European Journal of Oral Implantology最新文献

Purpose: To evaluate whether there are aesthetic and clinical benefits to using a newly designed abutment (Curvomax), over a conventional control abutment (GingiHue).

Materials and methods: A total of 49 patients, who required at least two implants, had two sites randomised according to a split-mouth design to receive one abutment of each type at seven different centres. The time of loading (immediate, early or delayed) and of prosthesis (provisional crowns of fixed prosthesis) was decided by the clinicians, but they had to restore both implants in a similar way. Provisional prostheses were replaced by definitive ones 3 months after initial loading, when the follow-up for the initial part of this study was completed. Outcome measures were: prosthesis failures, implant failures, complications, pink esthetic score (PES), peri-implant marginal bone level changes, and patient preference.

Results: In total, 49 Curvomax and 49 GingiHue abutments were delivered. Two patients dropped out. No implant failure, prosthesis failure or complication was reported. There were no differences at 3 months post-loading for PES (difference = -0.15, 95% CI -0.55 to 0.25; P (paired t test) = 0.443) and marginal bone level changes (difference = -0.02 mm, 95% CI -0.20 to 0.16; P (paired t test) = 0.817). The majority of the patients (30) had no preference regarding the two abutment designs; 11 patients preferred the Curvomax, while five patients preferred the GingiHue abutments (P (McNemar test) = 0.210).

Conclusions: The preliminary results of the comparison between two different abutment designs did not disclose any statistically significant differences between the evaluated abutments. However the large number of missing radiographs and clinical pictures casts doubt on the reliability of the results. Longer follow-ups of wider patient populations are needed to better understand whether there is an effective advantage with one of the two abutment designs.

Purpose: To describe a rare case of odontogenic brain abscess.

Materials and methods: A healthy, 35-year-old male had two dental implants placed in a simultaneously augmented maxillary sinus. One implant failed and the patient developed a maxillary sinusitis that failed to improve following antibiotic treatment at home. The neglected sinus infection led to formation of a brain abscess. The patient was hospitalised only when he had pan sinusitis with neurological signs. Symptoms were headache attacks, a subfebrile fever and a purulent secretion from the left nostril. The osteomeatal complex was blocked, the maxillary sinus was filled with pus and the Schneiderian membrane thickened. The patient was treated with intravenous antibiotic treatment. Computerised tomography (CT) and magnetic resonance imaging (MRI) scans and functional endoscopic sinus surgery (FESS), were implemented. When his conditions worsened, the patient underwent a left frontal mini craniotomy.

Results: Following the craniotomy and antibiotic treatment, there was a gradual resolution and the patient was dismissed after 2 months in hospital with no neurological deficit or signs of sinusitis.

Conclusions: Maxillary sinusitis following dental implant insertion and concomitant maxillary sinus elevation should be treated immediately and thoroughly since untreated sinusitis may cause life-threatening situations such as a brain abscess. In case of severe infection, clinicians should refer immediately the patient to hospital specialists.

Purpose: To compare the clinical outcome of immediately loaded cross-arch maxillary prostheses supported by zygomatic implants vs conventional implants placed in augmented bone.

Materials and methods: A total of 71 edentulous patients with severely atrophic maxillas, who did not have sufficient bone volume to place dental implants or when it was possible to place only two implants in the front area (minimal diameter 3.5 mm and length of 8 mm) and less than 4.0 mm of bone height subantrally, were randomised according to a parallel group design. They (35 patients) received zygomatic implants to be loaded immediately vs grafting with a xenograft, followed, after 6 months of graft consolidation, by the placement of six to eight conventional dental implants, submerged for 4 months (36 patients). To be loaded immediately, zygomatic implants had to be inserted with an insertion torque superior to 40 Ncm. Screw-retained, metal-reinforced, acrylic provisional prostheses were provided to be replaced by definitive Procera Implant Bridge Titanium prostheses (Nobel Biocare, Göteborg, Sweden) with ceramic or acrylic veneer materials 4 months after initial loading. Outcome measures were: prosthesis, implant and augmentation failures, any complications, quality of life (OHIP-14), the number of days that patients experienced total or partial impaired activity, time to function, and number of dental visits, assessed by independent assessors. Patients were followed up to 4 months after loading.

Results: No augmentation procedure failed. Three patients dropped out from the augmentation group. Six prostheses could not be delivered or failed in the augmentation group vs one prosthesis in the zygomatic group, the difference being statistically significant (difference in proportions = 15.32%; P = 0.04; 95% CI: 0.23 to 31.7). Eight patients lost 35 implants in the augmentation group vs three implants in one patient from the zygomatic group, the difference being statistically significant (difference in proportions = 21.38%; P = 0.001; 95% CI: 3.53 to 39.61). In total, 14 augmented patients were affected by 20 complications vs 26 zygomatic patients (35 complications), the difference being statistically significant (difference in proportions = 31.87%; P = 0.008; 95% CI: 6.48 to 53.37). The OHIP-14 score was 3.68 ± 5.41 for augmented patients and 4.97 ± 5.79 for zygomatic patients, with no statistically significant differences between groups (mean difference = 1.29; 95%CI -1.60 to 4.18; P = 0.439). Both groups had significantly improved OHIP-14 scores from before rehabilitation (P < 0.001 for both augmented and zygomatic patients). The number of days of total infirmity was, on average, 7.42 ± 3.17 for the augmented group and 7.17 ± 1.96 for the zygomatic group, the difference not being statistically significant (mean difference = -0.25; 95% CI: -1.52 to 1.02; P = 0.692). Days of partial infirmity were on avera

This section presents a brief review of articles on dental implants considered of special interest for the reader, in order to encourage the development of research, the interest for data analysis and the attention to scientific publications. Your comments are welcome. Please contact Dr Michele Nieri at michelenieri@gmail.com.

Purpose: To evaluate whether 5.0 × 5.0 mm dental implants with a novel nanostructured calcium-incorporated titanium surface could be an alternative to implants of at least 10.0 mm long placed in bone augmented with bone substitutes in posterior atrophic jaws.

Materials and methods: Forty patients with atrophic posterior (premolar and molar areas) mandibles with 5.0 mm to 7.0 mm bone height above the mandibular canal, and 40 patients with atrophic maxillas with 4.0 mm to 6.0 mm below the maxillary sinus, were randomised according to a parallel group design to receive between one and three 5.0 mm implants or one to three at least 10.0 mm-long implants in augmented bone at two centres. All implants had a diameter of 5.0 mm. Mandibles were vertically augmented with interpositional bovine bone blocks covered with resorbable barriers. Implants were placed after 4 months. Maxillary sinuses were augmented with particulated porcine bone via a lateral window covered with resorbable barriers, and implants were placed simultaneously. All implants were submerged and loaded after 4 months with provisional prostheses. Four months later, definitive screw-retained or provisionally cement metal-ceramic or zirconia prostheses were delivered. Patients were followed to 3 years post-loading and the outcome measures were: prosthesis and implant failures, any complication, and peri-implant marginal bone level changes.

Results: Seven patients dropped out before the 3-year evaluation (two short mandibles, one short maxilla, two augmented mandibles and two augmented maxillae). In mandibles, two grafted patients were not prosthetically rehabilitated because of multiple complications and two implants failed in the same patient (the second was a replacement implant) vs one patient who lost a short implant and crown 2 years after loading. In maxillas one short implant failed with its provisional crown 3 months post-loading. There were no statistically significant differences in prostheses (difference in proportion = 0.001; 95% CI: -0.12 to 0.13; P = 1.000) and implant failures (difference in proportion = 0.00; 95% CI: -0.13 to 0.13; P = 1.000) up to 3 years after loading. Significantly, more complications occurred at mandibular grafted sites: 17 augmented patients were affected by complications vs eight patients treated with short implants in mandibles (difference in proportion = 0.43; 95% CI: 0.13 to 0.64; P = 0.008). In the maxilla, six sinus-lifted patients vs two patients treated with short implants were affected by complications; the difference not being statistically significant (difference in proportion = 0.21; 95% CI: -0.05 to 0.45; P = 0.232). Patients with mandibular short implants lost on average 1.10 mm of peri-implant bone at 3 years and patients with 10.0 mm or longer mandibular implants lost 1.39 mm. Patients with maxillary short implants lost on average 1.04 mm of peri-implant bone at 3 years and