Implants In Maxilla Research Articles

A fixed reconstruction of fully edentulous patients with immediate function using an apically tapered implant design: a retrospective clinical study

BackgroundImmediate function has become an accepted treatment modality for fixed restorations in completely edentulous jaws. It is known that implant microtopography (surface) may enhance osseointegration, while implant macrotopography (macrodesign) plays an important role in primary stability in the patient requiring an immediate loading. The aim of this retrospective study was to evaluate the clinical and radiographic outcomes of the edentulous subjects treated with narrow and/or regular diameter, which placed and loaded immediately.MethodsForty-two consecutive patients received 171 implants, including regular and narrow diameter implants (NDIs). Each jaw, 19 mandibles and 24 maxillae, was treated with a fixed-full arch prosthesis according to the Straumann® Pro Arch concept. The majority (95%) of the restorations were supported by four implants, of which the posterior two implants were tilted. A provisional functional acrylic prosthesis was delivered on the day of surgery. All patients were followed up to 55 months. Cumulative survival rate was determined using Kaplan-Meier analysis. Radiological measurement of marginal bone level was performed.ResultsThe overall follow-up time for survival rate was up to 55 months. Four implants (3 implants in maxilla, 1 implant in mandible) were lost, resulting in an overall cumulative implant survival rate of 97.7%. Implant survival rate in the axial and tilted implants was not statistically significant. The mean of interproximal marginal bone loss was 0.15 mm after 24 months. Good soft tissue health was observed in almost 99% of patients. The final prosthesis survival rate was 100%.ConclusionsThe results of this retrospective pilot study indicated that total edentulous patients requiring an immediate implant placement and loading can be successfully treated with this implant design. The improved mechanical properties of these implants might give a more conservative treatment option for the jaws showing a severe horizontal alveolar bone resorption.

Factors Influencing Primary and Secondary Implant Stability—A Retrospective Cohort Study with 582 Implants in 272 Patients

The success rate of dental implants depends on primary and secondary stability. We investigate predictive factors for future risk stratification models. We retrospectively analyze 272 patients with a total of 582 implants. Implant stability is measured with resonance frequency analysis and evaluated based on the implant stability quotient (ISQ). A linear regression model with regression coefficients (reg. coeff.) and its 95% confidence interval (95% CI) is applied to assess predictive factors for implant stability. Implant diameter (reg. coeff.: 3.28; 95% CI: 1.89–4.66, p < 0.001), implant length (reg. coeff.: 0.67, 95% CI: 0.26–1.08, p < 0.001), and implant localization (maxillary vs. mandibular, reg. coeff.: −7.45, 95% CI: −8.70–(−6.20), p < 0.001) are significant prognostic factors for primary implant stability. An increase in ISQ between insertion and exposure is significantly correlated with healing time (reg. coeff.: 0.11, 95% CI: 0.04–0.19). Patients with maxillary implants have lower ISQ at insertion but show a higher increase in ISQ after insertion than patients with mandibular implants. We observe positive associations between primary implant stability and implant diameter, implant length, and localization (mandibular vs. maxillary). An increase in implant stability between insertion and exposure is significantly correlated with healing time and is higher for maxillary implants. These predictive factors should be further evaluated in prospective cohort studies to develop future preoperative risk-stratification models.

Tooth movement adjacent to single anterior maxillary implants after 14‐20 year follow‐up

Tooth movement adjacent to single anterior maxillary implants after 14‐20 year follow‐up

Implant loss and sinusitis after sinus lift ‐ an underestimated complication?

Background: Sinus lift is designed to enable the placement of maxillary implants in situations with vertically reduced alveolar bone. It has become a more frequently performed procedure. Possible complications comprise sinusitis, failing grafts and failing of the dental implant. More severe problems and chronic sinusitis have been reported. Aim/Hypothesis: To report on 76 patients with implant loss after sinuslift. To report the reasons, the possibilities for repair in routine cases and in more severe situations of sinusitis with multiple implant loss and damage to surrounding structures. To report the long‐term outcome. Materials and Methods: Between 2000 and 2020 76 patients with failing implants after sinuslift were referred to four Oral Surgery and ENT services in Switzerland. Of 169 implants originally placed 71 implants were already lost before the first consultation. 14 patients had no complaints other than implant loss. The other 62 patients complained about varying degrees of pain, swollen midface, pussy exudates, paresthesia etc. In 3 patients implants had been failing repeatedly. CBCT showed in 58 patients maxillary sinusitis, in 4 patients half‐sided pan‐sinusitis. In 11 patients, nasal fiberoptic endoscopy was carried out. Further investigations consisted of bacteriology, mycology and histology. Reasons for sinusitis were attributable to postoperative blowing of the nose, infection of the graft, antiresorptive drugs, peri‐implantitis reaching the floor of the sinus and allergic reaction to sinus grafting material mixed with collagen. Another reason for implant loss was a failing graft without signs of sinusitis. Results: 53 implants had to be removed under Local Anaesthesia (LA), 9 implants could be left in situ. 8 patients did not need surgical intervention for sinusitis but only antibiotic treatment. 41 patients needed surgical intervention under LA for cleaning the sinus of infected graft material and closing of fistula. 27 patients needed surgical intervention under General Anaesthesia (GA) because of more extensive disease, removal of debris, fungi, dislocated dental implants and nasal endoscopy. 51 patients became pain free. In 11 patients some chronic pain remained. In 18 patients the sinus did not heal to a degree that re‐sinuslift was deemed appropriate. Whilst 29 patients were subsequently treated with dentures, 47 patients underwent a second surgery for new grafting procedures with autologous bone, followed by implant insertion. This was possible in 28 patients under LA, whilst 19 patients needed GA for reconstruction of lost maxillary structures with large mandibular or with hip bone graft. Conclusions and Clinical Implications: Whilst many complications after sinus lift are not severe and can be treated locally, some patients exhibit more severe problems with e.g. pan‐sinusitis and chronic sinusitis. Multidisciplinary cooperation between dentists, oral surgeons, and ear, nose and throat specialists can be very helpful in diagnosing and treating these cases. To estimate the chance for success of redo of sinus lift is rather difficult, especially when bone substitutes were used beforehand which may not have integrated.

Two Years after Loading Performance of Implant-Supported Overdenture with Metal Bar and Low-Profile Attachments: A Prospective Case Series Multicenter Clinical Study

Background. Prosthetic rehabilitation of patients with atrophic arches can be very challenging. Purpose. The aim of the present prospective multicenter study was to report the two-year preliminary data on clinical and radiographic performance of implant-supported overdentures with a metal bar and low-profile attachments. Material and Methods. A computer-aided design/computer-aided manufacturing (CAD/CAM) titanium bar or a conventional cast metal bar was fabricated according to the anatomy of the ridge, prosthetic contours (teeth setup), and implant position. Three to six threadable OT Equator attachments (Rhein 83, Bologna, Italy) were placed along the implant bar. A cobalt-chromium alloy metal framework was fabricated and fitted onto the metal bar as a counterpart. Prosthetic survival rate, biologic and technical complications, peri-implant bone loss, changes in oral health impact profile index, bleeding on probing, and plaque index were reported. Results. Overall, 177 implants were placed (range three to six) to support 43 metal bars with 170 OT Equators (Rhein 83, range three to six). Eleven metal bars were fabricated using CAD/CAM technology, while the other 32 were conventionally produced using cast technique. All the participants were followed up for at least two years (mean 42.2 months, range 24–88 months) after prosthesis delivery. Two maxillary implants failed in one nonsmoking patient (1.1%). The 2-year prosthesis survival rate was 97.7%. Only three minor technical complications were reported. Two years after loading, the mean marginal bone loss was 0.22 ± 0.09 mm (95% CI: 0.16 to 0.26). Two years after loading, OHIP was 22.3 ± 7.1 (95% CI from 17.4 to 24.6). Compared to the baseline, the difference was statistically significant ( P ≤ 0.001 ). At the two-year follow-up session, successful periodontal parameters were experienced. Conclusions. Implant overdenture supported by a CAD/CAM titanium bar may be a reliable option for the treatment of the edentulous arch over a 2-year period. Oral health-related quality of life significantly improved in all treated participants.

An Anatomic Study on the Maxillary Sinus Mucosal Thickness and the Distance between the Maxillary Sinus Ostium and Sinus Floor for the Maxillary Sinus Augmentation.

Background and objectives: The average rate of chronic sinusitis after maxillary implantation was approximately 5.1%. However, the evidence of predictive risk factors for sinusitis after implantation is lacking. The aim of this study was to perform an anatomic study on the maxillary sinus mucosal thickness (MSMT), the distance between the maxillary sinus ostium and sinus floor (MOD), and the MSMT/MOD ratio as a preoperative risk indicator for sinusitis after maxillary dental implantation. Materials and Methods: Between October 2008 and October 2019, all patients referred to the otolaryngology department were included in this study. A total of 120 patients were enrolled. The 95 patients who received no treatment prior to implantation were classified into Group A, the 16 patients who used antibiotics before implantation were classified into Group B, and the patients who had implants inserted after functional endoscopic sinus surgery were classified into Group C. The MSMT, MOD, MSMT/MOD ratio, anatomical factors associated with ostial obstruction, and the occurrence of postoperative sinusitis were reviewed. Results: There were significant group differences in MSMT (Group A vs. Group B, p = 0.001; Group B vs. Group C, p = 0.003; Group C vs. Group A, p < 0.0001). The MOD showed no significant difference among the three groups. The MSMT/MOD ratio showed significant differences between Groups A and B (p = 0.001), B and C (p < 0.0001), and C and A (p < 0.0001). Conclusions: It is important to check not only the proportion of the maxillary sinus occupying lesion, but also the status of the maxillary sinus osteomeatal complex when making therapeutic decisions. In addition, collaboration between dentists and otolaryngologists could improve outcomes in patients with maxillary sinus lesions.

Immediate Placement and Provisionalization of Maxillary Incisors Implants in an Adolescent Patient: A Case Report

Immediate Placement and Provisionalization of Maxillary Incisors Implants in an Adolescent Patient: A Case Report

A Retrospective Study of Bone Level Stability Around 441 Mandibular and 350 Maxillary Molar Implants Placed with an Immediate Implant Protocol.

The purpose of this retrospective study was to evaluate bone level stability around 441 mandibular and 350 maxillary molar implants, placed using an immediate implant protocol, that had been in function from 2 to 17 years postrestoration (mean: 9.9 years). Independent radiographic measurements using the known distance between threads on the specific implant that was used indicated a mean bone loss of 0.27 ± 0.68 mm around maxillary implants and 0.27 ± 0.67 mm around mandibular implants. Maxillary implants showed a statistically significant (SS) difference in bone loss on the mesial (0.20 mm) compared to the distal side (0.34 mm). In the mandibular group, there was an SS difference in bone loss around implants with wide (≥ 5 mm) and regular (< 5 mm) diameters. There was also an SS difference in bone loss in patients 50 years and older (0.28 mm) compared to patients younger than 50 (0.18 mm). In both groups, there were no SS differences in bone loss between machined- and rough-surface implants, men and women, single and splinted implants, nonsmokers and light/heavy smokers, or in patients with a penicillin allergy who were prescribed azithromycin as an alternate prophylactic antibiotic. All SS differences found in variables evaluated in the study were < 1.0 mm and therefore were considered clinically insignificant.

Oral rehabilitation of Papillon-Lefèvre syndrome patients by dental implants: a systematic review.

ObjectivesPapillon–Lefèvre syndrome (PLS) is a rare autosomal recessive disorder. These patients lose their teeth at a young age and are in need of prosthetic rehabilitation. The aim of this systematic review was to assess the success of dental implant placement in these patients.Materials and MethodsAn electronic search was performed in PubMed Central, Scopus, and Web of Science using the keyword “Papillon–Lefèvre syndrome” AND “dental implant” OR “prosthodontics”. Articles reporting implant placement in patients with PLS until July 2019 were included.ResultsAssessment of the included 11 articles reporting 15 cases showed 136 implant placements in these patients. Implant failure occurred in 3 patients (20 implants). The peri-implantitis and failure rate was higher in the maxilla. Meta-analysis showed the probability of failure to be 7% (95% confidence interval [CI] 0%-31%) for maxillary implants and 2% (95% CI 0%-9%) for mandibular implants. The follow-up time ranged between 1 and 20 years. Healing after bone graft and implant placement in these patients was uneventful.ConclusionDental implants may be a viable treatment option for PLS patients. Implantation can help preserve alveolar bone if the patients’ immunological and growing conditions are well-considered and proper oral hygiene and compliance with the maintenance program are continued.

The effect of keratinized mucosa on the severity of peri-implant mucositis differs between periodontally healthy subjects and the general population: a cross-sectional study

ObjectiveThe study aims to investigate the effect of reduced keratinized mucosa (KM) and other risk indicators on the severity of peri-implant mucositis in (i) the general population, (ii) in periodontally healthy patients, and (iii) in periodontally healthy patients without a history of periodontitis.Materials and methodsAnamnesis and the following clinical parameters were taken: mucosal-index, bleeding on probing, local plaque index, oral hygiene-index, and width of KM. Mucositis severity score was determined for each implant. Multi-level and subgroup analysis was performed on the patient and implant level.ResultsSix hundred twelve implants in 130 patients were analyzed. Subgroup analysis showed significant associations between KM < 2 mm and the severity score in (ii) periodontally healthy patients (p = 0.014) and in (iii) patients without history of periodontitis (p = 0.017). Secondary outcome showed higher severity scores for patients with insufficient oral hygiene or without residual teeth (p ≤ 0.001), in maxillary implants (p = 0.04), and for the number of implants per patient (p ≤ 0.001).ConclusionWithin the limits of the study, one may conclude that a reduced width of KM is a risk indicator for the severity of peri-implant mucositis in periodontally healthy patients and patients without a history of periodontitis.Clinical relevanceThe results indicate a band of ≥ 2 mm KM to reduce the severity of peri-implant mucositis in periodontally healthy patients.

Conservative technique for the removal of implants displaced into maxillary sinus

Displaced dental implants into the maxillary sinus are relatively rare. Treatment consists of implant surgical removal. Objective: To present two case reports of the removal of implants displaced into maxillary sinus by a conservative technique. Case report: Report 1: A 44-year-old female sought for treatment complaining about headaches and recurrent sinusitis. In the anamnesis she reported she had been undergone placement of nine maxillary implants, fifteen years ago, with total loss of those elements. At the imaging exams it was possible to observe two displaced implants into the bilateral maxillary sinus, besides radiopaque image on the left maxillary sinus, compatible with maxillary sinusitis. Based on this data, the proposed treatment plan was the removal of the displaced implants through Caldwell Luc approach and sinusotomy in the left side, under general anesthesia. The patient has a follow-up of 6 months without complaints. Report 2: A 42-year-old male was referred to the Surgery and Maxillofacial Traumatology Department for implant removal from the right maxillary sinus. Patient underwent implant installation in the area around 9 months ago. In the computarized tomography it was possible to diagnose the implant migration into the right maxillary sinus. the proposed treatment plan was the removal of the displaced implant via Caldwell Luc Access by repositioning the bony window and sinusotomy. Results: Patient has been with no complaints at 30 days after surgery. Conclusion: The technique has been shown to be effective in treating the condition.

The impact of the alveolar bone sites on early implant failure: a systematic review with meta-analysis.

Dental implants are the first option for replacement of missing teeth. Failure usually involves additional cost and procedures. As a result, the physician should limit the risk factors associated with implant failures. Implant site is one of many factors that can influence the success or failure of dental implants. The association between early implant failure (EIF) and implant site has yet to be documented. This review aims to estimate the impact of insertion site on the percentage of EIFs. An electronic and manual search of studies that reported early failure of dental implants based on collection site. A total of 21 studies were included in the review and examined for the association between EIF and alveolar site. Subgroup analysis, including a comparison between implants inserted in four alveolar ridge regions of both jaws was performed. The early failure rate was higher for maxillary implants (3.14%) compared to mandibular implants (1.96%). Applying a random effect, risk ratio (RR), and confidence interval (CI) of 95% revealed higher failure in the maxilla compared to the mandible (RR 1.41; 95% CI [1.19, 1.67]; P<0.0001; I2=58%). The anterior maxilla is more critical for early implant loss than other alveolar bone sites. Implants in the anterior mandible exhibited the best success rate compared of the sites.

Correlation between alveolar bone morphology and volumetric dimensional changes in immediate maxillary implant placement: A 1-year prospective cohort study.

After a single tooth extraction, remodelling processes are initiated and morphological changes occur in the alveolar bone. It has been suggested that implant placement in a fresh extraction socket may partly reduce the alveolar ridge contraction and that several factors like the thickness of the buccal bone wall and the size of the gap between the implant and the facial bone wall may play a role on peri-implant tissues dimensional alterations. Twenty-six patients treated with single-tooth maxillary implants were included in this study. A CBCT exam allowed to access the initial buccal bone thickness (BT). Digital impressions were taken prior to extractions (T0), 1 month (T1), 4 months (T2), and 12 months (T3) after implant insertion and superimposed with a computer software allowing to quantitatively analyse the three-dimensional changes occurred in the adjacent tissues. Variables related to thickness and volume were computed. Participants with BT ≤ 1mm exhibited a significantly increased buccal peri-implant tissue thickness change than patients with BT>1mm (P=0.049). At T3 patients representing BT ≤ 1mm exhibited a total volume change of -8.53% ± 5.47% compared with patients presenting BT>1mm, -4.37% ± 2.08%. No statistical significance was found on the distance between implant shoulder and the buccal bone plate (BID) effect. After the first year of treatment peri-implant tissues showed continuous changes resulting in a higher thickness and volume reduction at thin buccal bone plates.

Maxillary Sinus Elevation Difficulty Score with Lateral Wall Technique

Maxillary sinus augmentation is a procedure commonly performed in patients in need of posterior maxillary implants with limited vertical ridge height and sinus pneumatization. However, minimal information has been presented to evaluate the complexity of the sinus elevation procedure via a lateral window approach based on patient examination, including extraoral findings, anatomical factors, and the possible influence from the surgeon's experience. Therefore, this article presents a new scheme of maxillary sinus floor elevation difficulty score based on comprehensive patient- and surgical-related factors. The proposed scoring tool aims to aid surgeons in performing a comprehensive presurgical evaluation prior to the lateral wall sinus augmentation surgery and also enhance communication between clinicians and patients regarding the complexity of the case.

Retreatment of multiple failing maxillary implants after full arch rehabilitation: a retrospective, observational cohort study

The aim of this study was to assess implant retreatment in a group of patients whose maxillary implants were all failing after full arch rehabilitation. Treatment involved implant removal, augmentation, and placement of an overdenture supported by four to six implants. All consecutive patients referred between 2008 and 2018, following multiple late implant failures in the rehabilitated maxilla, were included in the study. Seventy implants in 15 patients were evaluated at 3.3 ± 2.5 years (range 1.1–8.6 years) after loading. Implant survival, complications, clinical parameters, marginal bone loss, and patient-related outcome measures were recorded at the time of evaluation. Overall implant survival was 95.7%. Three implant failures occurred within the first year of function. Marginal bone loss was 0.32 ± 0.46 mm; pocket probing depth was 4.55 ± 1.59 mm. Plaque, calculus, inflammation, and bleeding were hardly seen (median index score 0). Patients scored their satisfaction with their overdentures as high (mean overall score 8.7 ± 1.2, maximum 10). Chewing soft and tough food was scored as ‘good’ and hard food as ‘moderate’. The mean Oral Health Impact Profile score was 29.5 ± 33.3. It can be concluded that the replacement of multiple failing implants in an edentulous maxilla after bone augmentation is a safe and predictable treatment procedure when applied as an implant-supported overdenture.

A Finite Element Analysis on Stress Distribution in Overdenture Implants and Implant Abutment Interface Using Different Attachment Systems: An In Vitro Study

Abstract Introduction The overdenture is an alternative to fixed implant-supported prosthesis for its relatively low-cost and in clinical cases where it is impossible to place multiple implants with appropriate number and arrangement in the arch to support a fixed prosthesis. In implant-supported overdentures, many attachments such as bars, ball, and magnets can be used. The anchorage system affects the retention and stability of the overdenture as well as the load transfer to the implant and the bone. The purpose of this study was to evaluate the exerted stresses on implants and implant–abutment interface by comparing different attachment systems used for implant-supported maxillary and mandibular overdentures using finite-element analysis. Materials and Methods Stress distribution in five different models with different attachments were evaluated using finite-element analysis. The studied attachment systems were Ball/O-ring and bar-clip attachments. Three models in mandible were studied, two implants with ball attachments, two implants with bar, and four implants connected with a bar. In maxilla, two models were studied, four implants with ball attachments, and four implants connected with bar. Forces were applied bilaterally on each model in the canine and molar region separately. The forces applied were 35N axially, 70N obliquely, and 10N horizontally. Results The ball attachments models showed the highest amount of stresses on the bone and on the implants in maxilla and mandible. The bar-clip attachment with four implants showed least stress in maxilla as well as in the mandible. The bar on four implants has better stress distribution as compared with the bar on the two implants.

The effect of transcrestal sinus-floor elevation without graft on the long-term prognosis of maxillary implants.

To evaluate the effects of (a) transcrestal sinus-floor elevation (TSFE) and (b) residual bone height on long-term implant survival. Chi-squared and t tests were used for descriptive comparison of the groups. Kaplan-Meier survival curves and corresponding log-rank tests were used to investigate implant survival over time. Multivariable Cox regressions were performed for the total population and experimental group. A total of 634 patients received 648 implants with TSFE, while 674 implants without TSFE served as controls. Thirty implant failures occurred in the experimental group and 28 in the control group. Ten-year Kaplan-Meier survival curves for the 157 implants (24.3%) still under observation showed a probability of survival of 93.7% for the implants with TSFE and 92.9% for the 72 implants without TSFE (p=.678). The probability of 10-year survival of all implants in the experimental group decreased to 77.4% for implants placed in residual bone heights of 1-3mm, compared with 95.7% for implant sites with bone heights of 4-6mm and 97.6% for bone heights of >6mm. Transcrestal sinus-floor elevation has no negative effect on the long-term implant survival. Membrane perforation or negligible bone height, however, reduces the probability of 10-year survival.

Peri-implantitis: an Unusual Presentation

Rehabilitation with dental implants is not without post-placement complications, one of which is peri-implantitis. Peri-implantitis is a progressive inflammatory disease which affects the hard and soft tissues around a dental implant. The consequent bone resorption and reduced osseointegration significantly affects the long-term viability of the implant fixture. Without treatment, peri-implantitis can progress in an accelerating, non-linear pattern. The aetiology of peri-implantitis is debated in the literature. Consequently, over the last ten years there have been numerous consensus meetings debating this topic and various guidelines have been written and updated by experts in the field. There is extensive, sometimes conflicting, literature on the subject in the scientific journals. The aetiological factors involved and the management of the condition remains up for debate… In 2011, a new patient attended the University Dental Hospital of Manchester with nine Xive implants (Dentsply Sirona), four maxillary and five mandibular. For various reasons the maxillary implants were all restored, however, only three of the mandibular implants were restored and two were left buried. In 2016, the patient returned with signs and symptoms of peri-implantitis around the most mesial buried implant (LL6 region). The potential reasons why this may have occurred were investigated and forms this case report. CPD/Clinical Relevance: Peri-implantitis may be associated with apparently buried implants.

Comparative clinical evaluation of esthetic parameters of immediately provisionalized implants in the esthetic zone with their natural counterparts

Background: An anterior single implant-supported crown restoration in the maxillary anterior region must meet a particularly high standard of esthetic quality. The standard of care for edentulous space in esthetic zone therefore would be the placement of an implant with immediate provisionalization. Aims and Objecectives: The aim of this study is to evaluate the esthetic parameters of immediately provisionalized implants in the esthetic zone and compare patients opinion with blinded clinicians opinion of the outcome of esthetics of implant in esthtic zone. Materials and Methods: In our study, we placed 10 maxillary anterior single-tooth implants in fully healed maxillary anterior sites in esthetic zone. All the implants were provisionalized within 24 hours. Zirconia prosthesis was delivered as definitive prosthesis after three months of implant placement. The esthetic zone was photographed three months after delivering the definitive prosthesis. The esthetic outcome was then evaluated objectively using Pink Esthetic Score (PES) and White Esthetic Score (WES) by a blinded clinician. In addition, we used a triple score technique Visual Analogue Scale(VAS) wherein the patients commented on the soft tissue, prosthetic as well as the overall esthetic outcome. Results: A mean PES of 9.2± 1.03 and a mean WES of 8.7± 1.16 recorded showed an acceptable peri-implant soft tissue outcome and an acceptable prosthetic outcome respectively. The statistical analysis revealed statistically significant correlation between patients' esthetic perception and dentists' perception of the anterior tooth. Conclusion: The PES/WES is an objective tool in rating the esthetics of implant supported single crowns and adjacent soft tissues. Orthodontists were the most critical observers, while periodontists were more generous than other observers. The statistical analysis revealed a statistically significant correlation between patients' esthetic perception and dentists' perception of the anterior tooth.

Association of Posterior Maxillary Bone Height and Dental Implant Placement: An Institutional Study.

This study evaluates the success of dental implants placed in the maxillary posterior region and whether an association exists regarding length and implant success. Dental implants are a surgical component that interfaces with jaw bone to support dental prostheses. In 1978, Brandmarks presented a two-stage threaded titanium root-form implant that has become the best-maintained dental implant. Differences in anatomy make treatment for posterior quadrants more challenging than that for anterior quadrants. The need for dental implants includes partial/complete edentulousness, tooth loss during a mixed dentition period, and immediate replacement due to trauma. This retrospective study was conducted as an institutional setting, and all patients undergoing implant surgery in the maxillary posterior region were considered. We performed Excel tabulation and data analysis using Statistical Package for the Social Sciences (IBM, Armonk, NY). Results show that posterior maxilla bone height was greater in females than males. Patients aged 41-50 yr with bone height of 12-14 mm occurred most often. For implant placement, females showed significant bone height in the posterior maxillary region, and age did not play a significant part in posterior bone height.