Immediate versus delayed implant placement of novel fully tapered tissue-level implants - A retrospective multicenter clinical study.

OBJECTIVES: To compare the clinical and radiological outcomes of novel fully tapered tissue-level implants in immediate implant placement (type 1) versus late implant placement (type 4) for the first time. MATERIALS AND METHODS: For this clinical study, 318 fully tapered tissue-level implants in 65 patients were inserted immediately (n = 68 implants) or late (n = 250 implants) in two different centers. Implant survival and success rates and marginal bone levels were analyzed. RESULTS: After a mean follow-up of 12.0 ± 5 months, implant survival rates were 97.8% for all implants. No statistically significant difference in implant survival rates between type 1 and type 4 could be detected (98.5% vs 97.6%, HR 0.70, 95%-CI 0.084-5.81). Neither for implant length (HR 0.53, 95%-CI 0.055-5.08) nor for implant width (HR 0.27, CI 0.028-2.55), a significant influence on implant survival could be detected. Type of used biomaterial for filling the gap and immediate loading showed no effect on implant survival. Mean marginal bone loss was 0.02 ± 0.05 mm for type 1 and 0.04 ± 0.1 for type 4. CONCLUSIONS: Within the limitations of this retrospective study and the short follow-up, the results demonstrated comparable high survival and success rates and stable marginal bone levels for type 1 and type 4 placement of this novel tissue-level implant (no clinical trial registration as retrospective study design).

Implant survival in the anterior mandible: A retrospective cohort study.

OBJECTIVE: This study aims to report the implant survival rate of dental implants of partially dentate patients in the anterior mandible and the potential risk indicators for implant failure. MATERIALS AND METHODS: Patients with implant-supported restorations of single or multiple teeth in the anterior mandible restored with fixed partial implant-supported restorations were evaluated. Patient demographic data, implant placement timing, and loading protocol, biological and/or technical complications at the time of the last clinical and radiographic follow-up visit were registered. Survival rate, success rate, and potential risk indicators for implant failure were calculated. RESULTS: A total of 108 patients and 186 implants with a mean follow-up period of 5.48 years (0.1-11.34 years) were included. The 11.3-year cumulative survival rate was 90.9%. Immediate implant placement (OR = 2.75) (p = .08) and immediate implant loading (OR = 8.8) (p = .02*) indicated a higher risk of failure than late implant placement or loading. When combining both categories (type 1A), an OR = 10.59 (p = .04*) for implant failure was found compared to category 4C. Implants placed following static-computer-assisted implant surgery (S-CAIS) showed less risk of failure compared to freehand implant placement (OR = 0.18; 95% CI: 0.02-1.37) (p = .09). CONCLUSIONS: The survival rate of implants placed in the anterior mandible was considerably low (90.9%). S-CAIS, late placement, and conventional loading are protective factor against implant failure in the anterior mandible.

Preservación alveolar post extracción en zona estética: decisiones clinicas predecibles en sitio severamente afectado / Alveolar ridge preservation in the esthesic zone: predictable decisions in a severly affected site

INTRODUCCIÓN: La valoración particular de sitios severamente comprometidos, involucra considerar los tiempos necesarios de cicatrización, así como evidencia actual en términos de biomateriales y técnicas quirúrgicas con el fin de lograr un tratamiento exitoso. MATERIAL Y MÉTODO: Paciente sexo femenino, 28 años, asiste por dolor e infección en diente 2.1 al Postítulo de Periodoncia UDD. Se observa defecto extenso y lesión que compromete tanto las tablas óseas vestibular como palatina. El tratamiento consistió en: exodoncia y regeneración ósea, instalación del implante 6 meses después de la exodoncia y cirugía de conexión 7 meses después más injerto de tejidos blandos. RESULTADOS: El tratamiento de defectos combinados (tejidos duros y blandos), asociados a procesos infecciosos de larga data, mediante rehabilitación implanto soportada puede ser muy predecible y exitoso en la medida que se respeten los tiempos de regeneración de diferentes estructuras.

INTRODUCTION: The specific assessment of a severely compromised sites involves: the consideration of healing time according to the different kinds of tissues involved and the knowledge of the evidence available concerning biomaterials and surgical techniques. MATERIAL AND METHODS: Female patient attends the postgraduate school of periodontics, UDD University in Santiago de Chile, because of pain and chronic infection compromising tooth 2.1. At clinical evaluation, the site has an extensive defect, with active fistula that compromises the buccal and palatal bone plates. The treatment consisted of exodontia and guided bone regeneration, implantation six months after initial exodontia and abutment connection surgery seven months after implant insertion. RESULTS: the treatment of combined defects associated with a long-standing infectious process can be very predictable and successful, only if the measures of time and tissue handling are considered and applied.

Early loading of titanium dental implants with an intra-operatively conditioned hydrophilic implant surface after 21 days of healing.

OBJECTIVES: The aim of the present observational medical device performance study was to test whether implants with an intra-operatively conditioned hydrophilic surface can be safely reconstructed when applying an early loading protocol after 21 days in partially edentulous posterior mandibles. MATERIAL AND METHODS: Partially edentulous patients with missing teeth in the posterior mandible were recruited. Immediately after implant placement, the implant position was indexed using a pickup impression technique. ISQ values were measured after 21 days of healing. When ISQ values were ≥70, the implants were directly restored with provisional reconstructions in occlusal contact allowing an early loading protocol. ISQ values were repeated again at 1, 3, and 6 months postloading. Clinical parameters (mPLI, mSBI, PPD, DIM, and CAL) were assessed. Standardized periapical radiographs were obtained after surgery, at implant loading and 3 and 6 months later. Changes over time were analyzed for statistical significance using the nonparametric method by Brunner & Langer (SAS Proc Mixed). RESULTS: Fifteen partially edentulous patients with healed sites in the posterior mandible received 20 implants. All implants healed uneventfully. At 21 days, all implants achieved an ISQ value of ≥70 (mean of 3 measurements) and were reconstructed at this time point with provisionals. ISQ values showed a gradual increase from baseline to 3 and 6 months postloading. The assessment of clinical parameters revealed stable tissue integration. The evaluation of the radiographs showed that 3 and 6 months after loading the median mesial and distal marginal bone levels had stabilized at the border between the rough surface and the 1-mm machined implant collar. CONCLUSION: Functional occlusal loading of implants with a hydrophilic, moderately rough endosseal surface 3 weeks after placement appears to be a safe and predictable treatment option in healed sites in the posterior mandible without need of bone augmentation procedures.