Implants In Posterior Maxilla Research Articles

Assessment of stability of early loaded nano-coated hydroxyapatite implants in posterior maxilla

Assessment of stability of early loaded nano-coated hydroxyapatite implants in posterior maxilla

Assessment of Stability of Early Loaded Nano Coated Hydroxyapatite Implants in Posterior Maxilla

Aim: The aim of the study was to assess the stability after early loading of nano coated hydroxyapatite implants in posterior maxilla. Methodology: This study was conducted on nine patients with at least a missing one maxillary posterior tooth. Ten Nano-coated hydroxyapatite implants (ETIII NH implant by Hiossen) were inserted in nine patients, and then subjected to early loading according to the secondary stability readings taken by Osstell®. Implant stability was measured at the time of implant insertion (T0), 4 (T1), 6 (T1 modified), weeks, and 4 months (T2) post-operative. Cone-beam computed tomography (CBCT) was performed in all patients before starting the treatment. Nine implants healed well except for one implant that failed due to infection. Results: Secondary stability results after 6 weeks of implant incretion were sufficient enough for implant loading, there was significant difference (F= 12.642, DF 3, P value <0.001) among T0, T1, T1 modified, and T2. Conclusion: Nano-coated hydroxyapatite implants are of good choice in posterior maxilla and they can be early loaded.

Assessment of Marginal Bone Loss of Early Loaded Nano Coated Hydroxyapatite Implants in Posterior Maxilla

Assessment of Marginal Bone Loss of Early Loaded Nano Coated Hydroxyapatite Implants in Posterior Maxilla

Influence of implant design and length on stress distribution in immediately loaded implants in posterior maxilla - A two-dimensional finite element analysis.

The aim of this two dimensional (2D) finite element analysis study was to evaluate the influence of implant design (step and tapered) and length on stress distribution at bone implant interface, when placed in maxillary posterior bone under immediate loading protocol. 2D finite element models were developed to simulate the two types of implant designs, i.e., Tapered and step implants of 3.75-mm - Diameter and 6 and 10 mm lengths, respectively. Maxillary posterior bone quality (D4 bone) was simulated with a very thin cortical bone (0.5 mm) for the placement of implants. The respective material properties were assigned. The implant designs incorporated microthreads at the crestal part and rest of the implant body incorporated Acme threads. Forces of 100 Newtons were applied vertically and in oblique direction (at an angle of 45°) to long axis of the implants. Total deformation (micromovements), stresses and strains were evaluated at the bone implant interface. The results of micromovements, stresses and strains were found to be lower for long implants as compared to short implants. Also, all the values were found to be higher for oblique loads as compared to vertical loads. The von mises stress values were highest for 6 mm step implants and lowest for 10 mm step implants. In the presence of low bone density with optimal bone height, standard diameter long step implants can be used. Incorporation of microthreads at the crestal portion and acme threads for body portion of the implant presents a good option to be used under immediate loading protocol.

Short implant in posterior maxilla with 2 years follow- up: A case report

Placement of the dental implants in posterior maxilla requires maxillary sinus floor elevation. However, this is avoided by placing short implant, these implants are increasingly being seen as an alternative to more extensive bone augmentation procedures. Long term follows up revealed survival of the implants. This case report describes extraction of teeth, followed by immediate placement of implantswiss short implant in posterior maxilla using jig trial in the prepared socket with two-year follow-up.

EFFICACY OF NANO-HYDROXYAPATITE COATING ON OSSEOINTEGRATION OF EARLY LOADED DENTAL IMPLANTS

Objectives:The aim of the present study is to evaluate the efficacy of Nano hydroxyapatite coating onosseointegration of early loaded dental implants in posterior maxilla. Patients and Methods: A clinical trial was carried out on twelve early loaded implants in 3 males and 7 femalepatients with ages ranging from 20 to 45years A root-form implant is the most frequently used type of dental implant today. The basis for dental implants is osseointegration, in which osteoblasts grow and directly integratewith Nanohydroxyapatite coating surfacetitanium posts surgically embedded into the jaw. After implant placement all implants were evaluated clinically at 3, 6 months and 12 months after loading and radiographically CBCT scan was taken at immediately after installation and 6 months after loading time. Clinical (implant stability using Osstell ISQ device, probing pocket depth PPD and modified sulcus bleeding index mSBI) and radiographic parameters at6 months after loading time (marginal bone loss MBL) were assessed. During the first year interval, no implant was lost and all patients showed favorable clinical and radiographic finding. Results: During the first year interval, no implant was lost and all patients showed favorable clinical and radiographic finding. The statistical tests showed that there were statistical significant differences in the mean values of the primary outcome (implant stability measured by Ostell device),probing pocket depth PPD, and marginal bone loss between the patients implants over time. Besides, no significant differences were observed between patients regarding the secondary outcomes which include modified sulcus bleeding index mSBI. Conclusions: Early loading of implant with coating Nano hydroxyapatite could be considered a valuable option to replace missing teeth.To the best of our knowledge, early loaded implants with nano HA coating have shown encouraging results in a stronger and favorable regeneration of bone and better osseointegration of implants.

Maxillary sinus lift using osteotomes: An indirect approach for implant placement in atrophic posterior maxilla

The maxillary posterior edentulous region presents many challenges in implant dentistry. Deficient alveolar ridges often jeopardize the placement of implants in posterior maxilla. This problem mostly occurs when due to ridge resorption, sinus pneumatization is encountered. The procedure of choice is the elevation of the floor of the sinus with the use of the osteotome technique so as to increase the alveolar ridge height for the placement of implant. The purpose of this case report is to demonstrate indirect maxillary sinus lift procedure through alveolar crest using osteotomes to prevent perforation of sinus lining during implant placement and restoring the implants using early loading protocol.

A Clinical Study of the Effect of Low-Level Laser Treatment on the Clinical Stability of Immediately Loaded Implants in Posterior Maxilla

A Clinical Study of the Effect of Low-Level Laser Treatment on the Clinical Stability of Immediately Loaded Implants in Posterior Maxilla

A comparative evaluation of bone regeneration using mesenchymal stem cells versus blood coagulum in sinus augmentation procedures.

Objective:The present study evaluated the quality and quantity of new bone formation in the maxillary sinus lift procedures and stability of implants in posterior atrophic maxilla.Materials and Methods:This prospective randomized controlled split-mouth study included 20 patients (16 males and 4 females having a mean age of 36.7 years) having atrophic maxilla. They were divided randomly into two groups: Group A using mesenchymal stem cells and Group B into blood coagulum. They were radiographically evaluated using cone-beam computed tomography (CBCT) for residual bone height preoperatively and availability of new bone formation around implants, density, and stability of implants 6 months postoperatively.Results:The placement of dental implants in posterior maxilla is challenging due to rapid resorption of alveolar bone after extraction of teeth due to pneumatization of maxillary sinuses. In both the groups, more pain and swelling were observed in the 2nd postoperative day which gradually decreased over a period of 7 days. Membrane perforation occurs in only four cases (20%). A significant gain in alveolar bone height was observed in Group A (7.69 mm ± 2.5 mm) and Group B (9.32 mm ± 2 mm) after 6 months. On comparing both the groups, there is a similar significant increase in bone density in Hounsfield units postoperatively at various levels buccally and palatally. Total 40 sinuses were lifted and 42 implants were placed, respectively. All implants showed primary stability.Conclusions:Such findings provide a significant contribution in future perspective studies that the use of stem cells had the same success rate as blood coagulum.

Evaluation of bone turnover around short finned implants in posterior maxilla with thin cortices

Evaluation of bone turnover around short finned implants in posterior maxilla with thin cortices

Comparison of different surgical procedures on the stability of dental implants in posterior maxilla: A randomized clinical study

BackgroundStability of a dental implant is very important when planning immediate loading and design of a final restoration. The aim of this study was to compare the primary and the secondary stability of dental implants inserted by three different surgical techniques: conventional (standard) technique using a sequence of drills for implant bed preparation, osteotome technique using tapered hand instruments for creating implant sites by condensing the bone and guided flapless implant surgery with surgical templates. Material and methodsThe study included 150 patients (80 males and 70 females), 46–71 years old, who required implant supported fixed partial dentures in the posterior maxilla of D3 or D4 bone density. Patients were randomly assigned into one of the three surgical insertion technique groups. All patients received tapered implants of the same manufacturer of the same length and two different widths (3.3 × 11.5 mm or 4.2 × 11.5 mm). Primary and secondary implant stability were measured by means of resonance frequency analysis (RFA) at the time of implant placement and 5 months after surgery using the Ostell ISQ device (Osstell AB, Sampgatan, Goteborg, Sweden). Statistical analysis included one-sample Kolmogorov Smirnov test, descriptive statistics, multivariate analysis (Bonferoni post-hoc tests) and paired t-tests. ResultsPatients in the osteotome group exhibited higher primary stability (P < 0.01) than in the conventional and surgically guided flapless groups. There were no significant differences in the secondary stability (p > 0.05). Wider implants presented higher ISQ values (P<0.01). ConclusionThe osteotome technique led to the highest implant primary stability, therefore it can be recommended when immediate loading is planned or for one-piece implant insertion.

Short Implants in Posterior Maxilla in Elderly Patients: A Case Series

Placement of dental implants in reduced bone in the posterior maxilla requires maxillary sinus floor elevation. However, in elderly patients this is to be avoided. A case series on the successful placement of multiple short implants in posterior maxilla and splinted crown restorations in elderly patients was presented. Long term follow up revealed survival of the implants. Short implant is a suitable treatment option for elderly patients.

Success Rate of Dental Implants Placed in the Atrophic Posterior Maxilla with Intentional Sinus Floor Perforation in Lieu of Indirect Sinus Augmentation: A Retrospective Report of 26 Consecutive Patients and Literature Review

Purpose: To assess surgical success rate of placing dental implants in the atrophic posterior maxilla engaging the maxillary sinus floor in patients with inadequate posterior maxillary alveolar bone height (PMABH). Methods: 26 patients with PMABH of 7 - 10 mm had 39 implants placed between July 2012 and June 2014. These implants were placed protruding apically 1 - 3 mm into the maxillary sinus engaging the sinus floor. At stage one, implants and cover screws were placed, followed by stage two, 5 - 6 months later. The implants were considered osseo-integrated in the absence of symptoms, mobility and inflammation. Periapical radiographs were taken to rule out peri-implant radiolucency. Restorative treatment was completed 2 months thereafter. Patients were scheduled to have a dental exam (6 - 12 months after delivery of prosthesis) and the implants were evaluated clinically and radiographically. A retrospective review was conducted to assess the surgical success rate of this treatment modality. Clinic charts, radiographs and digital implant log were reviewed for all patients with PMABH of 7 - 10 mm who received dental implants in the posterior maxilla to determine the success rate of this treatment modality. Results: 26 patients who had 39 implants placed were included in the study. All implants (100%) were osseo-integrated at the time of uncovering (stage 2). None of the implants (0%) had mobility or inflammation around them. Stage 2 was successfully performed on all 39 implants (100%). All implants (100%) in these patients had been restored, and were in good condition without mobility or inflammation, and had been functioning well 6 - 12 months after restoration. Conclusion: This study suggests that a high success rate can be attained placing dental implants in the posterior maxilla while perforating and engaging the cortical maxillary sinus floor. A future prospective study that compares this technique with the internal sinus lift would likely help elucidate this suggestion.

Assessment of bone healing around immediately loading dental implants in posterior maxilla with two different osteotomy techniques

The posterior region of the maxilla is characterized by thin cortical bone and trabecular bone of low-density. In addition, in many instances the height of the bone in this region is insufficient to achieve high primary stability because of the presence of the maxillary sinus. The aim of this study was to assess bone healing around immediately loaded dental implants in the posterior maxillary region with two different osteotomy techniques, conventional technique versus condensing technique. Twenty implants were inserted in 10 patients each patient received 2 implants. One implant was inserted by a conventional technique other implant was inserted by condensing technique one on each side of the maxilla. The follow-up was done at the following intervals, immediate postoperative, 6-, 12-, and 24-week. One implant from the group of condensing technique showed failure after 4 weeks. The results of this research demonstrate the success rate was 90% for condensing group and 100% for the conventional group.

Recent Trends in Sinus Lift Surgery and Their Clinical Implications.

Sinus lift procedures are used to allow residual bone to accommodate functional implants in atrophic posterior maxilla. Numerous anatomical and surgical advancements in sinus lift surgery are still inspiring clinicians. The purpose of this study was to describe the recent trends in sinus lift surgery focusing on implant survival, bone grafting, anatomical and surgical considerations, and their clinical implications on the practice of implant dentistry in atrophic posterior maxilla. We performed an extensive search in MEDLINE, Embase, Scopus, Web of Science, Trip, Cochrane Oral Health Group's Trials Register, Cochrane Central Register of Controlled Trials, and ProQuest Dissertations & Theses. Articles were critically reviewed to determine the level of evidence as per the Canadian Task Force on Preventive Health Care. Comprehensive assessment of sinus septa, sinus pathology, and bone quality and quantity using three-dimensional cone beam computed tomography radiographs is important before placing implants in posterior maxilla. With a residual bone height of less than 5 mm, the survival rate of implant decreases substantially. Lateral window approach can increase the vertical bone height to greater than 9 mm, while osteotome approach can increase this height from 3 to 9 mm. The perforation of Schneiderian membrane doubles the risk for the incidence of sinusitis or infection. The use of piezoelectric surgery allows adequate sinus lift while protecting soft tissues and minimizing patient discomfort. Although both osteotome and lateral window procedures can help clinicians in overcoming the challenges of placing implants in atrophic posterior maxilla, pre-implant residual bone height is crucial in determining the survival of these implants. Future research directions should consider study designs grounded on longitudinal randomized controlled trials of large sample size.

Twelve-Year Retrospective Follow-Up of Machined Implants in the Posterior Maxilla: Radiographic and Peri-Implant Outcome.

To retrospectively evaluate the survival rate of machined implants in sinus-lifted posterior maxilla after 12 years, with special reference to radiographic outcome and peri-implantitis. From 37 possible candidates, 29 patients with 59 implants were evaluated. Implants were placed in the posterior maxilla in combination with a sinus elevation procedure (27 patients) or 6 months after sinus elevation (2 patients). Marginal bone level changes were radiographically evaluated at baseline and 1, 7, and 12 years post-loading. Probing depth was measured; presence/absence of plaque and bleeding on probing were recorded. Four out of 59 implants failed in 4 out of 29 patients (cumulative survival rate = 93.2%). The mean bone loss was 0.78 mm (± 0.88) after 12 years. Changes in the mean bone level were statistically significant between baseline and all the other follow-up intervals (p < .001). Statistically significant differences could be demonstrated for the first- to 12th-year interval (p < .05) and for the seventh- to 12th-year interval (p < 0.001). No statistically significant differences could be demonstrated at the first- to seventh-year interval (p = .32). The mean overall probing depth was 2.9 ± 0.66 mm. Probing depth was moderately correlated with the marginal bone changes at 7 year and after 12 year follow up (p = .05). No signs of peri-implantitis were reported during the 12-year follow-up period. This follow-up demonstrates a very good prognosis when implants with machined surfaces are used. The frequencies of implant failures were very small. Within the limits of the results from this study, the risk of peri-implantitis in the posterior maxilla might be considered a minor problem when implants with machined surfaces are used.

Long-Term Outcomes for the Treatment of Atrophic Posterior Maxilla: A Systematic Review of Literature

The aim of the present systematic review was to estimate the implant survival rate in different types of techniques for the rehabilitation of posterior atrophic maxilla, after at least 3 years of follow-up. MEDLINE database was searched using a combination of specific terms. A hand searching of the relevant journals and of the reference lists of systematic reviews was also performed. All retrospective and prospective studies evaluating short implants in posterior maxilla, osteotome sinus floor elevation and lateral approach sinus floor elevation, and having a follow-up of at least 3 years, were included. Forty-four articles were included in the review. In four studies reporting on a total of 901 short implants, the implant survival rate varied from 86.5% to 98.2% with up to 5 years follow-up. For the osteotome technique, 1,208 implants in eight studies were considered, showing a survival rate varying from 95.4% to 100% after 3-year follow-up. Twenty-nine studies, accounting for 6,940 implants placed in 2,707 sinuses augmented through lateral technique were considered. Implant survival rate varied from 75.57% to 100%. Only three comparative studies were found that showed no significant difference in clinical outcomes between lateral approach and osteotome technique. Sinus floor elevation with the lateral approach and with the osteotome technique is an effective and well-documented therapeutic option for the rehabilitation of atrophic posterior maxilla. The use of short implants is promising but needs further investigation to be considered as effective as the other techniques in the long term. However, the indication for the three different techniques is not perfectly equivalent and the treatment choice should be based on a careful evaluation of the individual case, in particular on the available residual bone.