Multi-Modal Oral Implantology. The Screw-Blade Single-Implant for the Replacement of the Upper Molar: A Case Report

Intense forces are naturally downloading on molar roots. Due to inflammation, the post-extraction sockets of the upper molars are often poor of bone on one side. A single implant supporting a prosthetic crown can easily go subject to displacing forces that reabsorbed and recently healed bone can hardly bear. By utilizing a couple of prosthetic roots, i.e.: one screw implant in the side in which bone is richer and one blade implant in the side in which the bony wall has gone subject to reabsorption, it is possible to build a better supported prosthetic crown. The clinical cases performed by the Authors confirm the validity of this implant architecture. Aim of the work is to describe a post-extraction multi-modal implantological technique useful for replacing the roots of upper molars with poor bone support on one side. Materials and Methods: Combination of submerged screw implant and submerged blade implant or emergent screw implant and emergent blade implant welded intraorally. Discussion: The combination of a palatal screw implant and a buccal blade implant, or vice versa, allowed to solve clinical cases and to make reliable prosthetic crowns. Conclusions: The presence of variable residual anatomies in the molar area of the upper jaw recommends the use of morphologically different implant shapes, suitable for the construction of a biomechanically functional prosthetic abutment. Specifically in the presence of bone resorption, the combination of a screw implant and a blade implant allowed us to obtain a reliable abutment. Given the small number of cases performed, further research will confirm the positive results of this technique.

Trueness of Intraoral Scanners in Implant-Supported Rehabilitations: An In Vitro Analysis on the Effect of Operators’ Experience and Implant Number

(1) Background: Intraoral scanners (IOS) are widely used in prosthodontics. However, a good trueness is mandatory to achieve optimal clinical results. The aim of the present in vitro study was to compare two IOS considering the operator’s experience and different implant clinical scenarios. (2) Methods: Two IOS (IT—Itero, Align Technology; and OS—Opera MC, Opera System, Monaco) were compared simulating three different clinical scenarios: single implant, two implants, and full-arch rehabilitation. Ten scans were taken for each configuration by two different operators (one expert, one inexperienced); influence of operator experience and the type of scanner used was investigated. (3) Results: Trueness of the scans differed between the experienced and non-experienced operator and this difference was statistically significant in all the three scenarios (p = 0.000–0.001, 0.037). A significant difference was present between the scanners (p = 0.000), in the two-implant and full-arch scenarios (p = 0.00). (4) Conclusions: Experience of the operator significantly affect trueness of IT and OP scanners. A statistically significant difference was present among IOS in the two-implant and full-arch scenarios.

Implant Stability Changes for a Single Implant Mandibular Overdenture

Objectives To compare the changes in implant stability for the nonsubmerged and submerged protocols for a single-implant retained mandibular overdenture using Cendres and Metaux Locator attachment throughout a 24-month follow-up. Materials and Methods Eighty edentulous patients who were seeking to install a single implant in the midline of the completely edentulous mandible. At the day of implant installation, patients were randomized into two groups using sealed envelopes: the nonsubmerged and submerged groups. After 3 months of healing period, randomization using sealed envelopes was performed and patients were randomized to receive the Cendres and Metaux Locator attachment. The periotest readings were recorded using the Periotest M device, every 3 months for the first year and annually in the second year. The scope of this clinical trial focused only on results of the Cendres and Metaux attachment. Statistical Analysis The Mann–Whitney U-test was used for comparison between study groups for independent samples. Two-sided p-values less than 0.05 were considered statistically significant. Results There was no statistically significant difference between the mean periotest readings of both groups throughout the 24-month follow-up. Both groups showed an improvement in mean periotest readings with the submerged group tending to show greater stability at 6, 12, and 24-month follow-ups. Conclusions The nonsubmerged and the submerged healing protocols resulted in reliable periotest readings with the submerged group showing greater improvement than the nonsubmerged, although this improvement is nonsignificant when using the Cendres and Metaux attachment for a single mandibular overdenture.

Clinical and radiological assessment of the condition of implants with fixed structures in the dynamics of 20-year follow-up

The statistically significant long-term results of the implant survival and the effectiveness of prostheses are inadequately represented in scientific literature. The study was aimed to assess the effectiveness of prosthetics with fixed structures on the intraosseous dental implants for the replacement of partially absent dentition in the dynamics of the 20-year follow-up. A total of 671 patients with partially missing teeth were examined at the Clinical Center of Dentistry of the FMBA of Russia, who were fitted with 1,700 intraosseous titanium dental implants with the terms from the moment of completion of prosthetics on implants of 5, 10, 15 or 20 years. The criteria for clinical and radiological evaluation of the implant condition were as follows: no complications affecting the condition of periimplant tissues (normal), mucositis, periimplantitis with bone resorption at 1/3 or 1/2 of the implant height, implant removal. Based on 20 years of experience, prosthetics with fixed structures on implants is highly effective in replacing the partial defects of dentition. In total, 62.2% of implants remain functional for 20 years. The average life of implant-supported fixed prostheses is 15 years for bridges, and 20 years for single and combined implant-supported crowns. The most effective are single implant-supported crowns, and the least effective are prostheses supported by implants and teeth. The significantly preserved implant-supported prostheses make it possible to support the concept of the long-term implant installation with respect to the implant-supported non-removable prostheses. The view is thus confirmed that the effectiveness of the implant-supported prosthetics is reduced with the inclusion of teeth in the bridge support, along with implants.

Hard and Soft Tissue Augmentation with Single-Implant Restoration in the Esthetic Zone

The removal of the central incisor of the upper jaw is a challenging process, since the restoration of a single implant in the esthetic zone is of great responsibility. When tooth extraction with immediate implant placement is not possible, modern protocols imply the use of the socket preservation technique. This method of preserving socket properties significantly reduces changes that occur during the healing process of the postextracted area and along with soft tissue augmentation allows to achieve a satisfying aesthetic result. The aim of present case report is to assess capabilities of socket preservation concept and application of soft tissue augmentation in the anterior maxillary region. The treatment steps of a 35-year-old woman who needed to remove tooth 11 with further dental implant placement are described. The clinical case is of interest because after socket preservation and soft tissue augmentation, an acceptable aesthetic result was not reached. However, additional soft tissue augmentation made it possible to achieve the desired result, which was stable for 7 years.

CLINICALLY EVALUATED ACCURACY OF SINGLE GUIDED IMPLANTATIONS WITH TWO DIFFERENT SYSTEMS – PRELIMINARY RESULTS

Introduction: Guided single implant placement ensures an optimal implant position, enables in-surgery immediate loading, and creates a predisposition for predictable treatment results. Aim: This article aims to present the surgical and loading protocols and assess the accuracy of two guided implant systems. Materials and methods: Ten patients missing a single molar were included. The semi-guided procedures with the two implant systems – AB Dental and Alpha Bio-Tec, were randomly assigned to each participant. The computer-assisted planning was performed with Implant Studio (3Shape, Denmark). Surgical guides and long-term, temporary, screw-retained restorations were virtually generated within the 3Shape system. Surgical appliances were printed from SG resin (Formlabs, USA), and crowns were milled from Telio CAD (Ivoclar Vivadent, Lichtenstein). Planning accuracy was evaluated based on the crown’s fit and relation to the adjacent teeth and antagonists. Results and discussion: The patients included for preliminary analysis (6 female and 4 male) were with a mean age of 33.42. The youngest was 24, and the oldest 49 years old. There were no surgical and technical complications for the period of evaluation, which ranged from 1 to 3 months. The crown’s fit was excellent in 8 cases. In two cases, minor adjustments were necessary – 1 in relation to the antagonists and 1 to the adjacent teeth. In one case, a healing screw was placed for 48 hours to facilitate adequate soft-tissue space for the Ti-base. Conclusion: The preliminary results presented in this report suggest that the clinical and laboratory protocols used for guided implantation and immediate loading are highly efficient.