Treatment Planning Dental Implants in the Anterior Maxilla. Risk Assessment for Successful Esthetic and Functional Clinical Outcomes

Abstract Dental implants are the new era in the field of dentistry providing the new opportunities to the clinicians to manage their patients with missing teeth. The procedure is more technique sensitive in maxilla than mandible. The scenario becomes even more challenging with severely resorbed maxillary arches. The idea of zygomatic bone implants put forward the new approach to manage such patients. The purpose of the present article is to describe the concept of zygomatic implantology with emphasis on case selection and clinical outcomes based on the literature. How to cite this article Nandeeshwar DB, Neha A. Zygomatic bone implants in prosthetic rehabilitation - A review. CODS J Dent 2014;6;90-95

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Clinical outcomes of dental implants placed in the same region where previous implants failed due to peri-implantitis: a retrospective study

International Journal of Implant Dentistry ◽

10.1186/s40729-021-00392-1 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Eduardo Anitua ◽

Adriana Montalvillo ◽

Asier Eguia ◽

Mohammad Hamdan Alkhraisat

Keyword(s):

Retrospective Study ◽

Survival Rate ◽

Bone Loss ◽

Clinical Outcomes ◽

Dental Implants ◽

Demographic Data ◽

High Survival ◽

Implant Survival ◽

Marginal Bone Loss ◽

Bone Level

Abstract Purpose There is paucity in the studies that assess dental implants replacing failed dental implants due to peri-implantitis. This study aims to evaluate the clinical outcomes of these implants in terms of implant survival and marginal bone loss. Methods Patients in this retrospective study were selected if having one or more implants removed due to peri-implantitis and the placement and loading of dental implants in the same region from April 2010 to December 2019. Information was collected about the patient's demographic data, implant dimensions, surgical and prosthetic variables. Changes in peri-implant bone level, cumulative implant survival rate and technical complications were assessed. Results Three hundred and eighty one dental implants in 146 patients that were placed in the same position or one-tooth position mesially/distally to the site of explantation were included. The patients' mean age was 63 ± 10 years. Ninety seven patients were females and 49 were males. After a mean follow-up of 34 ± 17 months, two implants failed. The cumulative survival rate was 99%. The marginal bone loss was −0.1 ± 0.6. Immediate or delay replacement of the failed implant did not affect implant survival or marginal bone stability. All the prostheses were screw-retained and presented the following complications: ceramic chipping (3 events), resin tooth fracture (1 event) and prosthetic screw loosening (1 event). Conclusions Dental implants replacing failed implants due to peri-implantitis would be an option in the management of peri-implantitis. They showed high survival rate and marginal bone stability.

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Dental Implant Placement with Simultaneous Anterior Maxillary Reconstruction with Block and Particulate Fresh Frozen Allograft Bone: A Case Report with 24-Month Follow-Up Data

Case Reports in Surgery ◽

10.1155/2017/1565973 ◽

2017 ◽

Vol 2017 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

J. S. Vieira ◽

E. M. Brandão-Filho ◽

F. R. Deliberador ◽

J. C. Zielak ◽

A. F. Giovanini ◽

...

Keyword(s):

Case Report ◽

Dental Implants ◽

Clinical Success ◽

Maxillofacial Surgery ◽

Oral And Maxillofacial Surgery ◽

Allograft Bone ◽

Anterior Maxilla ◽

Implant Placement ◽

Fresh Frozen ◽

Fixed Prosthesis

Fresh frozen allograft bone is routinely used in orthopedic surgery for the reconstruction of large bone defects, and its use in oral and maxillofacial surgery is increasing. The purpose of this case was to demonstrate the installation of dental implants and the use of fresh frozen bone for reconstruction of anterior maxilla in the same surgery. This case report presents the insertion of dental implants followed immediately by a placement of fresh frozen allograft in block and particle for a reconstruction of atrophic anterior maxillary in the same surgery. Ten months subsequent to this procedure, provisional fixed prosthesis was installed on the implants. Four months later (postoperative month 14), the final fixed prosthesis was installed and the clinical success was observed. The insertion of dental implants followed immediately by a placement of fresh frozen allograft is a safe and efficient process that results in the successful return of dental function and aesthetic rehabilitation for the patient.

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343 A benefit-risk assessment of daridorexant for the treatment of insomnia using patient preference data from two phase 3 trials

SLEEP ◽

10.1093/sleep/zsab072.342 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A137-A137

Author(s):

Sebastian Heidenreich ◽

Andrea Phillips-Beyer ◽

Melissa Ross ◽

Gin Nie Chua ◽

Ingo Fietze ◽

...

Keyword(s):

Risk Assessment ◽

Clinical Outcomes ◽

Trial Data ◽

Behavioral Changes ◽

Treatment Withdrawal ◽

Phase Iii ◽

P Value ◽

Daytime Functioning ◽

Preference Data ◽

Benefit Risk Assessment

Abstract Introduction The efficacy and safety of daridorexant, a dual orexin receptor antagonist intended to treat insomnia, was demonstrated in two placebo-controlled phase III trials. Both pivotal trials included instruments for eliciting treatment preferences of enrolled patients, to interpret the trial findings from their perspective using a patient-centered benefit-risk assessment (pBRA). Methods Digital ethnographies and qualitative interviews with insomnia patients informed the design of a discrete choice experiment (DCE). The DCE was pre-tested in qualitative and quantitative pilots before inclusion in the trials. Within the DCE, patients were asked to make trade-offs between seven outcomes (“time to fall asleep,” “total time asleep,” “daytime functioning,” “likelihood of daytime dizziness/grogginess,” “likelihood of abnormal thoughts and behavioural changes,” “likelihood of falls in the night,” and “treatment withdrawal”). The preference data were analysed using a mixed logit (MXL) model that accounted for preference heterogeneity. Relative attribute importance (RAI) and maximum acceptable risk (MAR) of abnormal thoughts and behavioral changes were obtained from the MXL. A pBRA combined elicited preferences with collected clinical trial data to predict preferences for daridorexant over placebo. Sensitivity analysis accounted for uncertainty in both clinical outcomes and preferences. Results Patients valued all seven outcomes (p < 0.05), but considered improving daytime functioning (RAI = 33.7%) and avoiding treatment withdrawal (RAI = 27.5%) as most important. Patients were also willing to accept an additional 18.8% risk (p-value < 0.001) of abnormal thoughts and behavioral changes for an improvement in daytime functioning from difficulty functioning to restricted functioning. The pBRA suggested that both daridorexant 50 mg and 25 mg were significantly preferred (p-value < 0.001) over placebo, and 50 mg was significantly preferred (p-value < 0.001) over 25 mg, even after accounting for uncertainty in clinical outcomes and preferences. Conclusion All seven outcomes included in the DCE were valued by patients, but improving daytime functioning and avoiding severe treatment withdrawal was considered as most important. Daridorexant 50 mg and 25 mg were found to be significantly preferred over placebo, suggesting a positive benefit-risk balance of both doses. Overall, the preference data allowed for an innovative interpretation of the trial data from patients’ perspective. Support (if any):

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Influence of Insertion Torque on Clinical and Biological Outcomes before and after Loading of Mandibular Implant-Retained Overdentures in Atrophic Edentulous Mandibles

BioMed Research International ◽

10.1155/2019/8132520 ◽

2019 ◽

Vol 2019 ◽

pp. 1-14 ◽

Cited By ~ 2

Author(s):

Fernanda Faot ◽

Amália Machado Bielemann ◽

Alessandra Julie Schuster ◽

Raissa Micaella Marcello-Machado ◽

Altair Antoninha Del Bel Cury ◽

...

Keyword(s):

Clinical Outcomes ◽

Dental Implants ◽

Survival Rates ◽

Rank Correlation ◽

Primary Stability ◽

Insertion Torque ◽

Success Rates ◽

Implant Stability ◽

Before And After ◽

Edentulous Patients

Aim. To evaluate the influence of primary insertion torque (IT) values of narrow dental implants on the peri-implant health, implant stability, immunoinflammatory responses, bone loss, and success and survival rates. Methods. Thirty-one edentulous patients received two narrow implants (2.9x10mm, Facility NeoPoros) to retain mandibular overdentures. The implants were categorized in four groups according to their IT: (G1) IT > 10 Ncm; (G2) IT ≥ 10Ncm and ≤ 30 Ncm; (G3) IT >30Ncm and < 45Ncm; (G4) IT ≥ 45Ncm, and all implants were loaded after 3 months of healing. The following clinical outcomes were evaluated 1, 3, 6, and 12 months after implant insertion: (i) peri-implant tissue health (PH), gingival index (GI), plaque index (PI), calculus presence (CP), probing depth (PD), and bleeding on probing (BOP); (ii) implant stability quotient (ISQ) by resonance frequency analysis; and (iii) IL-1β and TNF-α concentration in the peri-implant crevicular fluid. The marginal bone level (MBL) and changes (MBC) were evaluated. The Chi2 test, Kruskal-Wallis test, mixed-effects regression analysis, and the Kendall rank correlation coefficient were used for statistical analysis (α = 5%). Results. G1 presented the highest PD at all evaluated periods. G2 presented higher PI at month 6 and 12. G4 showed increased GI at month 3 and 12 and more CP at month 1 (p=.003). G2 and G4 had higher ISQ values over the study period, while those from G1 and G3 presented lower ISQ values. The IL-1β concentration increased until month 12 and was independent of IT and bone type; G4 had a higher IL-1β concentration in month 3 than the other groups (p=.015). The TNF-α release was negatively correlated with IT, and TNF-α release was highest in G1 at month 12. The MBL immediately after surgery and the MBC at month 12 were similar between the groups, and G4 presented a positive MBC at month 12. The survival and success rates were 75% for G1, 81.3% for G2, 64.3% for G3, and 95% for G4. Conclusion. The IT did not influence the clinical outcomes and the peri-implant immunoinflammatory responses and was weakly correlated with the narrow dental implants primary stability. The observed success rates suggest that the ideal IT for atrophic fully edentulous patients may deviate from the standardized IT of 32 Ncm.

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