International Journal of Oral Implantology, 3/2022
PubMed-ID: 36082660Seiten: 265-275, Sprache: Englisch
The aim of the present study was to generate an international and multidisciplinary consensus on the clinical management of implant protrusion into the maxillary sinuses and nasal fossae. A total of 31 experts participated, 23 of whom were experts in implantology (periodontologists, maxillofacial surgeons and implantologists), 6 were otolaryngologists and 2 were radiologists. All the participants were informed of the current scientific knowledge on the topic based on a systematic search of the literature. A list of statements was created and divided into three surveys: one for all participants, one for implant providers and radiologists and one for otolaryngologists and radiologists. A consensus was reached on 15 out of 17 statements. According to the participants, osseointegrated implants protruding radiographically into the maxillary sinus or nasal fossae require as much monitoring and maintenance as implants fully covered by bone. In the event of symptoms of sinusitis, collaboration between implant providers and otolaryngologists is required. Implant removal should be considered only after pharmacological and surgical management of sinusitis have failed.
Schlagwörter: consensus, dental implants, maxillary sinus, nasal fossae
Conflict-of-interest statement: The authors declare there are no conflicts of interest relating to this study.
International Journal of Periodontics & Restorative Dentistry, 3/2021
Seiten: 457-465a, Sprache: Englisch
A simplified surgical technique is presented for closure and soft tissue augmentation of fresh extraction sockets that utilizes a xenogeneic collagen matrix as a substitute for a combined onlay-interpositional connective tissue graft. Ten alveoli receiving a socket preservation procedure (n = 5) or an immediate submerged implant (n = 5) were sealed with a xenogeneic collagen matrix, stabilized under small palatal and buccal full-thickness envelope flaps. Eight weeks after surgery, full wound closure was achieved in 9 out of 10 sites with satisfactory esthetic integration (mean ΔE score: 3.76). Results from this descriptive observational study suggest that this technique may represent a valuable and minimally invasive solution to simplify closure and soft tissue augmentation of fresh extraction sockets.
International Journal of Periodontics & Restorative Dentistry, 4/2018
DOI: 10.11607/prd.3403, PubMed-ID: 29889923Seiten: 593-599, Sprache: Englisch
The purpose of this study was to evaluate clinical and radiologic outcomes using a newly developed device for maxillary sinus membrane elevation. Patients with a residual bone height of at least 3 mm were enrolled. Crestal sinus lift elevation and sinus graft were performed using the crestal approach sinus (CAS) kit. Graft was avoided if the residual bone crest was ≤ 2 mm less than the length of the planned implant. Outcome measures were implant and prosthesis failure, any biologic or technical complications, and marginal bone loss (MBL). A total of 35 consecutive patients underwent 49 crestal elevations of the sinus membrane. All the implants were followed for at least 2 years after placement (mean follow-up 37.3 months; range 24 to 54 months). No implants or prostheses failed during follow-up, and no membrane tears or other intraoperative or postoperative adverse events were observed. At the 2-year follow-up, mean MBL was 0.33 ± 0.24 mm (95% confidence interval: 0.08 to 0.30 mm). A total of 32 implants were placed after filling the sinus with anorganic bovine bone, while 17 implants were placed without grafting the sinus. Post-hoc analysis was performed using the sinus grafting remodeling index (SGRI) to evaluate radiographically the tissue remodeling patterns. The SGRI was statistically significantly higher when the sinus was grafted (P = .000). The CAS kit may provide a new option for minimally invasive crestal sinus surgery. Long-term randomized controlled trials with larger sample size are needed to confirm these preliminary results.
International Journal of Oral Implantology, 6/2016
SupplementPubMed-ID: 28112283Seiten: 3-4, Sprache: Englisch
International Journal of Oral Implantology, 2/2015
SupplementPubMed-ID: 26021220Seiten: 3-4, Sprache: Englisch
The International Journal of Oral & Maxillofacial Implants, 2/2015
DOI: 10.11607/jomi.3763, PubMed-ID: 25830406Seiten: 450-460, Sprache: Englisch
Purpose: The objectives of this study were to evaluate: (1) the clinical outcome of fresh frozen human allogeneic bone grafts (FFB) used for the reconstruction of severely atrophied edentulous ridges; (2) the survival rate of implants placed in the reconstructed areas; and (3) bone resorption.
Materials and Methods: During a 2-year period, 19 patients with severely atrophied partially or totally edentulous ridges who were candidates for an implant-supported prosthesis were consecutively enrolled and reconstructed with FFB iliac blocks. Five to 7 months later, 117 implants were placed in the reconstructed areas, and prosthetic rehabilitation was started 5 to 6 months afterward.
Results: The mean follow-up of patients after prosthetic loading was 27 months (range, 20 to 32 months). Prior to implant placement, graft exposure with partial or total loss of the graft occurred in four patients. After implant placement, bone graft exposures with partial loss of the grafts occurred in nine patients; in two patients, both grafts and implants were removed. The cumulative survival rate of implants was 90.2%. The mean (± standard deviation) graft resorption before implant placement was 0.98 ± 0.77 mm (range, 0 to 4 mm), while these values were 1.21 ± 1.05 mm (range, 0 to 6 mm) at loading, 1.55 ± 1.57 mm (range, 0 to 8 mm) at 12 months, and 1.93 ± 1.38 mm (range, 1 to 9 mm) at 24 months.
Conclusion: Within the limits of this study (limited sample of patients and short follow-up), the reconstruction of severely atrophic edentulous ridges with FFB is associated with a relevant incidence of bone exposures and partial or total loss of the grafts, which may compromise the long-term survival of implants placed in the reconstructed areas.
Schlagwörter: allogeneic grafts, atrophy, bone graft, dental implant, fresh frozen allogeneic bone, reconstruction
The International Journal of Oral & Maxillofacial Implants, 1/2013
DOI: 10.11607/jomi.2668, PubMed-ID: 23377075Seiten: 281-287, Sprache: Englisch
Purpose: To verify, in a medium-term follow-up, whether or not zirconia (Zr) abutments show similar survival outcomes as titanium (Ti) abutments in posterior areas.
Materials and Methods: A two-stage surgical protocol was used. Each patient was followed for 5 years after the definitive prosthesis insertion. Clinical and radiographic parameters were assessed at the yearly follow-up visit, and prosthetic complications were recorded. Statistical analysis (Wilcoxon signed rank test) was used to compare any difference in biologic and radiographic parameters between implants and the natural contralateral teeth. Descriptive statistics were used to analyze the changes over time (from baseline to the last follow-up) of clinical and radiographic parameters.
Results: A total of 85 patients with a single posterior tooth gap were treated with 85 implants supporting 47 Ti and 38 Zr abutments, respectively. All-ceramic (38) and metal-ceramic (47) single crowns were fabricated. Four patients were classified as dropouts. Eighty-one implants supporting 44 Ti and 37 Zr abutments completed the 5-year follow-up examination. No implant, reconstruction, or abutment failures were recorded. Therefore, the prosthetic survival after 5 years of function was 100% for all the abutments and restorations. No significant differences in biologic and radiographic indexes were found between Ti and Zr abutments when compared with each other and with the natural teeth after 5 years. No significant marginal bone loss was found between the baseline and the last follow-up, both for Zr and Ti abutments.
Conclusions: The medium-term survival of Zr abutments in posterior regions was comparable with that of Ti abutments. Long-term evaluations are needed to confirm this finding.
Schlagwörter: zirconia abutments, titanium abutments, single-tooth fixed prostheses, survival rate
The International Journal of Oral & Maxillofacial Implants, 7/2009
SupplementPubMed-ID: 19885448Seiten: 237-259, Sprache: Englisch
Purpose: This review evaluated (1) the success of different surgical techniques for the reconstruction of edentulous deficient alveolar ridges and (2) the survival/success rates of implants placed in the augmented areas.
Materials and Methods: Clinical investigations published in English involving more than 10 consecutively treated patients and mean follow-up of at least 12 months after commencement of prosthetic loading were included. The following procedures were considered: onlay bone grafts, sinus floor elevation via a lateral approach, Le Fort I osteotomy with interpositional grafts, split ridge/ridge expansion techniques, and alveolar distraction osteogenesis. Full-text articles were identified using computerized and hand searches by key words. Success and related morbidity of augmentation procedures and survival/success rates of implants placed in the augmented sites were analyzed.
Results and Conclusion: A wide range of surgical procedures were identified. However, it was difficult to demonstrate that one surgical procedure offered better outcomes than another. Moreover, it is not yet known if some surgical procedures, eg, reconstruction of atrophic edentulous mandibles with onlay autogenous bone grafts or maxillary sinus grafting procedures in case of limited/moderate sinus pneumatization, improve long-term implant survival. Every surgical procedure presents advantages and disadvantages. Priority should be given to those procedures which are simpler and less invasive, involve less risk of complications, and reach their goals within the shortest time frame. The main limit encountered in this literature review was the overall poor methodological quality of the published articles. Larger well-designed long-term trials are needed.
Schlagwörter: alveolar bone loss, alveolar ridge augmentation, atrophy, autogenous bone, graft material, oral implant
The International Journal of Oral & Maxillofacial Implants, 7/2009
SupplementPubMed-ID: 19885450Seiten: 272-278, Sprache: Englisch
International Journal of Periodontics & Restorative Dentistry, 5/2009
PubMed-ID: 19888499Seiten: 549-555, Sprache: Englisch
The aim of this study was to evaluate the early phases of bone healing around two different implant surfaces. For this purpose, four minipigs were used. Implants with rough titanium surfaces (ITI sandblasted/acid-etched and Brånemark TiUnite) were placed in the maxillae of the animals and sacrifice was scheduled in such a way that healing times of 3 days, 1 week, 2 weeks, 3 weeks, 4 weeks, 5 weeks, 6 weeks, and 7 weeks were obtained. Histologic analysis revealed that a similar pattern was observed in the phases of bone healing around both types of implants between 3 days and 7 weeks. This pattern consisted of the replacement of blood clot and bone debris with a provisional connective tissue in the first few weeks and with mineralized tissue and marrow spaces later on. Both rough surfaces allowed for "contact osteogenesis" to take place.