap and resection prosthesis is a persistent challenge for patients with oncologic defects where immediate dental rehabilitation is not a possibility. Additionally, conventional prosthesis fabrication techniques are impractical or impossible due to postoperative anatomical changes and limitations in clinical armamentarium. To address these limitations, a technique and a novel implant-supported prosthetic workflow for the oncologic patient were developed to provide interim dental rehabilitation for such clinical situations. This article describes the prosthesis fabrication technique, reports short-term outcomes, and evaluates patient-reported quality-of-life outcomes using the FACE-Q Head and Neck Cancer Module.


Asunto(s)
Implantes Dentales , Colgajos Tisulares Libres , Reconstrucción Mandibular , Implantación Dental Endoósea , Prótesis Dental de Soporte Implantado , Peroné/cirugía , Humanos , Calidad de Vida
6.
Int J Periodontics Restorative Dent ; 40(6): e235-e240, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33151196

RESUMEN

This case report describes the rehabilitation of an extremely atrophic posterior mandible using 4-mm ultrashort implants and reports clinical and radiographic outcomes 7 years after loading. The patient refused to undergo any other treatment, from the removable prosthesis to the reconstructive surgery, and asked for a fixed, minimally invasive solution in the shortest possible time. The residual bone height above the alveolar nerve was an average of about 5 mm, so it was decided to treat the patient with four 4-mm ultrashort implants. Within the limitations of this case report, this procedure appears successful at 7 years after loading in this specific case and could reduce invasiveness, rehabilitative times, and costs. However, longer follow-ups on a large number of patients coming from randomized controlled clinical trials are necessary before making more reliable recommendations.


Asunto(s)
Pérdida de Hueso Alveolar , Aumento de la Cresta Alveolar , Implantes Dentales , Pérdida de Hueso Alveolar/cirugía , Implantación Dental Endoósea , Diseño de Prótesis Dental , Prótesis Dental de Soporte Implantado , Fracaso de la Restauración Dental , Estudios de Seguimiento , Humanos , Mandíbula/diagnóstico por imagen , Mandíbula/cirugía , Resultado del Tratamiento
7.
Artículo en Inglés | MEDLINE | ID: mdl-33151197

RESUMEN

The significance of keratinized mucosa around dental implants for the prevention of biologic complications has been a subject of controversy. Agreement, however, exists on the benefits provided to achieve more satisfactory oral hygiene measures and reduced clinical inflammation. A prospective interventional case series of 14 patients (31 implants) were examined every 3 months for up to 12 months. The effect of soft tissue conditioning by means of free autologous epithelial graft on the management of peri-implantitis with supracrestal and/or dehiscence-type defect morphology was evaluated. All clinical parameters were significantly reduced (P < .001), with complete disease resolution in 78.6% of the patients and 87.1% of the peri-implantitis implants. Unsuccessful cases were associated with less gain of keratinized mucosa, deep probing pocket depths, bleeding on probing, and less satisfaction during brushing at 12 months. Dimensional changes following soft tissue grafting were more significant during the first 3 months and led to a 42.4% shrinkage at 12 months. Soft tissue conditioning by means of free autologous epithelial graft in combination with apically positioned flap is a viable and effective therapy to manage peri-implantitis associated with deficient keratinized mucosa.


Asunto(s)
Implantes Dentales , Periimplantitis , Implantes Dentales/efectos adversos , Humanos , Higiene Bucal , Periimplantitis/cirugía , Estudios Prospectivos , Colgajos Quirúrgicos
8.
Int J Periodontics Restorative Dent ; 40(6): e241-e248, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33151199

RESUMEN

Trace registration is a new, alternative registration method for dynamic navigation implant surgery that eliminates the need for an artificial fiducial marker and stent to be present in the CBCT scan, substituting it with other high-contrast landmarks such as teeth, implants, or abutments. Clinical advantages include a streamlined, simplified workflow with fewer opportunities for error; elimination of presurgical steps associated with stent fabrication and imaging; and reduction in radiation risk. Sufficient high-contrast intraoral structures are a prerequisite for using this technique. This case series presents the trace registration protocol and workflow and reports on cases that demonstrate the application of this technology, including postoperative placement accuracy evaluation.


Asunto(s)
Implantes Dentales , Cirugía Asistida por Computador , Tomografía Computarizada de Haz Cónico , Imagenología Tridimensional
9.
Artículo en Inglés | MEDLINE | ID: mdl-33151200

RESUMEN

This study evaluated the effect of the antimicrobial photodynamic therapy (aPDT) on the osseointegration of immediate implants in a healing situation with greater challenges. The mandibular premolars of eight beagle dogs were submitted to ligature-induced periodontal disease. After 3 months, teeth were extracted and immediate implants were placed in the sockets previously decontaminated by mechanical debridement (MD) or MD+aPDT. Following 12 weeks, the dogs were euthanized and the specimens were analyzed. Histologic and histomorphometric analyses demonstrated significantly better results for the immediate implants decontaminated by debridement associated with aPDT. The sites treated with MD+aPDT led to osseointegration of the immediate implants without evidence of inflammation; conversely, evidence of peri-implantitis was observed where aPDT was not used.


Asunto(s)
Antiinfecciosos , Implantes Dentales , Periodontitis , Fotoquimioterapia , Animales , Perros , Oseointegración
10.
Georgian Med News ; (306): 147-151, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-33130663

RESUMEN

In this review, we have discussed the relationships between oral squamous cell carcinoma (OSCC) and dental implants. In the last decade, dental implants have been widely used for the treatment of complete or partial edentulism. Despite the fact that they have seen incredible success and the use of dental implants increases, concerns over safety and efficiency is rising as well. The literature analysis has shown that the number of reported cases when the OSCC development is associated with peri implantitis is gradually increasing. The possibility of squamous cell carcinoma development must be considered when evaluating the peri-implantitis. We highly recommend periodic oral and radiographic examination after the implant placement. The patients with peri-implantitis that do not respond to conventional treatment methods, and the patients who have a severe or rapid progression of peri-implantitis require biopsy. The histopathological examination will aid with the differential diagnosis between peri-implantitis and OSCC, and hence, provide the correct diagnosis.


Asunto(s)
Carcinoma de Células Escamosas , Implantes Dentales , Neoplasias de la Boca , Periimplantitis , Biopsia , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/etiología , Implantes Dentales/efectos adversos , Diagnóstico Diferencial , Humanos , Neoplasias de la Boca/diagnóstico , Neoplasias de la Boca/etiología
11.
Artículo en Inglés | MEDLINE | ID: mdl-33151187

RESUMEN

Pterygoid implant placement has not been a common treatment modality to manage the atrophic posterior maxilla. This randomized, controlled clinical trial evaluated the accuracy of dynamic navigation using trace registration (TR) technology in pterygoid implant placement when compared to free-hand surgery. Partially edentulous patients requiring at least one pterygoid implant to rehabilitate the atrophic posterior maxilla were included. Implant accuracy (in a prosthetically directed context) and the relation of the placed implants to the greater palatine canal (GPC) were evaluated using EvaluNav to compare the preoperative CBCT plan with the postoperative CBCT implant location. Osseointegration success, mucosal thickness, implant length, time spent for surgical placement, and ease of prosthetic restorability via degree of multi-unit abutment angulation were assessed. A total of 63 pterygoid implants were placed (31 using TR, 32 using free-hand) in 39 partially edentulous patients. Mean deviations between the planned and actual position for TR-placed implants were 0.66 mm at the coronal level, 1.13 mm at the apical level, 0.67 mm in depth, and 2.64 degrees of angular deviation, compared to 1.54 mm, 2.73 mm, 1.17 mm, and 12.49 degrees, respectively, for free-hand implants. In relation to the GPC, TR implants were more accurate when compared to the presurgical plan and took less surgical time. The mean mucosal thickness measured for all implants was 5.41 mm. Most implants were 15 to 18 mm long, and most prostheses (92%) could be accommodated by a 17- or 30-degree multi-unit screw-retained abutment. TR implants had greater short-term osseointegration success rates than free-hand implants (100% vs 93.75%). Pterygoid implant surgery can be a predictable and successful modality for prosthetically directed implant rehabilitation in the atrophic posterior maxilla, is more accurate than free-hand surgery, and takes less time when using dynamic navigation via TR.


Asunto(s)
Implantes Dentales , Boca Edéntula , Cirugía Asistida por Computador , Implantación Dental Endoósea , Humanos , Maxilar/diagnóstico por imagen , Maxilar/cirugía
12.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(11): 803-808, 2020 Nov 09.
Artículo en Chino | MEDLINE | ID: mdl-33171550

RESUMEN

Oral implantology has experienced more than half a century of development, the theoretical foundation and clinical technology are becoming more mature. This article elaborates on the establishment of implant timing, implant-related bone augmentation technology, surgical alternatives to bone augmentation technology, implant-related soft tissue augmentation technology, and computer-guided surgery. Provide a reference for a comprehensive understanding of dental implant surgery technology and its new developments.


Asunto(s)
Aumento de la Cresta Alveolar , Implantes Dentales , Implantación Dental Endoósea
13.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(11): 814-818, 2020 Nov 09.
Artículo en Chino | MEDLINE | ID: mdl-33171552

RESUMEN

Due to the highly predictable long-term clinical outcomes, modern implant dentistry has become one of the most preferred treatment modalities for restoring missing teeth. However, the complications of implant therapy compromise the long-term implant success and remain a great challenge to clinicians. Hardware complications include the mechanical complications which are related to the manufacturer-fabricated components of the prosthesis, such as abutment/screw loosening, fracture and implant fracture; and the technical complication which are related to laboratory-fabricated components of the prosthesis, such as veneer chipping. The biological complications mainly include peri-implant mucositis and peri-implantitis. It is crucial to figure out how to effectively avoid and manage the complications of implant therapy. This article reported the definitions, incidences, risk factors, prevention and treatment of both mechanical and biological complications of implant therapy.


Asunto(s)
Implantes Dentales , Periimplantitis , Estomatitis , Pérdida de Diente , Implantes Dentales/efectos adversos , Prótesis Dental de Soporte Implantado , Fracaso de la Restauración Dental , Humanos , Periimplantitis/etiología , Periimplantitis/prevención & control
14.
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
15.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(11): 825-830, 2020 Nov 09.
Artículo en Chino | MEDLINE | ID: mdl-33171554

RESUMEN

Passive fit is a key prerequisite for successful implant-supported restorations, especially for full-arch implant-supported fixed restoration. The precise passive fit comes from the fine control of the entire manufacturing process of resorations. Intraoral welding directly connects the metal framework and the upper abutment in the mouth, which can ensure precise and stable passive fit. This article will explain the definition, necessity, influencing factors and clinical control methods of passive fit, in order to provide guidance for achieving precise passive fit in implant-supported full-arch prostheses.


Asunto(s)
Implantes Dentales , Soldadura , Prótesis Dental de Soporte Implantado
16.
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
17.
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
18.
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
19.
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
20.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(11): 871-877, 2020 Nov 09.
Artículo en Chino | MEDLINE | ID: mdl-33171561

RESUMEN

Objective: To investigate the feasibility of two-stage crestal approach sinus elevation in severe atrophic maxilla. Methods: A total of 25 patients (male: 13 cases,female: 12 cases) who attended Department of Implant Center, Stomatological Hospital, Southern Medical University from May 2016 to May 2018 were included in this study. The age of the patients was 32-49 years old. The inclusion criteria were: single or multiple tooth loss in posterior maxilla with residual bone height ranged from 1.5 to 3.0 mm and vertical bone width≥6 mm, no pathological changes or septum were detected in the sinus. The elevated sides were divided into three groups according to different buccal-palatal sinus width (SW): wide (16 case, SW>15 mm), normal (12 case, 12 mm≤SW≤15 mm), narrow (5 case, SW<12 mm). Finally, 23 patients with 33 implants were placed by the two-stage crestal approach for sinus elevation. Six months after implant placement, final restorations were delivered. Implant survival rate, implant stability quotient (ISQ), immediate vertical bone height (VBH) after surgeries, changes of sinus elevation height (cSEH), marginal bone loss (MBL) at 1 year follow-up were examined. Results: Twenty-three patients were finally included in the study, including 12 males and 11 females, aged (41.2±7.6) years old. All implants healed uneventfully. ISQ (wide: 50.81±2.69; normal: 60.58±2.54; narrow: 63.12±3.58), immediate VBH after 1st surgery [wide: (7.99±1.13) mm; normal: (8.95±0.81) mm; narrow: (9.18±0.90) mm] and 2nd surgery [wide: (11.46±0.88) mm; normal: (12.77±0.49) mm; narrow: (12.57±0.55) mm], cSEH six months after 1st [wide: (3.87±0.43) mm; normal: (2.01±0.65) mm; narrow: (1.49±0.33) mm] and 2nd [wide: (1.16±0.29) mm; normal: (1.04±0.33) mm ; narrow: (0.97±0.41) mm] surgery, MBL [wide: (0.91±0.05) mm; normal: (0.79±0.10) mm; narrow: (0.74±0.07) mm] were significantly different among three groups (P<0.05). In all the three groups, cSEH was barely detected at 1-year follow-up (P>0.05). Conclusions: Two-stage crestal approach for sinus elevation might be an alternative protocol in severe atrophic posterior maxilla, especially in cases with narrow and normal buccal-palatal width. There is an urgent need for long time follow-up and more clinical cases.


Asunto(s)
Implantes Dentales , Elevación del Piso del Seno Maxilar , Adulto , Atrofia , Implantación Dental Endoósea , Femenino , Humanos , Masculino , Maxilar/cirugía , Seno Maxilar/cirugía , Persona de Mediana Edad , Resultado del Tratamiento
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