Average Bone Resorption Research Articles

Clinical Study of 14 Cases of Bone Augmentation with Selective Laser Melting Titanium Mesh Plates.

Additive manufacturing techniques are being used in the medical field. Orthopedic hip prostheses and denture bases are designed and fabricated based on the patient's computer-aided design (CAD) data. We attempted to incorporate this technique into dental implant bone augmentation. Surgical simulation was performed using patient data. Fourteen patients underwent bone augmentation using a selective laser melting (SLM) titanium mesh plate. The results showed no evidence of infection in any of the 14 patients. In 12 patients, only one fixation screw was used, and good results were obtained. The SLM titanium mesh plate was good adaptation in all cases, with bone occupancy greater than 90%. The average bone resorption of the marginal alveolar bone from the time of dental implant placement to the time of the superstructure placement was 0.69 ± 0.25 mm. Implant superstructures were placed in all cases, and bone augmentation with SLM titanium mesh plates was considered a useful technique.

Periodontal diseases assessed by average bone resorption are associated with microvascular complications in patients with type 2 diabetes.

The online version contains supplementary material available at 10.1007/s13340-022-00591-0.

The 10 Year Outcomes of Implants Inserted with Dehiscence or Fenestrations in the Rehabilitation of Completely Edentulous Jaws with the All-on-4 Concept

Background: There is a need for a long-term evidence of implants placed in challenging conditions. The aim of this study was to investigate the outcome of full-arch rehabilitations with the All-on-4 concept for implants inserted with dehiscence or fenestrations. Methods: This retrospective cohort study included 123 patients (dehiscence, n = 87 patients; fenestrations, n = 28 patients; both conditions, n = 8 patients), with a total of 192 implants in immediate function presenting dehiscence (n = 150), fenestrations (n = 40), or both conditions (n = 2). Primary outcome measures were cumulative implant survival (CSurR) and success (CSucR) rates. Secondary outcome measures were prosthetic survival, marginal bone loss, and incidence of biological complications. Results: CSurRs were 94.1% (overall), 95.6% (dehiscence), and 88.1% (fenestrations) at 10 years using the patient as the unit of analysis. Smoking affected implant failure significantly (p = 0.019). Implant-level CSurRs and CSucRs at 10 years were 96.2% and 93.5% (overall), 97.2% and 94.6% (dehiscence), and 90.0% and 87.6% (fenestrations), respectively. Average bone resorption at 5 and 10 years was 1.22 mm and 1.53 mm, respectively. Biological complications occurred in 18 patients (n = 18 implants). Conclusions: Implants inserted with dehiscence or fenestrations demonstrate good long-term outcomes with overall high success and survival rates and low average marginal bone resorption, despite an inferior outcome in implants with fenestrations and smoking’s negative effect.

Alveolar Bone Resorption Evaluation Around Single-piece Designed Bicortical Implants, Using Immediate Loading Protocol, Based on Orthopantomographs

Abstract Background: Inserting dental implants in severely atrophied jawbones is a great challenge for the dental practitioner. There are an increasing number of patients who choose dental implantanchored prosthetic restorations despite compromised bone quality and quantity. There have been numerous attempts in adapting implant design for the atrophic crestal bone. One-piece, needle-type basal implant design is a typical design for these cases. These implants are inserted in the remaining compact bone located in the basal aspect of the jawbones. If high primary stability is achieved, these implants are used for immediate loading protocol. From many points of view, this technique is based on contradictory principles compared to classic implant surgery and loading protocols. The aim of this study was to investigate the long-term success of basal one-piece short-diameter dental implants used for immediate loading protocol. Materials and methods: A total of 56 dental implants were included in this study. Peri-implant bone loss was measured on orthopantomographs. Bone resorption was measured in millimeters in the first 6 and 12 months of functional loading. Results: There were no failing implants in this period; average bone resorption was 1.59 mm after 6 months of functional loading and 2.05 mm after 12 months. Bone resorption was slightly higher in the mandible than in the maxilla. Conclusions: Immediate implant loading protocol might be an attractive solution for fixed fullarch restoration using short-diameter one-stage basal implants, but long-term effects require further investigations.

Split-Overlapping Genioplasty: Surgical Technique, Morphological and Radiological Long-Term Outcomes.

The overlapping bone flap genioplasty, described by Tessier, was developed to treat major retrognathia or long and retruded chins. For 15 years, we have used a modified version of this technique to avoid its drawbacks. The aim of this article is to describe our modification and evaluate the long-term morphologic and radiologic outcomes. The authors included every split-overlapping genioplasty performed in our department between 2004 and 2014. Demographics, surgical data, and complications were recorded. Radiologic bone resorption was evaluated comparing preoperative, day-1 postoperative, and year-1 postoperative cephalometric x-rays. Morphologic outcomes were evaluated on standardized pre- and postoperative views using an analogic Likert scale. The main modification of the procedure consists in separating the posterior cortex of the transplant using a reciprocating saw. After overlapping the reduced transplant onto the mandible, the posterior cortex is used as an apposition graft to soften the labiomental crease. Forty-seven patients were analyzed during this period. In 44 patients, the procedure was combined with mandibular and/or maxillary osteotomy. The average reduction of symphysis height was 5 mm, and the average pogonion advancement was 4.3 mm. After 1 year, we recorded 7% average bone resorption. No major complications (nerve injury, hematoma, among others) were reported. Morphologic outcomes were deemed satisfactory or very satisfactory in the vast majority of cases. Split-overlapping genioplasty is a safe and reliable procedure with stable, long-lasting outcomes. This versatile technique is particularly useful for the correction of a massive symphysis or high and retruded chins.

Complications During Maxillary Sinus Augmentation Associated with Interfering Septa: A New Classification of Septa

Purpose:A new classification of maxillary sinus interfering septa based on its orientation is presented along with its relationship to the prevalence and severity of sinus membrane perforations. Additionally, the impact of membrane perforation on post-operative complications and marginal bone loss during the first year of loading is evaluated.Materials & Methods:Retrospective chart review of 79 consecutive sinus lift procedures with lateral window technique and 107 implants. Preoperative Cone Beam Computed Tomography (CBCT) images were evaluated for the incidence and the direction of maxillary septa. Chart notes were examined for the incidence of membrane perforation and postoperative complications. Measurements of mesial and distal marginal bone levels and average bone resorption adjacent to each implant were calculated in intraoral radiographs taken at implant placement and during follow up appointments.Results:Interfering septa were identified in 48.1 percent of sinuses. 71.1 percent of them had the septum oriented in a buccal-lingual direction (Class I). The overall incidence of membrane perforation was 22.8 percent, and the presence of an interfering septum on CBCT scan was found to be significantly associated with the occurrence of a sinus membrane perforation (P<0.001). The mean implant marginal bone loss for sinuses, which did not experience a membrane perforation, was 0.6±0.8mm, compared with 0.9 ± 0.9 mm for the sinuses that did experience a perforation (P = 0.325).Conclusion:Septa should be identified, classified and managed with a meticulous attention to technical details. A classification based on the septal orientation is proposed since the orientation of the septa can complicate the surgical procedure and requires modification of the surgical technique.

Comparison of autogenous tooth bone graft and synthetic bone graft materials used for bone resorption around implants after crestal approach sinus lifting: a retrospective study.

This retrospective study compares the amount of bone resorption around implants between an autogenous tooth bone graft (AutoBT) and a synthetic bone graft after a bone-added crestally approached sinus lift with simultaneous implant placements. In all, 37 patients participated in this study. Seventeen patients were grouped as group I and underwent an AutoBT-added sinus lift using the crestal approach. The remaining 20 patients were grouped as group II and underwent synthetic bone grafting. Both groups received the implant placements simultaneously. Of the 37 participating patients, only 22 patients were included in the final results: Eleven patients of group I and 11 patients of group II. Before the surgery, the distance from the alveolar crest to the sinus floor was measured using panoramic radiography. After the surgery, the distance was measured again from the neck of the implant thread to the most superior border of the added graft materials. Then, the amount of sinus lift was calculated by comparing the two panoramic radiographs. After a year, a panoramic radiograph was taken to calculate the resorption of the bone graft material from the radiograph that was taken after the surgery. The significance of the resorption amount between the two types of graft materials was statistically analyzed. The bone height was increased to an average of 4.89 mm in group I and 6.22 mm in group II. The analysis of panoramic radiographs 1 year after the surgery showed an average bone resorption of 0.76 mm and 0.53 mm, respectively. However, the degree of lifting (P=0.460) and the amount of bone-grafted material resorption (P=0.570) showed no statistically significant difference. Based on this limited study, AutoBT can be considered a good alternative bone graft to a synthetic bone graft in a bone-added sinus lift, when extraction is necessary prior to the surgery.

A 5- to 8-year Retrospective Study Comparing the Clinical Results of Implant-Supported Telescopic Crown Versus Bar Overdentures in Patients With Edentulous Maxillae

The objective of this study was to compare implant survival and success rates, peri-implant parameters, and prosthodontic maintenance efforts for implant-supported telescopic crown overdentures and bar overdentures to restore maxillary edentulism. This retrospective clinical study involved patients with maxillary edentulism who were fitted with implant-supported overdentures from January 2004 to June 2007. During a 5- to 8-year follow-up period, the implant survival and success rates, biologic and mechanical complications, prosthodontic maintenance, and patient satisfaction were retrospectively analyzed. The data were evaluated statistically and P < .05 was considered to be statistically significant. Forty-four patients with maxillary edentulism received implant-supported removable overdentures. Twenty-one patients chose telescopic crown overdentures and 23 patients chose bar overdentures. A total of 41 patients and 201 implants were available for follow-up. The implant survival and success rates, average bone resorption, and subjective patient satisfaction scores showed no difference between the telescopic crown and the bar overdenture group at follow-up. However, there were higher values for Plaque and Calculus Indexes in the bar group compared with the telescopic crown group, and these values showed a statistically significant difference annually from the 3-year follow-up (P < .05). Each year, the number of prosthodontics maintenance procedures per patient did not significantly differ between the telescopic crown (approximately 0.36 to 0.58) and bar groups (approximately 0.30 to 0.49) (P = .16). Although there were higher plaque and calculus levels in the bar group and more maintenance was required for the telescopic crown group, overdentures provided a healthy peri-implant structure for implants in both groups. Implant-supported telescopic crown or bar overdentures can provide a good treatment option for patients with edentulous maxillae.

Clinical assessment of submerged vs non-submerged implants placed in pristine bone

The medium-long term success of osseointegrated dental implants is evaluated on the basis of the degree of osseointegration over time, assessed by radiographic or instrumental analysis (ISQ). Over the years, the question has always been which surgical technique can provide a better performance in the medium-long term and, thanks to literature studies, it has been evidenced that there are no differences between "one stage" and "two stage" interventions. The purpose of this study is to evaluate clinical and radiographic parameters, referring to interventions for the insertion of dental implants characterized by a new kind of implant surface (Synthegra® GEASS, Udine). The prospective study, not randomized and controlled, referred to the insertion of 18 implants on 9 patients with mono or bilateral edentulism, with measurements at 1, 3, 6 and 12 months and an overall follow-up at 3 years, in order to evaluate the different degree of crestal bone resorption using the submerged and transmucosal surgical technique. The results of our study show that there are no differences in the resorption of the two surgical techniques, with an average bone resorption of 2,05±0,16 mm, comparable with values reported in literature.

Bactercline(®)-coated implants: Clinical results up to 1 year after loading from a controlled clinical trial.

Background:Titanium dioxide exists in three different crystal lattices, anatase, rutile, and brookite. Anatase coating releases, under ultraviolet (UV) irradiation, free radicals such as ·OH, O2-, HO2-, and H2O2. This potent oxidizing power characteristically results in the lysis of bacteria and other organic substances. The purpose of this study was to evaluate the bone response to implants made of titanium alloy or coated with a new combination of anatase and Bactercline® product.Materials and Methods:In the period between July 2009 and June 2010, 26 patients (10 females and 16 males; median age 51 ± 11 years, min. 27 years, max. 72 years) were operated and 62 implants were inserted. Lost fixtures and peri-implant bone resorption were considered as predictors of clinical outcomes. Pearson χ2-test was used. Prosthesis and implant failures, any complications after loading, and peri-implant marginal bone-level changes were assessed by a masked assessor. All patients were followed up to 1 year after loading.Results:No implant was lost. Average bone resorption around implant was 0.33 mm (both for 25 standard and 37 Bactercline-coated implants), and thus no statistical difference was detected.Conclusion:These results shown that no adverse effects on osseo-integration were present.

Clinical and radiographical evaluation of maximus implants, with immediate nonfunctional loading

This study was carried out to clinically and radiographically investigate Maximus implants which were installed in the regions of maxillary lateral and mandibular incisors using immediate nonfunctional loading. In this study, 21 implants for 12 patients between 18 and 42 years were inserted. Nineteen patients completed the course of study. Clinical and radiographical measurements were recorded in recall sessions and analysed statistically. After one year none of implants failed and average bone resorption was 1.06 ± 0.90. Using low diameter implants for edentulous regions of small bone width or mesiodistal space is a less expensive and simpler treatment as compared to techniques such as regeneration.

Implants placed in immediate function in periodontally compromised sites: A five-year retrospective and one-year prospective study

Placing implants in periodontally compromised sites is generally considered a risk factor. Good results have been reported when rehabilitating partial or complete edentulous sites in patients with a history of periodontitis. However, there is a need for more documentation of this treatment modality. The purpose of this study was to report, retrospectively, on the placement of implants in periodontally compromised areas of the maxilla and mandible without a prior healing period and in immediate function. This study also presents a prospective preliminary 1-year report using a standardized clinical protocol, including a regenerative surgical procedure, control of the inflammatory response, a maintenance protocol, and use of an implant with an oxidized surface. The clinical study encompassed 184 consecutively included patients with 433 implants (165 with a machined surface and 268 with an oxidized surface) placed in immediate function (140 in the maxilla and 293 in the mandible) supporting 218 fixed prostheses. Two groups were defined: the Retrospective group (using an unstandardized surgical technique and a majority of machined surface implants) with a retrospective approach and the Prospective group (using standardized surgical and maintenance protocols and oxidized surface implants) with a prospective approach. The 2 groups were evaluated for implant survival, clinical implant stability, bone resorption, absence of radiolucent areas around implants on the radiographs, and patient-reported function of the implants. Definitive prostheses were placed 6 months after the surgery. The data was analyzed using descriptive statistics. Thirteen implants were lost in 9 patients, providing a cumulative survival rate of 91% at 5 years for the Retrospective group. In the Prospective group, a 100% cumulative survival rate was recorded after 1 year. The average bone resorption (SD) was 1.2 mm (0.9 mm) and 1.1 mm (1.1 mm) after the first year for the Retrospective and Prospective groups, respectively, and 1.7 mm (1.0 mm) for the Retrospective group after the fifth year of function. The cumulative survival rate of 91% at 5 years for the Retrospective group is low compared to protocols for noncompromised situations, but the use of a standardized protocol together with oxidized surface implants seems to improve the treatment outcome and bring the survival rate to levels comparable to noncompromised situations.

Clinical analysis of immediate implant and implant-supported complete denture for 12 patients with severe periodontitis

To evaluate clinical results of implant-supported complete denture of 12 patients with severe chronic periodontitis. After systematically periodontic treatment and controlling the inflammation, 12 cases with severe chronic periodontitis were extracted the residual teeth and received immediate implant placement. The implant-supported complete dentures were finished at 5 or 6 months after operation. Restorative results were evaluated with clinical examination, radiological examination and chief complaints of the patients. A total of 108 implants were placed into 20 dental arches, including 37 immediate implants. Average loading was for 3 years and all implants were stable. Progressive bone resorption was observed around two implants. The average bone resorption of other peri-implants was (1.33 +/- 0.10) mm. The implant survival rate was 98.1%. The immediate implant survival rate was 97.3%. After periodontic treatment, the patients with severe chronic periodontitis could be restored using immediate implant placement and implant-supported complete denture. It can shorten the treatment period, reduce absorption of alveolar and obtain a favorable result by oral health care.

Short Implants Placed One‐Stage in Maxillae and Mandibles: A Retrospective Clinical Study with 1 to 9 Years of Follow‐Up

The use of short implants (7-8.5 mm) has historically been associated with lower survival rates than for longer implants. However, recent clinical studies indicate that short implants may support most prosthetic restorations quite adequately, but still clinical documentation is sparse. The purpose of this study was to report on the placement of short Brånemark implants, testing the hypothesis that short implants in atrophied jaws might give similar long-term implant survival rates as longer implants used in larger bone volumes. This retrospective clinical study included 237 consecutively treated patients with 408 short Brånemark implants supporting 151 fixed prostheses. One hundred thirty-one of the implants were 7-mm long, and 277 were 8.5-mm long. Final abutments were delivered at the time of surgery, and final prostheses were delivered 4 to 6 months later. One hundred and twenty six of the 7-mm implants (96%) have passed the 1-year follow-up; 110 (84%), the 2-year follow-up; and 88 (67%), the 5-year follow-up. Five implants failed in four patients before the 6-month follow-up, giving a cumulative survival rate of 96.2% at 5 years. The average bone resorption was 1 mm (SD=0.6 mm) after the first year and 1.8 mm (SD=0.8 mm) after the fifth year of function. Two hundred sixty nine of the 8.5-mm implants (97%) have passed the 1-year follow-up; 220 (79%), the 2-year follow-up; and 142 (51%), the 5-year follow-up. Eight implants failed in seven patients before the 6-month follow-up, giving a cumulative survival rate of 97.1% at 5 years. The average bone resorption was 1.3 mm (SD=0.8 mm) after the first year and 2.2 mm (SD=0.9 mm) after the fifth year of function. The cumulative survival rates of 96.2 and 97.1% at 5 years for implants of 7.0- and 8.5-mm length, respectively, indicate that one-stage short Brånemark implants used in both jaws is a viable concept.

"All-on-Four" immediate-function concept with Brånemark System implants for completely edentulous mandibles: a retrospective clinical study.

Immediate-function Brånemark System implants (Nobel Biocare AB, Gothenburg, Sweden) have become an accepted alternative for fixed restorations in edentulous mandibles, based on documented high success rates. Continuous development is ongoing to find simple protocols for their use. The purpose of this study was to develop and document a simple, safe, and effective surgical and prosthetic protocol for immediate function (within 2 hours) of four Brånemark System implants supporting fixed prostheses in completely edentulous mandibles: the "All-on-Four" concept. This retrospective clinical study included 44 patients with 176 immediately loaded implants, placed in the anterior region, supporting fixed complete-arch mandibular prostheses in acrylic. In addition to the immediately loaded implants, 24 of the 44 patients had 62 rescue implants not incorporated in the provisional prostheses but incorporated in final prostheses later on. Five immediately loaded implants were lost in five patients before the 6-month follow-up, giving cumulative survival rates of 96.7 and 98.2% for development and routine groups, respectively. The prostheses' survival was 100%, and the average bone resorption was low. The high cumulative implant and prostheses survival rates indicate that the "All-on-Four" immediate-function concept with Brånemark System implants used in completely edentulous mandibles is a viable concept.

Immediate Function of Brånemark Implants in the Esthetic Zone: A Retrospective Clinical Study with 6 Months to 4 Years of Follow‐up

Immediate implant function is a psychological benefit for the patient and makes a substantial reduction in treatment cost possible. Currently, immediate function using Brånemark implants has become an accepted alternative for complete-arch fixed restorations in mandibles and for overdenture support for some other screw-shaped implants. Clinical documentation is lacking for other applications. The purpose of this study was to investigate a concept for immediate function of Brånemark implants supporting fixed prosthesis in the esthetic regions of the jaws. This retrospective clinical study included 49 consecutively treated patients with 94 implants supporting 54 fixed prostheses, all in esthetically critical regions: 23 of the prostheses were bridges, 14 in maxillae and 9 in mandibles; 31 of the prostheses were crowns, 22 in maxillae and 9 in mandibles. At surgery, the implant platform was positioned above the surrounding bone level and bicortical anchorage was the goal whenever possible. The minimum insertion torque for accepting the implant for immediate function was 32 Ncm. Provisional implant-supported prostheses without occlusal contacts were delivered at time of surgery, and final prostheses with normal occlusion were delivered 5 months later. Eighty-five of the implants (90%) have passed the 1-year and 40 (43%) the 2-year follow-ups, respectively. Two implants failed in one patient before the 6-month follow-up, and another two implants between the 6-month and the 1-year follow-up, in two other patients, giving a cumulative survival rate of 96%. The average bone resorption was 0.8 mm after the first year as evaluated from 35 patients with readable radiographs. The failed implants were replaced after 3 to 4 months with immediate function; these were successful in all cases (not included in this study). The number of complications was small and did not differ in character from those normally encountered at implant treatment using a conventional protocol. The cumulative survival rate of 96% at 1 and 2 years indicates that immediate function of Brånemark implants used in the esthetic zone in both jaws can be a viable concept. All failures occurred in fresh extraction sites, and extra care is recommended to avoid situations with ongoing inflammation in these situations.