International journal of oral implantology (Berlin, Germany)最新文献

Purpose: To investigate the accuracy of a novel sleeveless implant surgical guide by comparing it with a conventional closed-sleeve guide and a freehand approach.

Materials and methods: Custom resin maxillary casts with corticocancellous compartments were used (n = 30). Seven implant sites were present per maxillary cast, corresponding to healed (right and left first premolars, left second premolar and first molar) and extraction sites (right canine and central incisors). The casts were assigned into three groups: freehand (FH), conventional closed-sleeve guide (CG) and surgical guide (SG) groups. Each group comprised 10 casts and 70 implant sites (30 extraction sites and 40 healed sites). Digital planning was used to design 3D printed conventional and surgical guide templates. The primary study outcome was implant deviation.

Results: At extraction sites, the largest difference between groups occurred in angular deviation, where the SG group (3.80 ± 1.67 degrees) exhibited ~1.6 times smaller deviation relative to the FH group (6.02 ± 3.44 degrees; P = 0.004). The CG group (0.69 ± 0.40 mm) exhibited smaller coronal horizontal deviation compared to the SG group (1.08 ± 0.54 mm; P = 0.005). For healed sites, the largest difference occurred for angular deviation, where the SG group (2.31 ± 1.30 degrees) exhibited 1.9 times smaller deviation relative to the CG group (4.42 ± 1.51 degrees; P < 0.001), and 1.7 times smaller deviation relative to the FH group (3.84 ± 2.14 degrees). Significant differences were found for all parameters except depth and coronal horizontal deviation. For the guided groups, there were fewer significant differences between healed and immediate sites compared to the FH group.

Conclusion: The novel sleeveless surgical guide showed similar accuracy to the conventional closed-sleeve guide.

Purpose: To describe a novel, noninvasive, intraoral optical scanning-based approach for characterising the buccolingual profile of peri-implant tissues using a 3D surface defect map.

Materials and methods: Intraoral optical scans of 20 isolated dental implants with peri-implant soft tissue dehiscence in 20 subjects were captured. The digital models were then imported into image analysis software, where an examiner (LM) performed a 3D surface defect map analysis characterising the buccolingual profile of the peri-implant tissues in respect to the adjacent teeth. Ten linear divergence points that were 0.5 mm apart in a corono-apical direction were identified at the midfacial aspect of the implants. Based on these points, the implants were grouped into three different buccolingual profiles.

Results: The method for creating the 3D surface defect map of isolated implant sites was outlined. Eight implants displayed pattern 1 (coronal profile of peri-implant tissues more lingual/palatal than their apical portion), six implants exhibited pattern 2 (opposite of pattern 1) and six sites showed pattern 3 (relatively uniform and "flat").

Conclusions: A novel method for assessing the buccolingual profile/position of peri-implant tissues using a single intraoral digital impression was proposed. The 3D surface defect map visualises the volumetric differences in the region of interest compared to the adjacent sites, allowing for objective quantification and reporting of profile/ridge deficiencies of isolated sites.

This article presents the first reported case series of three cases of aspiration of a dental implant screwdriver, which was successfully removed by flexible bronchoscopy. The report highlights preventive measures that can be taken in the dental office and the clinical signs and symptoms of the presence of a dental implant screwdriver in the bronchial tree. The nine reports published to date on this phenomenon are reviewed and compared, and an action protocol for dental practitioners, anaesthetists and pulmonologists is proposed to address this emergency. Some early and late complications are also described.

This review focuses on intrasocket reactive tissue and its impact on extraction socket healing. It summarises the current knowledge about intrasocket reactive tissue from a histopathological and biological perspective and discusses the mechanisms by which residual intrasocket reactive tissue can have a positive or negative effect on healing. Additionally, it provides an overview of the various hand and rotary instruments that are currently used for intrasocket reactive tissue debridement. The review also discusses preserving intrasocket reactive tissue as a socket sealing material and the benefits this may offer. It presents clinical cases where either removal or preservation of intrasocket reactive tissue was adopted following extraction and prior to alveolar ridge preservation. Future studies are needed to investigate the suggested beneficial effects of intrasocket reactive tissue on socket healing outcomes.

Purpose: To explore whether extra-short (4-mm) implants could be used to rehabilitate sites where regenerative procedures had failed in order to avoid additional bone grafting.

Materials and methods: A retrospective study was conducted among patients who had received extra-short implants after failed regenerative procedures in the posterior atrophic mandible. The research outcomes were complications, implant failure and peri-implant marginal bone loss.

Results: The study population was composed of 35 patients with 103 extra-short implants placed after the failure of different reconstructive approaches. The mean follow-up duration was 41.3 ± 21.4 months post-loading. Two implants failed, leading to a failure rate of 1.94% (95% confidence interval 0.24%-6.84%) and an implant survival rate of 98.06%. The mean amount of marginal bone loss at 5 years post-loading was 0.32 ± 0.32 mm. It was significantly lower in extra-short implants placed in regenerative sites that had previously received a loaded long implant (P = 0.004). Failure of guided bone regeneration before placement of short implants tended to lead to the highest annual rate of marginal bone loss (P = 0.089). The overall rate of biological and prosthetic complications was 6.79% (95% confidence interval 1.94%-11.70%) and 3.88% (95% confidence interval 1.07%-9.65%), respectively. The success rate was 86.4% (95% confidence interval 65.10%-97.10%) after 5 years of loading.

Conclusions: Within the limitations of this study, extra-short implants seem to be a good clinical option to manage reconstructive surgical failures, reducing surgical invasiveness and rehabilitation time.

Introduction: Papilla reformation is one of the most difficult and elusive surgical techniques for clinicians. Although it involves similar tenets to those applied for soft tissue grafting at recession defects, crafting a small tissue in restricted space remains unpredictable. Numerous grafting techniques have been developed to correct interproximal and buccal recession, but so far, only a limited number of techniques have been prescribed for interproximal remediation.

Case presentation: This report describes in detail a modern technique (the vertical interproximal tunnel approach) for reforming the interproximal papilla and treating interproximal recession. It also documents three challenging cases of papilla loss. The first case presented Class II papilla loss and a recession type 3 gingival defect adjacent to a dental implant, managed using the vertical interproximal tunnel approach through a short vertical incision. A 6-mm increase in attachment level and almost complete papilla fill were observed in this case with this surgical technique for papilla reconstruction. The second and third cases presented Class II papilla loss between two adjacent teeth, managed using the vertical interproximal tunnel approach through a semilunar incision and achieving full papilla reconstruction.

Conclusion: Both described incision designs for the vertical interproximal tunnel approach require technical meticulousness. When executed carefully and using the most beneficial pattern of blood supply, predictable reconstruction of the interproximal papilla can be achieved. It also helps alleviate concerns associated with inadequate flap thickness, blood supply and flap retraction.

Purpose: To evaluate the impact of immediate and delayed zirconia implant placement on crestal bone loss and the clinical outcomes achieved with this approach 1 year after prosthetic loading. Further objectives were to evaluate the influence of age, sex, smoking, implant dimensions, platelet-rich fibrin application and location of the implants in the jawbone on the crestal bone level.

Materials and methods: Clinical and radiographic analysis were performed to evaluate the success rates for both groups. The data were analysed statistically through a linear regression analysis.

Results: No significant difference was found between immediate and delayed implant placement concerning the amount of crestal bone loss. Sex, age, bone augmentation, diabetes and prosthetic complications did not have a statistically significant influence; only smoking had a negative and statistically significant influence on crestal bone loss (P < 0.05).

Conclusions: Immediate or delayed placement of one-piece zirconia implants may be a good alternative to the use of titanium implants concerning success and survival.

Partial fixed dental prostheses supported by dental implants have become a reliable long-term treatment option. Nevertheless, the replacement of two adjacent missing teeth, irrespective of location, still represents a clinical challenge. To overcome this, the use of fixed dental prostheses with cantilever extensions has gained popularity with a view to limiting morbidity, reducing costs and avoiding major surgical interventions prior to implant placement. The present review summarises the level of evidence for the use of fixed dental prostheses with cantilever extensions both in the posterior and anterior regions and indicates the advantages and disadvantages of each treatment, focusing on available medium- to long-term outcomes.