RESUMO
UNLABELLED: The purpose of this manuscript was to assess mandibular ramus block grafts used for augmentation of mandibular posterior segments, followed by subsequent implant placement. Twenty-four human subjects in need of lateral ridge mandibular augmentation were included in the current patient series. INCLUSION CRITERIA: recipient site had at least 10-mm residual height, but less than 4.3-mm bucco-lingual dimension. Autogenous bone blocks were harvested from the mandibular ramus. In the first group ramus block was used in association with platelet-rich fibrin and in the second in association with pericardium membrane. Implant surgery was performed 4 months after bone graft surgery when a total number of 44 implants were placed. Abutments were placed 4 months after implant surgery followed by final restoration. Ramus bone graft was successful in 100% patients for the first group and in 91.67% patients for the second group. Measurement on cone beam computed tomography revealed an average of 5.35âmm of lateral ridge augmentation for group 1 and 5.099âmm for group 2, achieved 4 months after surgery. All implants placed received fixed prosthetic restorations and are in use. Ramus block grafts can be used to allow optimal implant placement, with favor long-term success. Lateral ridge augmentation using mandibular ramus bone graft in association with platelet-rich fibrin is a more predictable and successful technique.
Assuntos
Aumento do Rebordo Alveolar/métodos , Mandíbula/cirurgia , Adulto , Transplante Ósseo/métodos , Tomografia Computadorizada de Feixe Cônico , Implantação Dentária Endóssea/métodos , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Pericárdio/fisiologia , Plasma Rico em Plaquetas/fisiologiaRESUMO
UNLABELLED: The aim of this paper is to present a technique for segmental dento-alveolar intrusive osteotomy in a posterior maxilla with lack of inter-arch distance for prosthetic rehabilitation combined with sinus floor elevation. METHODS: A full thickness flap is elevated exposing the lateral wall of the maxillary sinus. A lateral window is opened and the Schneiderian membrane elevated. Segmental dento-alveolar osteotomy is performed. After complete detachment of the segment, it is adapted and fixed to the new position using the pre-prepared guide, making sure not to damage or perforate the Schneiderian membrane. RESULTS: Four cases of segmental dento-alveolar intrusive osteotomy in a posterior maxilla combined with sinus floor elevation were performed utilizing the above-mentioned technique. All surgeries went according to plan, and healing was uneventful except for swelling and pain that lasted for 10-14 days post- operatively. The opposing dentition was later treated by implant placement. The average follow-up time for those cases was 5.4 months. Vitality test four months after surgery was positive. CONCLUSION: The presented technique for segmental dento-alveolar intrusive osteotomy combined with sinus floor elevation can serve as a viable treatment option in the posterior maxilla with lack of inter-arch distance due to severe overeruption.
Assuntos
Osteotomia Maxilar/métodos , Levantamento do Assoalho do Seio Maxilar/métodos , Placas Ósseas , Transplante Ósseo/métodos , Seguimentos , Humanos , Osteotomia Maxilar/instrumentação , Seio Maxilar/patologia , Membranas Artificiais , Dente Molar/patologia , Mucosa Nasal/patologia , Piezocirurgia/métodos , Retalhos Cirúrgicos/cirurgia , Erupção Dentária , Resultado do TratamentoRESUMO
Transition from a hopeless dentition to a fixed-implant-supported full-arch reconstruction can be difficult for patients if wearing a transitional removable denture is involved. In addition, an increased risk for trauma to bone augmentation areas and to the implant-bone interface exists when using a removable transitional complete denture during the implant healing period; such risk can compromise implant success or increase crestal bone loss around implants before the final restoration. This article describes a treatment approach that allows replacement of the hopeless dentition with an osseointegrated fixed prosthesis, without rendering the patient totally edentulous before the delivery of the final implant-supported prosthesis. A staged approach using a few hopeless teeth to support a provisional fixed restoration during the healing process can help avoid discomfort and improve implants' outcome. A treatment plan for a maxillary arch reconstruction is used to illustrate the staged approach protocol. This protocol addresses patients' psychologic need to remain dentate during partial or full-mouth rehabilitation, while providing good esthetics and function during restoration of a dental arch.
Assuntos
Arco Dental/cirurgia , Implantes Dentários , Prótese Dentária Fixada por Implante , Maxila/cirurgia , Planejamento de Assistência ao Paciente , Extração Dentária/métodos , Implantação Dentária Endóssea/métodos , Planejamento de Dentadura , Prótese Total Superior , Prótese Parcial Fixa , Prótese Parcial Temporária , Feminino , Humanos , Arcada Parcialmente Edêntula/reabilitação , Arcada Parcialmente Edêntula/cirurgia , Pessoa de Meia-Idade , Osseointegração/fisiologia , Levantamento do Assoalho do Seio Maxilar/métodosRESUMO
OBJECTIVES: The aim of the present study was to evaluate the influence of implant length and diameter on implant survival. METHODS: A retrospective cohort of 787 consecutive patients from 2 private practices between the years 2008 and 2011 had been evaluated. Patient demographics, site and implant characteristics, and time of follow-up were recorded from the medical files. RESULTS: Overall, 3043 implants were investigated. Overall survival rate was 98.7% with 39 implant failures recorded. Survival rates for narrow- (<3.75 mm), regular- (3.75-5 mm), and wide- (>5 mm) diameter implants were 98.2%, 98.7%, and 98.5%, respectively (P = 0.89). Survival rates of short (<10 mm) and regular (10 mm and above) implants were 97% and 98.7%, respectively (P = 0.22). CONCLUSIONS: Implant length and diameter were not found to be significant factors affecting implant survival during the first 2 years of function in the present investigation of this specific implant system by a single manufacturer. Further long-term follow-up studies are warranted because 2-years are only interim short-term results when dealing with dental implants.
Assuntos
Implantes Dentários/estatística & dados numéricos , Planejamento de Prótese Dentária/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Aumento do Rebordo Alveolar/estatística & dados numéricos , Estudos de Coortes , Falha de Restauração Dentária/estatística & dados numéricos , Seguimentos , Humanos , Carga Imediata em Implante Dentário/estatística & dados numéricos , Mandíbula/cirurgia , Maxila/cirurgia , Pessoa de Meia-Idade , Estudos Retrospectivos , Propriedades de Superfície , Análise de Sobrevida , Adulto JovemRESUMO
OBJECTIVES: The aim of the present study was to present results of single molar area rehabilitated by 2 narrow diameter dental implants. METHODS: A retrospective cohort of 33 consecutive patients from 2 private practices between the years 2008 and 2009 had been evaluated. Patients who had a first molar single replaced by 2 narrow diameter implants (3 mm wide) were included in this case series. Patients' demographics, site and implant characteristics, and time of follow-up were recorded from the medical files. RESULTS: Overall, 33 patients received 66 implants replacing 33 missing first molars. Patients' age ranged from 23 to 76 years with an average of 49.2 ± 12.7 years. Most of the implants were used to replace a mandibular molar (76%) and 16 were used to replace 8 maxillary molars. In 2 patients, immediate implantation was performed. The mean distance between the adjacent teeth was 12.1 ± 1.0 mm. Follow-up time ranged from 10 to 18 months (average, 12.2 ± 1.9 months). All implants survived the follow-up time. One implant presented with 1 mm of bone loss at 12-month follow-up. CONCLUSION: Replacing a single missing molar with 2 narrow diameter dental implants might serve as a viable treatment option providing good and predictable long-term results.
Assuntos
Implantação Dentária Endóssea/métodos , Dente Molar/cirurgia , Adulto , Idoso , Planejamento de Prótese Dentária , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Extração Dentária , Alvéolo Dental/cirurgia , Resultado do Tratamento , Adulto JovemRESUMO
PURPOSE: A new tissue-level implant design with angulations of 17, 30, and 45 degrees has been introduced to allow the use of the existing bone while maintaining the restorative platform at an angle to ensure an optimal functional and esthetic result for treatment of edentulous patients. The aim of this study was to measure implant survival, bone loss, and peri-implant health of the novel tissue-level angled-head dental implant system. MATERIALS AND METHODS: A retrospective analysis of cases from three private offices that were using the new implant system was performed. Data regarding patients' demographics, number and location of implants, restoration type, bone loss, implant failure, bleeding, and pocket depths were collected and analyzed. The data collected were analyzed using mainly descriptive statistics. RESULTS: A total of 29 participants were selected, and 185 dental implants were placed. The average patient age was 61 ± 7 years, and 52% were female. Some of the patients were medically compromised; 7% were diabetic, 20% were smokers, and 7% had osteoporosis. The average time from dental implant placement to the placement of the screw-retained crowns was 6 ± 5 months. Four implants failed with an average time to failure of 18 ± 8 months. Implant survival rate was 97.8%. The average bone loss was 0.014 ± 0.082 mm at 1 year, 0.133 ± 0.306 mm at 5 years, and 0.426 ± 0.903 mm at 10 years. Overall, 18.9% of implants were associated with bleeding, and only one implant had a pocket depth greater than or equal to 5 mm. CONCLUSION: The new tissue-level implant design with angulations of 17, 30, and 45 degrees has demonstrated predictable survival and success rates with minimal bone loss. The long-term follow-up seems highly promising; however, further studies are warranted to validate the results.
Assuntos
Perda do Osso Alveolar , Implantes Dentários , Idoso , Perda do Osso Alveolar/etiologia , Implantação Dentária Endóssea/métodos , Implantes Dentários/efeitos adversos , Planejamento de Prótese Dentária , Prótese Dentária Fixada por Implante , Falha de Restauração Dentária , Estética Dentária , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Reabilitação Bucal , Estudos Retrospectivos , Resultado do TratamentoRESUMO
PURPOSE: This study sought to evaluate treatment outcomes of implant-prosthetic rehabilitation with implants in the edentulous maxilla or mandible that were immediately loaded by fixed prostheses. Special consideration was given to the time of implantation (immediate, delayed, or late implant placement). MATERIALS AND METHODS: Twenty-five patients who received 283 immediately loaded screw-type implants were included in this retrospective study. Data captured included patient file information, panoramic and periapical radiographs obtained during treatment, and clinical parameters examined during the recall period. Clinical and radiographic status of peri-implant soft and hard tissue was evaluated, as well as the function of prostheses and subjective assessment by the patients of the treatment. Survival/success rates were analyzed with respect to the time of implantation. RESULTS: Following a maximum observation period of 120 months (median 29 months) postimplantation and subsequent immediate functional loading, implant survival was 99.6% (one implant failed after 20 months). The success rates were 98.2% for implants and 88% for patients; five implants in three patients did not meet success criteria. Neither the implant site nor the time of implantation were associated with unsuccessful outcomes. Implant-related evaluations revealed a significant association between implant success and implant length of 10 mm or less (P < .018). CONCLUSION: Within the limits of this study, immediate loading of rough-surfaced, screw-type implants supporting fixed dentures for the treatment of edentulous maxilla or mandible appears to be a reliable treatment option with a high probability of success. The time of implantation did not influence implant survival or success rates.
Assuntos
Implantes Dentários , Carga Imediata em Implante Dentário , Mandíbula/cirurgia , Maxila/cirurgia , Boca Edêntula/cirurgia , Idoso , Perda do Osso Alveolar/etiologia , Aumento do Rebordo Alveolar/métodos , Implantação Dentária Endóssea/métodos , Planejamento de Prótese Dentária , Prótese Dentária Fixada por Implante , Falha de Restauração Dentária , Feminino , Seguimentos , Regeneração Tecidual Guiada Periodontal/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Boca Edêntula/reabilitação , Dor Pós-Operatória/etiologia , Satisfação do Paciente , Periodontite/etiologia , Radiografia Interproximal , Radiografia Panorâmica , Estudos Retrospectivos , Análise de Sobrevida , Resultado do TratamentoRESUMO
In the atrophic posterior maxilla, successful implant placement is often complicated by the lack of quality and volume of available bone. In these cases, sinus floor augmentation is recommended to gain sufficient bone around the implants. Sinus elevation can be performed by either an open lateral window approach or by a closed osteotome approach depending on available bone height. This case series demonstrates the feasibility and safety of minimally invasive antral membrane balloon elevation, followed by bone augmentation and implant fixation in 20 patients with a residual bone height of 2 to 6 mm below the sinus floor. The surgical procedure was performed using a flapless approach. At 18 months follow-up, the implant survival rate was 100%. Absence of patient morbidity and satisfactory bone augmentation with this minimally invasive procedure suggests that minimally invasive antral membrane balloon elevation should be considered as an alternative to some of the currently used methods of maxillary bone augmentation.
Assuntos
Cateterismo/métodos , Seio Maxilar/cirurgia , Mucosa Nasal/patologia , Levantamento do Assoalho do Seio Maxilar/métodos , Adulto , Idoso , Substitutos Ósseos/uso terapêutico , Cateterismo/instrumentação , Tomografia Computadorizada de Feixe Cônico/métodos , Projeto do Implante Dentário-Pivô , Prótese Dentária Fixada por Implante , Estudos de Viabilidade , Seguimentos , Humanos , Carga Imediata em Implante Dentário , Maxila/diagnóstico por imagem , Maxila/cirurgia , Seio Maxilar/diagnóstico por imagem , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Minimamente Invasivos , Mucosa Nasal/diagnóstico por imagem , Osseointegração/fisiologia , Osteotomia/métodos , Piezocirurgia/métodos , Radiografia Interproximal , Segurança , Análise de SobrevidaRESUMO
PURPOSE: The objective of this study was to report implant survival rates, marginal bone loss, and the impact of prosthesis type among patients with type 2 diabetes mellitus (DMT2), with high hemoglobin A1C (HbA1c) values. MATERIALS AND METHODS: This retrospective study utilized patient medical records from an oral surgeon's office. Patients who had moderately or poorly controlled DMT2 with HbA1c values up to 10% were reviewed. Inclusion criteria were partially or fully edentulous patients diagnosed with DMT2 who were subsequently treated with implant-supported prosthetic restorations. Patients were at least 18 years of age. Exclusion criteria were patients who did not present for annual follow-up visits, patient records with incomplete surgical or restorative data, or nondiagnostic radiographs. All the fixed restorations were cement-retained, and the removable restorations were supported by two to six implants. Marginal bone loss and the consequences of prosthetic type were assessed from the last available radiograph compared with the one taken after the surgical procedure. RESULTS: Data of 357 implants were extracted from the records of 38 patients with HbA1c values (6.9% to 10.0%). The mean follow-up was 7.3 years, with a minimum of 5 years. Six implants failed, yielding a 98.4% overall implant survival rate. The patients were divided into two groups according to the HbA1c values before implant placement. The moderately controlled group included 25 patients with DMT2, with HbA1c values of 6.9% to 8.0%, and the poorly controlled group included 13 patients, with HbA1c values of 8.1% to 10.0%. The overall mean bone loss was 2.02 ± 2.43 mm. In both groups, the maxilla demonstrated more bone loss than the mandible (P < .05). Marginal bone loss in moderately controlled and poorly controlled groups was 1.86 (± 2.21) mm and 2.33 (± 2.85) mm, respectively (P < .05). Removable prostheses also revealed greater bone loss rates compared with fixed prostheses in both groups (P < .05). CONCLUSION: Patients with high HbA1c values (8.1% to 10.0%) had more marginal bone loss than those with lower HbA1c values. Removable dentures should be reconsidered as a standard treatment option in these patients.
Assuntos
Perda do Osso Alveolar , Implantes Dentários , Diabetes Mellitus Tipo 2 , Perda do Osso Alveolar/diagnóstico por imagem , Perda do Osso Alveolar/etiologia , Implantação Dentária Endóssea/efeitos adversos , Implantes Dentários/efeitos adversos , Planejamento de Prótese Dentária , Prótese Dentária Fixada por Implante , Falha de Restauração Dentária , Diabetes Mellitus Tipo 2/complicações , Seguimentos , Hemoglobinas Glicadas , Humanos , Estudos RetrospectivosRESUMO
OBJECTIVES: Severe atrophied edentulous posterior mandible with inadequate bone height superior to the inferior alveolar canal may require transposition of the inferior alveolar nerve in order to insert dental implants. Mandibular fractures are considered a rare complication of this procedure. Implant-related spontaneous fractures of the mandible represent 0.2% of patients with inserted implants in an edentulous mandible. This report presents two cases of mandibular fractures that occurred 3 to 4 weeks after inferior alveolar nerve transposition, and were managed successfully by conservative nonsurgical treatments. METHOD AND MATERIALS: Overall, 132 procedures of inferior alveolar nerve transposition in 98 patients were performed over a period of 10 years with 379 dental implants inserted in one stage with the procedure. Patients were examined every 2 weeks. The inferior alveolar nerve function was evaluated with various sensory tests. Panoramic radiographs were obtained immediately, at 3 months, and at 1 year after the surgery. The patients received implant-supported fixed prostheses after 3 to 5 months. RESULTS: The healing process was uneventful in 96 patients; however, in two patients (1.5%) spontaneous fracture of the treated site was observed 3 and 4 weeks postoperatively. The fractures lines occurred at a failed implant site. Both cases were treated conservatively. CONCLUSIONS: Spontaneous fractures following inferior alveolar nerve transposition are an important but rare complication. Conservative treatment modalities might be useful and indicated in some of those cases.
Assuntos
Perda do Osso Alveolar , Implantes Dentários , Fraturas Espontâneas , Fraturas Mandibulares , Tratamento Conservador , Implantação Dentária Endóssea , Prótese Dentária Fixada por Implante , Humanos , Mandíbula , Nervo MandibularRESUMO
OBJECTIVES: To evaluate the effectiveness of 0.2% delmopinol mouth rinse in maintenance of peri-implant tissue health and prevention or inhibition of peri-implant mucositis and peri-implantitis. MATERIALS AND METHODS: Four weeks following tooth extraction, eight titanium dental implants, were placed in six dogs' mandibles. Three dogs were assigned to the test or placebo mouth rinse. Eight weeks following implant installation (T2) ligature was placed to induce peri-implant disease. Clinical and radiographic assessment was performed during the study period as well as micro-CT analysis and histologic assessment to evaluate Bone-Implant Contact at the end of the follow-up (T4). RESULTS: Plaque at implant sites before ligature placement (T2) was lower for the test group (0.7 ± 1.0 vs 1.5 ± 1.3, P < .05). The ratio of affected implant (PD â§4 mm) at T2 and T4 in the test group was significantly smaller than that of the placebo group (T2, 17% vs 47%, P < .01; T4, 67% vs 83%, P < .05). The test agent also seemed to be effective in partially preventing bone loss induced by ligature placement according to the Computed Tomography and histologic analysis (test, 1.1 ± 0.8 mm; placebo, 1.5 ± 0.9 mm). CONCLUSIONS: Within the limits of this animal model study, the results of the study indicate that the 0.2% delmopinol rinse might play a role in prevention of peri-implant disease development.
Assuntos
Antibacterianos , Implantes Dentários , Morfolinas , Peri-Implantite , Estomatite , Animais , Cães , Masculino , Antibacterianos/administração & dosagem , Antibacterianos/uso terapêutico , Implantes Dentários/efeitos adversos , Modelos Animais de Doenças , Morfolinas/administração & dosagem , Morfolinas/uso terapêutico , Antissépticos Bucais/uso terapêutico , Peri-Implantite/etiologia , Peri-Implantite/prevenção & controle , Distribuição Aleatória , Estomatite/etiologia , Estomatite/prevenção & controleRESUMO
The use of hormonal anti-inflammatory drugs is a common practice in oral and dental surgery. They have proven enhanced efficacy, increasing therapeutic success when the treatment is properly chosen and managed. However, given the complexity of neurophysiologic processes, little is known regarding the consequences of administering glucocorticoids on brain function. This article aims to bring to the attention of dental health professionals the main neurophysiologic mechanisms by which glucocorticoid hormones can affect memory and attention. In addition, in the context of increasing global prevalence and incidence of cannabinoid consumption, both for medical and recreational purposes, the issue of the association of cortisone-derived drugs in the systemic context of these phytocannabinoids is addressed, in terms of memory issues and attention.
Assuntos
Atenção/efeitos dos fármacos , Cannabis/efeitos adversos , Glucocorticoides/efeitos adversos , Memória/efeitos dos fármacos , Procedimentos Cirúrgicos Bucais , HumanosRESUMO
OBJECTIVES: To evaluate the accuracy, safety, and anticipation effect of a novel electrical conductivity device (SG) in maxillary osteotomy preparation for placement of dental implants. MATERIALS AND METHODS: Thirty-seven osteotomies were prepared by three operators with different levels of expertise, using the SG protocol in the maxilla of six fresh frozen cadavers. A pre-op CT measurement of the length of bone in the desired implant location was taken and compared with the final length of the osteotomy created using SG during surgery. A comparison was made between the results of the different operators. RESULTS: The pre-op CT bone length measurements and the final depth assessment of the osteotomy with SG had a very high correlation level (0.977) with a significant mean difference of 0.639 mm (P < .0001), with the pre-op CT measurements being longer. The least experienced operator had placed the implants 0.924 mm less deep than the pre-op CT length measurements while the most experienced operator had placed the implants 0.244 mm less deep than the pre op CT length measurements. All implants were placed in the correct position and no breach of the sinus/nasal floor or buccal/palatine bone plates was detected. CONCLUSIONS: The SG electrical conductivity device offers the operator real-time monitoring during the surgical procedure. It provides a simple, safe, and sensitive method of detecting breaches, making it simple and safe for oral surgeons with different levels of expertise to use, with promising results.
Assuntos
Implantes Dentários , Condutividade Elétrica , Procedimentos Cirúrgicos Pré-Protéticos Bucais/instrumentação , Osteotomia/instrumentação , Osteotomia/métodos , Cadáver , Tomografia Computadorizada de Feixe Cônico , Implantação Dentária Endóssea/instrumentação , Implantação Dentária Endóssea/métodos , Humanos , Maxila/diagnóstico por imagem , Maxila/cirurgia , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/cirurgia , Procedimentos Cirúrgicos Pré-Protéticos Bucais/métodos , Sensibilidade e EspecificidadeRESUMO
The article describes complications following dental implant dislocation into the maxillary sinus and their management and attempts to elucidate the reasons for these complications and their prevention. This retrospective study presents 55 cases of dental implant migration into the maxillary sinus. Patients were 30 men and 25 women with average age of 58 years. Oroantral communication was found in 46 cases, primarily in cases without prior bone augmentation, in patients aged older than 60 years (mean), and medically compromised patients (ASA > 1). The dislocated implant and the infected tissue were removed from the sinus in most cases by Caldwell-luc intervention. The oroantral communication was closed by local and regional flaps. In most of the cases, the oroantral communication was closed by a single intervention. The conclusion was that oroantral communication and maxillary sinusitis are common findings following dental implant migration and dislocation into the maxillary sinus. The risk factors for these complications were dental implantation in the posterior maxilla without sufficient alveolar bone, implantation without prior maxillary sinus augmentation, and older and medically compromised patients. Successful closure of the communication is usually performed with local or regional flaps.
Assuntos
Implantes Dentários/efeitos adversos , Migração de Corpo Estranho/etiologia , Migração de Corpo Estranho/cirurgia , Seio Maxilar/cirurgia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Implantação Dentária Endóssea/efeitos adversos , Feminino , Migração de Corpo Estranho/prevenção & controle , Humanos , Masculino , Sinusite Maxilar/etiologia , Sinusite Maxilar/prevenção & controle , Sinusite Maxilar/cirurgia , Pessoa de Meia-Idade , Complicações Pós-Operatórias/prevenção & controle , Complicações Pós-Operatórias/cirurgia , Estudos Retrospectivos , Fatores de Risco , Retalhos CirúrgicosRESUMO
BACKGROUND: Survival rates of dental implants are reported to be very high and seem to indicate minimal complications related to dental implants. PURPOSE: The aim of this report was to evaluate in a cross-sectional study the prevalence of implant positioning complications as appears in postimplantation Cone-Beam Computerized Tomography (CBCT) in two of the major imaging facilities in Bucharest, Romania. METHODS: Demographic and implant data was collected from two of the three main CBCT facilities in Bucharest, Romania. All postimplantation CBCT imaging were assessed and evaluated for the presence of different implant positioning related complications. Data were entered into Excel spreadsheet and analyzed statistically. RESULTS: Of the 2323 CBCT's that were analyzed, a total of 160 (6.89%) presented with implant positioning related complications. Out of those, 62 cases revealed penetration of the implant to adjacent anatomic structure. More specifically, there were 21 instances of sinus penetration, 19 instances of nasal cavity penetration, 9 instances of inferior alveolar canal penetration, and 13 instances of lingual plate perforations. There were also 15 cases of adjacent tooth injury noted. CONCLUSIONS: Despite the popularity of dental implants, the surgical placement of these implants is not a riskless procedure. Implant mal-positioning might be life-threatening and can lead to serious bleeding, airway obstruction, and unnecessary postoperative surgeries. Complications of dental implants are not obsolete and dental implant associated problems may not be apparent immediately. Surgeons must have proper training and use evidenced-based treatment planning in order to prevent dental implant complications.
Assuntos
Tomografia Computadorizada de Feixe Cônico , Implantes Dentários , Achados Incidentais , Complicações Pós-Operatórias/diagnóstico por imagem , Estudos de Coortes , Estudos Transversais , Feminino , Humanos , Masculino , Complicações Pós-Operatórias/epidemiologia , Prevalência , Estudos RetrospectivosRESUMO
The aim of this study is to evaluate the performance of implant-derived minimally invasive sinus floor elevation. A multicenter retrospective study was performed in 5 dental clinics. Patients requiring sinus augmentation for single implant placement were recorded and followed up. The dental implant used in this trial was a self-tapping endosseous dental implant that contains an internal channel to allow the introduction of liquids through the implant body into the maxillary sinus; those liquids include saline and a flowable bone grafting material. Overall, 37 implants were installed in 37 patients. The age range of the patients was 37-75 years (mean: 51.2 years). The average residual bone height prior to the procedure was 5.24 ± 1 mm. Of all cases, 25 implants replaced the maxillary first molar and 12 replaced the maxillary second premolar. All surgeries were uneventful with no apparent perforation of the sinus membrane. The mean follow-up time was 24.81 ± 13 months ranging from 12 to 65 months. All implants integrated and showed stable marginal bone level. No adverse events were recorded during the follow-up period. The presented method for transcrestal sinus floor elevation procedure can be accomplished using a specially designed dental implant. Further long-term studies are warranted to reaffirm the results of this study.
Assuntos
Implantação Dentária Endóssea , Seio Maxilar , Levantamento do Assoalho do Seio Maxilar , Adulto , Idoso , Implantes Dentários , Feminino , Seguimentos , Humanos , Masculino , Maxila , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do TratamentoRESUMO
PURPOSE: The aim of the present report is to describe the long-term follow-up of cases treated with implant tooth-supported removable partial denture (ITSRPD) after at least 15 years. MATERIALS AND METHODS: The study sample comprised 20 consecutively partially edentulous patients treated with ITSRPD. Implants were placed in order to improve unfavorable removable partial denture design resulting from unfavorable teeth distribution and biomechanical considerations, esthetic, or periodontal challenges. All patients were followed up every 6 months for the first 2 years and annually thereafter for at least 15 years. Recall visits for professional cleaning and oral hygiene re-enforcement were scheduled every 3 to 6 mounts. RESULTS: A total of 42 implants were placed in 20 patients and restored with ITSRPD. All implants and prosthetic devices functioned successfully throughout the 15 years of follow-up. Three patients had gone through further implant placement several years after ITSRPD was provided, and a fixed implant-supported restoration was provided on the original and new implants. No implant failure was noted during follow-up, resulting in a rate for implant survival of 100% for the study. Marginal bone loss around implants ranged between 0 and 2 mm (mean 0.64 ± 0.6 mm). During the follow-up period, prosthetic complications were minor and included one rest rupture. All patients answered a questionnaire and were satisfied with the prosthesis. They reported good chewing ability and stability of the prosthetic devices. CONCLUSIONS: ITSRPD can be used with predictable long-term results in carefully selected and well-maintained population. Patients should be advised of their role in maintenance, and a comprehensive recall system is mandatory to obtain satisfactory long-term results.
Assuntos
Prótese Dentária Fixada por Implante , Prótese Parcial Removível , Mandíbula/cirurgia , Maxila/cirurgia , Idoso , Prótese Dentária Fixada por Implante/estatística & dados numéricos , Prótese Parcial Removível/estatística & dados numéricos , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
PURPOSE: To evaluate the survival rate of dental implants replacing failed implants in grafted maxillary sinuses using the lateral approach vs nongrafted posterior maxillae. MATERIALS AND METHODS: A retrospective analysis was conducted to study the survival of secondary dental implants inserted in the posterior maxilla in previously failed implant sites between the years 2000 and 2010. The study group consisted of patients who had also undergone maxillary sinus augmentation, and the control group consisted of patients in whom implants in the posterior maxilla had failed. Clinical and demographic data were analyzed using a structured form. RESULTS: Seventy-five patients with a total of 75 replaced implants were included in the study. The study group comprised 40 patients and the control group, 35 patients. None of the replaced implants in the study group failed, resulting in an overall survival of 100%; three replaced implants in the control group failed (92% survival). The main reason for the primary implant removal was lack of osseointegration (35 [87.5%] of 40 study group implants and 23 [65.7%] of 35 control group implants [P = .027]). The difference between the groups with regard to the timing of primary implant failure was statistically significant. The study group had more early failures of the primary implant than did the control group (77% vs 62%; P = .038). CONCLUSION: Dental implants replaced in the posterior maxilla had a high survival rate. A higher rate of survival was found in augmented maxillary sinus sites. Within the limits of the present study, it can be concluded that previous implant failures in the grafted maxillary sinus should not discourage practitioners from a second attempt.