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J Periodontol. 2021 Jul 14. doi: 10.1002/JPER.21-0347.
Long-term clinical outcomes of periodontal regeneration with enamel matrix derivative: A retrospective cohort study with a mean follow-up of 10 years
S P De Ry, A Roccuzzo, N P Lang, A Sculean, G E Salvi
Study objectives and methods
Despite the large body of evidence on the efficacy of enamel matrix derivative (EMD) in the treatment of periodontal intrabony defects, few studies reported long-term data (≥10-year). Periodontal patients treated with regenerative surgery with EMD between 1999 and 2012 were invited to participate in a clinical examination. The following clinical parameters were recorded and compared at baseline (T0), 6 months after surgery (T1) and after at least 8 years of follow-up (T2): probing depth (PD), gingival recession (GR), clinical attachment level (CAL), plaque and bleeding scores. The primary outcome variable was CAL change.
Results
• Forty-one patients with 75 treated teeth were available for analysis. Out of these, 68 (tooth survival rate: 90.7%) reached the latest follow-up with a mean observation period of 10.3 years (range: 8.0 to 21.3). • The most frequent reason for tooth loss was recurrence of periodontal disease. • Tooth survival curves showed a statistically significant difference between smokers and non-smokers (P = 0.028).
Mean CAL changed from 8.43 ± 1.86 (T0) to 6.47 ± 1.70 (T1) (P < 0.001) and to 5.91 ± 1.83 (T2) (P < 0.001). • At T1, a CAL gain of ≥3 mm was measured in 35% of the defects whereas at T2 it was detected in 51% of cases.
Conclusions
Within their limitations, the present results have shown that in intrabony defects, the clinical improvements obtained following regenerative surgery with EMD can be maintained on a mean period of 10 years. Smoking status and maxillary molars were correlated with an increased risk for tooth and CAL loss, respectively.
Adapted from S P De Ry, et al., J Periodontol. 2021 Jul 14, for more info about this publication click HERE
Shanghai Kou Qiang Yi Xue. 2021 Jun;30(3):292-296
Prevalence of peri-implantitis and peri-implant mucositis within 15 years of implant placement.
[Article in Chinese] T T Zahng, X J Hu, L Lin
Study objectives and methods
To explore the incidence of peri-implantitis (PI) and peri-implant mucositis (PM) during 15 years of implant placement.
A retrospective analysis of 507 patients (1 162 implants in total) who underwent oral implant restoration in the Affiliated Stomatological Hospital of Nanchang University from January 2001 to December 2005 were performed and followed up for 12-15 years. The clinical data of the patients were collected, and the individual and implant-level PI, PM incidence and influencing factors were analyzed. SPSS 22.0 software package was used for statistical analysis.
Results
• After an average of 13.37 years of follow-up, the overall incidence of PM and PI in 507 implant restoration patients was 45.0% and 9.7%, respectively. The incidence of PM and PI in 1 162 implants was 44.1% and 10.9%, respectively. • Among 127 implants with PI, there were 8 implants (6.3%) failed. PI had a low incidence within 0.5 to 1 year after implantation and restoration, with a significant increase in incidence within 1 to 5 years, a decrease in incidence within 5 to 10 years, and a continuous decrease in incidence over 10 years. • The incidence of PM was relatively high within 0.5-1 year of implantation and restoration, gradually decreased in 1-5 years, and remained basically unchanged for 5-10 years and more than 10 years. • The incidence of PI and PM using Straumann system was the lowest, and the incidence of Osstem system was the highest (P<0.05). • The incidence of PI and PM in the upper anterior tooth area was significantly higher than that of other teeth(P<0.05). • The probability of PI and PM was the highest in patients with non-closed crown edges, followed by loose abutment screws, loose crown-retained screws, and broken abutment screws(P<0.05). • Multivariate logistic regression analysis showed that implantation time, implant system, implant position, and restorative factors were high-risk factors affecting the incidence of PM and PI (P<0.05).
Conclusions
The incidence of PM is widespread within 15 years of implant placement. The incidence of PI does not increase with the increase of restoration time, but is related to implantation time, implant system, implant position and later restoration factors.
Adapted from T T Zahng et al., Shanghai Kou Qiang Yi Xue. 2021 Jun;30(3):292-296, for more info about this publication click HERE
Int J Oral Maxillofac Implants. Jul-Aug 2021;36(4):807-817.doi: 10.11607/jomi.8603
Identification of the Pathway and Appropriate Use of Four Zygomatic Implants in the Atrophic Maxilla: A Cross-Sectional Study
C Aparicio, W D Polido, J Chow, L David, R Davo, E J De Moraes, A Fibishenko, M Ando, G Mclellan, C Nicolopoulos, M A Pikos, H Zarrinkelk, T J Balshi, M Peñarrocha
Study objectives and methods
This cross-sectional study aimed to identify and characterize the pathway for appropriate placement of four zygomatic implants in the severely atrophic maxilla and to group the anatomical variations of the osteotomy trajectory for anterior zygomatic implants.
CBCT images of patients presenting indications for the use of four zygomatic implants to withstand a maxillary rehabilitation were reviewed. Cross-sectional planes corresponding to the implant trajectories, designed according to a zygoma anatomyguided approach for implants placed in the anterior and posterior maxilla, were assessed separately. The relationship of the implant osteotomy trajectory with the correlated residual alveolar bone, nasal and sinus cavities, maxillary wall, and zygomatic bone anatomies was established.
Results
• The study population included 122 globally recruited patients, with 488 zygomatic implants, 244 of which had their starting point on the anterior incisor-canine area and 244 on the posterior premolar-molar area. • The anatomy of the osteotomy path designed for the anterior implants ("A") was named and grouped into five assemblies from zygomatic anatomy-guided ZAGA A-0 to A-4, representing 2.9%, 4.5%, 19.7%, 55.7%, and 17.2% of the studied sites. • Percentages for posterior implant ("P") trajectories of the osteotomy were grouped and named as ZAGA P-0 to P-4, representing 5.7%, 10.2%, 8.2%, 18.4%, and 57.4% of the sites, respectively. • Approximately 70% of the population presented anatomical intra-individual differences.
Conclusions
The trajectory of the zygomatic implant followed different anatomical pathways depending on its coronal point being anteriorly or posteriorly located, which justifies a new zygoma anatomy-guided approach classification for anteriorly placed zygomatic implants. Topographic characteristics of the anatomical structures that are cut by an anterior oblique plane joining the lateral incisor-canine area to the zygomatic bone, representing the planned anterior osteotomy path in a quadruple-zygoma indication, have not been previously reported. Adaptation of surgical procedures and implant sections/designs to individual patients' anatomical characteristics is essential to reduce early and long-term complications.
Adapted from C Aparicio et al., Int J Oral Maxillofac Implants. Jul-Aug 2021;36(4):807-817, for more info about this publication click HERE
J Oral Implantol. 2021 Sep 7. doi: 10.1563/aaid-joi-D-20-00411.
Comparative assessment of the primary stability of Straumann® BLX implant design using an in-vitro sinus lift-simultaneous implant insertion model
M Emmert, J Spille, E Behrens, M Ayna, F Karayurek, J Wiltfang, Y Acil, A Gülses
Study objectives and methods
Straumann ® BLX is a novel implant system, which has been proclaimed to provide an ideal primary stability in all types of bone. In the current study, the primary stability of Straumann ® BLX implant systems with Straumann ® tapered effect (TE) implants have been comparatively assessed in bovine ribs by using a simultaneous sinus elevation and implant insertion model.
In the study group, BLX (4.0 x 12 mm), TE (4.1 x 12 mm), BLX (4,5 x 12 mm) and TE (4.8 x 12 mm) were placed in each bony window, which resembles sinus maxillaris. As a control, BLX and TE implants with same sizes were inserted into the proximal diaphysis of the bovine ribs. A total of 40 implant insertions were performed. The stability was measured with resonance frequence analysis.
Results
• In the study group, TE implants of 4.8 mm showed significantly higher values compared to 4.5 mm BLX implants (p=0.116). However, BLX implants of 4.0 mm in the control group showed higher stability compared to TE with 4.0 mm diameter. (p=0.014). • The primary stability of BLX implants in the control group was significantly higher compared to the experimental group in both widths (p=0.018 for BLX 4.0 and p=0.002 for BLX 4.5 respectively).
Conclusions
The use of TE design with wide diameter in simultaneous implant placement with sinus lift could present higher ISQ values and might be more appropriate option for implant recipient sites with poor bone volume and quality. However, the advantage of BLX design in standard implant insertion protocols could be precious.
Adapted from M Emmert et al., J Oral Implantol. 2021 Sep 7, for more info about this publication click HERE
J Long Term Eff Med Implants. 2021;31(3):51-56. doi: 10.1615/JLongTermEffMedImplants.2021038608
Retrospective Analysis of the Bone Density in the Maxillary Anterior Region among Patients with Dental Implants
A A Ahamed, R Subhashree, V Rakshagan, V Ashok
Abstract
Implant systems today have come a long way to provide comfort and long-term success rate in patients requiring implant supported prosthesis as part of their oral rehabilitation. It is currently overtaking the other prosthetic treatment especially in the case of replacing anterior teeth. The aim of this study was to evaluate the association of age, gender, bone density and implant brands with respect to implants placed in the maxillary anterior region in a private hospital setup. It is a retrospective university setting study performed by evaluating the case histories of patients placed with implants in the anterior region. The data was extracted and subjected to statistical analyses using SPSS software. I n this study, D2 bone was most commonly seen in the anterior region followed by D3 and D1. D1 and D3 bone were prevalent in patients in the age group of 41 to 60 years and D2 bone was prevalent in the group of 2640 years. Males showed greater bone density than females. Implant brand Straumann Roxolid SLActive was mostly used in the anterior region and most of the implants are placed equicrestal in position. As a practitioner, one should have clear knowledge on implant brand, bone densities, crestal relation and age association in order to exert a successful treatment response in the future.
Adapted from A A Ahamed et al., J Long Term Eff Med Implants.2021;31(3):51-56 for more info about this publication click HERE
Compend Contin Educ Dent. Jul-Aug 2021;42(7):f1-f4.
Using a Digital Dentistry Integrated Planning and Manufacturing Service in Completely Edentulous Treatment
H AlQallaf, W S Lin, C C Yang
Abstract
The use of an integrated digital planning and manufacturing modular service and a time-tested dental implant system to treat a completely edentulous patient, as shown in this case report, offers numerous clinical benefits. Computer-guided surgery and digital dentistry have gained in popularity and demonstrated great clinical success; however, clinicians and dental laboratory technicians can further maximize the benefit gained from these technologies through additional training and resource investment. By using the streamlining solution (Smile in a Box®, Straumann) described in a clinical step-by-step manner in this case report, dental professionals can provide effective digital solutions for improved patient treatment acceptance, experience, and satisfaction.
Adapted from H AlQallaf et al., Compend Contin Educ Dent. Jul-Aug 2021;42(7):f1-f4., for more info about this publication click HERE
Atlas Oral Maxillofac Surg Clin North Am. 2021 Sep;29(2):203-231.doi: 10.1016/j.cxom.2021.05.004
The Zygoma Anatomy-Guided Approach for Placement of Zygomatic Implants
C Aparicio, W D Polido, H M Zarrinkelk
Abstract
The essence of the ZAGA Concept is to provide the patient with a zygomatic anchored rehabilitation according to their specific anatomy.
ZAGA Concept includes the choice of the adequate implant design able to adapt to the performed osteotomy.
The ZAGA concept recommends aiming for a tunnel osteotomy, whenever possible, regardless of the maxillary wall curvature.
A channel osteotomy is a groove made on the coronal-alveolar bone and sometimes also in the lateral maxillary wall and zygomatic buttress.
It is critical to preserve the sinus membrane integrity and as much bone thickness as possible at the zygomatic implant critical zone crest level.
Adapted from C Aparicio et al., Atlas Oral Maxillofac Surg Clin North Am. 2021 Sep;29(2):203-231, for more info about this publication click HERE
J Dent Imp Res 2021; 40(3): 59-65
Immediate placement and immediate loading of full edentulous arches in 20 periodontally compromised patients – in-line clinical case series with 3 years follow-up
L Tran-Hung , M Dard
Study objectives and methods
These in-line clinical case series aim to assess the cumulative implant and definitive prosthesis survival rate of full edentulous arches in periodontally compromised patients using 4 to 6 Bone Level Tapered (BLT) implants (Straumann, Basel, Switzerland) for up to 3 years of loading.
Ninety-four implants were placed in 20 patients under the full controlled principle of in-line clinical case series (14 successive days of surgery). Each subject received an immediate loaded and complete-arch provisional prosthesis during 24 hours after implant surgery. The definitive prostheses were delivered within 6 to 8 weeks after implant insertion. A life table method was used to determine implant cumulative survival rate.
Results
• Up to 3 years of loading, our results demonstrated a cumulative implant survival rate of 98.94%. • The definitive prosthesis survival rate was 100%.
Conclusions
These results support the use of BLT implants according to the ProArch concept for immediate placement and immediate loading of full edentulous arches in periodontally compromised patients. These in-line case series need to be followed by longterm clinical evaluations.
Adapted from L Tran-Hung et al., J Dent Imp Res 2021; 40(3): 59-65, for more info about this publication click HERE
Int J Implant Dent. 2021 Jul 13;7(1):93.doi: 10.1186/s40729-021-00373-4.
E Schiegnitz, L K Müller, K Sagheb, L Theis, V Cagiran, P W Kämmerer, J Wegener, W Wagner, B Al-Nawas
Study objectives and methods
The aim of this clinical study was to investigate the clinical long-term and patient-reported outcome of dental implants in patients with oral cancer. In addition, analysis of the influence of radiation therapy, timing of implant insertion, and augmentation procedures on implant survival was performed.
This retrospective study investigated the clinical outcome of 711 dental implants in 164 oral cancer patients, inserted by experienced surgeons of the Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Germany. Oral health-related quality of life (OHRQoL) was evaluated.
Results
• Cumulative 5-year and 10-year implant survival rates for all included implants were 87.3% and 80.0%. • Implants placed straight after ablative surgery (primary implant placement) and implants placed after completing the oncologic treatment (secondary implant placement) showed a comparable implant survival (92.5% vs. 89.5%; p = 0.635). • Irradiation therapy had no significant influence on implant survival of secondary placed implants (p = 0.929). However, regarding implant site (native bone vs. augmented bone) and radiation therapy (non-irradiated bone vs. irradiated bone), implants inserted in irradiated bone that received augmentation procedures showed a statistically significant lower implant survival (p < 0.001). Patients reported a distinct improvement in OHRQoL.
Conclusions
Promising long-term survival rates of dental implants in patients after treatment of oral cancer were seen. In addition, patients benefit in form of an improved OHRQoL. However, bone augmentation procedures in irradiated bone may result in an impaired implants' prognosis.
Adapted from E Schiegnitz et al., Int J Implant Dent. 2021 Jul 13;7(1):93, for more info about this publication click HERE
Int J Dent. 2021 Aug 31;2021:4134932. doi: 10.1155/2021/4134932
Pain Experience after Dental Implant Placement Compared to Tooth Extraction
A W AlQutub
Abstract
A patients' main concern when visiting the dentist is the pain experience during the procedure and postoperatively. Patients who are undergoing dental surgical procedures in particular may experience more concerns and higher level of anxiety and stress that can affect their psychology and decision-making ability. A thorough discussion with the patients about the planned surgical procedure and the expected postsurgical pain and discomfort level is crucial to reduce their fear and stress. Despite increasing popularity of dental implants, limited data are available on pain experience related to surgical implant placement. This review is to discuss and compare postoperative pain and discomfort level after dental implant placement procedure and tooth extraction. The review has a clinical significance as it can be used as a reference when explaining to the patients about the anticipated pain and discomfort level after implant placement.
Conclusions
Informing patients about implant placement surgical procedure and the anticipated postsurgical pain can reduce their anxiety level and affect postsurgical pain and discomfort. Implant placement surgical procedure is less unpleasant than tooth extraction, with less postsurgical pain and limitation of daily activities.
Adapted from A W AlQutub, Int J Dent. 2021 Aug 31;2021:4134932, for more info about this publication click HERE
