Usefulness of Wedge-Shaped Implants in the Full-Arch Rehabilitation of Severe Maxillary Atrophy: A Case Report.

The management of marked horizontal bone atrophy represents a critical challenge for traditional implantology procedures. For this purpose, clinicians have developed several protocols and procedures to allow the most suitable and accurate surgical and prosthetic implant rehabilitation. Despite the development of guided bone regeneration methods and the use of small-diameter implants, the rehabilitation of thin bone areas is a clinical dilemma for the medium- and long-term survival of implant-prosthetic therapies. This clinical case evaluates the use of wedge-shaped implants for the full-arch rehabilitation of an atrophic maxilla with a thin ridge. This treatment choice allowed a minimally invasive rehabilitation, avoiding regenerative bone surgery, while respecting biologic and prosthetic limits. Furthermore, evaluation of the implant stability quotient and marginal bone loss values during the first year of follow-up allowed analysis of the behavior of this rehabilitation in fullarch maxillary cases.

Usefulness of wedge-shaped implants in the full-arch rehabilitation of severe maxillary atrophy: a case report.

The management of marked horizontal bone atrophy represents a critical challenge for traditional implantology procedures. For this purpose, clinicians have developed several protocols and procedure to allow the most suitable and accurate surgical and prosthetic implant rehabilitation. Despite the development of guided-bone regeneration methods or the use of small-diameter implants, the rehabilitation of thin bone areas represents a clinical dilemma for the medium- and long-term survival of implant-prosthetic therapies. This clinical case evaluates the use of wedge implants for the full arch rehabilitation of an atrophic maxilla with a thin ridge. This treatment choice allowed a minimally invasive rehabilitation, avoiding regenerative bone surgery, while respecting biological and prosthetic limits. Furthermore, the evaluation of ISQ and MBL values during the first year of follow-up allowed us to analyse the behaviour of this rehabilitation solution in full arch maxillary cases.

Effect of Implant Macro-Design and Magnetodynamic Surgical Preparation on Primary Implant Stability: An In Vitro Investigation.

BACKGROUND: Macro-geometry and surgical implant site preparation are two of the main factors influencing implant stability and potentially determining loading protocol. The purpose of this study was to assess the initial stability of various implant macro-designs using both magnetodynamic and traditional osteotomy techniques in low-density bone. The parameters examined included peak insertion torque (PIT), implant stability quotient (ISQ), and peak removal torque (PRT). METHODS: Four groups of 34 implants each were identified in accordance with the surgery and implant shape: T5 group (Five implant and osteotomy using drills); M5 group (Five implant and magnetodynamic osteotomy using Magnetic Mallet); TT group (TiSmart implant and osteotomy with drills); and MT group (TiSmart implant and magnetodynamic osteotomy). Every implant was placed into a low-density bone animal model and scanned using CBCT. The PIT and PRT were digitally measured in Newton-centimeters (Ncm) using a torque gauge device. The ISQ was analyzed by conducting resonance frequency analysis. RESULTS: The PIT values were 25.04 ± 4.4 Ncm for T5, 30.62 ± 3.81 Ncm for M5, 30 ± 3.74 Ncm for TT, and 32.05 ± 3.55 Ncm for MT. The average ISQ values were 68.11 ± 3.86 for T5, 71.41 ± 3.69 for M5, 70.88 ± 3.08 for TT, and 73 ± 3.5 for MT. The PRT values were 16.47 ± 4.56 Ncm for T5, 26.02 ± 4.03 Ncm for M5, 23.91 ± 3.28 Ncm for TT, and 26.93 ± 3.96 Ncm for MT. Based on our data analysis using a t-test with α = 0.05, significant differences in PIT were observed between TT and T5 (p < 0.0001), M5 and T5 (p < 0.0001), and MT and TT (p = 0.02). Significant differences in the ISQ were found between TT and T5 (p = 0.001), M5 and T5 (p < 0.001), and MT and TT (p = 0.01). The PRT also exhibited significant differences between TT and T5, M5 and T5, and MT and TT (p < 0.0001). CONCLUSION: Our data showed favorable primary implant stability (PS) values for both implant macro-geometries. Furthermore, the magnetodynamic preparation technique appears to be more effective in achieving higher PS values in low-density bone.

Primary Stability of Three Different Osteotomy Techniques in Medullary Bone: An in Vitro Study.

BACKGROUND: The aim of this in vitro study was to analyse the primary stability of 20 implants placed with Twist drills (TD) versus 20 implants placed with Summers osteotomes (SO) and 20 implants placed with B&B bone compactors (BC) in medullary bone (quality type III and type IV). METHODS: The implants were placed in 10 fresh pig ribs fixed on a bench vice in order to avoid micro-movements during surgical procedures and measure recording. Peak insertion torque (PIT) and Peak removal torque (PRT) were recorded with MGT-12 digital torque gauge and ISQ was recorded through OSSTELL ISQ™ device by an independent operator. RESULTS: Comparing our data (Tukey test p = 0.05), it was evidenced a statistically significant difference in the PIT between TD and BC groups (p = 0.01). Analysing ISQ data, there was a statistically significant difference between the TD and BC groups (p = 0.0001) and between the SO and BC groups (p = 0.014). The analysis of PRT evidenced a statistically significant difference between the TD and BC groups (p = 0.038). CONCLUSIONS: This study evidenced that bone compactor preparation can positively influence primary implant stability (PS), however further in vivo studies and a larger sample are necessary to assess the usefulness in several clinical settings.

Flapless Cone Beam Computed Tomography-Guided Implant Surgery with Contextual Transcrestal Sinus Lift Augmentation Using New Bone Compactor Tools.

In the present paper, the authors present a case report of premolar edentulism in the upper jaw treated through a guided flapless oral implant surgery with contextual crestal sinus lift, performed with a system of manual screw-tapered bone expanders (B&B Dental, San Benedetto, BO, Italy). The surgery was planned by means of dedicated software, through which the data obtained from the CBCT and from intraoral scanner impression were matched, with consequent production of a surgical template. The proposed surgical procedure is minimally invasive, very simple, and fast and ensures good comfort for the patient by avoiding the elevation of mucoperiosteal flaps and uncomfortable malleting maneuvers. In addition, the presented method shows a good degree of correspondence between the ideal position of the implant in the planning phase and the actual one detectable after the surgery.

Horizontal Ridge Augmentation and Contextual Implant Placement with a Resorbable Membrane and Particulated Anorganic Bovine Bone-Derived Mineral.

Alveolar ridge deficiency is considered a major limitation for successful implant placement. Various approaches have been developed to horizontal augmentation of bone volume. This case report presents the medium-term results of one-stage guided bone augmentation using an anorganic bovine bone (70%) and autologous bone (30%), placed in layers, in association with resorbable collagen membrane for a subsequent implant placement. The patient presented with a localized horizontal ridge defect in the posterior zone of the jaw. The clinical and radiographic presentations, as well as relevant literature, are presented.