Placement Of Implants Research Articles

Comparison of Three-Dimensional Bone Changes in Socket Shield Technique Versus Immediate Implant Placement – A Non-Randomized Clinical Trial

ABSTRACT Aim: The present study assessed the three-dimensional bone loss, at three different levels, around implants placed immediately after extraction using the socket shield method versus immediate implant placement. Materials and Methods: A non-randomized clinical trial was conducted in 30 cases divided into two groups: socket shield method and immediate implant placement (15 cases each). Horizontal bone width (HBW) (at three different levels from baseline) and vertical bone level (VBL) (mesial and distal surfaces of the implant) were measured preoperatively and 6 months postoperatively by using cone beam computed tomography and radio visio graphy. Results: The mean difference at 2-mm and 8-mm HBW from the baseline was better in the socket shield technique, although the results were not significant. Significant results were found in Levene’s test for equality of error variances. The VBL was significant at both the distal and mesial surfaces of the implant. Conclusion: The socket shield approach demonstrated promising clinical outcomes in preserving alveolar ridge morphology. It can be utilized as a substitute for the typical instantaneous implant placement in the aesthetic zone.

Enhancement of Buccal Bone with Immediate Implant placement in Anterior Maxilla for Maximizing Esthetical Outcome

Enhancement of Buccal Bone with Immediate Implant placement in Anterior Maxilla for Maximizing Esthetical Outcome

Assessment of Peri-Implant Tissue Health and Marginal Bone Loss in Immediate Versus Delayed Implant Placement

ABSTRACT Objectives: The ambition of this research is to gauge marginal bone loss (MBL) and peri-implant tissue health by comparing immediate and delayed implant implantation in a tertiary care setting. Methods: Subjects who had immediate and delayed implants were assessed. Clinical indicators such as bleeding on probing (BOP), peri-implant probing depth, and MBL were assessed at baseline and six months postimplantation. A result was considered statistically significant if it was P < 0.05. Findings: At first, there was no discernible variance between the demographic traits of the two groups. Regarding MBL and peri-implant probing depth, there were statistically significant (P < 0.05) deviations between groups at the six-month mark following implant installation. There were no appreciable variations in bleeding between the two groups, according to probing. Conclusion: In summary, compared to delayed implant placement, rapid implant placement was associated with MBL and increased peri-implant probing depth throughout a six-month follow-up period. These results emphasize the need for careful patient selection and treatment planning in implant dentistry.

Comparative Evaluation of Hard- and Soft-tissue Changes in Immediate Implant Placement Using Flapless Approach with and without Demineralized Freeze-dried Bone Allograft Clinically and Radiographically Using Cone-beam Computed Tomography.

The present study evaluated hard- and soft-tissue changes in immediate implants using flapless approach with and without demineralized freeze-dried bone allograft (DFDBA) clinically and radiographically using cone-beam computed tomography (CBCT). Thirty-two sites in patients requiring immediate implants in the maxillary anterior region including the premolars were grouped according to the treatment provided with (test group) or without (control group) DFDBA. Plaque index, probing depth, soft-tissue assessment using Testori Esthetic Score (TS), and ridge width were recorded at baseline and postoperatively at 6 and 12 months, while crestal bone height (CBH), buccal bone thickness (BBT), jump space (JS), and gingival thickness were evaluated using CBCT at baseline and 12 months. Considerable differences among the different time lines and the groups in favor of the test group were prominently seen on the midfacial aspects at 12 months, with CBH values of -0.28 ± 0.17 mm in the test group as compared to -0.78 ± 0.34 in the control group (P < 0.0001). The JS was maximum on the buccal aspects being 1.42 ± 0.87 mm in the test group and 1.12 ± 0.81 mm in the control group which reduced at 12 months to 0.13 ± 0.35 mm and 0.73 ± 0.79 mm, respectively. Immediate implants with DFDBA augmentation using a flapless protocol demonstrated reduced CBH with resolution of JS and increased BBT, especially at the coronal aspects which influence the tissue stability and overall esthetics.

Assessment of Bone Thickness at the Infra Zygomatic Crest Region for Various Orthodontic Miniscrew Implant (OMSI) Insertion Angles: A Cone-Beam Computed Tomographic Study.

To evaluate the infrazygomatic crest (IZC) bone and develop guidelines for the optimum placement of orthodontic miniscrew implants (OMSIs) along the distobuccal root of the permanent maxillary first molar. Bone thickness of the IZC region of 50 young adults (25 males and 25 females) aged 18-30 years were evaluated using cone-beam computed tomography images. The infrazygomatic bone thickness along the distobuccal root of the permanent maxillary first molar was assessed at various insertion angles (40° to 75° i.r.t the maxillary occlusal plane) with an increment of 5°. Student's t-test was used to compare the IZC bone thickness and height at the orthodontic miniscrew insertion site for males and females on the right and left sides. The bone thickness of the IZC region above the distobuccal root of the permanent maxillary first molar was estimated between 4.39±0.25 mm and 9.03±0.45 mm for insertion angles from 40° to 75° to the maxillary occlusal plane. The corresponding OMSI insertion heights were 17.71±0.61 mm to 13.69±0.75 mm, respectively, above the maxillary occlusal plane. There were statistically significant gender and side-wise variations in bone thickness at the IZC area and insertion height. The safe position for OMSI placement at the IZC was 13.69-16 mm from the maxillary occlusal plane with an insertion angle between 55° and 75°. These parameters provide the optimum placement of OMSIs along the distobuccal root of the permanent maxillary first molar.

Impact of Interproximal Features on Marginal Bone Level Changes of Autograft, Allograft, and Xenograft after Functional Loading: A Retrospective Study

Abstract Aim: This study aims to investigate the marginal bone level changes (MBLCs) concerning interproximal features of posterior implant-supported single crowns using different bone grafts. Materials and Methods: This retrospective study included 27 patients requiring 46 dental implants using autograft, allograft, or xenograft between January 2007 and December 2016. MBLCs were assessed using digital periapical radiographs at 3 months (T1), 12–15 months (T2), and 21–24 months (T3) after prosthesis delivery. The influence of interproximal features, such as embrasure surface area, emergence angle, and horizontal distance to adjacent teeth/implants, was assessed. Secondarily, age, gender, diabetes and smoking, arch distribution, implant locations, implant characteristics, average gonial angle, antagonist type, clinical crown-to-fixture ratio, retention method, and nearby tooth/implant were considered. Wilcoxon signed-rank test, Mann–Whitney U tests, and Kruskal–Wallis tests were employed with statistical significance set at a P value of &lt;0.05. Results: The results revealed that mean MBLCs at T3–T1 were similar (autograft 0.5 ± 0.47 mm, allograft 0.51 ± 0.35 mm, and xenograft 0.57 ± 0.42 mm). There were significant increases in MBLCs associated with EA ≤ 30° in autograft (P = 0.04), and HD ≤ 3 mm in allograft (P = 0.03). Mesial/distal MBLCs showed no significant differences, except in cases with HD ≤ 3 mm in the distal area of autograft (P = 0.03). Regarding secondary factors, significant differences in MBLCs emerged between autograft and xenograft in the molar area (P = 0.03), and between premolar and molar areas within the xenograft group (P = 0.01). Conclusion: This study concludes that interproximal features, EA ≤ 30° and HD ≤ 3 mm, markedly influenced MBLCs for specific types of bone grafts. Furthermore, MBLCs exhibited a direct relationship with the posterior placement of dental implants.

Flap Versus Flapless Implant Placement in Immediate Functional Loading: A Comparative Study

ABSTRACT Background: Dental implants are now the typical tooth replacement method. Because it speeds up therapy, quick functional loading—attaching prosthetic restorations to implants following surgery—has become popular. Flapless implant implantation reduces surgical stress and expedites recovery. Methods: A prospective comparative study of 100 flap and flapless dental implant patients was done. Patient-reported outcomes, implant survival, peri-implant parameters, and surgical complications were assessed. Statistical analysis compared the two groups’ results. Results: Both flap and flapless methods exhibited good implant survival and similar peri-implant characteristics. Patients reported equal postoperative comfort and satisfaction in both groups. Surgical complications were similar for flap and flapless surgeries. Conclusion: In immediate functional loading, flap and flapless implant insertion are equally effective and safe. Both methods yield dependable implant survival, peri-implant health, patient comfort, and surgical safety. Dental professionals should evaluate patient variables and anatomical aspects while choosing an implant implantation surgery. Implant dentistry needs further study on long-term results and treatment regimens.

The "Four Corners" Method of Auditory Brainstem Implant Placement.

The "Four Corners" Method of Auditory Brainstem Implant Placement.

One-step Approach for Radicular Cyst Removal in the Maxillary Sinus and Implant Placement in the Posterior Maxilla: A Case Report with a 3-Year Follow-Up

One-step Approach for Radicular Cyst Removal in the Maxillary Sinus and Implant Placement in the Posterior Maxilla: A Case Report with a 3-Year Follow-Up

Attitudes of Oral Surgeons and Periodontists towards Immediate Dental Implant Placement.

This cross-sectional study aimed to evaluate the factors that determine the choice of oral surgeons and periodontists to perform immediate dental implant placement. An anonymous survey was carried out from January 6, 2024 to February 29, 2024. The questionnaire was distributed online to Lithuanian specialists - oral surgeons and periodontists, who perform implantation procedures. A total of 186 professionals were included in this survey. Chi-square test, its degrees of freedom was used for the analysis of variables. The main reason for refusing immediate implant placement is a periapical lesion greater than 5 mm, reported by 91.7% of oral surgeons and 96.9% of periodontists. Good aesthetics and preservation of anatomical structures are identified as an advantage by 99.2% of oral surgeons and 92.3% of periodontists. In the aesthetic zone, for periodontists, the main criterion for choosing a method is the quantitative and qualitative indicators of the soft tissue of the extraction socket 96.9%, and for oral surgeons - the morphology of the bone walls of the socket 87.6%. Only 43.1% of periodontists and 33.9% of oral surgeons are familiar with and use extraction socket morphology assessment classifications for immediate dental implant placement. Taking into account study's results, it is recommended to adjust the teaching programs at Universities and to increase the knowledge of specialists performing dental implantation procedures, by carrying out continuous educational programs.

Full arch rehabilitation of patients with severe atrophy of the upper jaw using the transnasal technique of implants placement

Full arch rehabilitation of patients with severe atrophy of the upper jaw using the transnasal technique of implants placement

Ridge Expansion in Two Surgical Stages Using the Transitional Implant Technique. Case Series with 8-Year Follow-Up

Extremely wide bony ridges require surgical procedures in order to insert dental implants. When less than 3 mm is present, different procedures are available, with ridge splitting being one of the most commonly used. The main limitation of this procedure is the angulation of the inserted implant. The two-stage split with transitional implants was created to overcome this drawback and achieve greater bone volume in the intervention area. This case series shows patients treated with this novel procedure. Material and Method: We retrospectively analysed patients who had undergone two-stage ridge expansion (using transitional implants) with at least 9 years of follow-up from the loading of the definitive implant, both in the maxilla and mandible. Data collection was performed by two independent examiners (different from those performing the prosthetic or surgical phase). All data were entered into a database which was managed by computer for the subsequent statistical analysis. The implant was the unit of analysis for descriptive statistics in terms of location, implant dimensions, and radiographic measurements. The primary variable was implant survival and as secondary variables mesial and distal bone loss and final bone crest width achieved after transitional implant integration, before replacement, were recorded. Results: Thirteen patients were recruited, and 30 transitional implants were inserted for width expansion in two surgical stages. These transitional implants were subsequently replaced by definitive implants at 5 months in the maxilla and at 3 months in the mandible. The mean initial ridge width of all two-stage split sites was 2.65 mm (+/- 0.63), range 1.32 to 3.70 mm. After placement of the transitional implants and bone healing, the final mean width of the specimen was 7.60 mm (+/- 0.26), range 4.31 to 12.20 mm. The mean mesial bone loss after loading of the final implant was 0.80 mm (+/- 0.26) and the mean distal bone loss was 0.85 mm (+/- 0.25). Conclusion: The two-stage split technique to achieve a gain in width of the residual bone crest is minimally invasive, predictable and the implants placed in the final (definitive) stage have a high survival rate, as we have seen in the present study with 9 years of follow-up.

Direct Sinus Lift with Immediate Implant Placement- A Modality in Atrophied Maxilla: A Case Report

The pneumatization of the maxillary sinus poses challenges for oral implantologists due to its natural expansion into the maxillary bone, often exacerbated by tooth loss. This reduces available bone for implant placement in the posterior maxilla, necessitating augmentation techniques to facilitate successful implantation. This article presents the case of a 23-year-old female with severe tooth decay in the left maxilla, desiring implant replacement. Cone-beam computed tomography (CBCT) revealed inadequate bone height (3.3 mm) complicated by sinus pneumatization. Surgical intervention involved tooth extraction followed by direct sinus augmentation with a bone graft to stimulate osteogenesis. Simultaneously, an implant was placed. Follow-up CBCT examination occurred at the 4-month interval. At the 4-month follow-up, CBCT examination demonstrated a significant increase in vertical bone height to 12.4 mm, indicating successful bone regeneration and implant stability. The case highlights the importance of a comprehensive diagnostic approach and strategic surgical planning in managing sinus pneumatization-related challenges for implant placement. Direct sinus augmentation combined with bone grafting proved effective in achieving sufficient bone height for implantation. This underscores the significance of appropriate therapeutic interventions and postoperative monitoring for favorable outcomes in such cases. Key Words: Bone augmentation, Cone-beam computed tomography, Dental implants, Maxillary sinus, Pneumatization,

A comparison of textured vs smooth surfaced implants in sub fascial breast augmentation.

Subfascial placement of breast implants has the advantages of subglandular and submuscular placement without the adverse outcomes. This study examined the differences in outcomes between textured and smooth implants. A total of 385 patients underwent subfascial breast augmentation in two cohorts. The initial series (n=209) employed textured implants and the second (n=176) employed smooth implants. In all other respects, patient management was identical. Adverse outcomes, changes in breast morphometry, and patient satisfaction were compared between the two groups. The follow-up period ranged from to 74-272 weeks for smooth implants (mean 164 weeks, STD 50.6) and 78-279 weeks for textured implants (mean= 186 weeks, STD=54). The incidence of capsular contracture was the same for smooth and textured implants (4.7% and 6.2%, P=.64). Changes in breast shape at the lower pole, patient satisfaction, and the incidence of other adverse outcomes were the same in both groups. Subfascial placement of smooth and textured breast implants yielded similar outcomes.

Immediate Implant Placement with Different Interradicular Osteotomies in the Mandible: A Randomized Clinical Study.

To assess the implant stability and amount of marginal bone loss in immediate implant placement (IIP) in mandibular molars by using pre-extractive interradicular implant bed preparation vs conventional post-extractive interradicular implant bed preparation. This randomized clinical trial was conducted on fourteen patients who had an immediate dental implant at the mandibular molar area by two different techniques. All patients were divided randomly into two equal groups: Group I (control) was treated with conventional post-extractive interradicular implant bed preparation, and group II (test) was treated by pre-extractive interradicular implant bed preparation All surgeries were performed by the same surgeon. All patients were followed up clinically at immediate post-surgery (T0), 7 days (T1), 3 weeks (T2), 90 days (T3), and 3 months after loading (T6) for healing and to evaluate the marginal bone loss radiographically at T0, T3 and T6. Descriptive and bivariate statistics were computed using the SPSS version (SPSS, IBM Inc., Chicago, IL), and p ≤ 0.05 was considered an indicator of statistical significance. A total of 7 female and 7 male patients with a mean age of 32.07 ± 5.87 years. Radiographically, there is no significant statistical difference in comparing between two groups for the marginal bone loss. However, there was a highly significant statistical difference (p < 0.001) in each group between different interval periods (T0, T3, T6) with mean start 5.27 ± 0.53, and 5.19 ± 0.72 at (T0) reaching 7.60 ± 0.89 and 7.09 ± 0.96 at (T3) and slightly decrease of 7.52 ± 0.79 and 7.02 ± 0.79 in (T6) with radiographic evaluation, and it represented clinically in each group with mean 3.57 ± 0.313 and 4.0 ± 0.58 at (T0) increase to 6.55 ± 0.395 and 6.52 ± 0.45 at (T6) for both group respectively. There is no statistically significant difference in soft tissue healing with an average mean of 4.57 ± 0.24 and 3.57 ± 0.509 (p = 0.001) when comparing between both groups respectively. Both techniques seem useful for dental implant placement in badly decayed mandibular molars. However, pre-extracted interradicular implant bed preparation for IIP might offer advantages in terms of primary implant stability and bone preservation. However, further studies are needed to confirm these findings. Both techniques are alternative methods for the treatment of badly decayed mandibular molars by immediate dental implant except for minor complications that do not interfere with dental implant placement. How to cite this article: Alzaibak LMA, Abdel-Monem TM, Elgohary NM, et al. Immediate Implant Placement with Different Interradicular Osteotomies in the Mandible: A Randomized Clinical Study. J Contemp Dent Pract 2024;25(4):303-312.

Avoiding Sinus Floor Elevation by Placing a Palatally Angled Implant: A Morphological Study Using Cross-Sectional Analysis Determined by CBCT.

Tooth loss in the posterior maxilla often necessitates dental implant placement, but the maxillary sinus anatomy poses challenges, especially during sinus floor elevation. Mesially angled implants are an alternative for total edentulism, but for single tooth deficiencies, palatally angled implants may offer a solution. This study evaluates the prevalence of avoiding sinus floor elevation by placing palatally angled implants in cases with a single missing tooth. A retrospective study at Ahmet Keleşoğlu Faculty of Dentistry involved 100 participants with a single missing tooth and prior CBCT scans. Virtual implants were placed using OnDemand3D (version 1.0.7462) software. On CBCT sections, implants were angled palatally to avoid sinus or nasal cavity perforation. Statistical analysis was conducted using R and MedCalc (version 4.3.2) software. Of the participants (60% female, average age 50.45), 76 edentulous regions required sinus elevation. The implant placeability rates varied across zones (second molar: 39.3%, first molar: 63.1%, second premolar: 78.5%). Implant placement at a palatal angle was significantly higher in the second premolar and first molar regions. Statistically significant differences were observed in the implant placeability between regions. This study supports the feasibility of avoiding sinus floor elevation through palatally angled implants in specific cases, reducing the associated complications.

Assessment of Accuracy of Implant Placement Using Surgical Stent Versus Conventional Technique.

The aim of this study was to assess the accuracy of the implant placement using surgical stents versus conventional implant placement. Twenty patients who reported to Rajarajeswari Dental College and Hospital were selected and they were randomly divided into two groups. In both the groups, the selection of the implant size was based on the ridge mapping. In Group I, tooth and tissue-supported surgical stent was fabricated and was used to place the implant. In Group II conventional technique was used for implant placement. In Group I the implant placement was parallel to the adjacent tooth with less variation in the angulation and the mesiodistal orientation of the implant was statistically significant compared to Group II. This technique of stent fabrication is easy, reliable, and cost-effective which also aids in the ideal placement of the implant in terms of orientation and angulation.

Prevalence of risk factors associated with development of capsular contracture after placement of breast implants

Prevalence of risk factors associated with development of capsular contracture after placement of breast implants

Clinical Evaluation of Role of Laser in Soft Tissue Surgical Guide for Implant Placement.

Applying automated laser ablation procedures with pulsed, electronically administered diode laser equipment, and large-area masking results in highly aligned, uniform microstructures on these surfaces. Clinical evaluation of role of laser in soft tissue surgical guide for implant placement. This study included 30 patients with dental implants in their oral cavity. These patients were divided into two categories. Category 1: Control where laser was not used for soft tissue guide. Category 2: Laser group where laser was used for soft tissue guide. There was the evaluation of bleeding index, plaque index, probing depth, and crestal bone loss in each patient at 3-month follow-up, 6-month follow-up, and 12-month follow-up by the same clinician. There was decline in values of bleeding index, plaque index, and probing depth in both control group and laser group at 3-month follow-up, 6-month follow-up, and 12-month follow-up. However, the decline in values was more pronounced in laser group. There was more increase in crestal bone loss as time progressed in control group while the increase in crestal bone loss in laser group was minimal as time progressed. Laser can be applied successfully in soft tissue surgical guide for implant placement as it gives better results regarding soft tissue health and crestal bone loss.

Immediate Implant Placement at an Inflammatory Periapical Cyst Site in the Aesthetic Area

A healthy 47-year-old woman consulted the Oral Surgery and Implantology Unit of the University Hospitals of Geneva with a request to treat her painful tooth 11 and replace the missing tooth 21. The dental history revealed that the patient had lost teeth 21 and 22 due to advanced caries. On clinical examination, tooth 11 showed an ill-fitting prosthetic crown with overhanging margins, an increased localized probing depth of 8 mm in the disto-vestibular area, and sensitivity to percussion. The edentulous site 21 showed horizontal bone atrophy. Radiological examination revealed a well-defined unilocular radiotransparent lesion surrounded by a thin radiolucent border, located at the apex of tooth 11 and measuring 10 × 8 mm. The treatment consisted of extraction of 11, enucleation of the apical lesion, and insertion of implants at sites 11 and 21 with simultaneous bone augmentation in a single surgical procedure, with aesthetic and functional results at 3-year follow-up without any complications. Our case highlights that immediate implant placement in cases of cystic periapical lesions represents a good valid alternative to standard treatment.