RESUMEN
OBJECTIVES: Aim of this controlled prospective randomized study was to evaluate the outcome of two-piece zirconia implants compared to titanium implants over a period of up to 24 months. MATERIAL AND METHODS: A total of 31 implants (16 zirconia/Ziterion vario Z(®) + 15 titanium/Ziterion vario T(®) ) were inserted primary stable (>30 Ncm) in the maxilla (7) and mandible (24) of 22 patients (13 male, nine female) requiring neither bone nor soft tissue augmentation. After a healing period of 6 months in the maxilla and 4 months in the mandible, ceramic abutments were luted adhesively to the zirconia implants and definitive all-ceramic restoration was performed with high-density ceramics. Radiographic bone levels, condition of the peri-implant mucosa, aesthetic outcome, implant survival and success were recorded for up to 24 months. RESULTS: Measurements of mean marginal bone levels 24 months after surgery showed a significant bone loss (P < 0.001) in both groups (Ti: 1.43 (SD ± 0.67) vs. Zir 1.48 (SD ± 1.05). One zirconia implant was lost 8 months after restoration. No further complications were recorded, giving an overall survival and success rate of 93.3% for zirconia and 100% for titanium implants after a period of up to 24 months. CONCLUSIONS: After 24 months, success rates of the two-piece ceramic implants showed no significant difference compared to control two-piece titanium implants. The bonded zirconia implant abutment connection appears to be capable with clinical application over the observed period. However, further control measurements need to confirm the presented data.
Asunto(s)
Cerámica/química , Implantes Dentales de Diente Único , Restauración Dental Permanente/métodos , Titanio/química , Circonio/química , Adulto , Anciano , Pérdida de Hueso Alveolar/diagnóstico , Diseño de Prótesis Dental , Femenino , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Estudios Prospectivos , Resultado del Tratamiento , Cicatrización de HeridasRESUMEN
OBJECTIVES: This study aims to evaluate the long-term success and stability of periodontal tissue around extensive one-piece prostheses supported by natural teeth in periodontally compromised maxillae. MATERIALS AND METHODS: A total of 28 fixed dental prostheses (FDPs) fabricated by different technologies were inserted in 28 patients with a history of chronic periodontitis after successful periodontal treatment. Subsequently, a program of supportive periodontal therapy (SPT) was instituted. Clinical parameters were evaluated in each patient after insertion of the FDP and during a follow-up examination. RESULTS: The reported follow-up examinations took place after a mean clinical service of 75.7 (9.9232.7) months. Probing depths had remained essentially unchanged by that time (2.6 ± 0.8 mm at baseline versus 2.7 ± 0.6 mm at follow-up). Significant deteriorations were observed based on plaque index scores (from 24.8% to 33.2%) and bleeding on probing (from 8.5% to 26.2%). One case of framework fracture was noted. CONCLUSIONS: Restorative treatment with extensive one-piece FDPs resulted in long-term stability of the periodontal outcomes. Gingival conditions were shown to deteriorate mildly despite periodic recalls for SPT. An association between deterioration and compliance was observed, suggesting that periodic examinations are essential for maintaining oral hygiene and hence to the success of treatment. CLINICAL RELEVANCE: Given a favorable distribution of potential abutment teeth, treatment with tooth-supported extensive FDPs is desirable even in patients with a history of periodontitis. Removable dentures would involve a number of shortcomings, including functional problems and severe degradation of oral ecology. Tooth-supported FDPs are capable of restoring function, esthetics, phonation, and mastication.
Asunto(s)
Periodontitis Crónica/terapia , Dentadura Parcial Fija , Arcada Parcialmente Edéntula/rehabilitación , Maxilar/patología , Adulto , Periodontitis Crónica/prevención & control , Pilares Dentales , Cementos Dentales/química , Índice de Placa Dental , Porcelana Dental/química , Fracaso de la Restauración Dental , Diseño de Dentadura , Femenino , Estudios de Seguimiento , Aleaciones de Oro/química , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Higiene Bucal , Cooperación del Paciente , Desbridamiento Periodontal , Índice Periodontal , Bolsa Periodontal/prevención & control , Bolsa Periodontal/terapia , Estudios Retrospectivos , Preparación Protodóncica del Diente/métodos , Resultado del Tratamiento , Adulto Joven , Circonio/químicaRESUMEN
PURPOSE: This prospective study was performed to evaluate the outcomes of XiVE® S plus implants (Dentsply Friadent, Mannheim, Germany) following conventional restoration with bar structures and overdentures in the edentulous mandible. MATERIALS AND METHODS: A total of 39 patients were treated with four interforaminal implants (n = 156) splinted by a Dolder bar. Overdentures were attached to the bars after 3 months of healing. As primary outcome measures, clinical and radiological parameters were evaluated at the time of implant placement (baseline) and once a year (1, 2, 3, 4, 5 years) after functional loading. Secondary outcome measures included (i) primary stability and surgical complications, as well as (ii) Periotest® (Medizintechnik Gulden, Modautal, Germany) values, implant survival, and prosthetic complications at baseline and follow-up. RESULTS: A total of 156 implants were placed. The vast majority (n = 149) were tightened to >30 Ncm, while torques in the range of 20-30 Ncm were obtained in the remaining cases (n = 7). Mean crestal bone levels around the implants were 0.41 mm at baseline and 1.04/1.20/1.34/1.45/1.44 mm after 1/2/3/4/5 years respectively. The mean values of the plaque, calculus, bleeding, and mucosal indices remained low throughout this period. The reported follow-up periods involved one implant loss after 3 months (survival rate: 99.4%) and one implant failure after 4 years (success rate: 98.4%). Prosthetic complications included factures of bars (n = 3) and denture teeth (n = 7). Prosthetic survival was 100%. CONCLUSIONS: Dolder bars to restore oral implants in the edentulous mandible appear to offer a high rate of implant survival, good stability of the peri-implant tissue, and a low rate of prosthetic complications.
Asunto(s)
Prótesis Dental de Soporte Implantado , Retención de Dentadura/instrumentación , Dentadura Completa Inferior , Prótesis de Recubrimiento , Arcada Edéntula/rehabilitación , Mandíbula/cirugía , Adulto , Anciano , Proceso Alveolar/diagnóstico por imagen , Cálculos Dentales/clasificación , Implantes Dentales , Índice de Placa Dental , Fracaso de la Restauración Dental , Diseño de Dentadura , Femenino , Estudios de Seguimiento , Humanos , Arcada Edéntula/diagnóstico por imagen , Arcada Edéntula/cirugía , Masculino , Mandíbula/diagnóstico por imagen , Persona de Mediana Edad , Oseointegración/fisiología , Índice Periodontal , Estudios Prospectivos , Radiografía , Análisis de Supervivencia , Diente Artificial , Torque , Resultado del TratamientoRESUMEN
PURPOSE: Precise preoperative implant planning and its exact intraoperative transfer are crucial for successful implant-supported rehabilitation of partially or completely edentulous patients. In the present pilot study, optical laser scanning was used to evaluate deviations between three-dimensional computer-assisted planned and actual implant positions by indirect methods. MATERIAL AND METHODS: Five patients receiving a total of 15 implants were included in this study. The used planning software was SimPlant 12.0 (Materialise Dental, Leuven, Belgium) to visualize the implant positions, and with an appropriate guided surgery protocol (Navigator™, Biomet 3i, Palm Beach Gardens, FL, USA) implant positions were implemented via tooth-supported stereolithografic surgical guides. All implants (Osseotite™, Biomet 3i) were inserted in a flapless approach and immediately provided with prefabricated temporary splinted restorations. Intraoral pickup impressions were taken postoperatively, and the implant positions of the master casts were compared with presurgical casts. Implant replica deviations were evaluated by three-dimensional optical laser scanning providing distances and angulations between implant replicas. RESULTS: Overall, the postsurgical implant replica positions were found to deviate from the positions in the preoperative cast by a mean of 0.46 ± 0.21 mm (range: 0.09-0.85 mm). Positional deviations were 0.27 ± 0.19 mm (range: 0.04-0.60 mm) along the x-axis representing the buccal-lingual directions, 0.15 ± 0.13 mm (range: 0.0-0.34 mm) along the y-axis representing the ventrodorsal direction, and 0.28 ± 0.19 mm (range: 0.02-0.59 mm) along the z-axis representing cranial and apical directions. Rotational deviations amounted to 14.04 ± 11.6° (range: 0.09-36.47°). CONCLUSIONS: The results of this pilot study demonstrate precise transfer of implant replica position by means of simulated guided implant insertion into a preoperative cast and a postoperative cast obtained from impressioning. Further studies are needed to identify appropriate evaluation techniques and mechanisms to increase the transfer precision of three-dimensional planning and guiding systems.
Asunto(s)
Implantes Dentales , Humanos , Persona de Mediana Edad , Resultado del TratamientoRESUMEN
OBJECTIVES: The aim of this prospective case series was to evaluate the results of an immediate loading concept using four Xi VE S plus implants in the edentulous mandible, after a period of up to 10 years of clinical function. MATERIAL AND METHODS: Thirty patients were treated with four implants each placed interforaminally and provisionally restored within 1 week. Radiographic bone levels, condition of the peri-implant mucosa, implant survival and success were recorded annually from implant insertion (baseline) up to 10 years after final restoration. RESULTS: A total of 120 Xi VE S plus implants were placed in the interforaminal region. A significant coronal bone loss of 1.80 mm (SD ± 0.65) was recorded within the first 8 years of function (P < 0.001). Within the next years no further significant increase of bone resorption was observed. The mean values of the plaque, calculus, bleeding and mucosal indices and probing depth remained low throughout this period. All implants were inserted with an insertion torque of more than 32 N cm. Two losses (1.7%) occurred prior to permanent restoration (1 and 3 months post-insertion), resulting in a survival rate of 98.3% over the entire observation period. Four implants were recorded as failures due to excessive bone resorption, resulting in an overall success rate of 95%. CONCLUSIONS: The results of this study indicate that in selected patients immediate restoration of dental implants in the edentulous mandible will achieve a clinically predictable outcome.
Asunto(s)
Implantación Dental Endoósea/métodos , Implantes Dentales , Diseño de Prótesis Dental , Arcada Edéntula/rehabilitación , Adulto , Anciano , Femenino , Humanos , Masculino , Mandíbula , Persona de Mediana Edad , Estudios Prospectivos , Resultado del TratamientoRESUMEN
OBJECTIVE: The aim of this prospective study was to evaluate the outcome of immediately provisionally restored implants in the posterior mandible after a minimum of 60 months in function. MATERIAL AND METHODS: Twenty-four patients were treated with 40 screw-type implants replacing mandibular molars and premolars. Implants were provisionalized immediately after placement. Radiographic coronal bone levels, implant survival and success were evaluated 12, 24, 36, 48 and 60 months after the final restoration. RESULTS: Measurements of the mean marginal bone levels around immediately loaded implants after 12 months showed a significant bone loss (P<0.001) within the first year after the final restoration. Measurements of coronal bone levels after 24, 36, 48 and 60 months, respectively, showed no further significant increase of bone resorption. Two implants were lost within the first year after the final restoration, resulting in an overall survival rate of 95%; a total of three implants were recorded as failures (two implant losses and one excessive bone resorption above 50%), resulting in an overall success rate of 92.5 after an implant observation period of up to 8 years. CONCLUSION: The present data revealed results comparable to conventionally loaded implants. Careful patient selection in combination with high primary stability seem to be key factors for immediately loaded implants. Larger long-term randomized clinical trials are needed to confirm the final evidence of this protocol as the standard treatment concept for the partially edentulous mandible.
Asunto(s)
Implantación Dental Endoósea/métodos , Prótesis Dental de Soporte Implantado/métodos , Restauración Dental Provisional/métodos , Mandíbula/cirugía , Adulto , Resorción Ósea , Pilares Dentales , Fracaso de la Restauración Dental , Femenino , Humanos , Masculino , Mandíbula/diagnóstico por imagen , Persona de Mediana Edad , Estudios Prospectivos , Diseño de Prótesis , Radiografía , Tasa de SupervivenciaRESUMEN
AIM: A randomized-controlled clinical pilot trial was designed to evaluate photodynamic therapy (PDT) for its bactericidal potential and clinical effect in the treatment of periodontitis. MATERIAL AND METHODS: Fifty-eight subjects with chronic periodontitis were included. Each subject exhibited at least three active periodontal pockets 5mm or deeper, bleeding on probing and the presence of Porphyromonas gingivalis. Subjects were randomly assigned to a control group treated by subgingival ultrasound only or to a study group additionally treated by PDT. Baseline clinical values of gingival index, bleeding on probing, probing pocket depths and clinical attachment levels were recorded and re-evaluated 90 days later. Pathogen screening for P. gingivalis, Tannerella forsythia and Treponema denticola was conducted at baseline as well as 10, 42 and 90 days after treatment. RESULTS: P. gingivalis was significantly reduced in both groups (laser group: p=0.020; control group: p=0.042). No significant reductions of T. forsythia and T. denticola were observed in either group. For the microbial parameters, no significant difference was found between the laser and the control group. All clinical parameters were significantly reduced in both groups after treatment. The mean probing pocket depths decreased from 5.79 to 4.55mm in the laser group and from 5.54 to 4.51 in the control group. The intergroup difference was not significant (p=0.82). Bleeding on probing was reduced from 100% evaluated at baseline to 47% in the laser group and 59% in the control group. The intergroup difference was not significant (p=0.28). No significant differences were observed in any other parameters. CONCLUSION: Application of a single cycle of PDT was not effective as an adjunct to ultrasonic periodontal treatment. There were no extra reductions in pocket depths and bleeding on probing. With regard to eradicating bacteria, however, there are no additional effects as compared with conventional treatment alone.