Does the Implant Surgical Technique Affect the Primary and/or Secondary Stability of Dental Implants? A Systematic Review

Background. A number of surgical techniques for implant site preparation have been advocated to enhance the implant of primary and secondary stability. However, there is insufficient scientific evidence to support the association between the surgical technique and implant stability.Purpose. This review aimed to investigate the influence of different surgical techniques including the undersized drilling, the osteotome, the piezosurgery, the flapless procedure, and the bone stimulation by low-level laser therapy on the primary and/or secondary stability of dental implants.Materials and methods. A search of PubMed, Cochrane Library, and grey literature was performed. The inclusion criteria comprised observational clinical studies and randomized controlled trials (RCTs) conducted in patients who received dental implants for rehabilitation, studies that evaluated the association between the surgical technique and the implant primary and/or secondary stability. The articles selected were carefully read and classified as low, moderate, and high methodological quality and data of interest were tabulated.Results. Eight clinical studies were included then they were classified as moderate or high methodological quality and control of bias.Conclusions. There is a weak evidence suggesting that any of previously mentioned surgical techniques could influence the primary and/or secondary implant stability.

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Comparative radiographic and resonance frequency analyses of the peri-implant tissue after dental implants placement using flap and flapless techniques: An experimental study on domestic pigs

Vojnosanitetski pregled ◽

10.2298/vsp1306586v ◽

2013 ◽

Vol 70 (6) ◽

pp. 586-594 ◽

Cited By ~ 6

Author(s):

Zoran Vlahovic ◽

Branko Mihailovic ◽

Zoran Lazic ◽

Mileta Golubovic

Keyword(s):

Bone Resorption ◽

Resonance Frequency ◽

Dental Implants ◽

Dental Implant ◽

Surgical Techniques ◽

Primary Stability ◽

Implant Stability ◽

Domestic Pigs ◽

Flap Technique ◽

Implant Placement

Background/Aim. Flapless implant surgery has become very important issue during recent years, mostly thanks to computerization of dentistry and software planning of dental implants placements. The aim of this study was to compare flap and flapless surgical techniques for implant placement through radiographic and radiofrequency analyses. Methods. The experiment was made in five domestic pigs. Nine weeks following domestic pigs teeth extraction, implants were placed, on the right side using surgical technique flap, and flapless on the left side. Digital dental Xrays were applied to determine primary dental implant stability quality (ISQ). At certain intervals, not later than three months, the experimental animals were sacrificed, and just before it, control X-rays were applied to measure dental implants stability. Results. Radiographic analysis showed that peri-implant bone resorption in the first 4 weeks following placement implants with flap and flapless surgical techniques was negligible. After the 3 months, mean value of peri-implant bone resorption of the implants placed using flap technique was 1.86 mm, and of those placed using flapless technique was 1.13 mm. In relation to the primary dental implant stability in the first and second week there was an expected decrease in ISQ values, but it was less expressed in the dental implants placed using the flapless technique. In the third week the ISQ values were increased in the dental implants placed by using both techniques, but the increase in flapless implant placement was higher (7.4 ISQ) than in flap implant placement (1.5 ISQ). The upward trend continued in a 4- week period, and after 3 months the dental implant stability values in the implants placed using flap technique were higher than the primary stability for 7.1 ISQ, and in the implants placed using flapless technique were higher comparing to the primary stability for 10.1 ISQ units. Conclusion. Based on the results of radiographic and resonance frequency analyses it can be concluded that the flapless technique in surgical implants placemat, leads to better results.

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Developing Stability of Posterior Mandibular Implants Placed With Osteotome Expansion Technique Compared With Conventional Drilling Techniques

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-16-00101 ◽

2017 ◽

Vol 43 (2) ◽

pp. 131-138 ◽

Cited By ~ 1

Author(s):

Yen-Ting Lin ◽

Adrienne Hong ◽

Ying-Chin Peng ◽

Hsiang-Hsi Hong

Keyword(s):

Bone Density ◽

Surgical Techniques ◽

Primary Stability ◽

Conventional Technique ◽

Implant Stability ◽

Implant Stability Quotient ◽

Expansion Technique ◽

The Stability ◽

Conventional Drilling ◽

Secondary Stability

Clinical decisions regarding the stability and osseointegration of mandibular implants positioned using the bone expansion techniques are conflicting and limited. The objective was to evaluate the stability of implants placed using 2 surgical techniques, selected according to the initial width of the mandibular posterior edentulous ridge, with D3 bone density, during a 12-week period. Fifty-eight implants in 33 patients were evaluated. Thirty-two implants in 24 patients were positioned using the osteotome expansion technique, and 26 fixtures in 17 patients were installed using the conventional drilling technique. The implant stability quotient values were recorded at weeks 0, 1, 2, 3, 4, 6, 8, 10, and 12 postsurgery and evaluated using analysis of variance, independent, and paired t tests. Calibrated according to the stability reading of a 3.3-mm diameter implant, the osteotome expansion group was associated with a lower bone density than the conventional group (64.96 ± 6.25 vs 68.98 ± 5.06, P = .011). The osteotome expansion group achieved a comparable primary stability (ISQb-0, P = .124) and greater increases in secondary stability (ISQb-12, P = .07) than did the conventional technique. A D3 quality ridge with mild horizontal deficiency is expandable by using the osteotome expansion technique. Although the 2 groups presented similar implant stability quotient readings during the study period, the osteotome expansion technique showed significant improvement in secondary stability. The healing patterns for these techniques are therefore inconsistent.

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Short Dental Implants: State of the Art and Systematic Review

MedNEXT Journal of Medical and Health Sciences ◽

10.34256/mdnt2138 ◽

2021 ◽

pp. 50-55

Author(s):

Marcelo Henrique Batista Santos ◽

Priscilla Janaína de Lima Borelli Bovo ◽

Henrique Esteves Magalhães ◽

Luciano Rodrigues Neves ◽

Elias Naim Kassis

Keyword(s):

Systematic Review ◽

Dental Implants ◽

State Of The Art ◽

Fibrous Tissue ◽

Surgical Techniques ◽

Cochrane Library ◽

Implant Surface ◽

Short Implants ◽

Correct Technique ◽

Bone Height

Introduction: The success of dental implants is due to their ability to osseointegrate, with direct contact of the implant surface with the bone, without the interposition of fibrous tissue. Because many patients do not receive implant treatments because they do not have adequate or sufficient bone height, the development of shorter implants could meet the needs of these patients. Objective: To carry out a brief systematic review to present the state of the art of using short implants. Methods: The present study followed a concise systematic review model. The search was carried out in the PubMed, Embase, Ovid, Cochrane Library, Web Of Science, and Scopus databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results: Short implants are an increasingly common alternative to other surgical techniques in areas where bone availability is reduced. Despite the advantages they offer, a variety of biological repercussions have been described in the literature that can even lead to their loss. Conclusion: The studies analyzed showed that short implants are a reliable, safe, and practical alternative to be used in situations with reduced bone height. They do not present bone loss or resorption over the years, nor the risk of fracture or any damage to patients, as long as they have an adequate design, correct technique, and meticulous planning.

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COMPARATIVE EVALUATION OF EFFECT OF IRRADIATION USING LOW- LEVEL LASER THERAPY WITH TWO DIFFERENT WAVELENGTHS ON STABILITY OF DENTAL IMPLANTS

International Journal of Medical Science and Diagnosis Research ◽

10.32553/ijmsdr.v5i3.772 ◽

2021 ◽

Vol 5 (3) ◽

Author(s):

Lakshmi Keerthi Kandavalli ◽

Aravind Kumar Pavuluri ◽

Musalaiah S.V.V. S

Keyword(s):

Bone Formation ◽

Laser Therapy ◽

Dental Implants ◽

Low Level Laser Therapy ◽

Osteotomy Site ◽

Implant Stability ◽

Low Level ◽

Low Level Laser ◽

Group I ◽

Level Laser

Aim: This study aimed to compare the effect of low-level laser therapy irradiation with two different wavelengths after osteotomy site preparation on the stability of dental implants. Materials and Methods: The current study is a double-masked, randomized clinical trial. A total of seven patients of age 25 to 55 years were assigned randomly into two groups. Group I: Osteotomy site irradiated with low-level laser therapy of wavelength 940nm. GROUP II: Osteotomy site irradiated with low-level laser therapy of wavelength 660nm. Implant stability was measured after implant placement using the Penguin RFA device. Bone formation was assessed with Cone Beam Computed Tomography. Results: The current trial results showed that low-level laser therapy aided in bone formation around the implants, but there is no significant difference between the two different wavelengths. Conclusion: Implant stability increased in both groups, but no difference is observed among the groups. Hounsfield units indicating bone formation improved in both the groups with no pronounced difference between the groups. All 14 implants were stable, thus indicating that low-level laser therapy aids bone formation, but the wavelength difference had no significant impact. Keywords: Low level laser therapy, Implant Stability, Resonance frequency analysis

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Superior Capsular Reconstruction of the Shoulder Using the Long Head of the Biceps Tendon: A Systematic Review of Surgical Techniques and Clinical Outcomes

Medicina ◽

10.3390/medicina57030229 ◽

2021 ◽

Vol 57 (3) ◽

pp. 229

Author(s):

Dimitrios Kitridis ◽

Christos Yiannakopoulos ◽

Chris Sinopidis ◽

Panagiotis Givissis ◽

Nikiforos Galanis

Keyword(s):

Pain Intensity ◽

Clinical Studies ◽

Biceps Tendon ◽

Surgical Techniques ◽

Fascia Lata ◽

Long Term Results ◽

Cochrane Library ◽

Superior Capsular Reconstruction ◽

Functional Scores ◽

Long Head

Background and Objectives: Superior capsular reconstruction (SCR) with the use of a fascia lata autograft or a dermal allograft is an established treatment in treating irreparable rotator cuff (RC) tears. The long head of the biceps tendon (LHBT) has been recently proposed as an alternative graft for SCR. The purpose of this study was to present the surgical techniques and clinical studies utilizing the LHBT for SCR. Material and Methods: Medline, Scopus, and the Cochrane library were searched for relevant studies up to December 2020. The primary outcomes were pain intensity improvement and the incidence of RC and LHBT graft retears. Secondary outcomes were functional scores and acromiohumeral distance (AHD) improvements. Results: Nine studies described surgical techniques of SCR using the LHBT, and four clinical studies reported the outcomes of the technique. The mean pain intensity improved from 4.9 ± 2.3 to 1.6 ± 1.5 in terms of the visual analog scale, exceeding the minimum clinically important difference for adequate pain relief. Significant improvements were also noted in functional scores and AHD. When compared with other repair techniques for massive RC tears, i.e., the double-row repair, the transosseous-equivalent technique with absorbable patch reinforcement, and the traditional SCR with a fascia lata autograft, there were no significant differences in pain and function improvements. Conclusion: SCR using the LHBT is a useful treatment option for massive RC tears; it is equally effective with the traditional SCR and other established techniques. It presents numerous advantages being a safe, easy, time-saving, and cost-effective method. The only precondition for the technique is the presence of an intact LHBT. Additional clinical trials are necessary to determine which treatment is superior for treating massive RC tears, as well as to evaluate the long-term results of the technique.

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Partial Extraction Therapy: A Review of Human Clinical Studies

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-21-00095 ◽

2021 ◽

Author(s):

David T Wu ◽

Shahram Raoof ◽

Jessica M Latimer ◽

Thomas T. Nguyen

Keyword(s):

Clinical Studies ◽

Comprehensive Evaluation ◽

Current Knowledge ◽

Grey Literature ◽

Surgical Techniques ◽

Bibliographic Databases ◽

Ridge Augmentation ◽

Manual Search ◽

Extraction Therapy ◽

Partial Extraction

Partial extraction therapy (PET) is a collective concept encompassing a group of surgical techniques including socket shield, root membrane, proximal shield, pontic shield and root submergence. PET utilizes the patient’s own root structure to maintain blood supply derived from the periodontal ligament complex in order to preserve the periodontium and peri-implant tissues during restorative and implant therapy. This review aims to summarize current knowledge regarding PET techniques and present a comprehensive evaluation of human clinical studies in the literature. Two independent reviewers conducted electronic and manual searches until January 1 st , 2021 in the following electronic bibliographic databases: PubMed, EMBASE, and Dentistry & Oral Sciences Source. Grey literature was searched to identify additional candidates for potential inclusion. Articles were screened by a group of 4 reviewers using the Covidence software and synthesized. Systematic search of the literature yielded 5,714 results. 64 articles were selected for full-text assessment, of which, 42 eligible studies were included in the review. 12 studies were added to the synthesis after manual search of the reference lists. A total of 54 studies were examined in this review. In sum, PET techniques offer several clinical advantages: 1) preservation of buccal bone post-extraction and limitation of alveolar ridge resorption 2) mitigation of the need for invasive ridge augmentation procedures 3) soft tissue dimensional stability and high esthetic outcomes. Further randomized clinical studies with larger sample sizes are needed to improve understanding of the long-term clinical outcomes of PET.

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Clinical Assessment of Dental Implants Placed in Low-Quality Bone Sites Prepared for the Healing Chamber with Osseodensification Concept: A Double-Blind, Randomized Clinical Trial

Applied Sciences ◽

10.3390/app11020640 ◽

2021 ◽

Vol 11 (2) ◽

pp. 640

Author(s):

Rafael Coutinho Mello-Machado ◽

Carlos Fernando de Almeida Barros Mourão ◽

Kayvon Javid ◽

Henrique T. Ferreira ◽

Pietro Montemezzi ◽

...

Keyword(s):

Dental Implants ◽

Insertion Torque ◽

Implant Survival ◽

Implant Stability ◽

Double Blind ◽

Implant Placement ◽

The Stability ◽

To Receive ◽

Preparation Techniques ◽

Secondary Stability

The present study aimed to compare the stability of dental implants placed in low-quality bone prepared for the healing chamber with osseodensification technique and a standard undersized drilling. Sixteen subjects presenting D3 or D4 bone density according to Misch’s classification were randomly distributed to receive dental implants following either osseodensification (G1: n = 29) or standard undersized drilling (G2: n = 26) preparation techniques. Implant insertion torque (IT) and implant stability quotient (ISQ) were measured immediately after implant placement. Implant survival and secondary stability (ISQ) were evaluated after six months. The G1 group showed higher IT (39.0 ± 6.4 Ncm) than G2 (32.0 ± 3.4 Ncm) (p < 0.001). ISQ values were similar (p > 0.05) at the implant insertion (67.1 ± 3.2 and 65.5 ± 2.7 for G1 and G2, respectively). After six months healing, implant survival was equally comparable in both groups (p > 0.05), and ISQ values were higher than those of implant insertion (p < 0.001) but similar (p > 0.05) for both groups (74.0 ± 3.6 and 73.3 ± 3.2 for G1 and G2, respectively). Within the limitations of this study, the present RCT demonstrated that a wider surgical bed prepared by osseodensification instrumentation allowed for the bone healing-chamber concept in low-quality bone without any reduction in implant stability and success rate.

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Reporting of the methodological quality of search strategies in orthodontic quantitative systematic reviews

European Journal of Orthodontics ◽

10.1093/ejo/cjaa078 ◽

2020 ◽

Author(s):

Danah AlMubarak ◽

Nikolaos Pandis ◽

Martyn T Cobourne ◽

Jadbinder Seehra

Keyword(s):

Systematic Reviews ◽

Methodological Quality ◽

Search Strategy ◽

Grey Literature ◽

Reporting Quality ◽

Search Strategies ◽

Cochrane Library ◽

Eligibility Criteria ◽

Cochrane Reviews

Summary Background This study aimed to assess the reporting of the methodological quality of search strategies undertaken in orthodontic quantitative systematic reviews (SRs) and hence their reproducibility. Materials and methods A search of a single electronic database (Medline via PubMed) was undertaken to identify interventional orthodontic SRs with meta-analysis published within a 10-year period. The Cochrane Library of Systematic Reviews was also sourced. Full articles were reviewed by two assessors against the eligibility criteria. The reporting quality of each search strategy was assessed using a previously validated checklist with a score of 1 or 2 given for each of the eight items. Cumulative totals were calculated. Guided by previous research, the authors agreed the following cut-offs to categorize the overall level of quality: 8–10 (poor), 10–12 (fair), and greater than 13 (good). Results A total of 127 SRs were analysed. The overall median quality score for the reporting of the search strategy was 14 [interquartile range (IQR): 13–15]. Cochrane SRs and those originating in Europe received higher aggregate scores, whereas no difference was evident based on Prospero registration. The continent of the corresponding author predicated the overall score. Non-Cochrane reviews achieved lower overall scores compared to Cochrane reviews (−1.0, 95% confidence interval: −1.65, −0.34, P = 0.003). The most frequently searched database was EMBASE (N = 93) and the median number of authors was 5 (IQR 4–6). Authors of 26.8% of SRs searched the grey literature. Language restrictions were applied to the search strategies of 88 (69.3%) SRs. Conclusions The reporting quality of search strategies undertaken in orthodontic SRs is at a good level but differences between Cochrane and non-Cochrane reviews currently exist. The reporting of searching of the grey literature and application of no language restrictions can be improved.

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Evaluation of Short and Regular Implants after Prosthesis Placement in the Mandible: A Nonrandomized Controlled Clinical Trial

The Journal of Contemporary Dental Practice ◽

10.5005/jp-journals-10024-2187 ◽

2017 ◽

Vol 18 (12) ◽

pp. 1122-1129 ◽

Cited By ~ 2

Author(s):

Frederico S Lages ◽

Carolina P Rivera ◽

Ana P de Souza Faloni

Keyword(s):

Clinical Trial ◽

Dental Implants ◽

Alveolar Bone ◽

Surgical Techniques ◽

Posterior Region ◽

Controlled Clinical Trial ◽

Success Rates ◽

Implant Stability ◽

Radiographic Measurements ◽

Short Implants

ABSTRACT Aim The aim of this nonrandomized controlled preliminary clinical trial was to compare treatment using short and conventional implants in the posterior region of the mandible after prosthesis installation by means of clinical, resonance frequency, and radiographic analyses. Materials and methods A total of 10 patients with 40 dental implants already installed were included in this study. Four implants were installed for each subject, in which the length of the implants (short and conventional) was distributed according to the reminiscent alveolar bone in the left and right side of the mandible. All implants received splinted prosthesis after the osseointegration period. Analyses were performed immediately after prosthesis installation (T1), and 3 (T2) and 6 months (T3) after prosthesis placement. Results The 6-month survival and success rates were 100% for the short and conventional implants. Probing depths (PDs) after 6 months did not show statistical differences between short and conventional implants. All groups showed mean implant stability quotient (ISQ) values above 60 in all periods evaluated, demonstrating great implant stability, and no differences were found between groups at T3. Radiographic measurements showed an increased bone loss for conventional implants compared with short implants in all the three periods evaluated. Conclusion Our findings suggest that treatment of resorbed posterior regions in the mandible with shorter dental implants is as reliable as treatment with conventional implants after 6 months of splinted prosthesis installation. Clinical significance Short implants might be considered a predictable treatment alternative to bone augmentation or extensive surgical techniques in regions of restricted vertical bone height in the posterior region of the mandible. How to cite this article de Molon RS, Lages FS, Rivera CP, de Souza Faloni AP, Margonar R, Queiroz TP. Evaluation of Short and Regular Implants after Prosthesis Placement in the Mandible: A Nonrandomized Controlled Clinical Trial. J Contemp Dent Pract 2017;18(12):1122-1129.

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Increasing the Stability of Dental Implants: the Concept of Osseodensification

Balkan Journal of Dental Medicine ◽

10.1515/bjdm-2017-0023 ◽

2017 ◽

Vol 21 (3) ◽

pp. 133-140 ◽

Cited By ~ 5

Author(s):

Leonidas Podaropoulos

Keyword(s):

Surgical Technique ◽

Dental Implants ◽

Surgical Techniques ◽

Primary Stability ◽

Rigid Fixation ◽

Low Density ◽

Success Rates ◽

Promising Technique ◽

The Stability ◽

Implant Bed

Summary One of the most important factors that affect osseointegration is the primary stability of the implant. Dental implants inserted at the posterior region of the maxilla exhibit the lowest success rates as the low density bone in this area often jeopardize rigid fixation of the implant. Many surgical techniques have been developed to increase the primary stability of an implant placed in low density bone, such as bicortical fixation of the implant, undersized preparation of the implant bed and bone condensation by the use of osteotomes. A new promising technique, named osseodensification, has been recently developed that creates an autograft layer of condensed bone at the periphery of the implant bed by the aid of specially designed burs rotating in a clockwise and anti-clockwise direction. The purpose of this review is to emphasize that implant primary stability is strongly influenced by the surgical technique, to quote and briefly analyse the various surgical procedures laying weight to osseodensification procedure.

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