ArticleLiterature Review

Evaluation of survival and success rates of dental implants reported in longitudinal studies with a follow-up period of at least 10 years: A systematic review

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Abstract

The aim of this systematic review was to evaluate the survival and success rates of osseointegrated implants determined in longitudinal studies that conducted a follow-up of at least 10 years. A broad electronic search was conducted in MEDLINE/PubMed and the Cochrane Central Register of Controlled Trials (CENTRAL) for relevant publications in indexed journals, evaluating the clinical performance of dental implants. Using inclusion and exclusion criteria, two reviewers analyzed titles, abstracts, and complete articles, prioritizing studies of the randomized clinical trial type. A total of 23 articles were included in this review. Ten prospective studies, nine retrospective studies, and four randomized clinical trials, which evaluated 7711 implants, were selected. The mean follow-up time of the studies included was 13.4 years. All of the studies reported survival rates and mean marginal bone resorption values, with cumulative mean values of 94.6% and 1.3mm, respectively. Fourteen studies related success rates. Taking into consideration the disparate outcome measures employed to assess dental implant performance and within the limitations of this systematic review, we may affirm that osseointegrated implants are safe and present high survival rates and minimal marginal bone resorption in the long term. Copyright © 2014 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

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... Endosseous dental implants have significantly transformed the restoration options available for individuals who are either completely or partially edentulous. The elevated survival rates documented for the replacement of a single tooth have underscored the efficacy of implant-supported restorations as a viable strategy for oral rehabilitation [1]. A comprehensive systematic review conducted by Hjalmarsson et al. encompassed nine investigations in which 367 individuals with solitary implants were monitored for a decade following implant placement [2]. ...
... This phenomenon typically arises due to biological complications whereby the organism fails to integrate the implant, often referred to as "rejection" of the dental implant. The factors contributing to early implant 1 failure may involve immunological, genetic, and environmental factors. Conversely, late implant failure transpires within one to three years after implantation [7]. ...
... Nevertheless, clinical evidence suggests otherwise. Despite the lack of any valid guidelines for dental implantation for SS patients [15] and despite the fact that maintaining oral hygiene might be more difficult in SS patients, routine oral rehabilitations using dental implantation have been shown successful over 10 years and more [15,16]. Such routine implants may be successful and safe for oral rehabilitation of edentulous patients suffering from some other autoimmune diseases as well [17]. ...
... Nevertheless, clinical evidence suggests otherwise. Despite the lack of any valid guidelines for dental implantation for SS patients [15] and despite the fact that maintaining oral hygiene might be more difficult in SS patients, routine oral rehabilitations using dental implantation have been shown successful over 10 years and more [15,16]. Such routine implants may be successful and safe for oral rehabilitation of edentulous patients suffering from some other autoimmune diseases as well [17]. ...
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Background: Systemic sclerosis (SS) is a debilitating disease that affects oral and any other tissues including skin, bone, blood vessels, and the connective tissues by excessive collagen accumulation. It is a difficult case for oral rehabilitation, let alone dental implantation. In this regard, only few studies have been conducted. This article reports a case of full-mouth implant–supported prostheses in a SS patient. Case: After diagnosing most remaining teeth as hopeless through clinical and radiographic examinations, implant-based fixed prosthesis for both jaws was planned, considering the progressive microstomia. Hopeless teeth were extracted. In the maxilla, the areas of central incisors, canines, first premolars, and first molars were implanted. In the mandible, the areas of the lateral incisors and the right second premolar were implanted. Also, according to the surgeon’s opinion, the anterior mandible needed bone grafting. After 3 months, the prosthetic treatment was started. Because in scleroderma, the limitation of mouth opening is progressive (and also in order to allow the restoration of the prosthesis in the future), screw-retained abutments were used for the posterior segment. Nevertheless, the anterior abutments were cement-retained. Result: The patient was followed up until the present time (for 3 years). In these follow-ups, no bone resorption was observed, and the treatment was deemed successful. Conclusion: This report suggests that dental implants might be successful and safe for at least some cases of systemic scleredema.
... Effective osseointegration minimizes the risk of implant failure, enhances load distribution, and improves the overall stability and functionality of the implant. For zygomatic implants, which are used in cases of severe maxillary bone loss, achieving robust osseointegration is essential to support the prosthetic structures and to facilitate optimal outcomes in complex maxillofacial reconstructions [17][18][19][20][21][22][23][24][25][26][27]. ...
... This study compares the performance of zygomatic implants and Implantize Compact from Boneeasy through Finite Element Analysis (FEA), focusing on bending and safety factors. The principle underlying this comparison is that for an implant to achieve osseointegration, the micro-vibration should be under 50 microns [1,2,[10][11][12][13][14][14][15][16][17][18][19][20][21][22]. Zygomatic implants were analyzed under various conditions, and their results were compared with those of the Implantize Compact system. ...
... Moraschini et al.'s systematic review reported an implant survival rate of 94.6% over 10 years [27]. High survival rates are commonly reported, and this can contribute to the perception that implants are always the superior option. ...
Article
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Restoring endodontically treated teeth has always been a challenge in dentistry. Dental posts are used when further retention is required for the final restoration, indicating that the tooth is already structurally compromised. Varying survival rates have been reported by previous studies, and there does not seem to be consensus on what factors are favorable regarding the survival of teeth treated with dental posts. Background/Objectives: This study investigated the survival of teeth treated with direct and indirect posts placed by dentists and dental students at an Australian university over a five-year period. Methods: This retrospective study included 684 direct and indirect posts placed from January 2018 to December 2022 at Griffith University dental clinic. The survival of the teeth treated with dental posts was assessed using Kaplan–Meier analysis. The potential effect of patient, tooth and operator factors was assessed using Cox regression analysis. Results: The posts had a five-year survival rate of 94% and survival time of 46.16 months. No statistically significant difference in survival was noted between the different groups in this study. Conclusions: Teeth treated with dental posts have been shown to have good short-term survival; however, long-term survival could not be commented on. Within the limitations of this study, survival was not associated with the location of the tooth, type of tooth, operator expertise, post material, cement, restoration or opposing dentition.
... Dental implants have demonstrated reliability, with a mean marginal bone loss of 1.3 mm over a 13.4-year period and a cumulative survival rate of 94.6% over a 20-year follow-up period. 1 Currently, there is no universal classification system for implants with various diameters. 2 In a recent classification, all dental implants were categorized based on implant diameters as extra narrow (<3.0 mm), narrow (≥3.0 to <3.75 mm), standard (≥3.75 to <5 mm), and wide (≥5 mm). 3 Specifically for narrow-diameter implants (NDIs), they were further categorized into category 1 (<3.0 mm, often referred to as 'mini-implants'), category 2 (3-3.25 mm), and category 3 (3.3-3.5 mm) based on a systematic review conducted by the International Team for Implantology (ITI). ...
Article
Purpose: This systematic review and meta-analysis aims to analyze the risk of prosthesis complications across different implant diameters. Materials and methods: An electronic search across PubMed (MEDLINE), Embase, Scopus, and Cochrane Central Register of Controlled Trials until December 2023 was performed. Studies comparing implant prosthesis complications among extra-narrow (<3.0 mm), narrow (≥3.0 to <3.75 mm), standard (≥3.75 to <5 mm), and wide-diameter (≥5 mm) implants were included. Meta-analyses were performed to evaluate the risk ratio of prosthesis complications across different diameters, particularly in non-full arch implant-supported fixed dental prostheses (ISFDP). Results: Eighteen clinical studies were included. In non-full arch ISFDP, the most prevalent complication was screw loosening in narrow, standard, and wide-diameter implants (17.28%, 4.08% and 12.45%, respectively), and decementation (3.4%) in extra-narrow diameter implants. In implant overdentures, extra-narrow, narrow and standard-diameter implants demonstrated high rates of retentive cap wear (58.33%, 80.49% and 70%, respectively), whereas wide-diameter implants had 16.67% overdenture repair. The meta-analyses showed a risk ratio of 0.20 (95% confidence interval= 0.04 to 0.94, p= 0.04) and 0.17 (95% CI= 0.06 to 0.45, p< 0.0004) for abutment fracture in single crowns and ISFDP comparing narrow versus standard-diameter implants. No significant differences in risk ratios were observed for screw loosening, decementation, porcelain chipping, fracture, or screw fracture among the different diameter groups. Conclusions: This systematic review highlights that screw loosening and retentive cap wear are the most common prosthesis complications in ISFDP and overdentures, regardless of implant diameter. While narrow-diameter implants have a lower risk of abutment fracture compared to standard-diameter implants, clinicians should carefully consider patient characteristics, implant locations, and abutment features when selecting the ideal implant diameter.
... Dental implant treatment for teeth replacement has continuously improved over the past few years and represents a highly predictable therapy [1,2]. An important factor that ensures the success of dental implants is proper stress distribution around the fixture under a given masticatory load [3]. ...
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This study aimed to comparatively evaluate the biomechanical behaviors of three types of dental implant restorations: a screw-and-cement-retained prosthetic system (SCRP); a cementless screw-retained prosthetic system (SRP); and a novel screwless hook-retained prosthetic system (HRP). Three-dimensional finite element analysis (FEA) was used to evaluate biomechanical behavior. A comparative study of three dental implant prostheses was performed under two loading conditions: a vertical load of 100 N and an oblique load of 100 N at an angle of 30°. Under both loading conditions, the maximum von Mises stress values in the dental implant using the HRP system were lower (21.33 MPa) than those of the SCRP system (32.91 MPa), and the stress distribution of the implant prosthetic components tended to be more favorable than that of the SCRP system. Thus, the results show that the performance of the HRP system was comparable to that of a conventional SRP system under the same conditions. Regarding stress distribution, the novel screwless HRP system presents a viable alternative implant prosthodontic system to the conventional SCRP system.
... Currently, prosthetic rehabilitation with dental implants is regarded as the optimal restorative option for missing teeth, offering functional, aesthetic, and psychological benefits to patients [1,2]. A crucial factor in the longevity of implant restorations is the passive fit between the implant and abutment, which ensures that no additional external forces are applied, preventing stress on both the implant and the surrounding bone [3]. ...
Article
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Objectives This study aimed to assess the vertical misfit at the implant-abutment interface in external and internal connections across various implant brands, comparing original milled titanium abutments with laser-sintered cobalt-chromium (Co-Cr) abutments. Materials and methods A total of 160 implants from four different brands were utilized, with 80 featuring external connections (EC) and 80 internal connections (IC). Original milled titanium abutments (n = 160) and Co-Cr laser-sintered abutments (n = 160) were randomly attached to each connection type, following the manufacturer’s recommended torque. After undergoing thermal cycling, the vertical misfit was measured using a scanning electron microscope. Statistical analyses were performed using the Kruskal-Wallis and Mann-Whitney U tests. The significance level was set at α = 0.05. Results The original milled titanium abutments exhibited the lowest misfit values. Significant differences were identified between both abutment types for EC (d = 109.578 μm; p = 0.0001) and IC (d = 44.317 μm; p = 0.002). The EC with laser-sintered abutments demonstrated the highest marginal misfit values, with an average of nearly 30 μm, while a misfit value of 11.382 μm was achieved in the IC. Differences were observed among the brands for milled abutments in both EC and IC. Similarly, variations were also noted for the laser-sintered Co-Cr abutments in EC and IC configurations. Conclusions The vertical misfit of the original milled titanium abutments in all groups was within the clinically acceptable range for IC. The connection type significantly impacted the vertical misfit in laser-sintered Co-Cr abutments. Differences among the implant systems were observed for both connection types and abutment types evaluated. Clinical relevance Using original milled titanium abutments, particularly in internal connection systems, can lead to better fit and stability at the implant-abutment interface, potentially reducing the risk of mechanical complications and improving long-term implant success.
... In this systematic review, data from 365 implants placed in a total of 153 patients were analyzed. Generally, the implant survival rate in healthy individuals is reported to be around 95-98% after 5 to 10 years of follow-up [42,43], which aligns with the 99.3% (50-100%) implant survival rate in this review for patients with OLP. However, survival rates can vary depending on disease severity, treatment, and the patient's response to implantation. ...
Article
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Objectives: This research is purposed to synthesize the existing evidence on implant survival rates in patients with oral potentially malignant disorders (OPMD) and assess potential risk factors associated with peri-implant disease. Material and Methods: A comprehensive search was performed across PubMed MEDLINE, Cochrane Library, and Web of Science. This review was conducted according to the PRISMA guidelines, including studies published between 2012 and 2023. Results: The review of studies related to oral lichen planus (OLP) revealed an implant survival rate of 99.3% (50% to 100%) with a mean follow-up of 40.1 months. One retrospective study focused on patients with leukoplakia and erythroplakia, but did not provide data on implant survival; however, it reported the presence of oral squamous cell carcinomas (OSCC) in the vicinity of dental implants. Data from a patient with proliferative verrucous leukoplakia (PVL) indicated a 100% implant survival rate, while patients with systemic lupus erythematosus (SLE) showed an implant survival rate of 97.67%. For all other entities of OPMD no articles could be found. Conclusions: With the exception of OLP, there is a limited number of studies or none on all other entities of OPMD. The available literature indicates no impact of OLP on implant survival rates and does not support OLP as a risk factor for peri-implant disease. For the other entities of OPMD, no conclusion regarding implant survival or peri-implant disease risk factors can be drawn due to a lack of studies. To validate the results and evaluate OPMD on peri-implant tissue, large-scale prospective studies for all types of OPMD, especially for leukoplakia and erythroplakia, are needed.
... Loss of permanent teeth owing to trauma or disease is a common problem worldwide. Currently, rehabilitation with osseointegrated dental implants is the therapy of choice for restoration of edentulous areas because it offers predictable outcomes and is biocompatible for most patients (Moraschini et al., 2015). However, local and systemic factors may limit the efficiency of this technique or lead to failure, especially in conditions that affect bone metabolism, such as diabetes mellitus (DM) (Jiang et al., 2021). ...
Article
Diabetes mellitus, a metabolic disorder, is widely known to negatively affect bone healing, especially by interfering with dental implant osseointegration. This review aimed to explore the mechanisms of metabolic bone changes around dental implants in patients with diabetes and the available therapies to improve osseointegration. A literature search was conducted in the PubMed, Cochrane Library, and Embase electronic databases to identify relevant studies. A substantial body of evidence has demonstrated the negative impact of diabetes mellitus on bone health and osseointegration. This can be attributed to several factors, including the over-expression of reactive oxygen species, accumulation of advanced glycation end products, impaired angiogenesis, and altered expression of proteoglycans and bone-related biomarkers. Various therapeutic approaches have been proposed to enhance osseointegration of dental implants in patients with diabetes. These include insulin therapy, hypoglycemic agents, hyperbaric oxygen treatment, parathyroid hormone therapy, implant surface modification, natural substances, mesenchymal stem cell management, gene expression, and growth factor modulation. Despite the potential of numerous therapies, either for glycemic control or osseointegration improvement, additional preclinical and clinical investigations are necessary to validate their effectiveness and safety.
... Сегодня для решения данной проблемы широко используются дентальные имплантаты различного дизайна. При этом высокие эстетические требования пациентов в сочетании с анатомическими ограничениями в переднем отделе верхней челюсти затрудняют достижение благоприятного эстетического и функционального результата [1,2]. ...
Article
Subject. Dental implantation and prosthetics are the main methods of replacing dental defects. One-stage implantation with immediate prosthetics reduces the number of operations and treatment time, preserving the surrounding tissues. It is important to achieve aesthetic results with the help of atraumatic tooth extraction, stable installation of the implant and rapid fixation of the crown. The presented technique covers all stages from planning to fixation of the crown, minimizing errors. Objectives. To clinically test an improved technique for manufacturing an anatomically correct and functional crown of the central incisor of the upper jaw with direct prosthetics based on an implant. Materials and methods. The clinical study involved 20 patients who underwent dental prosthetic treatment using an improved technique. The main group consisted of patients who had a screw-fixed crown based on an innovative angular implant, the control group included patients with a crown made on a direct implant. The assessment of the quality of the treatment was carried out on 2 control examinations. 6 months after the fixation of the temporary crown and 6 months after the fixation of the zirconium dioxide crown or 1 year after the installation of the implant. The results. Studies have shown that after the treatment, all patients showed stable fixation of the crown and aesthetic parameters, namely the contour of the gum, around the artificial crown. The results of the survey showed 100% satisfaction of patients with the treatment. Conclusions. The technique makes it possible to plan and implement dental orthopedic treatment of patients with loss of the central incisor of the upper jaw and at the same time produce a functional and anatomically correct crown based on an implant. Clinical observations have shown 100% success in treating the patient according to the algorithm proposed in the developed methodology.
... Dental implants have become one of the most widely performed procedures in daily practice due to their predictability, as shown by long-term survival rates exceeding 90% at 10 years [1,2]. Initially, clinicians were primarily concerned with achieving osseointegration on machined implant surfaces due to their low hydrophilicity [3]. ...
... Patients who are entirely or partly edentulous can now receive excellent oral rehabilitation because to the widespread use of prosthetic restorations that depend on dental implants, which increases the range of options for therapy [2]. The prevalence of dental implants in the global population is estimated to reach up to 23% by the year 2026 [3]. Since the introduction of titanium alloys for the purpose around 1981, there has been a marked increase in the use of dental implants to replace lost teeth in patients. ...
Article
An inflammatory reaction is elicited by implants, which is critical for osseointegration. During the first phase of osseointegration, leukocyte-infiltrated blood coagulum fills the gaps surrounding implants. Reactive oxygen species are produced when polymorphonuclear neutrophils are quickly drawn to inflammatory areas and have been demonstrated to adhere to artificial implant surfaces in a matter of minutes. Neutrophils release their own DNA in response to infection and inflammation; this process is known as "neutrophil extracellular trap formation," or "NETosis." The function of neutrophil extracellular trap process in dental implants will be the main topic of this review.
... Numerous important factors contribute to a favorable clinical outcome in immediate implant placement following extraction. These factors include the socket healing process, anatomical elements of the alveolar process (such as buccal bone width and the gap between the implant surface and the innermost part of the socket walls), the necessity for regenerative procedures, and enhanced surgical techniques [1]. Traditional implant installation methods often require a period of 12 months or more for bone regeneration after tooth extraction before placing a dental implant [2]. ...
... Numerous important factors contribute to a favorable clinical outcome in immediate implant placement following extraction. These factors include the socket healing process, anatomical elements of the alveolar process (such as buccal bone width and the gap between the implant surface and the innermost part of the socket walls), the necessity for regenerative procedures, and enhanced surgical techniques [1]. Traditional implant installation methods often require a period of 12 months or more for bone regeneration after tooth extraction before placing a dental implant [2]. ...
Article
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Introduction: The esthetics of immediate implant dentistry can be challenging. Clinical considerations for immediate implant placement have demonstrated long-term success rates comparable to traditional delayed implant protocols. However, it is a sensitive technique that requires proper treatment planning as well as meticulous execution to be predictable and successful in the long term. Methods: This clinical situation demands extensive knowledge of soft and hard tissue management for atraumatic tooth extraction followed by implant therapy, along with an understanding of the available materials to meet esthetic needs. This case report features a female patient with the chief complaint of needing to replace an anterior crown due to loss of retention. After a comprehensive oral assessment and cone beam computed tomography (CBCT) radiographic examination, it was determined that the crown on Tooth #9 was fractured at the subgingival level. Furthermore, gingival zenith positions displayed differences at the keratinized mucosa level in Teeth #7, #8, and #9, and the metal marginal areas of the porcelain-fused-to-metal (PFM) crowns in the anterior area of Teeth #5, #7, #8, #9, and #10 were apparent. The procedure involved atraumatic extraction of Tooth #9, followed by immediate implant placement. Crowns on Teeth #5, #7, #8, and #10 were replaced, and veneers on Teeth #6 and #11 were fabricated using press lithium disilicate-reinforced ceramic. Connective tissue graft (CTG) was contoured before final implant restorations. Results: The final implant crown was restored using a prefabricated abutment with a titanium base and lithium disilicate ceramic dental material. A well-planned combined treatment, including atraumatic tooth extractions for immediate implants and ideal contouring of soft tissues, can significantly impact the outcome of esthetic restorations. Conclusions: Single immediate implant–supported crowns in the esthetic zone were able to fulfill the patient’s esthetic expectations.
... As técnicas regenerativas tentam regenerar o osso ao redor dos locais da peri-implantite. Os materiais utilizados são enxertos ósseos, com ou sem membrana, ou apenas membrana, agentes biológicos, como fatores de crescimento ou proteínas morfogênicas ósseas (Moraschini et al., 2015). ...
Article
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Introdução: A invenção dos implantes dentários osseointegráveis foi um marco na odontologia contemporânea. Atualmente, milhões de implantes são instalados todos os anos, dos quais alguns desenvolvem problemas relacionados à cicatrização, como inflamação e perda de tecido ósseo. Objetivo: discutir as formas de preservar a integridade dos tecidos peri-implantares, identificar os principais desafios associados a esses problemas e apresentar as principais técnicas utilizadas para o seu tratamento. Metodologia: Foi realizado um levantamento e análise de artigos dados da plataforma MEDLINE (PubMed) com texto completo nos idiomas português e inglês, com o emprego dos descritores “mucosite”, “peri-implantite”, “implantes dentários”, “peri-implant mucositis”; “peri-implantitis”; “dental implants”, aplicando-os isoladamente ou combinados através dos operadores booleanos “and” e “or”. Resultados: Ao todo, foram obtidos 50 artigos com a utilização das palavras chave apresentadas. Aplicando os critérios de inclusão e de exclusão, foram selecionados 40 artigos para a elaboração deste trabalho. Conclusão: A literatura disponível sobre as técnicas e desafios associados à mucosite implantar e peri-implantite na preservação estética do sorriso é abundante. Os danos que essas duas patologias causam na saúde e autoestima dos pacientes são muito discutidos entre os pesquisadores, que propõem técnicas para o tratamento e contorno dos desafios que surgem. A atualização dessas técnicas e surgimento de novas pesquisas de ensaio clínico são essenciais para o avanço dos tratamentos e, consequentemente, melhor prognóstico para os pacientes portadores de mucosite implantar e peri-implantite.
... Periodontitis is the most common chronic inflammatory noncommunicable human disease and the main cause of tooth loss in adult populations in industrialized countries [1]. In the last decades, the use of osseointegrated dental implants has become an established and widely used treatment option for rehabilitating both fully and partially edentulous patients [2,3]. The high prevalence of peri-implant diseases, however, between 43% and 46.83% for peri-implant mucositis and between 19.5% and 22% for peri-implantitis at patient level [4][5][6][7], has gained attention in recent years, consistently with the increased use of dental implants for oral rehabilitations. ...
Article
Aim This systematic review investigates the effectiveness of implant therapy in patients with and without a history of periodontitis in terms of implant loss, peri‐implant marginal bone loss (MBL), and occurrence of peri‐implant diseases. Methods The protocol of the present meta‐analysis was registered on PROSPERO (CRD42021264980). An electronic search was conducted up to April 2024. All prospective cohort studies reporting implant loss, MBL, and occurrence of peri‐implant diseases in both patients with a history of periodontitis (HP) and patients with no history of periodontitis (NHP) after at least 36‐month follow‐up were included. The risk of bias was evaluated using the Newcastle‐Ottawa Scale and the quality of the evidence was also assessed. A meta‐analysis was performed on the selected outcomes at the available follow‐up time points. Subgroup analyses were conducted based on follow‐up time, rate of progression and severity of periodontitis, and implant surface characteristics. Publication bias was evaluated using the Funnel plot and Egger's test. Results From 13 761 initial records, 14 studies (17 articles) were finally included. Eight studies had a low risk of bias level, and six had a medium risk of bias level. Meta‐analysis showed that HP patients had a significantly greater risk for implant loss (HR: 1.75; 95% CI: 1.28–2.40; p = 0.0005; I ² = 0%), MBL (MD: 0.41 mm; 95% CI 0.19, 0.63; p = 0.0002; I ² = 54%), and peri‐implantitis (3.24; 95% CI: 1.58–6.64; p = 0.001; I ² = 57%) compared to NHP, whereas no significant intergroup difference for peri‐implant mucositis was found. Subgroup analyses revealed a particularly greater risk for implant loss for HP patients over a ≥ 10‐year follow‐up (HR: 2.02; 95% CI: 1.06–3.85; p = 0.03; I ² = 0%) and for patients with a history of grade C (formerly aggressive) periodontitis (HR: 6.16; 95% CI: 2.53–15.01; p < 0.0001; I ² = 0%). A greater risk for implant loss for stages III–IV (severe) periodontitis, and implants with rough surfaces was also found. Conclusions Within the limits of heterogeneous case definitions and methods of assessment, a history of periodontitis has been proved to significantly increase the risk for implant loss, particularly at long follow‐up (≥ 10 years) and in case of rapidly progressive forms (grade C), and for MBL and peri‐implantitis.
... Dental implants are likely to function for an extremely long period [1]. The success of dental implantation hinges not only on the initial surgical and prosthetic aspects, but also on the ability of dental professionals to address challenges that may arise during long-term maintenance [2]. ...
... Dental implants have emerged as a safe and effective solution for the replacement of missing teeth, with longitudinal studies reporting high predictability in terms of survival rates (90%-95%) and success rates (74%-90%) (Berglundh, Persson, and Klinge 2002;Karoussis et al. 2004;Moraschini et al. 2015). Despite these high success rates, inflammatory biological complications associated with dental implants, peri-implant mucositis, and peri-implantitis, have become a growing concern (Derks and Tomasi 2015). ...
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ABSTRACT Objectives: This study aimed to assess the effect of an oscillating chitosan brush (OCB) compared with an ultrasonic device with PEEK tip (US-PEEK) for mechanical implant surface decontamination using an in vitro model combining 3D models and a validated dynamic multispecies biofilm. Materials and Methods: A multispecies biofilm using six bacterial strains (Streptococcus oralis, Veillonella parvula, Actinomyces naeslundii, Fusobacterium nucleatum, Porphyromonas gingivalis, and Aggregatibacter actinomycetemcomitans) was seeded on dental implants with machined and sandblasted, large-grit and acid-etched (SLA) surfaces. These were installed in 3D models depicting peri-implant defect. Mechanical decontamination was performed for 120 s using either an OCB or a US-PEEK. A negative control group received no treatment. Scanning electron microscopy (SEM) was used to evaluate the bacterial composition and quantitative PCR (qPCR) analyzed the number of each bacterial species [colony-forming units per milliliter (CFU/mL)]. Results: Well-structured biofilms with a dense microbial distribution were observed on the negative control implants after 72 h. qPCR following mechanical decontamination showed a scarce bacterial reduction in the OCB group. The US-PEEK group exhibited a significant decrease in bacterial species compared to both OCB and control groups (p < 0.05). A biofilm removal effect was also observed in the OCB group for the machined implant surfaces. Conclusion: In vitro assessment using an anatomical 3D model showed that mechanical decontamination effectively reduced biofilm. The US-PEEK group demonstrated biofilm reduction on the SLA surface, while the OCB group showed a reduction on the machined implant surface. Additionally, the US-PEEK group demonstrated greater efficacy in reducing bacterial numbers.
... Osseointegrated dental implants represent a well-documented and highly successful treatment for edentulous patients [1][2][3]. The definition of osseointegration has evolved from "A direct contact between living bone and implant at the light microscopic level" [4] reflecting the histological pictureto "A structural and functional connection between ordered living bone and the surface of load-carrying implant" [5] incorporating the loading condition into the definition. ...
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Objective The present retrospective study aimed to determine the relationship between the secondary implant stability quotient and different parameters related to an oxidized implant. Methods A total of 135 patients (305 oxidized implants) were included. Implant-related factors (length, diameter, surgical and loading protocols, grafting, insertion torque, and primary stability) were used for comparisons and linear regression analyses, using secondary ISQ as the dependent variable. Results At the patient level, the mean time from implantation to secondary ISQ registration was 20.3 ± 29 weeks, and the mean secondary ISQ was 77.30 ± 7.22. The ISQ did not reveal significant differences regarding implant lengths, loading protocol, and simultaneous grafting. In contrast, platform diameters (3.5, 4.3, and 5.0), surgical protocols (one stage versus two stages), insertion torque (<35 Ncm versus >35 Ncm), and primary stability (achieved versus not achieved) all revealed significant secondary ISQ differences. Nevertheless, the regression analysis demonstrated that the platform diameter was the only variable significantly and positively predicted the secondary ISQ. Similar findings were found with the implant level analysis. Conclusions Among different implant- and protocol-related parameters, the platform diameter of the oxidized implant appears to be the only significant predictor of high secondary ISQ values at the time of superstructure connection.
... In order to accurately determine its accretion in the days following surgery, a sufficient observation period is necessary. [32,33,34] In the present study, the value of the measured swelling was significantly different on day 1, 3, 7 and day 14 between the groups with the study group receving PRP showing significantly lesser swelling. The results of Özgül et al, [35] and Kumar et al, [36] showed a significant effect of platelet-rich fibrin on reducing swelling after surgical removal of the impacted lower third molar also measured lesser swelling after the 1st, 3rd, and 7th postoperative day using a flexible ruler. ...
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Background: Trans-alveolar extraction of the tooth is a routine procedure in the field of oral and maxillofacial surgery and the role of Platelet Rich Fibrin (PRF) in regulating alterations in alveolar dimensions following tooth extraction is one potential area of study. The study plans to evaluate the efficacy of autologous PRF in healing of trans-alveolar extractions of mandibular molars by evaluating the pain, swelling through comparison soft tissue markings and wound dehiscence on day 1, 3, 7 and 14. Material & Methods: This randomized controlled study was conducted among 24 patients aged 18 to 40 years requiring trans-alveolar mandibular molars extraction with normal hematologic profile, fulfilling ASA 1 and 2 criteria with good oral hygiene and surgical site free of active infection. The study Group (12) received a-PRF after trans-alveolar extraction along with routine surgical management while control Group received routine surgical care. Results: The presence of wound dehiscence was lower in the study group as compared to control but it was not statistically significant. The mean (SD) pain score was lower in the study Group on Day 1, 3, 7 and 14 as compared to Control Group and it was found to be statistically significant (p<0.001). There was statistically significant reduction in swelling in study Group patients on Day 1, 3, 7 and 14 as compared to Control Group patients (p<0.001). Conclusions: The PRF treatment group has significantly lower pain and swelling on day 1,3,7 and 14. PRF can act as an accelerating factor in wound healing and maybe utilized in other maxillofacial surgical procedures for enhanced healing.
... The most recent meta-analysis by Howe et al. included 2688 implants for the 10-year survival rate [3]. Previous works, depending on the research question, also encompassed between 101 and 1435 implants for the relatively short period of just 10 years [5,41]. The long follow-up period is also extraordinary since in 2010 the median length of follow-up in RCTs was one year [42]. ...
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Objective This meta-analysis aims to investigate the long-term survival rates of dental implants over a 20-year period, providing a practical guide for clinicians while identifying potential areas for future research. Materials and methods Data were sourced from recent publications, focusing exclusively on screw-shaped titanium implants with a rough surface. Both retrospective and prospective studies were included to ensure an adequate sample size. A systematic electronic literature search was conducted in the databases: MEDLINE (PubMed), Cochrane, and Web of Science. The risk of bias for all studies was analyzed using a tool by Hoy et al. Results Three prospective studies (n = 237 implants) revealed a mean implant survival rate of 92% (95% CI: 82% to 97%), decreasing to 78% (95% CI: 74%-82%) after imputation (n = 422 implants). A total of five retrospective studies (n = 1440 implants) showed a survival rate of 88% (95% CI: 78%-94%). Implant failure causes were multifactorial. Conclusion This review consolidates 20-year dental implant survival data, reflecting a remarkable 4 out of 5 implants success rate. It emphasizes the need for long-term follow-up care, addressing multifactorial implant failure. Prioritizing quality standards is crucial to prevent overestimating treatment effectiveness due to potential statistical errors. While dental implantology boasts reliable therapies, there is still room for improvement, and additional high-quality studies are needed, particularly to evaluate implant success. Clinical relevance Never before have the implant survival over 20 years been systematically analyzed in a meta-analysis. Although a long-term survival can be expected, follow-up is essential and shouldn't end after insertion or even after 10 years.
... The Branemark protocol to ensure osseointegration has been the main dental implant socket preparation approach over the last 4 decades. 25 Osteotomy is usually performed using a series of drills, a counter sink, and final tapping. 26,27 In this protocol, the osteotomy site is increased gradually with calculated speed and copious irrigation to minimize the damage to the tissue at the preparation site. ...
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Background: Bone augmentation aims to provide sufficient bone volume around dental implants. Available bone augmentation methods include autogenous bone grafts, xenografts, and alloplastic materials. All have their advantages and disadvantages. However, autogenous bone graft remains the gold standard for bone augmentation. Autogenous bone grafts are usually taken from the patient's oral donor sites such as the chin and mandibular ramus. However, there is a newly developed implant preparation protocol, known as the peripheral-bone-removal (PBR) technique, which can provide bone augmentation from the dental implant site. Purpose: This study aims to determine the need for bone substitute materials in the PBR technique in dental implant surgery. Methods: This study included 130 patients who were treated for dental implants. These patients were treated between 7.1.2018 and 3.2.2023. Six dental implant systems were used. Five of these systems (ImplantKa ® , DeTech ® , NeoBiotech ® , Easy Implant ® , and Dentaurum ® Implant) used a conventional method (sequential drilling technique). The sixth (IBS ®) system used the PBR protocol. Both descriptive and Chi-Square Test statistics were used for data analysis. Results: The included patients were treated with a total of 198 dental implants. Seventy patients were treated with the PBR protocol, while 60 patients were treated with the sequential drilling protocol. For the PBR protocol, only 2 cases required bone substitute material, whereas 11 cases treated with the sequential drilling protocol required augmentation materials. This difference between both drilling protocols has been statistically confirmed (P=0.008). Conclusion: The PBR technique appears to be less traumatic and more cost-effective for cases that require horizontal bone augmentation.
... Conversely, it is contraindicated in pregnancy, patients with acute or terminal illness, severe periodontal disease, poor oral hygiene, chronic steroid therapy, high-dose irradiation, smoking and alcohol abuse, and uncontrolled metabolic disease. [7][8][9][10] Among several contraindications reported, controversies still exist in implant placement among individuals with diabetes mellitus, one of the most prevalent chronic metabolic disorders in the Indian population. Duration and severity of the disease and diabetic-related oral complications such as compromised periodontal health are predominant aspects that influence the implant survival and success rate. ...
Article
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Background Surgical and postoperative challenges impose the need for noninvasive techniques to enhance bone healing process and reduce complications during implant therapy in diabetic patients. Photobiomodulation therapy (PBMT) has shown a substantial effect in the management of postoperative pain, neurosensory recovery, and healing at surgical sites. Objectives The present study aimed to assess the effect of PBMT on peri-implant osteoblastic activity, soft-tissue wound healing, and Post operative pain discmofort among type 2 diabetic patients. Material and Methods Five type 2 diabetic patients with bilaterally edentulous mandibular posterior teeth necessitating 10 implants with two-segment variant type were included in the study. The study site (SS) with implants was treated with PBMT (gallium–aluminum–arsenide diode laser 810 nm), and the control site (CS) with implant (opposite side) was left untreated. The Wound Healing Index (WHI), Visual Analog Scale, and bone scintigraphy were used to assess postoperative discomfort and peri-implant osteoblastic activity, respectively. Results The average WHI scores and Visual Analog Scale at the SS were not significantly higher than the CS score. Although lack of significant increase in osteoblastic activity was observed under bone scan, the difference in experimental values highlights a possible association of PBMT and osseointegration potential among the study group. Clinical Implications The application of Photobiomodulation Therapy (PBMT) as an adjunct around dental implants will improve osteoblastic activity and bone healing to reduce the probability of early-onset failures in patients diagnosed with type 2 diabetes mellitus. However, to assess the impact of the PBMT on peri-implant bone with different bone densities, further well-controlled long-term trials on larger study groups are needed. Conclusion Within the limitations of the study, irradiation using PBMT at the peri-implant tissue site has shown favorable osteoblastic activity, WHI score, and Visual Analog Score postoperatively, but the results were statistically not significant. However, further long-term trials on diabetic individuals on a larger scale are needed for validating these study results.
... Dental implants have demonstrated impressive survival and success rates [1][2][3][4][5] However, they are not without flaws, and various complications are frequently reported in clinical studies [6,7]. Of these, complications of biologic nature are not only the most frequent ones but also often most difficult to manage [8,9]. ...
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Objective Dental implants show impressive survival and like rates, but peri-implantitis is a frequent inflammatory disease which affects the implant-surrounding tissues. While biofilms on the implant surface is considered its etiologic reason, several risk factors determine the pace of progression of peri-implant bone loss. Some risk factors are generally accepted while others are still unconfirmed and a matter of ongoing discussion. Among the latter, tissue macrophage sensitization on TiO2 has gained scientific interest in recent years. The aim of the present case-control study was to test for potential associations between clinically manifest peri-implantitis and MS related parameters. Materials and methods In patients with implants affected by peri-implantitis in the test group and healthy implants in the control group clinical parameters (peri-implant pocket depths (PPD) and bleeding on probing (BOP) were measured. Samples of aMMP-8 were taken from the entrance of the peri-implant sulcus and bacterial samples were collected from the sulcus. Blood samples were obtained from the basilic vein to assess MA-related laboratory parameters. Potential correlations between clinical and laboratory parameters were tested by multiple regression (p < 0.05). Results No statistically significant correlations were found between clinical or bacteriological findings and laboratory parameters were found. Conclusions Based on the findings of this study elevated MA-related laboratory parameters do not appear to be linked to peri-implantitis. Clinical relevance Sensitization on TiO2 is not associated with clinical symptoms of peri-implantitis.
... A dental implant is inserted into the jawbone to support restorative components, such as crowns, bridges, or prostheses [2]. Numerous studies have substantiated that implants offer maximum efficiency and comfort, ensuring safety, aes-thetic appeal, and high success rates [3,4,5]. Research suggests that dental implants may provide considerable stability than traditional dentures through osseointegration, where the implant fuses with the jawbone. ...
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AIM: Dental implant placement requires precise angulation for long-term success and optimal restoration function. Therefore, this study explores the potential association between the experience of oral and maxillofacial surgeons and the accuracy of implant angulation, including its relationship to neighboring teeth and other implants. METHODS: This retrospective study included 80 patients involving dental implants, each assessed through postoperative panoramic X-rays. Computer software was employed to measure the angle between the longitudinal axis of the selected implant and adjacent reference points. An angle less than 180°denoted convergence of the implant, while an angle greater than 180°indicated divergence. RESULTS: The average angle regarding the implant-tooth relationship on the mesial side was 177.74 ± 6.94 (convergent), while on the distal side, it was 182.39 ± 7.77 (divergent). There were no statistically significant variations in insertion angles between procedures performed by experienced specialists (with over 5 years of expertise) and those performed by residents (with less than 5 years of experience). In comparing implants on the right side of the mouth to those on the left, given that all the surgeons were right-handed, no statistical significance was found for either the mesial reference (177.56 ± 7.44 vs. 178.06 ± 6.04, p = 0.76) or the distal reference (182.01 ± 8.38 vs. 183.15 ± 6.52, p = 0.53). However, a statistically significant difference was identified between the inclinations of implants towards the mesial reference compared to the distal inclinations in both cases (p = 0.005 for the right side and p = 0.004 for the left side). CONCLUSIONS: In summary, satisfactory axial relationship in implant placement is effectively attained by both oral and maxillofacial surgery specialists and residents. Notably, implants consistently show a mesial inclination, irrespective of the specific side of the mouth. Additional research is needed to uncover the root cause of this inclination bias, aiming to promote the parallel alignment of implants with reference structures. Keywords: implant angulation; surgeon experience; dental implants; implant placement accuracy; axial relationships; implant orienta-tion; surgical experience
... Implant therapy has dramatically changed oral rehabilitation since its introduction [1], with an improved survival rate over the last decade [2,3]. However, adverse events such as biological complications including mucositis and peri-implantitis may compromise the treatment outcome. ...
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Methods Patients examined during postloading maintenance visits were included in this study. The presence of peri-implant mucositis, peri-implantitis and several patient- and implant-related independent variables was recorded. Statistical analysis was performed using the logistic regression analysis. The odds ratios (OR) of the potential association between each variable and the occurrence of peri-implant diseases were evaluated. Results Among the 114 participants with 403 implants, peri-implantitis was found in at least one implant of nine individuals (7.89%), and a total of 13 implants were affected by peri-implantitis (3.22%). The univariate regression analysis revealed a statistically significant association between arch (OR = 4.81; 95% CI = 1.27–31.36) and soft tissue thickness (OR = 4.07; 95% CI = 1.33–13.73) with the occurrence of peri-implantitis. The multivariate analysis confirmed the significant impact of soft tissue thickness (OR = 3.60; 95% CI = 1.16–12.24). Conclusion The occurrence of peri-implant diseases can be influenced by various factors. However, in order to accurately identify risk indicators, it is necessary to conduct long-term prospective studies.
... Dental implants have revolutionized dentistry (Belibasakis & Manoil, 2021;Derks et al., 2016;Hammerle & Tarnow, 2018;Schwarz et al., 2018) and are viable alternatives for the treatment of partially and fully edentulous areas (Guida et al., 2020;Monje, Wang, et al., 2017;Serino & Strom, 2009;Wang et al., 2020). Despite the proven success, their susceptibility to biological complications, such as peri-implantitis (PI), is a concern (Howe et al., 2019;Moraschini et al., 2015;Ravida et al., 2019;Roccuzzo et al., 2018). ...
Article
Aim: To investigate the influence of diabetes mellitus (DM) in a murine model of peri-implantitis (PI). Materials and methods: Twenty-seven 4-week-old C57BL/6J male mice had their first and second maxillary left molars extracted. Eight weeks later, one machined implant was placed in each mouse. Four weeks after osseointegration, the mice were divided into three groups: (a) control (C), (b) PI and (c) DM + PI. DM was induced by streptozotocin (STZ) administration. After DM induction, PI was induced using ligatures for 2 weeks. The hemimaxillae were collected for micro-CT and histological analyses. The primary outcomes consisted of linear (mm) and volumetric (mm3) bone loss. Secondary outcomes were based on histological analysis and included inflammatory infiltrate, osteoclastic activity, matrix organization, composition and remodelling. Data are presented as means ± SEM. Statistical analyses were performed using one-way ANOVA, followed by Tukey's test. Results: Gingival tissue oedema was detected in the PI and DM + PI groups. Micro-CT showed significantly increased linear and volumetric bone loss in the DM + PI group compared to the C and PI groups. H&E staining showed greater inflammatory response and bone resorption in the PI and DM + PI groups than in the C group. The DM + PI group had significantly higher osteoclast numbers than the C and PI groups. Picrosirius red stained less for types I and III collagen in the PI and DM + PI groups than in the C group. There was a significant increase in monocyte/macrophage (CD-11b) counts and matrix metalloproteinases (MMP-2 and MMP-8) marker levels and a significant decrease in the matrix metalloproteinases inhibition marker (TIMP-2) levels in the DM + PI group compared to the C and PI groups. Conclusions: DM exacerbates PI-induced soft-tissue inflammation, matrix degradation and bone loss.
... Thus, the large-scale use of dental implants, which demonstrate predictable longterm results from a functional, aesthetic and peri-implant health point of view, has high survival rates well demonstrated in the literature (1). Recent studies reported 86%-98% survival rates for dental implants after 5 years of follow-up (2,3) and around 90% even after 10 years of follow-up (4, 5). ...
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Objectives The aim of this study was to assess the survival rate and identify possible risk factors for failure of dental implants placed by postgraduate students in Implantology at a Brazilian Dental School. Materials & methods A retrospective observational study was conducted to evaluate 1,164 dental implants placed by postgraduate students in Implantology at São Leopoldo Mandic Dental School (Brazil) during a 3-year time period (2018–2020). Data collected from the patients' medical charts included the following: implant loss, gender, diabetes, smoking, continuous use of medication, type of implant connection system, implant position (maxilla or mandible), previous bone grafting and type of prosthetic provisioning (temporary prosthesis, immediate prosthesis or permanent prosthesis). The association between all the independent variables and implant loss was run using χ ² and G tests ( α = 5%). The implant survival rate was estimated using Kaplan-Meier curve. Results Gender, diabetes, smoking, continuous use of medication, type of implant connection system, implant position, previous bone grafting and type of prosthetic provisioning showed no statistically significant association with implant loss. Of the 1,164 implants installed, 29 (2.5%) failed. The overall survival rate of dental implants placed by postgraduate students up to 52 months was 90.5% (IC95%: 74.5%–96.7%). Conclusions Implants placed by postgraduate students in Implantology at São Leopoldo Mandic Dental School showed a high survival rate, with gender, diabetes, smoking, continuous use of medication, type of implant connection system, implant position, previous bone grafting and type of prosthetic provisioning not accounting for the risk of implant failure.
... Dental implants have been widely accepted as a predictable treatment option for the replacement of missing teeth (1). Sufficient bone width at the implant site is a major prerequisite for a predictable, long-term prognosis in implant dentistry (2). ...
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Aim The present article reports clinical, radiographic, and histological healing of a case of alveolar ridge preservation treated with a cortical bone allograft and a bioabsorbable collagen wound dressing membrane for the reconstruction of a damaged extraction socket with a buccal bone dehiscence. Case report In the case reported, alveolar ridge preservation technique was applied in an extraction site with a buccal dehiscence type defect, using an allograft bone substitute and a bioabsorbable collagen wound dressing membrane followed by a successful implant placement at a later stage. Conclusion This case report showed that alveolar ridge preservation technique in a damaged socket with buccal dehiscence, using a freeze dried bone allograft covered with a fast resorption collagen membrane, can lead to new bone formation, of up to 53.53%, and ultimately allow safe implant placement. TO CITE THIS ARTICLE Haddad M, Dagher M, Chakar C. Healing after tooth extraction and alveolar ridge preservation using demineralized cortical allograft particles in a dehiscence type defect: clinical, radiographic and histomorphometric case report.
Article
Objectives To assess the implant accuracy, safety, and efficiency between robotic‐assisted and freehand dental implant placement with a half‐year follow‐up. Methods Patients requiring single‐tooth implant restorations were recruited and randomized into two groups: robotic‐assisted surgery and freehand implant surgery. The accuracy of implant positioning was compared by assessing immediate postoperative CBCT scans against preoperative planning software. Intraoperative and postoperative complications were recorded, and data were analyzed using an intention‐to‐treat approach. The time required for implant placement in each group was documented. A 6‐month follow‐up measured the implant survival rates. Results The study included 24 patients (median age 36, 18 female). In the robotic‐assisted surgery group, the average platform global deviation, apex global deviation, and angular deviation were 0.70 ± 0.11 mm, 0.70 ± 0.12 mm, and 1.09° ± 0.67°, respectively. In the freehand implant surgery group, these measures were 1.24 ± 0.59 mm, 2.13 ± 1.26 mm, and 7.43° ± 6.12°, respectively, with statistically significant differences. Regarding the duration of surgery, the robotic‐assisted surgery group required 18.8 ± 4.89 min. Intraoperative and postoperative complications were similar across both groups, and the implant survival rate was 100% in both groups at the 6‐month follow‐up. Conclusions This study found that robot‐assisted implant placement offers higher accuracy in implant positioning compared to freehand placement, while requiring longer operation times. Future developments should focus on simplifying the registration and design of robot systems to enhance efficiency and facilitate their broader clinical adoption.
Article
Introduction Cone-beam computed tomography (CBCT) is the recommended imaging modality for implant planning. It is important to evaluate the accuracy of CBCT-based implant size prediction. This study aims to correlate projected implant sizes from CBCT alveolar ridge measurements with the actual sizes of placed implants, to determine the accuracy of the prediction. Materials and Methods CBCTs taken for implant placement were included. The heights and widths of edentulous ridges were measured with Anatomage in vivo dental three-dimensional software, and actual implant size data were retrieved from treatment notes. Central incisor, canine, first premolar and first molar locations were analysed. One-way analysis of variance (ANOVA) was run to determine the average sizes for edentulous ridges and implants and Pearson correlation was conducted to determine the accuracy of CBCT-based implant size prediction. Results Of 544 cases analysed, the average implant diameter was 4.17 mm (standard deviation [SD] =0.38) and the length was 10.05 mm (SD =1.17). Alveolar width and height were 3.74 mm and 4.31 mm larger than the implant diameters and lengths, respectively providing approximately 1.5–2 mm of extra space on either side of the implant in relation to adjacent anatomical structures. Implants placed at mandibular canine and first molar and maxillary first premolar demonstrated significant correlations with the sizes of the edentulous ridges ( P < 0.05). Discussion CBCT-based alveolar ridge measurements have been demonstrated as reliable parameters to predict implant sizes. However, its accuracy may be limited by the factors such as edentulous ridge morphology and proximity to vital anatomic landmarks.
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Introduction : The destruction that occurs in peri-implantitis, if left untreated, can eventually lead to dental implant failure. Autogenous growth factor is prepared by centrifugation of whole blood samples and has been widely applied in wound healing and tissue regeneration. This platelet concentrate can be used alone or in combination with other biomaterials for soft tissue healing or bone formation. CGF (concentrated growth factor) is a derivative of PRF (platelet-rich fibrin) and has the same 3-dimensional structural complex as PRF. However, it contains more growth factors than PRF and has a more rigid fibrinogen structure. Aims : The objective of this systematic review is to obtain scientific data related to the use of concentrated growth factors in peri-implantitis treatment in order to avoid dental implant failure. Method : A total of 5,339 studies were initially identified from the three databases (Wiley, Researchgate and Google Scholar) between January 2018 and July 2023. Result : Three randomised clinical trials (RCTs) were selected for analysis. Conclusion : Concentrated Growth Factor (CGF) can be employed in combination with bone graft material for the treatment of peri-implantitis, with the objective to prevent dental implant failure that may result from peri-implantitis. However, it is not the sole recommended approach.
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Dental implants are widely used for replacing missing teeth. This chapter looks at the role of particle release from implant biomaterials in the onset of peri-implantitis, and materials that can potentially provide resistance to implant failure. The chapter aims to bridge the knowledge gap between the role of dental implant biomaterials in the onset and progression of peri-implantitis and preventative strategies, which is important for clinical, manufacturing, and research.
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Bacteria are capable of developing biofilms on various types of surfaces, and the bacterial adhesion process can be altered by the characteristics and micromorphology of these surfaces. This way, the properties of biomaterials can be targeted to inhibit bacterial adhesion and colonization.
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Purpose The polarization of macrophages towards the pro-inflammatory M1 phenotype and osteoclast overactivation play a significant role in the pathogenesis of aseptic loosening of orthopedic implants. This study sought to examine the expression and activation of macrophages and osteoclasts in implant biopsies with respect to epidermal growth factor receptor (EGFR) signaling and to assess the potential of EGFR inhibition in mitigating titanium particle-induced bone resorption in a cranial resorption murine model. Methods Bone marrow-derived macrophages (BMDMs) were stimulated with Tumor Necrosis Factor-alpha (TNF-α) and Interferon-gamma (IFN-γ) initially. Subsequently, Osteoclast differentiation was initiated after Gefitinib was added to the treatment groups. Male C57BL/6 mice were treated with Gefitinib or 0.5% Carboxymethyl Cellulose-Sodium (CMC-Na) by oral gavage daily for two weeks. A sham group received no further intervention, while the other groups had titanium particles implanted. Tissues were collected and analyzed by measurements such as micro-computed tomography (micro-CT) analyses, histology, immunofluorescence stainings, cell viability assays, assays for resorption pit formation, Reverse Transcription-Polymerase Chain Reactions (RT-PCRs), and Western blots were conducted. Results The study demonstrated a significant upregulation of EGFR in response to titanium particle exposure. Inhibition of EGFR phosphorylation with gefitinib effectively reduced bone degradation at osteolytic sites in a murine model. Gefitinib treatment led to a notable reduction in M1 macrophage polarization, as indicated by immunofluorescence staining and Western blot analysis of macrophage markers. Mechanistically, selective EGFR inhibitors mitigate osteoclastogenesis and osteoclast resorption by inhibiting the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT) and nuclear factor-κB (NF-κB) signaling pathways. Conclusion Our findings provide compelling evidence of the essential role of EGFR-related pathways in M1 polarization, osteoclast activation, and ensuing periprosthetic osteolysis. Overall, EGFR presents a novel target for addressing bone resorption-associated conditions triggered by particles or modulated by macrophages and osteoclasts.
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Statement of the Problem The satisfaction of patients with dentures on implants has different points of view that become fundamental aspects for the development of research on the quality of life of these patients, the eventual biomechanical complications to which these prostheses and implants can be subjected, and design considerations for cantilever extensions. Purpose The objective of research was to assess the implants and prosthesis survival rates, biomechanical complications relative to the length of the distal extensions (cantilevers), and the satisfaction of the patients with a fixed implant-supported full-arch fiber-reinforced composites prosthesis Materials and Method A retrospective clinical and radiographic cohort study was developed. Clinical records of a selected cohort were analyzed according to inclusion and exclusion criteria. Data on a patient who underwent to fixed implant-supported full-arch fiber-reinforced composites prosthesis at least of five years of function were collected. Data analysis was performed using Kaplan-Meier curves and Fisher's Exact Test. P values less than 0.05 were considered statistically significant Results After insertion, 1 of 29 prostheses failed, the overall prosthetic survival rate observed at 5 years was 96.5%. Of the 120 implants placed in 28 patients, only 4 patients experienced loss of an implant during the 5 years of observation; the implant survival rate throughout the observation period was 86.2%. Distal extension seems to negatively affect the prognosis of implant-supported rehabilitation. Regarding the level of satisfaction of the patient with the prosthesis, none reported being uncomfortable or dissatisfied neither with their appearance nor with the taste of food throughout the studied period Conclusion No relevant associations were found between the variables involved. The study found the improvement in quality of life following the installation of fixed rehabilitation on the patients. Once the potential benefits of patients are obtained, controlled clinical trials are encouraged.
Article
Introduction Osseodensification (OD) compaction increases primary stability by leaving the residual bone particles in the osteotomy site, which in turn act as an autograft. [1] Condensing the bone trabeculae through OD has demonstrated to have a potentiating influence on secondary stability. [2] Materials and Methods A split-mouth study was conducted in 40 patients to determine the effect of OD on implant success rate in terms of primary and secondary stability in situations including immediate loading of implants placed in low-density bone, which was tested using resonance frequency analysis (RFA) at the interval of 0, 6 th month. In order to assess the implant success rate, gingival probing depth and crestal bone loss (CBL) around the implant were also assessed at baseline and 6 months. Results With respect to primary stability, at baseline, the mean RFA of Densah burs is 71.6 ± 9.5 and of conventional drills is 67.6 ± 10.4. The mean stability of Densah burs is significantly higher than conventional drills, both at baseline and after 6 months as well. CBL, at baseline, the mean CBL of Densah burs is 0.58 ± 0.11 and of conventional drills is 0.64 ± 0.12. The mean CBL of Densah burs is significantly lower than that of conventional drills for both. Conclusion The implant stability values found in the present study were remarkable when compared between OD and conventional osteotomy techniques. Decreased loss of bone at the crest probing depth also aided in the increased success rate.
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Introduction: Maintenance of dental implant with different hygiene methods or instruments may cause a surface alteration. It directly affects bacterial colonization and adhesion on titanium implant surfaces that result in peri-implant diseases. This study aimed to compare the Streptococcus sanguinis (S. sanguinis) adhesion on titanium implant abutments after instrumentation with a rubber cup with pumice and erbium, chromium-doped: yttrium, scandium, gallium, and garnet (Er, Cr: YSGG) laser using scanning electron microscope (SEM) observation and colony-forming unit (CFU) measurement. Methods: Twenty-one MegaGen titanium implant abutments were randomly distributed into three groups. Seven abutments were respectively selected for the control/untreated (C) group, while the other two groups were treated with rubber cups with pumice (P) and Er, Cr: YSGG laser (L). All samples were cultured with S. sanguinis for bacterial colonization and adhesion. One sample for each group was selected for SEM observation, while the other samples were prepared for CFU calculation. Results: For SEM results, at 2,000× magnification, machining marks were intact in the C group, roughened in the L group, and smoothened in the P group. At 5,000× and 10,000× magnifications, moderate colonies of S. sanguinis were revealed in C and L groups, while sparse bacterial colonies were detected in the P group. However, for CFU results, statistical analysis showed no significant value (p>0.05) comparing all three groups. Conclusion: P instrumentation revealed a lesser amount of S. sanguinis adhesion in SEM photographs, but no statistical significance of CFU results was noted for all three groups.
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This study is initiated with the aim of regulating the release of silver (Ag) as an antibacterial agent from the micro‐arc oxidation (MAO) coating. Herein, an external 5 wt% Tin(II) chloride (SnCl2) containing biodegradable polycaprolactone (PCL) layer is formed on the 0.8 wt% Ag‐incorporated MAO coating by the dip coating method. 5 wt% SnCl2 addition into PCL provides a steady release of Ag into concentrated simulated body fluid (1.5X SBF) from the underlying MAO coating at 37 °C. When the Ag release rate is taken into consideration, it is quantified as 0.0089 and 0.0586 ppm day⁻¹ for PCL‐covered MAO and PCL‐free MAO coatings, respectively. It is finally concluded that the preliminary result of this study can be promising for minimizing the in vivo adverse effects of Ag⁺ ions arising from rapid release as well as maintaining antibacterial efficacy for prolonged periods, which is ideal for preventing the risk of postimplantation infections.
Article
Objectives: This study was conducted to evaluate the attitudes and knowledge of patients attending Ataturk University Faculty of Dentistry Prosthodontics Clinic regarding their preferences for providing professional implant care and awareness of implant-specific oral hygiene methods. Material and Methods: A questionnaire was administered to 130 randomly selected patients with fixed or removable prosthetic restorations on implants attending the Prosthodontics Clinic of Ataturk University Faculty of Dentistry. Results: It was found that patients answered yes to the questions of flossing (27.7%), use of interface brush (21.5%), use of mouth shower (7.7%), and use of mouthwash (80.8%) among the preferred methods for cleaning implant prosthetic restorations. When the rates of mouth shower use were analyzed in terms of the relationship between education and the use of mouth shower, a statistically significant relationship was found (P < 0.001). Conclusion: Dentists play a major role in explaining and raising awareness of their patients about the cleaning of implant prostheses and home care recommendations. The general awareness tendency of patients at this point is low. This study proved that patients need to know how to take care of and clean their dentures. Our study's hypothesis, which was founded on our clinical findings prior to the investigation, suggested that there might be variations in how implant-retained prosthetic restorations are cleaned depending on the age and educational level of the patient.
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Design This retrospective cohort study aimed to investigate the risk and variables of tooth loss for teeth adjacent to dental implants compared to teeth nonadjacent to implants. The study followed the STROBE guidelines and was approved by the Institutional Review Board. Cohort selection The study included patients treated with dental implants at UCSF School of Dentistry between 2000 and 2020. The inclusion criteria for teeth adjacent to implants required the implant to support a fixed prosthesis and a follow-up period of at least 12 months. Nonadjacent teeth also required a follow-up period of at least 12 months. Teeth were excluded if they had a hopeless prognosis or were planned for extraction before the completion of restorative treatment. Data analysis Data were extracted from electronic health records, including patient demographics, dental histories, and outcomes for teeth adjacent and nonadjacent to implants. Statistical analyses, including Kaplan-Meier survival plots, log-rank tests, and multivariate logistic regression, were used to compare tooth survival and identify aetiologies of tooth loss. Results The study included 787 patients, with 2048 teeth adjacent and 15,637 teeth nonadjacent to implants. The 10-year cumulative survival rate was 89.2% for teeth adjacent to implants and 99.3% for nonadjacent teeth. Teeth adjacent to implants had a significantly higher risk of tooth loss (Odds Ratio [OR] 13.15). The primary etiology of tooth loss adjacent to implants was root fracture (45.2%), followed by caries (28.9%), periodontitis (24.1%), and endodontic failure (1.8%). For nonadjacent teeth, periodontitis was the leading cause of tooth loss (51.9%). Conclusions The study found that teeth adjacent to dental implants had a significantly higher risk of tooth loss, primarily due to root fractures. The findings suggest that dental implants may act as an iatrogenic factor, increasing the risk of complications for adjacent teeth. Conservative management of natural dentition should be prioritized, with emphasis on stringent periodontal surveillance and effective home care. Future research should focus on prospective studies to further explore these associations and improve clinical outcomes.
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Several treatment-oriented classifications for the management of peri-implant marginal mucosal defects (PMMDs) have been published to date. While each classification provides valuable insights into key diagnostic and therapeutic aspects, there is a marked heterogeneity regarding the recommended clinical guidelines to achieve success in specific scenarios. The purpose of this review was to critically analyze and organize the similarities and differences enclosed in the available classifications linked with treatment recommendations on the management of PMMDs at single implant non-molar sites with the purpose of providing an overview of recommended interdisciplinary treatment options to facilitate clinical decision-making processes.
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Systematic reviews and meta-analyses are essential to summarize evidence relating to efficacy and safety of health care interventions accurately and reliably. The clarity and transparency of these reports, however, is not optimal. Poor reporting of systematic reviews diminishes their value to clinicians, policy makers, and other users. Since the development of the QUOROM (QUality Of Reporting Of Meta-analysis) Statement—a reporting guideline published in 1999—there have been several conceptual, methodological, and practical advances regarding the conduct and reporting of systematic reviews and meta-analyses. Also, reviews of published systematic reviews have found that key information about these studies is often poorly reported. Realizing these issues, an international group that included experienced authors and methodologists developed PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) as an evolution of the original QUOROM guideline for systematic reviews and meta-analyses of evaluations of health care interventions. The PRISMA Statement consists of a 27-item checklist and a four-phase flow diagram. The checklist includes items deemed essential for transparent reporting of a systematic review. In this Explanation and Elaboration document, we explain the meaning and rationale for each checklist item. For each item, we include an example of good reporting and, where possible, references to relevant empirical studies and methodological literature. The PRISMA Statement, this document, and the associated Web site (http://www.prisma-statement.org/) should be helpful resources to improve reporting of systematic reviews and meta-analyses.
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Objective: The aim of this study was to evaluate the long-term outcome of short (8-mm) locking-taper implants supporting single crowns in the posterior regions and to analyze the influence of different factors on implant survival and implant-crown success rates. Materials and methods: Between June 2002 and September 2011, all patients referred to two private practices for treatment with short (8-mm) implants supporting single tooth restorations in posterior areas of both jaws were considered for inclusion in this study. At each annual follow-up session, clinical and radiographic parameters were assessed. Implant-crown success criteria included absence of pain, suppuration, mobility, and peri-implant radiolucency, distance between the implant shoulder and the first visible bone-to-implant contact (DIB) <1.5 mm after 12 months and not exceeding 0.2 mm for each following year, absence of prosthetic complications. The cumulative survival and implant-crown success were assessed using the Kaplan-Meier survival estimator; Chi-square test was applied to evaluate correlations between the study variables. The statistical analysis was performed at the patient and at the implant level. Results: Two hundred and fifteen implants (124 maxilla; 91 mandible) were placed in 194 patients (104 men; 90 women). Three implants failed (2 maxilla; 1 mandible). The 10-year cumulative survival rate was 98.4% (patient-based) and 98.5% (implant-based). Among the surviving implants, the mean DIB was 0.31 (±0.24), 0.43 (±0.29), and 0.62 (±0.31) mm at the 1-, 5-, and 10-year follow-up session; two biologic and three prosthetic complications were reported, for a 10-year cumulative implant-crown success rate of 95.8% (patient-based) and 95.9% (implant-based). The implant survival and implant-crown success rates did not differ significantly with respect to patients' gender, age, smoking habit, parafunctional habit, implant location, implant diameter, and bone type. Conclusions: The use of short (8-mm) locking-taper implants is a predictable treatment modality for the restoration of single tooth gaps of posterior segments of dentition.
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Purpose: This retrospective study assessed the 10-year outcomes of titanium implants with a sandblasted and acid-etched (SLA) surface in a large cohort of partially edentulous patients. Materials and methods: Records of patients treated with SLA implants between May 1997 and January 2001 were screened. Eligible patients were contacted and invited to undergo a clinical and radiologic examination. Each implant was classified according to strict success criteria. Results: Three hundred three patients with 511 SLA implants were available for the examination. The mean age of the patients at implant surgery was 48 years. Over the 10-year period, no implant fracture was noted, whereas six implants (1.2%) were lost. Two implants (0.4%) showed signs of suppuration at the 10-year examination, whereas seven implants had a history of peri-implantitis (1.4%) during the 10-year period, but presented with healthy peri-implant soft tissues at examination. The remaining 496 implants fulfilled the success criteria. The mean Plaque Index was 0.65 (±0.64), the mean Sulcus Bleeding Index 1.32 (±0.57), the mean Probing Depth 3.27 mm (±1.06), and the mean distance from the implant shoulder to the mucosal margin value -0.42 mm (±1.27). The radiologic mean distance from the implant shoulder to the first bone-to-implant contact was 3.32 mm (±0.73). Conclusion: The present retrospective analysis resulted in a 10-year implant survival rate of 98.8% and a success rate of 97.0%. In addition, the prevalence of peri-implantitis in this large cohort of orally healthy patients was low with 1.8% during the 10-year period.
Article
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Purpose. Evaluation of the short implant (8 mm in height) long-term prognosis and of the implant site influence on the prognosis. Methods. A longitudinal study was carried out on 121 patients (57 males and 64 females) consecutively treated with 257 implants. 108 implants were short. Results. Four (3.6%) short implants supporting fixed partial prostheses failed. Similarly, three standard implants supporting fixed partial prostheses and one supporting single-crown prosthesis failed. Mean marginal bone loss (MBL) and probing depth (PD) of short and standard implants were statistically comparable (P > .05). The 20-year cumulative survival rates of short and standard implants were 92.3 and 95.9%, respectively. The cumulative success rates were 78.3 and 81.4%. The survival rates of short implants in posterior and anterior regions were comparable: 95 and 96.4%, respectively. The difference between survival rates was not significant (P > .05). Conclusions. The high reliability of short implants in supporting fixed prostheses was confirmed. Short and standard implants long-term prognoses were not significantly different. The prognosis of short implants in posterior regions was comparable to that of in anterior regions. Nevertheless, a larger sample is required to confirm this trend.
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This article updates the results of a prospective clinical trial of press-fit, sintered, porous-surfaced dental implants placed in the posterior mandible of partially edentulous patients. Implants used had overall lengths (including transgingival collar regions) of 7 or 9 mm with designed intrabony lengths (lengths of sintered surface in contact with bone) of 6 or 8 mm. Forty-eight implants were placed in 24 patients, the majority of which replaced molar teeth, and the mean crown-to-root ratio was 1.4. Over 10 years of implant function, 2 patients with 3 implants died and 3 patients with 4 implants were lost to follow-up because of infirmity or relocation. The survival and success rates were both 95.5%. Two implants failed; the mean cumulative crestal bone loss (measured from the implant-abutment interface) for the remaining implants was 1.2 mm. Crestal bone loss was not affected by the crown-to-root ratio, prosthesis design, or whether an implant was the most distal unit in a sextant. However, there was a trend for greater crestal bone loss when implants were opposed by implants rather than by natural teeth.
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Objectives: The objective of this systematic review was to assess the 5- and 10-year survival of implant supported fixed partial dentures (FPDs) and to describe the incidence of biological and technical complications. Methods: An electronic MEDLINE search complemented by manual searching was conducted to identify prospective and retrospective cohort studies on FPDs with a mean follow-up time of at least 5 years. Patients had to have been examined clinically at the follow-up visit. Assessment of the identified studies and data abstraction was performed independently by two reviewers. Failure and complication rates were analyzed using random-effects Poisson regression models to obtain summary estimates of 5- and 10-year survival proportions. Results: The search provided 3844 titles and 560 abstracts. Full-text analysis was performed for 176 articles resulting in 21 studies that met the inclusion criteria. Meta-analysis of these studies indicated an estimated survival of implants in implant-supported FPDs of 95.4% (95 percent confidence interval (95% CI): 93.9-96.5%) after 5 and 92.8% (95% CI: 90-94.8%) after 10 years. The survival rate of FPDs supported by implants was 95% (95% CI: 92.2-96.8%) after 5 and 86.7% (95% CI: 82.8-89.8%) after 10 years of function. Only 61.3% (95% CI: 55.3-66.8%) of the patients were free of any complications after 5 years. Peri-implantitis and soft tissue complications occurred in 8.6% (95% CI: 5.1-14.1%) of FPDs after 5 years. Technical complications included implant fractures, connection-related and suprastructure-related complications. The cumulative incidence of implant fractures after 5 years was 0.4% (95% CI: 0.1-1.2%). After 5 years, the cumulative incidence of connection-related complications (screw loosening or fracture) was 7.3% and 14% for suprastructure-related complications (veneer and framework fracture). Conclusion: Despite a high survival of FPDs, biological and technical complications are frequent. This, in turn, means that substantial amounts of chair time have to be accepted by the clinician following the incorporation of implant-supported FPDs. More studies with follow-up times of 10 and more years are needed as only few studies have described the long-term outcomes.
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Background: The immediate loading of implants with a porous anodized surface is a well-described technique. Few data are however available on the long-term outcomes. Purpose: The aim of this prospective study was to assess the 10-year performance of TiUnite implants supporting fixed prostheses placed with an immediate loading approach in both postextractive and healed sites. Materials and Methods: All patients received a fixed provisional restoration supported by immediately loaded parallel design, self-tapping implants with a porous anodized TiUnite surface, and an external-hexagonal connection. Both healed and postextractive cases were included. Success and survival rate for restorations and implants, changes in marginal peri-implant bone level, probing depth measurements, biological or technical complications, and any other adverse event were recorded at yearly follow-up up to 10 years after surgery. Results: A total of 210 implants fulfilled the inclusion criteria and were consecutively placed in 59 patients. Forty-seven (22.38%) implants were lost because of the recalled patient refused to attend the planned 10-year follow-up. Five over 210 (2.38%) implants were lost. At the final follow-up, the accumulated mean marginal bone loss and probing depth were, respectively, 1.93 mm (SD 0.40) and 2.54 mm (SD 0.44) for the implants placed in healed sites (n = 84); 1.98 mm (SD 0.37) and 2.63 mm (SD 0.39) for the implants placed in postextractive sites (n = 74). The restorations examined achieved a cumulative 65.26% success rate and 97.96% survival rate. The implants placed in healed and postextractive sites, respectively, achieved a 98.05% and a 96.52% cumulative survival rate. Conclusions: Positive results in terms of bone maintenance in the long-term perspective are to be expected using immediately loaded implants with a TiUnite porous anodized surface in both postextractive and healed sites when adequate levels of oral hygiene are kept.
Article
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The aim of this retrospective study is to analyze the relationship between local factors and survival rate of dental implant which had been installed and restored in Seoul Veterans Hospital dental center for past 10 years. And when the relationship is found out, it could be helpful to predict the prognosis of dental implants. A retrospective study of patients receiving root-shaped screw-type dental implants placed from January 2000 to December 2009 was conducted. 6385 implants were placed in 3755 patients. The following data were collected from the dental records and radiographs: patient's age, gender, implant type and surface, length, diameter, location of implant placement, bone quality, prosthesis type. The correlations between these data and survival rate were analyzed. Statistical analysis was performed with the use of Kaplan-Meier analysis, Chi-square test and odds ratio. In all, 6385 implants were placed in 3755 patients (3120 male, 635 female; mean age 65 ± 10.58 years). 108 implants failed and the cumulative survival rate was 96.33%. There were significant differences in age, implant type and surface, length, location and prosthesis type (P<.05). No significant differences were found in relation to the following factors: gender, diameter and bone quality (P>.05). Related factors such as age, implant type, length, location and prosthesis type had a significant effect on the implant survival.
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The purpose of this study was to examine the most frequently used criteria to define treatment success in implant dentistry. An electronic MEDLINE/PubMED search was conducted to identify randomized controlled trials and prospective studies reporting on outcomes of implant dentistry. Only studies conducted with roughened surface implants and at least five-year follow-up were included. Data were analyzed for success at the implant level, peri-implant soft tissue, prosthetics, and patient satisfaction. Most frequently reported criteria for success at the implant level were mobility, pain, radiolucency, and peri-implant bone loss (> 1.5 mm), and for success at the peri-implant soft-tissue level, suppuration, and bleeding. The criteria for success at the prosthetic level were the occurrence of technical complications/prosthetic maintenance, adequate function, and esthetics during the five-year period. The criteria at patient satisfaction level were discomfort and paresthesia, satisfaction with appearance, and ability to chew/taste. Success in implant dentistry should ideally evaluate a long-term primary outcome of an implant-prosthetic complex as a whole.
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Abstract This study evaluated the success rates of 50 full-arch maxillary and/or mandibular implant supported fixed complete dentures. After a mean follow-up time of 42.1 month, 269 implants remained in function corresponding to cumulative implant success rates of 85.2% with an absolute success rate of 90.6% (269/297 implants). This study suggested that higher implant failure rates might be associated with a dental history of bruxism (29.3%) versus non-bruxers (4.6%) and surgeons with limited experience (≤5 years; 12.2%) versus surgeons with experience (2.4%).
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The aim of this study was to evaluate the long-term failure rates of short dental implants (≤ 10 mm) and to analyze the influence of various factors on implant failure. The PubMed and Cochrane Library databases were consulted for follow-up studies published between the years 1980 and 2009. For those studies that met the inclusion and exclusion criteria, data concerning the number of implants (≤ 10 mm) placed and lost and any related risk factors were gathered in tables and subjected to analysis. Univariate and multivariate analyses were performed. The heterogeneity and low quality of the included studies made meta-analysis impossible. A total of 35 human studies fulfilled the criteria. The studies included 14,722 implants, of which 659 failed. The total failure rate was 4.5%. The failure rates of implants with lengths of 6, 7, 7.5, 8, 8.5, 9, and 10 mm were 4.1%, 5.9%, 0%, 2.5%, 3.2%, 0.6%, and 6.5%, respectively. A majority (57.9%) of failures occurred before prosthesis connection. There was no statistically significant difference between the failure rates of short dental implants and standard implants or between those placed in a single stage and those placed in two stages (multivariate analysis). There was a tendency toward higher failure rates for the maxilla and for dental implants with a machined surface compared with the mandible and dental implants with a rough surface, respectively. Among the risk factors examined, most failures of short implants can be attributed to poor bone quality in the maxilla and a machined surface. Although short implants in atrophied jaws can achieve similar long-term prognoses as standard dental implants with a reasonable prosthetic design according to this review, stronger evidence is essential to confirm this finding.
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The CONSORT (Consolidated Standards of Reporting Trials) statement is used worldwide to improve the reporting of randomized, controlled trials. Schulz and colleagues describe the latest version, CONSORT 2010, which updates the reporting guideline based on new methodological evidence and accumulating experience.
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Criteria for the evaluation of dental implant success are proposed. These criteria are applied in an assessment of the long-term efficacy of currently used dental implants including the subperiosteal implant, the vitreous carbon implant, the blade-vent implant, the single-crystal sapphire implant, the Tübingen implant, the TCP-implant, the TPS-screw, the ITI hollow-cylinder implant, the IMZ dental implant, the Core-Vent titanium alloy implant, the transosteal mandibular staple bone plate, and the Brånemark osseointegrated titanium implant. An attempt has been made to standardize the basis for comments on each type of implant.
Article
Objectives: The aim of this study was to analyse the proportions of peri-implant lesions at implants after 9-14 years of function. Material and Methods: Two hundred and ninety-four patients underwent implant therapy during the years 1988-1992 in Kristianstad County. These individuals were recalled to the speciality clinic I and 5 years after placement of the suprastructure. Between 2000 and 2002, 218 patients with 999 implants were examined clinically and radiographically. Results: Forty-eight per cent of the implants had probing depth >= 4 mm and bleeding on probing (peri-implant mucositis). In 20.4% of the implants, the bone level was located 3.1 mm apical to the implant shoulder. Progressive bone loss (>= 1.8 mm) during the observation period was found in 7.7% of the implants. Peri-implantitis defined as bone loss >= 1.8 mm compared with 1-year data (the apical border of the bony defect located at or apical to the third thread, i.e. a minimum of 3.1 mm apical to the implant shoulder), combined with bleeding on probing and or pus, were diagnosed among 16% of the patients and 6.6% of the implants. Conclusion: After 10 years in use without systematic supportive treatment, peri-implant lesions is a common clinical entity adjacent to titanium implants.
Article
In the mid-nineties, 27 patients received 31 implant-supported crowns in the anterior maxillary region, and 12 to 15 years later, 18 patients (67%) with 22 implants (67%) participated in a retrospective study evaluating implant survival, bone loss, prosthetic complications, patient satisfaction, and patient and professional evaluation of esthetics. One implant was lost because of implant fracture after 10 years. Mean marginal bone loss was 1.53 mm (standard error ± 0.17 mm). In 6 patients, 6 crowns were replaced and 1 repaired. In 3 patients, 3 crowns had minor unrepaired porcelain fractures. Implant survival was 95.5%, and, despite the high frequency of prosthetic complications, patients were generally very satisfied with the long-term treatment outcome.
Article
Purpose: The use of short implants can reduce the need for augmentative procedures prior to implant placement and, thus, morbidity and treatment time for patients with severely atrophied alveolar ridges. However, the inevitably less favorable crown-to-implant ratio is often associated with higher implant failure rates and greater marginal bone loss. The aim of this study was to evaluate the long-term survival and success rates of short implants in severely atrophic alveolar ridges retaining restorations on these short implants only. Materials and methods: In this study, 8-mm and 9-mm implants were inserted in atrophic alveolar ridges according to the manufacturer's protocol for the respective bone quality and loaded after 3 months of healing. Prosthetic restorations were supported only by short implants (not in combination with longer implants). After a mean observation period of 10.1 years (±1.9 years), all patients were re-examined clinically and radiographically. Results: In this study, fifty-two 8-mm and 9-mm implants were placed in 14 patients. After 10.1 years, no implants and suprastructures had been lost. A mean marginal bone loss of 0.3 mm (±0.4 mm) was recorded. According to the Albrektsson criteria, all implants were successful; with respect to the more rigorous Karoussis et al criteria, four implants failed. Conclusions: The results of this long-term study suggest that the use of short implants results in marginal bone resorption and failure rates similar to those for longer implants. The higher crown-to-implant ratio did not seem to have any negative influence on implant success in this study.
Article
Purpose: Immediate loading has become a widely reported practice in implant dentistry. The aim of this study is to report on the 10-year clinical and radiographic outcomes of an immediate-loading treatment protocol that included flapless surgery. Materials and methods: Forty-six patients were treated with 97 immediately loaded Mk IV implants (Nobel Biocare) with machined surface in the maxilla. Presurgically, a three-dimensional model of each patient's soft tissue and underlying alveolar bone anatomy was created and a surgical template was fabricated. A circular mucotome was used to punch out a 5-mm hole in the mucosa to avoid flap elevation. Control examinations were performed on the day of surgery and at 1, 2, 3, 6, 8, and 10 years after surgery. Results: All prepared implant sites had intact buccal and lingual bone walls. The prefabricated provisional restorations showed excellent fit. Nine implants failed within 8 weeks of loading, resulting in a cumulative survival rate of 91% after 10 years of loading. The survival rates were 94% for implants supporting partial prostheses and 81% for implants supporting single restorations. Average marginal bone resorption was 1 mm during the first year, 0.4 mm during the second year, and 0.1 mm during the third year and after 10 years. Conclusions: The unchanged survival rate and the low average bone loss after 10 years confirm the feasibility of an immediate loading treatment protocol in the maxilla that included flapless surgery.
Article
Objective This study was undertaken to assess short, sintered porous-surfaced (SPS), press-fit implants with mandibular overdentures to restore edentulous patients with severe mandibular resorption. Materials and Methods Implant lengths of 7, 8, 9, and 10mm were used, all with 2-mm polished collars, making the designed intrabony lengths 5, 6, 7, and 8mm. Each patient received three non-splinted implants placed using a two-stage protocol. ResultsOnly 22 (with 53 implants) of the original 52 patients were available after 20years. All but one of these patients was functioning with their implant-retained overdentures. Life table analysis accounted for all patients and implants, and showed a 20-year survival of 73.4%. Analysis of carefully standardized radiographs revealed mean cumulative bone loss after 20years of 0.67mm relative to the polished collar-SPS junction. Conclusions Short SPS implants with mandibular overdentures can provide an acceptable treatment over a 20-year period for fully edentulous patients with severe alveolar resorption.
Article
Aim: To study the long-term outcome of implant survival rate, soft and hard tissue conditions and prosthetic status in a group of individuals treated with either Astra Tech TiOblast or Brånemark turned implants supporting a full-arch bridge. Material and methods: Edentulous patients treated with either Astra Tech TiOblast surface or Brånemark turned implants were recalled for examination after 12-15 years. Out of initially 66 patients 46 were available for examination. Intra-oral radiographs were taken for bone level assessments. Clinical prosthetic conditions, number of surviving implants, implant stability, plaque scores, probing pocket depths, bleeding and pus after probing were recorded. Analyses of bone level changes during the total observation period were performed. Results: Three patients in the Astra Tech group lost totally eight implants and five patients in the Brånemark group lost 10 implants during the total observation period. No statistically significant difference in implant loss or bone level change was found. Sixteen per cent of Astra Tech and 29% of Brånemark patients showed at least one implant with ≥2 mm bone loss after the first year in function. The corresponding prevalence on implant level was 6% and 5% respectively. No significant differences were found between the other examined variables. Two patients showed prosthetic complications of the supra construction in need of repair. Seven bridges had minor ceramic chippings. Conclusion: Treatment with Astra Tech TiOblast implants and Brånemark turned implants supporting full-arch bridges showed generally good clinical results with low numbers of implants with marginal bone loss indicative of peri-implantitis. No significant differences were found between the implant systems after 12-15 years in function.
Article
Background: Implant-supported prostheses are today often used in rehabilitation of partially or totally edentulous patients. Both patients and the dental profession often regard implant treatment as successful in a life perspective. Therefore, studies with a long-term follow-up are important. Purpose: The aim was to investigate the outcome of implant treatment with fixed prostheses in edentulous jaws after 20 years, with special reference to survival rate of implants and prostheses and frequency of peri-implantitis. Materials and Methods: The patient material was a group of patients treated in the early 1980s. The original patient group comprised the first 48 consecutive patients treated with implant-supported prostheses at Umeå University. All patients were edentulous in one or two jaws. The patients had a mean age at the implant insertion of 54.3 years (range 40–74). At the planning of this study 20 years after treatment, 19 of the 48 patients were found to be deceased. Of the 29 patients still alive, 21 patients with altogether 23 implant-supported prostheses could be examined clinically and radiographically. All patients were treated ad modum Brånemark® (Nobel Biocare AB, Göteborg, Sweden) with a two-stage surgical procedure. The implants had a turned surface. Abutment connections were performed 3 to 4 months after fixture insertion in the mandible, and after a minimum of 6 months in the maxilla. The prostheses were fabricated with a framework of gold alloy and acrylic artificial teeth. Results: The 21 patients (with 23 implant prostheses) examined had at the time of treatment got 123 implants (27 in the upper jaw and 96 in the lower jaw) inserted. Only one of these implants had been lost (about 2 years after loading) giving a survival rate of 99.2%. Very small changes occurred in the marginal bone level. Between the 1 and 20-year examinations, the mean bone loss was 0.53 mm and the mean bone level at the final examination was 2.33 mm below the reference point. Conclusions: This follow-up over two decades of implant-supported prostheses demonstrates a very good prognosis for the treatment performed. The frequencies of peri-implantitis, implant failures, or other complications were very small, and the original treatment concept with a two-stage surgery and a turned surface of the implants will obviously give very good results.
Article
Background: Concerns have been raised that use of surface-modified implants may result in peri-implant infection and marked marginal bone loss over time. Purpose: The aim of this prospective study was to evaluate the survival rate, marginal bone, and soft tissue conditions at surface-modified titanium dental implants after 10 years of function. Material and methods: Forty-six totally and partially edentulous patients were provided with 121 Brånemark oxidized implants (TiUnite™, Nobel Biocare AB, Gothenburg, Sweden). Twenty-four (20%) implants were immediate loaded and 97 (80%) were placed using a two-stage procedure. A total of 22 single, 23 partial, and 7 total restorations were delivered. Clinical and radiographic checkups were carried out after 3, 6, 12 months, and thereafter annually up to 10 years. At these occasions, oral hygiene was evaluated and peri-implant mucosa examined by probing. If needed, patients were enrolled in an individual program for hygiene controls and professional cleaning. Marginal bone loss was evaluated in intraoral radiographs taken at baseline and after 1, 5, and 10 years of function. Results: One (0.8%) implant failed after 8 years giving a Survival Rate (SR) of 99.2% after 10 years. A total of 11 sites (9.2%) showed bleeding on probing (BP) at the 10th annual checkup. The mean marginal bone loss was 0.7 ± 1.35 mm based on 106 readable pairs of radiographs from baseline and from the 10th annual examination. Twelve (11.3%) implants showed more than 2 mm bone loss, and five (4.7%) showed more than 3 mm of bone loss after 10 years. For the latter, all patients were smokers and had poor or acceptable oral hygiene. All five implants with >3 mm bone loss showed BP and two (1.9%) showed suppuration from the pocket. For the remaining seven implants with more than 2 mm bone loss, no correlation to smoking, oral hygiene, bleeding, or pus could be seen. Time/marginal bone level plots of the 12 implants with more than 2 mm bone loss after 10 years, showed minor changes from the first annual checkup except for the two infected implants. Conclusions: It is concluded that good long-term clinical outcomes can be obtained with oxidized titanium dental implants. Only 1.9% of examined implants showed significant marginal bone loss together with bleeding and suppuration after 10 years of function.
Article
There is a lack of consensus on measures to assess implant performance in clinical research. To investigate the outcomes measures and reference groups employed to evaluate and compare implant success and failure. MEDLINE (OVID) and Web of Science with searching reference lists of included papers. Inclusion: root form, titanium implants in dentate or edentulous individuals. Longitudinal studies reporting survival or success outcomes on at least 20 participants ≥ mean 5 years. Descriptive statistics. Two-hundred and sixteen studies were included. Implant survival was the most commonly reported primary outcome (60%) with success at 15.7%. Success constituted a wide variety of measures with little consistency. A percentage of 98.6% of studies employed the implant as the unit of analysis with little consideration of clustering within patients. The status of periodontal and general heath of study groups was unclear for more than 80% studies. The proportion of studies comprising randomized trials or using appropriate analytical methods increased from 1980 to 2011. Considers only English language and there was no author contact. In view of the disparate outcome measures employed to assess dental implant performance, agreement is needed both on a core set of implant outcomes and their statistical management.
Article
To systematically examine the evidence guiding the use of implant therapy relative to glycemic control for patients with diabetes and to consider the potential for both implant therapy to support diabetes management and hyperglycemia to compromise implant integration. A systematic approach was used to identify and review clinical investigations directly assessing implant survival or failure for patients with diabetes. A MEDLINE (PubMED) database search identified potential articles for inclusion using the search strategy: (dental implants OR oral implants) AND (diabetes OR diabetic). Inclusion in this review required longitudinal assessments including at least 10 patients, with included articles assessed relative to documentation of glycemic status for patients. Although the initial search identified 129 publications, this was reduced to 16, for inclusion. Reported implant failure rates for diabetic patients ranged from 0% to 14.3%. The identification and reporting of glycemic control was insufficient or lacking in 13 of the 16 studies with 11 of these enrolling only patients deemed as having acceptable glycemic control, limiting interpretation of findings relative to glycemic control. Three of the 16 studies having interpretable information on glycemic control failed to demonstrate a significant relationship between glycemic control and implant failure, with failure rates ranging from 0% to 2.9%. Clinical evidence is lacking for the association of glycemic control with implant failure while support is emerging for implant therapy in diabetes patients with appropriate accommodations for delays in implant integration based on glycemic control. The role for implants to improve oral function in diabetes management and the effects of hyperglycemia on implant integration remain to be determined.
Article
Peri-implant diseases present in two forms - peri-implant mucositis and peri-implantitis. The literature was systematically searched and critically reviewed. Four manuscripts were produced in specific topics identified as key areas to understand the microbial aetiology and the pathogenesis of peri-implant diseases and how the implant surface structure may affect pathogenesis. While peri-implant mucositis represents the host response of the peri-implant tissues to the bacterial challenge that is not fundamentally different from gingivitis representing the host response to the bacterial challenge in the gingiva, peri-implantitis may differ from periodontitis both in the extent and the composition of cells in the lesion as well as the progression rate. A self-limiting process with a "protective" connective tissue capsule developing appears to dominate the periodontitis lesion while such a process may occasionally be lacking in peri-implantitis lesions. Bacterial biofilm formation on implant surfaces does not differ from that on tooth surfaces, but may be influenced by surface roughness. Nevertheless there is no evidence that such differences may influence the development of peri-implantitis. It was agreed that clinical and radiographic data should routinely be obtained after prosthesis installation on implants in order to establish a baseline for the diagnosis of peri-implantitis during maintenance of implant patients.
Article
Many studies have dealt with the clinical outcome of oral implants, yet none applied a randomized split-mouth design for a long-term follow-up of similar implant systems. To evaluate two oral implant systems with different surface characteristics in a randomized split-mouth design and to radiologically analyse peri-implant bone level and density over an up to 16-year period. The study comprised clinical and radiographic records of 18 partially edentulous patients treated with both implant types randomly placed in either left or right jaw sides. Outcome was evaluated over time. Clinical and radiographic parameters showed no significant differences over time for both systems. Ten years after implant placement, a significantly increasing peri-implant bone density was noted, while Periotest values were found to be significantly decreasing. Fifteen years after implant loading, mean bone loss was 0.02 mm (range -1.15 to 1.51; SD 0.45) for Astra Tech® implants (n=24) and 0.31 mm (range -0.98 to 2.31; SD 0.69) for Brånemark® implants (n=23). The study failed to demonstrate significant differences in the outcome of the peri-implant bone for two implant systems with different surface characteristics. The marginal bone level around oral implants changed <0.5 mm after 15 years of loading.
Article
The aim of the present study was to evaluate the long-term results of dental implants using implant survival and implant success as outcome variables. Of the 76 patients who received 162 implants of the Straumann Dental Implant System during the years 1990-1997, 55 patients with 131 implants were recalled 10-16 years after implant placement for a complete clinical and radiographic examination, followed by a questionnaire that examined the degree of satisfaction. The incidence of biological and technical complications has been carefully analysed for each implant. Success was defined as being free of all these complications over the entire observation period. Associated factors related to peri-implant lesions were analysed for each implant. The long-term implant cumulative survival rate up to 16 years was 82.94%. The prevalence of biological complications was 16.94% and the prevalence of technical complications was 31.09%. The cumulative complication rate after an observation period of 10-16 years was 48.03%, which meant that substantial amounts of chair time were necessary following implant placement. The majority of implant losses and biological complications were concentrated in a relatively small number of patients. Despite a relatively high long-term survival rate, biological and technical complications were frequent. Patients with a history of periodontitis may have lower implant survival rates than patients without a history of periodontitis and were more prone to biological complications such as peri-implant mucositis and peri-implantitis.
Article
The aim of this study was to evaluate long-term marginal bone levels for two unsplinted implants supporting mandibular overdentures using conventional and early loading protocols with different implant surfaces and attachment systems. A cohort of 106 edentulous participants (mean age: 65 years) was treated with mandibular two-implant overdentures opposing complete maxillary dentures. Participants were randomly allocated into three loading protocol groups using four implant systems; single-stage surgery was performed for all participants, followed by an unsplinted prosthesis using six different attachment systems. Standardized intraoral radiographs taken at baseline (loading) and over 10 years appraised marginal bone levels mesially and distally from reference points under magnification. Three calibrated examiners repeated measurements, diminishing intra- and interobserver variability. Progressive attrition of participants occurred as a result of deaths, dropouts, and emigration. Seventy-nine participants (74.5%, mean age: 72 years) were available at the 10-year recall. Differences in bone loss among different loading protocols, implant surfaces, and attachment systems were tested using chi-square and one-way analysis of variance tests. Minimal, time-dependent, long-term marginal bone loss occurred with all loading protocols. Annual marginal bone loss progressed at low levels after the first year with episodes of bone loss and gain. There was stability in marginal bone levels over the long term, with the majority of remodeling occurring during the first year of function. Roughened implant surfaces may be beneficial during the early remodeling period. The amount of marginal bone loss in the first year of loading differed significantly by loading protocol and implant surface, whereas attachment system had a minor influence. Differences were not reflected in the success rates calculated using standard criteria. The remaining participants at 10 years were classified as successful related to the criterion of marginal bone loss, irrespective of the determining criteria for success. Either a 2- , 6-, or 12-week loading protocol for mandibular two-implant overdentures is possible in the long term, irrespective of the attachment system used. Minimal marginal bone loss may be attributed primarily to mandibular basal bone remaining from long-term edentulism. Revision of the current implant success criteria to offer a stricter limit is desirable.
Article
Implant treatment is an attractive substitute to traditional fixed/removable prosthetic appliances. In patients with diabetes, dental implant therapy has been considered a contraindication. Hyperglycemia augments the severity of periodontal disease, and glycemic control is an essential variable in determining the success of dental implants in subjects with diabetes. Subjects with well-controlled diabetes may not be significantly compromised and can have high dental implant success rates compared to individuals with poorly controlled diabetes. The focused questions addressed in this systematic review were as follows: Can patients with diabetes be good candidates for dental implant therapy? And how does hyperglycemia and glycemic control influence osseointegration? A systematic literature search of MEDLINE/PubMed articles published from 1982 up to and including July 2009 was independently performed by two investigators. In addition, reference lists of original and review articles were searched. The search strategy was to use the following terms in different combinations: dental implants, immediate implants, osseointegration, periodontal disease, diabetes, hyperglycemia, metabolic control, and glycemic control. The search included studies on humans and diabetes-induced animal models. The selection criteria included all levels of available evidence. Suitable variables included the implant survival rate among individuals with diabetes, effects of hyperglycemia and glycemic control on bone, and maintenance of dental implants in subjects with diabetes. Articles published only in the English language were considered, and unpublished data were not sought. We initially identified 33 studies. Fifteen studies, which did not fulfill the selection criteria, were excluded. The included studies reported that poorly controlled diabetes negatively affects implant osseointegration; however, under optimal serum glycemic control, osseointegration can successfully occur in patients with diabetes. Animal studies have confirmed that osseointegration can be successfully achieved in insulin-controlled rats with diabetes, whereas in uncontrolled rats with diabetes, the bone-to-implant contact appears to decrease with time. The use of antiseptic mouthrinses and oral-hygiene maintenance helps in achieving a successful dental implant osseointegration in subjects with diabetes. A successful dental implant osseointegration can be accomplished in subjects with diabetes with good metabolic control (serum glycemic level and hemoglobin A1c in normal range) in a similar manner as in subjects without diabetes.
Article
The aim of the study was to evaluate the biological and technical outcomes of early and delayed placed single tooth implants after 10 years of follow-up. Twenty consecutive patients who needed a single tooth replacement in the anterior maxilla were included in this study. Ten implants were placed with an early placement protocol, that is, 4 weeks after tooth extraction, whereas the other 10 implants were placed with a conventional delayed placement protocol, for example, 12 weeks after tooth extraction. At the baseline and at the annual re-examinations, pain from implant regions, mobility, plaque, mucositis, and marginal bone levels were recorded. Biological and technical complications were registered. The patients evaluated the functional and aesthetic outcomes subjectively on a visual analogue scale after 3 and 10 years. All implants were still in situ after 10 years. The cumulative implant survival rate was 100%. Two implant-supported crowns were remade because of ceramic fractures. The 10-year crown survival rate was 90%. No significant differences in implant survival rates were found between the early and delayed protocols, regarding plaque retention, mucositis, or marginal bone levels. After 10 years, the mean marginal bone loss at both sides of the implants was less than 1.0 mm in the two groups. During the 10-year interval, 1 patient lost more than 1.5 mm of marginal bone, 3 patients lost between 1.0 mm and 1.4 mm of bone, and 16 patients lost less than 1.0 mm of bone as an average of the mesial and distal bone loss. This 10-year prospective clinical trial demonstrated a 100% implant survival and a 90% crown survival. The average marginal bone level change was less than 1 mm, and there was no difference between early and delayed implant placement. Patient satisfaction with the implant-supported single crowns reduced with time.