To assess both the radiographic and profilometric outcomes of early implant placement with or without alveolar ridge preservation (ARP) (using two different ARP techniques) after 1 year of loading.
Seventy-five patients with a failing single tooth in the anterior maxilla were randomly allocated to three groups (1:1:1): (a) ARP using demineralized bovine bone mineral containing 10% collagen (DBBM-C) covered by a collagen matrix (CM), (b) ARP using DBBM-C covered with a palatal graft (PG), and (c) unassisted socket healing (control). Eight weeks after tooth extraction, early implant placement was performed in all patients. Cone-beam computed tomography (CBCT) and impressions were taken 8 weeks after tooth extraction (ARP/unassisted healing) prior to implant placement and 1-year post-loading. Radiographic and profilometric outcomes were evaluated.
Out of the 70 patients available for re-examination at 1-year post-loading, 55 datasets could be assessed (ARP-CM 19; ARP-PG 17; Control 19). The need for additional guided bone regeneration (GBR) at implant placement amounted to 31.6% (ARP-CM), 29.4% (ARP-PG), and 68.4% (unassisted healing). Adjusted models revealed that residual buccal bone height and additional GBR at implant placement significantly influenced the magnitude of the alveolar changes at 1 year (p < 0.05). In patients with ARP (group ARP-CM or ARP-PG) without additional GBR, the presence of bone convexity amounted to 36.0% (9/25) at 1-year post-loading. For patients that received ARP and additional GBR at implant placement, the frequency of bone convexity increased to 72.7% (8/11) (p = 0.042). Regarding profilometric measurements, a tendency toward agreement with radiographic outcomes was observed.
Early implant placement with ARP can attenuate alveolar ridge changes at 1-year post loading by minimizing both radiographic and profilometric alterations. However, early implant placement with simultaneous GBR consistently yields superior radiographic and profilometric outcomes, regardless of whether ARP is performed.
The cover image is based on the Original Article Full block or split block?—Comparison of two different autogenous block grafting techniques for alveolar ridge reconstruction by Christian Mertens DDS et al., https://doi.org/10.1111/cid.13263.
The objective of this study is to assess the effectiveness of horizontal ridge augmentation using FDBA in combination with injectable-platelet rich fibrin (i-PRF) versus FDBA alone. To fulfill this aim, the radiographic and histomorphometric outcomes are compared.
The study involved 41 patients who had horizontal alveolar ridge defects categorized as either B (2.5–7 mm) or C (0–2.5 mm). The control group received FDBA alone (n = 20), while the test group received FDBA in combination with i-PRF (n = 21). The horizontal dimensions of the alveolar ridge were measured at 0, 2, 4, and 6 mm from the bone crest using CBCT before and 6 months after alveolar ridge augmentation. In the second-stage surgery, 24 biopsies were taken from the augmented bone — 13 from the control group and 11 from the test group, and were examined histologically and histomorphometrically. The data were analyzed using Pearson correlation coefficient, chi-square, paired-t, and two-sample t tests.
There was no significant difference (p > 0.05) in the increase of mean ridge width between the test group and the control group after 6 months at distances of 0, 2, 4, and 6 mm from the crest, with differences of −0.28, 0.12, 0.52, and 1.04 mm, respectively. However, the amount of newly formed bone and material residues was significantly higher in the FDBA + i-PRF group compared to the FDBA alone group (45.01% and 13.06% vs 54.03% and 8.48%, respectively). There was no significant difference in the amount of soft tissue between the two groups (41.02% and 37.5%, p > 0.05).
The study found that there was no statistically significant difference in the increase of horizontal ridge width between the FDBA + i-PRF group and the FDBA group. However, the histomorphometric analysis revealed that the FDBA + i-PRF group had a higher proportion of newly formed bone, less connective tissue, and fewer residual particles. This suggests a superior quality of bone formation compared to the FDBA group.
The objective of the study was to provide long-term clinical outcomes and complications in the severely atrophic edentulous maxillae treated by means of the quad zygoma protocol (QZP) using the Anatomy-Guided Approach (AGA).
This was a retrospective cohort study of all consecutive patients with severely atrophic edentulous maxilla and insufficient bone height and width in the anterior and posterior regions bilaterally, who underwent rehabilitation with the QZP between May 2006 and December 2021. All patients were followed for at least 1 year. All zygomatic implants (ZIs) were placed by the same surgeon. The primary endpoint of the study was the implant survival rate. Secondary endpoints were implant success rate, prosthesis success rate, complications, and Oral Health-Related Quality of Life using the OHIP-14 questionnaire.
A total of 56 patients (men 16, women 40) with 224 ZIs (Nobel Biocare, n = 204; Straumann, n = 16; Southern Implant, n = 4) placement were included with a mean follow-up period 8.8 ± 3.9 years (range, 1.2–17.0). The survival (success) rate was 97.7%. Five ZIs in four patients failed. The mean time between implant placement and failure was 8.6 years (range, 0.5–13.3). All patients received immediate loading with acrylic prosthesis. The successful rates for the definitive prosthesis were 98.2%. Forty-two patients received posterior cantilever for rehabilitation of fixed definitive prosthesis. Local orofacial inflammation (35.7%) and Sinusitis (12.5%) were the most common complications, occurring at a mean follow-up of 10.0 (range, 4.2–14.9) and 10.3 (range, 4.3–16.2) years, respectively. In 48 patients, the mean score of the OHIP-14 questionnaire was 1.7 ± 2.6 with the follow-up period of 9.0 ± 4.1 years.
The rehabilitation of severely atrophic edentulous maxilla using the QZP has shown a predictable and high survival rate in the long term. The implementation of an immediate loading protocol offers potential benefits in stabilizing ZIs with cross-arch stabilization. Moreover, the use of a posterior cantilever in reconstruction can effectively establish functional occlusion through well-distributed ZIs, eliminating the need for additional implant placement.
To compare patient-reported outcome measures and additional surgical outcomes after sinus floor elevation (SFE) with osseodensification (OD) versus lateral window (LW), both with simultaneous implant placement.
Twenty participants requiring single-implant rehabilitation with residual bone height (RBH) ≤4 mm were enrolled. Pain experience, quality of life (QoL) via the Oral Health Impact Profile-14 (OHIP-14), analgesics intake, and other symptoms were self-reported for a week on a daily basis. Surgery duration, complications, and implant stability quotient at baseline (ISQ T0) and after 6 months (ISQ T6) were registered. Participants were followed up for 1 year.
From Day 0 (day of surgery) to Day 3, pain experience was significantly lower (p < 0.05) in the OD group. OHIP-14 score was significantly lower (p < 0.05) in the OD group on all postoperative days, except on Day 5. Average analgesics intake was significantly lower (p < 0.001) in the OD group. Surgery mean duration was significantly higher (p < 0.001) in LW compared to OD (71.1 ± 10.4 vs. 32.9 ± 5.3 min). After osseointegration period, all implants were successfully restored with screw-retained crowns.
Within the limitations of this study, it can be concluded that OD and LW techniques were similarly effective in SFE with simultaneous implant placement when RBH ≤ 4 mm. However, OD significantly outperformed LW in pain experience, impact on self-perceived QoL, surgery duration, postoperative edema, and analgesics intake.
Lithium disilicate can be reliable when restoring implants in the esthetic zone. However, it has a high elastic modulus. This might increase the amount of forces transmitted to the crestal bone.
To evaluate the crestal bone loss and peri-implant periodontal parameters of polymer infiltrated ceramic network compared to lithium disilicate implant-supported hybrid abutment crowns after 12 months of follow-up.
44 patients were enrolled. They were randomly assigned into two groups (n = 22). The first group received 22 implants restored with polymer-infiltrated ceramic network (Vitaenamic) hybrid abutment crowns. The second group received 22 implants restored with lithium disilicate (e.max) hybrid abutment crowns over immediately placed implants in the esthetic zone. Periapical radiographs were taken immediately after prosthetic placement and 1 year later utilizing a parallel technique, to assess crestal bone loss. Periodontal parameters were assessed after 1 year.
Regarding crestal bone loss, a comparison between group I (Vitaenamic) and group II (e.max) was made by using an Independent t-test, which showed an insignificant difference between them (p > 0.05). A comparison between groups I and II revealed insignificant differences regarding periodontal parameters (probing depth, bleeding on probing, visible plaque, and suppuration).
Regarding bone stability and periodontal parameters, polymer infiltrated ceramic network and lithium disilicate hybrid abutment crowns showed comparable results. Both materials showed clinically acceptable hard and soft tissue responses.
Full-arch IOS scan of edentulous areas rehabilitated with dental implants is nowadays still described as an unpredictable procedure. To improve the accuracy, a universal scan template (UST®) is proposed in this article. The clinician can easily assemble the template with a mechanical coupling, by matching the scan bodies with objects of known dimension characterized by specific markers. The UST® facilitates the scanning of an entire arch on scan bodies, reducing the learning curve, simplifying acquisition movements, shortening the scanning time, and drastically reducing the risk of distortions and aberrations of the scans.
In a case series study on 12 patients, the improvement in the accuracy of the scans with UST® was validated by comparing the STL files derived from scans with and without the guide in place. A titanium bar was produced from each optical impression.
The bars obtained from the optical impressions taken without UST® were found to be nonpassive in the mouth in the majority of the cases. On the contrary with the use of UST® we obtained 12 passive prosthetic rehabilitations.
The proposed solution may represent a valid method to improve the predictability of full arch optical impressions on implants.
The influence of dental implant length and diameter on primary stability in various bone densities is not well understood.
To in vitro study the effect of length and diameter on resonance frequency analysis (RFA), insertion torque (IT) and displacement (DP) measurements of dental implants in different implant site densities.
Dental implants of four different diameters (Ø 3.5, 4.0, 4.5 and 5.0 mm) and three different lengths (7, 11 and 15 mm) (Neoss Ltd, Harrogate, UK) were placed in polyurethane blocks of three different densities (Sawbones Europe AB, Malmö, Sweden). The primary stability was assessed by RFA (ISQ) (Osstell, Osstell AB, Gothenburg, Sweden) and insertion torque measurements (ITmax in N cm) (iChiropo™, Bien-Air Dental SA, Bienne, Switzerland). In addition, the blocks were mounted in a rig and a lateral force of 25 N cm was applied to the implants and the DP was measured in μm with a micrometer gauge placed on the opposite side of the load transducer. Statistical analyses using linear and quadratic models were applied.
Implant length, diameter and block density were found to be significant independent predictors of RFA, ITmax, and DP measurements. Implant length had a strong effect, while the effect of diameter in general was subtle, particularly in the softest block.
Implant length affects primary stability more than implant diameter in polyurethane blocks of uniform density along the whole length of the tested implants.
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