Molar Septum Expansion with Osseodensification for Immediate Implant Placement, Retrospective Multicenter Study with Up-to-5-Year Follow-Up, Introducing a New Molar Socket Classification

The ideal positioning of immediate implants in molar extraction sockets often requires the osteotomy to be in the interradicular septum, which can be challenging in some cases, with traditional site preparation techniques. Patients who had undergone molar tooth extraction and immediate implant placement at five different centers, and followed up between August 2015 and September 2020, were evaluated. Inclusion criteria were use of the osseodensification technique for implant site preparation. The primary outcome was septum width measurement pre-instrumentation and osteotomy diameter post expansion. Clinical outcomes, such as implant insertion torque (ISQ) and implant survival rate, were also collected. A total of 131 patients, who received 145 immediate implants, were included. The mean overall septum width at baseline was 3.3 mm and the mean osteotomy diameter post instrumentation was 4.65 mm. A total of ten implants failed: seven within the healing period and three after loading; resulting in a cumulative implant survival rate of 93.1%. This retrospective study showed that osseodensification is a predictable method for immediate implant placement with interradicular septum expansion in molar extraction sockets. Furthermore, it allowed the introduction of a new molar socket classification. In the future, well-designed controlled clinical studies are needed to confirm these results and further explore the potential advantages of this technique.

Treatment outcomes of implant-assisted removable partial denture with distal extension based on the Kennedy classification and attachment type: a systematic review

Background Implant-assisted removable partial dentures (IARPDs) have recently become popular, but little information is available on the treatment outcomes based on the Kennedy classification and attachment types. Objective The objective of this review was to evaluate the treatment outcomes of IARPD delivered for distal extension edentulous areas based on the differences in the Kennedy classification and attachment type. Materials and methods English-language clinical studies on IARPD published between January 1980 and February 2020 were collected from MEDLINE (via PubMed), the Cochrane Library (via the Cochrane Central Register of Controlled Trials), Scopus online database, and manual searching. Two reviewers selected the articles based on pre-determined inclusion and exclusion criteria, followed by data extraction and analysis. Results Eighty-one studies were selected after evaluating the titles and abstracts of 2410 papers. Nineteen studies were finally included after the perusal of the full text. Fourteen studies focused on Class I, 4 studies investigated both Class I and II, and only 1 study was conducted on Kennedy’s class II. Eight types of attachments were reported. The ball attachment was the most frequently used attachment, which was employed in 8 of the included studies. The implant survival rate ranged from 91 to 100%. The reported marginal bone loss ranged from 0.3 mm to 2.30 mm. The patient satisfaction was higher with IARPD than with conventional RPDs or that before treatment. The results of prosthetic complications were heterogeneous and inconclusive. Conclusion IARPD exhibited favorable clinical outcomes when used as a replacement for distal extension edentulous areas. The comparison between the clinical outcomes of Kennedy’s class I and II was inconclusive owing to the lack of studies focusing on Kennedy Class II alone. The stud attachment was the most commonly used type in IARPDs. Overall, the different attachment systems did not influence the implant survival rate and patient satisfaction. Further high-quality studies are needed to investigate the attachment systems used in IARPD.

Comparison of Clinical Parameters in Dental Implant Therapy between Implant Site Development Using Porcine- and Bovine-Derived Xenografts

Purpose: The aim of this study is to compare the effects of two xenografts, i.e., porcine- and bovine-derived xenografts, on dental implant therapy after implant site development. Materials and Methods: This retrospective study involved adults who underwent dental implantation between January 2012 and December 2020. Various patient and implant-site characteristics were collected from the patient records. The implant-surgery clinical parameters of the porcine- and bovine-derived xenografts used for implant site development were analyzed and compared. Results: A total of 116 subjects with 168 dental implants were included in this study. There was less soft bone in the porcine bone group of the maxilla. However, there was less soft bone and a greater percentage of “primary stability ≥35 N” in the bovine bone group of the mandible. However, no significant differences in regrafting rate, post-operative infection rate, or implant survival rate were found between the bovine and porcine bone groups. Conclusion: The effects of implant site development using bovine- and porcine-origin xenografts are comparable in terms of the implant-therapy clinical parameters, including the regrafting rate and implant survival rate. Thus, the choice of xenografts could be made according to the patient’s religious requirements. However, the reported results should be used with caution, considering the limitations of this retrospective study.

Implants Survival Rate in Regenerated Sites with Innovative Graft Biomaterials: 1 Year Follow-Up

In thirteen different dental clinics in Singapore, Spain, Czech Republic and Italy, 504 patients were selected, and 483 dental implants were placed in maxillary sites after alveolar socket preservation (ASP) procedures with an autologous demineralized tooth extracted as graft material from an innovative Tooth Transformer device was obtained. All procedures used were reported in n°638 Ethical Committee surgical protocol of University of Chieti and approved. After 4 months, at dental implant placing, bone biopsies were performed to evaluate the histologic outcomes, and 12 months after implant loading, global implant survival rate, failure percentage and peri-implant bone loss were detected. After ASP, only 27 post-operative complications were observed and after 4 months, bone biopsy histomorphometric analysis showed a high percentage of bone volume (BV) 43.58 (±12.09), and vital new bone (NB) 32.38 (±17.15) with an absence of inflammation or necrosis areas. Twelve months after loading, only 10 dental implants failed (2.3%), with a 98.2% overall implant survival rate, nine cases showed mucositis (1.8%) and eight showed peri-implantitis (1.6%). At mesial sites, 0.43 mm (±0.83) of bone loss around the implants was detected and 0.23 mm (±0.38) at the distal sites with an average value of 0.37 mm (±0.68) (p > 0.568). Several studies with a longer follow-up will be necessary to confirm the preliminary data observed. However, clinical results seem to suggest that the post-extraction socket preservation procedure using innovative demineralized autologous tooth-derived biomaterial may be a predictable procedure to produce new vital bone able to support dental implant rehabilitation of maxilla edentulous sites.

Oral Rehabilitation of Oncology Patients With Microvascular Free Flaps With a Follow-Up of 2 to 6 Years

BACKGROUND: Reconstruction with free flaps after radical cancer surgery in terms of function and esthetics can be quite demanding. The aim of this study was to evaluate retrospectively oral rehabilitation with microvascular free flaps and dental implants for maxillofacial reconstruction in oncologic patients with a minimum follow-up of 2 years after implant insertions.METHODS: The study consisted of 17 patients diagnosed with either squamous cell carcinoma, fusocellular carcinoma, or mucoepidermoid carcinoma. The reconstruction of the maxillofacial defects was done with microvascular free flaps (free fibular flap, antero-lateral thigh flap, or radial forearm flap). Implants were inserted on the average 30.2±15.5 months after reconstructive operations. A total of 74 implants were inserted. Mean follow up after maxillo-facial surgery was 6.16 years (mean 73.93±14.48 months). Mean follow up after implant insertions was 3.61 years (mean 43.50±12.96). Primary outcome was implant survival. Secondary outcome was evaluation of post-surgical complications.RESULTS: There were surgical revisions in seven patients after reconstructive surgery with flaps, mainly due to tumor relapse. Complications were seen in 11 patients. 1 implant was lost in a female patient 15 months after placement. Overall implant survival rate was 97.5%. No relations were found between implant survival rate and gender, type of tumor, type of microvascular free flap, radiation therapy, chemotherapy, and prosthesis type.CONCLUSION: According to the results of this study, oral rehabilitation with dental implants inserted in free flaps for maxillofacial reconstruction after ablative oncologic surgery can be considered as a safe treatment modality with successful outcomes.

Implant-supported mandibular overdentures: a retrospective case series study in a daily dental practice

Background Evaluation of dental implant treatment is mostly based on studies with well-controlled study groups treated within a university-based setting. There are no long-term observational practice-based studies known on implant-supported overdentures. The present retrospective study deals with implant survival, peri-implant hard and soft tissue health, surgical and prosthetic aftercare, and satisfaction of patients treated with an implant-supported mandibular overdenture in a daily dental practice. Materials and methods Within the years 2006 till 2015, 295 patients were treated with two, three, or four implants for mandibular overdenture treatment in a daily dental practice in Zaandam, The Netherlands. Outcome parameters were scored at a routine yearly inspection including implant loss, plaque index, gingival index, bleeding index, presence of calculus, probing depth, and satisfaction with implant-supported overdenture. Radiographic analysis was performed to assess peri-implant bone changes. Surgical and prosthetic aftercare was obtained from the medical record. Results A total of 133 patients were seen for an evaluation visit (mean follow-up 51.2 months). Cumulative implant survival rate in the 2-implant group, 3-implant group, and 4-implant group was 100%, 99.1%, and 97.8% respectively, with a mean peri-implant bone loss of 0.53 mm, 0.61 mm, and 0.40 mm. Patients’ satisfaction was high in all groups. Conclusion It was demonstrated, within the limitations of this study, that patients, who were treated with an implant-supported mandibular overdenture in a daily dental practice, experienced a high cumulative implant survival rate and a good peri-implant health, and were very satisfied. Trial registration Netherlands Trial Register, NL8867. Registered 15 September 2020—retrospectively registered.

Surgical and Prosthetic Outcomes of 967 Implants Under Immediate or Delayed Loading in Full-Arch Rehabilitation: a Retrospective Study With up To 5 Years of Follow-Up

Objective: The aim of this study was to evaluate implant and prosthesis survival rates in full-arch rehabilitation supported by implants with platform-switched Morse taper connection submitted to immediate or delayed loading, after up to 5 years of follow-up. Material and Methods: Data was retrospectively collected from clinical records of patients who were treated by means of implant-supported full-arch rehabilitation. Survival rates of implants and prostheses were evaluated according to immediate or delayed loading. Results: The sample comprised 967 implants. Of those, 627 were submitted to immediate loading (IL) while 340 to delayed loading (DL). After a follow-up period of up to 5 years, the implant survival rate for IL was of 99.7% (622/627 implants) and 97.2% (333/340 implants) for DL. The overall implant survival rate was 98.8% (955/967 implants). Prosthesis survival rate was 100% (N = 178) for both groups. Significantly more implants in the DL group presented bone loss (p > 0.01), either greater or lower than 2 mm, during the follow-up period. Conclusion: Within their limits, the present results suggest that full-arch rehabilitation with platform-switched Morse taper connection implants can lead to surgical and prosthetic predictable outcomes. Moreover, immediate loading protocol seems to be a good option for the rehabilitation of fully edentulous patients, as it involves a shorter treatment time, which may lead to greater patient satisfaction. Keywords Dental implants; Rehabilitation; Survival rate; Retrospective study.

Survival Rate of Zygomatic Implants for Fixed Oral Maxillary Rehabilitations: A Systematic Review and Meta-Analysis Comparing Outcomes between Zygomatic and Regular Implants

Background: Zygomatic implants have been proposed alone or in combination with premaxillary conventional implants for severe resorbed maxillary atrophy rehabilitation. The aim of the present investigation was to evaluate through a qualitative systematic review and meta-analysis the survival rate of zygomatic implants in conjunction with regular fixtures for maxillary rehabilitation. Methods: The article screening was conducted on the PubMed/Medline and EMBASE electronic databases according to the “Preferred Reporting Items for Systematic Reviews and Meta-Analyses” (PRISMA) guidelines. The scientific papers were included for qualitative analysis and risk-of-bias evaluation. Only the papers that included rehabilitation with zygomatic implants in combination with regular implants were considered for the meta-analysis comparative evaluation of the implant survival rate. Results: The paper search screened a total of 137 papers. After the initial screening, a total of 32 articles were considered for the qualitative analysis. There was a similar implant survival rate between zygomatic and premaxilla regular implants (p = 0.02; Z: 2.26). Conclusions: Zygomatic and conventional implants showed a high long-term survival rate for fixed maxillary rehabilitations, but few included studies reported the marginal bone loss after loading. Further studies are necessary to evaluate the pattern of marginal bone loss between zygomatic and conventional implants after long-term functional loading.