Abstract
ObjectivesImplants are used to replace congenitally missing lateral incisors but often the space across the alveolar crest is too narrow to permit their use. This multicenter study (Dental Clinic of the University of Foggia, Odontostomatology Clinic of the University of L’Aquila) evaluated the efficacy of mini-implants in cases of maxillary lateral incisor agenesis with severe osseous atrophy in 10-year follow-up.Materials and methodsForty-seven mini-implants have been inserted in 35 patients affected by lateral incisors agenesis (23 single and 12 bilateral ageneses). All patients underwent orthodontic opening of the space of the upper lateral incisors. After the insertion of the implants, the immediate, non-functional loading, positioning of crowns, presence of pain during percussion and mini-implant function, horizontal and vertical movement when a force of 5 N was applied, ridge loss, and plaque index have been evaluated 1 month after loading, 1 year after loading, and then every 5 years in the following 10 years. Little’s test was used to evaluate the assumption that data of loss to follow-up implants are missing completely at random (MCAR) and that a complete-case scenario could be adopted. Wilcoxon test was carried out to look statistically significant differences between the various parameters resulting in the complete-case scenario and those assumed for the worst scenario. The software R (v. 3.6.1, 2019) was employed to perform the statistical analysis.ResultsThe results obtained over 10 years range from 89% of success rate in a worst-case scenario to the 100% using a complete-case analysis with satisfactory values of marginal bone resorption and good conditions of the peri-implant tissue. Ten-year follow-up using complete-case analysis shows survival rates of 100% for implants with no signs of peri-implantitis, stability of the marginal bone levels and soft tissue around the dental implants.ConclusionsThe data collected show very good implant stability, absence of progressive peri-implantitis, and satisfactory aesthetical results in time (no signs of infraocclusion).Clinical relevanceMini-implants can be considered a valid and stable over time solution in the restorative treatment of maxillary lateral incisors agenesis.
Highlights
The prevalence of permanent dentition agenesis is reported to range from 2.2 to 7.6% with a variable prevalence in different ethnic groups and a modest preference toward females1 3 Vol.:(0123456789)Clinical Oral Investigations [1]
Bilateral ageneses of a particular tooth have been highlighted with maxillary lateral incisors being most common (54%) followed by maxillary second premolars (49%), mandibular second premolars (46%) and mandibular central incisors (41%) [2]
The hypothesis of this study is to evaluate the efficacy of mini-implants in cases of maxillary lateral incisor agenesis with patients affected by severe osseous atrophy (Type B: breadth 7/64–13/64 in, 25/64–31/64 height, length 7/64–13/64), bone density according to Misch D-3, 350–850 uH B [23] in the long term (10-year follow-up)
Summary
The prevalence of permanent dentition agenesis is reported to range from 2.2 to 7.6% with a variable prevalence in different ethnic groups and a modest preference toward females1 3 Vol.:(0123456789)Clinical Oral Investigations [1]. According to Bozga et al, the range of agenesis of maxillary lateral incisors is 2.2% to 10.1%[3], whereas Alvesalo and Portin [4] reported a prevalence of maxillary lateral incisor agenesis of 0.52–8.4%, studies on the Northwestern European population showed a lower congenital prevalence, from 1 to 2% [5]. Dental agenesis is often associated with tooth ectopias and/or other abnormal dental conditions [6, 7] like a smaller or a conoid tooth on the opposite side of the arch. In such cases, the canines are often mesially or lingually positioned, compared with their normal position, the midline being deviated towards the side affected by the agenesis
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