Implant loading protocols for the partially edentulous esthetic zone.
ABSTRACT The scientific evidence related to different or novel implant loading (primary objective) and directly associated implant placement (secondary objective) protocols developed for the anterior maxillae of partially edentulous patients was reviewed.
A comprehensive search of electronic databases and a hand search of six relevant journals was performed. The principal outcome variables were implant survival, implant success, and esthetic appearance. Concerning esthetic treatment outcomes, articles were specifically screened for the presence of objective evaluation parameters and patient satisfaction assessment.
The analysis of the literature on immediately restored or conventionally loaded implants in the esthetic zone revealed an initial survival rate of 97.3% after 1 year (10 prospective cohort studies and one case series). For periods of 1 to 5 years, the survival rate was 96.7%. These survival rates are consistent with previous reports on more traditional loading modalities. However, for immediately placed implants with immediate restoration and occlusal loading, the survival rate dropped by approximately 10% (four studies). Success criteria such as stable crestal bone levels, soft tissue recession, and probing depth could not be evaluated on the basis of the available literature.
There is a paucity of prospective cohort studies addressing patient-centered outcomes. No parameters specific to immediate loading protocols were available for evaluation. In order to validate or reject such implant protocols for use in the esthetically sensitive anterior maxilla, long-term clinical trials should routinely include objective esthetic criteria that comprehensively embrace the pertinent elements of "pink and white esthetics" in the form of readily used indices.
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ABSTRACT: Purpose: The purpose of this study was to evaluate the esthetic result of monophasic zirconium dental implants, placed in the highly esthetic areas of the jaws. Material and Methods: In this case series the results of 12 monophasic zirconium dental implants placed in highly esthetic areas of 8 patients (6 male and 2 female). For each implant the Pink Esthetic Score (PES) and the White Esthetic Score (WES) were evaluated. All implants were inserted in fresh postextraction sites. Results: The esthetic parameters PES/ WES has given a total average value of 15.5 ± 1.5. Analyzing the two indices individually, the PES has given a value equal to 7.5 ± 1 and the WES has given a value equal to 8 ± 1.13. Both values obtained indicate the achievement of an absolutely satisfactory esthetic result. Conclusion: Within the limits of this study, the zirconium dental implants seems to give excellent results with regard to the esthetic result and for the maintenance of peri-implant soft tissues.European journal of esthetic dentistry : official journal of the European Academy of Esthetic Dentistry, The 01/2013; 8(4):532-45.
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ABSTRACT: To assess the survival percentage, clinical and radiographic outcomes of sandblasted and acid-etched (SLA) dental implants and its modified surface (SLActive) in protocols involving immediate and early occlusal loading. MEDLINE, EMBASE and the Cochrane Oral Health Group's Trials Register CENTRAL were searched in duplicate up to, and including, June 2013 to include randomised controlled trials (RCTs) and prospective observational studies of at least 6-month duration published in all languages. Studies limited to patients treated with SLA and/or SLActive implants involving a treatment protocol describing immediate and early loading of these implants were eligible for inclusion. Data on clinical and/or radiographic outcomes following implant placement were considered for inclusion. Of the 447 potentially eligible publications identified by the search strategy, seven RCTs comprising a total of 853 implants (8% titanium plasma-sprayed, 41.5% SLA and 50.5% SLActive) and 12 prospective observational studies including 1394 SLA and 145 SLActive implants were included in this review. According to the Cochrane Collaboration's tool for assessing risk of bias, one of the studies was considered to be at a low risk of bias, whereas the remaining studies were considered to be at an unclear risk. Regarding the observational studies, all of them presented a medium methodological quality based on the Modified Newcastle-Ottawa scale. There were no significant differences reported in the studies in relation to implant loss or clinical parameters between the immediate/early loading and delayed loading protocols. Overall, 95% of SLA and 97% of SLActive implants still survive at the end of follow-up. Despite of the positive findings achieved by the included studies, few RCTs were available for analysis for SLActive implants. Study heterogeneity, scarcity of data and the lack of pooled estimates represent a limitation between studies' comparisons and should be considered when interpreting the present findings.Clinical Oral Implants Research 02/2014; · 3.43 Impact Factor
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ABSTRACT: In the esthetic zone, remodeling of the peri-implant soft-tissue contours through the use of provisional restorations is one of the imperative key factors for optimizing outcomes. Several methods have been described to produce the desired peri-implant soft-tissue contours using customized impression copings or cement-retained provisional crowns. The aim of this article is to present an alternative method for obtaining the desired peri-implant soft-tissue contours by using screw-retained provisional restorations as impression copings, which facilitates the definitive prosthesis fabrication.Journal of Oral Implantology 10/2011; 37(5):605-9. · 1.15 Impact Factor