Placement Of Dental Implants Research Articles

Innovative Alveolar Ridge Preservation Surgical Technique with Immediate Dental Implant Placement: A Retrospective Case Report of 1-Year Follow-Up.

Following tooth extraction, the alveolar ridge undergoes morphological and dimensional changes, including a clot formation that is gradually replaced by granulation tissue. Studies indicate that both horizontal and vertical ridge dimensions decrease after extraction; however, these changes can be mitigated through grafting with biomaterials and barrier membranes. Alveolar ridge preservation (ARP) techniques are employed to counteract bone resorption postextraction, encompassing periosteal inhibition and modified periosteal inhibition (MPI) techniques. The Degidi clot chamber technique offers a means to achieve biomaterial-free extraction sockets, promoting healing and osteointegration. This study aims to present the first rehabilitation of a postextraction dental implant in the maxilla using an innovative ARP procedure via a MPI technique. The technique does not involve autologous or heterologous grafting materials; instead, a cortical lamina and a customized screw are used in conjunction with the blood clot. The primary objective is to protect the vestibular cortical bone from preosteoclastic aggression, which can trigger bone resorption. The technique employs a 0.5-mm cortical lamina to mechanically shield the vestibular cortical bone, preventing vestibular cortical bone resorption and increasing its thickness without the need for biomaterial insertion, relying on the blood clot. The effectiveness of the technique was assessed through a 12-month postimplantation cone-beam computed tomography scan, revealing a 0.5-mm increase. Although based on a single case, the 1-year follow-up results are promising, and further studies are warranted to validate the technique's efficacy.

Development, Characterization, and Antibacterial Analysis of the Selenium-Doped Bio-Glass-Collagen-Gelatin Composite Scaffold for Guided Bone Regeneration.

Background Guided bone regeneration (GBR) is an often-used technique to aid the successful placement of dental implants in sites with deficient bone. The search for the ideal GBR membrane with bioactive components improving the regenerative outcomes is still on. In this study, a novel composite GBR membrane was developed using selenium-doped bio-glass, collagen, and gelatin. It was further characterized for surface, chemical, biocompatibility, and antibacterial properties. Methodology Selenium-doped bio-glass was prepared using the sol-gel method. The membrane was fabricated using an equal ratio of collagen and gelatin mixed with 1% selenium-doped bio-glass. The solution was poured to obtain a thin layer of the material which was lyophilized to obtain the final GBR membrane. The membrane was analyzed with scanning electron microscopy, energy dispersive X-ray (EDX) analysis, attenuated total reflectance-Fourier transform infrared spectroscopy (ATR-FTIR), zebrafish cytotoxicity test, and antibacterial assay. Results The membrane revealed good surface roughness with lamellar and fibrillar arrangement with a minute granular surface ideal for cell attachment and proliferation. The EDX analysis revealed the presence of carbon, oxygen, and nitrogen as predominant components with trace amounts of calcium, phosphorus, silica, and selenium. Fourier transform infrared spectroscopy analysis also proved the presence of collagen, gelatin, and bio-glass. The membrane revealed excellent biocompatibility with zebrafish growth at a normal rate with 90% viability maintained at 48, 72, and 96 hours and 95% viability at 120 hours. It also exhibited excellent antibacterial activity against Staphylococcus aureus and Escherichia coli with minimal growth of bacterial colonies. Conclusion The developed novel selenium bio-glass collagen and gelatin composite scaffold has a good surface and antibacterial properties along with excellent biocompatibility. Further cell line and in vivo studies should be conducted to explore its role in bone regeneration.

Reducing Hemoglobin A1C Levels in Type II Diabetes: A Retrospective Analysis of the Renew Procedure.

Periodontal disease and type 2 diabetes are interrelated, with inflammation playing a significant role in the progression of both conditions. Previous research has demonstrated the potential of various treatments, such as diet, exercise, and periodontal therapies, to improve glycemic control in diabetic patients. This study proposed a novel surgical approach, the Renew Procedure, as a potential solution to enhance glycemic control in type 2 diabetic patients with periodontal issues. The procedure involves the removal of all teeth, the elimination of oral and maxillofacial infections, the placement of dental implants, and the provision of implant-supported and implant-retained removable dentures. Preliminary findings indicated a significant reduction in HbA1c levels post-surgery, suggesting that this approach may improve overall oral health, reduce inflammation, and consequently lower HbA1c levels. Further research is necessary to confirm the efficacy of the proposed solution, but these initial results highlight the importance of addressing oral health through comprehensive strategies for diabetic and periodontitis patients.

A Systematic Review of Antibiotic Use in Dental Implant Therapy: Efficacy, Guidelines, and Recommendations

Objective: The objective of this research is to respond to that specific question: Are antibiotics needed for the placement of dental implants? Methods: A systematic search was done, and the selected studies were pooled from MEDLINE/PubMed, and Cochrane Library databases up to March 2022. Articles in which the main objective was to evaluate the relationship between antibiotics and dental implants were selected. The first search was done with Medline and Cochrane Library. Results: A total of 17 articles were finally included in the present review. Four clinical trials (CTs), two reviews, and eleven systematic reviews (SR); six of them with meta-analysis. Conclusion: Antibiotics may be used in dental implants to prevent or treat infections that may occur after implant surgery. The type and duration of antibiotic therapy depend on the patient’s medical history, the type of implant surgery being performed, and other factors. However, the use of antibiotics in dental implant surgery is debatable, and it is important to note that antibiotics should not be used routinely in dental implant surgery. Overuse of antibiotics can lead to antibiotic resistance which can make it harder to treat infections in the future. Thus, antibiotics should only be used when necessary and prescribed by a qualified healthcare professional.

Effects of Sinus Membrane Stabilization by Dental Implant Placement and Membrane Suturing on Endo-Sinus Bone Gain in Cases of Lateral Sinus Elevation Performed Without Graft Material.

To investigate the effects of sinus membrane stabilization (via suturing) and dental implant placement on the endo-sinus bone formation in lateral sinus elevations performed without grafting. Maxillary sinus elevation surgery using the lateral approach was performed bilaterally on 30 New Zealand white rabbits. The maxillary sinus areas were divided into control and test groups. In the control group, a titanium screw was placed after sinus membrane elevation; in the test group, the sinus membrane was sutured to the lateral walls, and a titanium screw was placed in the center of the alveolar crest. The subjects were sacrificed at 4 and 8 weeks. Then samples were collected, and a microcomputed tomography (micro-CT) analysis was performed. In addition, the volume of newly formed bone, percentage of osseointegration, sinus volume, residual bone height, and implant protrusion length were measured using micro-CT analysis. The sinus volume, volume of newly formed bone, and percentage of osseointegration in the test group were significantly higher than in the control group at 4 weeks (P = .01, P = .04, P = .02, respectively). While the volume of newly formed bone was 17.1 ± 3.08 mm3 in the control group, it was 26.9 ± 14.26 mm3 in the test group at 4 weeks. The volume of newly formed bone significantly decreased from 26.9 ± 14.26 mm3 to 17 ± 3.66 mm3 at 8 weeks (P = .02). No significant difference in residual bone height was found at 4 and 8 weeks (P = .07). No significant difference in implant protrusion length was found between the control and test groups (P = .18). Protrusion length and new bone formation in the sinus showed a negative relationship (P = .01). Suturing the sinus membrane to the lateral sinus wall is an effective approach for increasing osseointegration, bone volume, and sinus volume in the short term. A slow-absorbing suture material can be used to maintain sinus and bone volumes in the long term.

Alveolar Bone Box Ostectomy Grafted with Particulate Bone Substitute with Subsequent Dental Implant Placement in a Case of Craniofacial Fibrous Dysplasia Involving the Posterior Maxilla: Case Report and Literature Review.

Patients with dysplastic bone diseases, including fibrous dysplasia (FD), represent a particular challenge for placement of dental implants. This is due to structural bony changes that may compromise the bone blood supply and plasticity, thus potentially affecting the process of osseointegration. This case report describes a novel approach for dental-implant-based rehabilitation of the posterior maxilla affected by craniofacial fibrous dysplasia (CFD), with 7 years of treatment follow-up. A 35-year-old female patient was referred due to a suspected unidentified bone lesion affecting the left side of the maxilla. A clinical and radiographic diagnosis of fibrous dysplasia was confirmed through a wedge bone biopsy. Particulate bone substitute was packed into a box-shaped ostectomy area of the lesion in the affected maxillary alveolar ridge. This was followed by the placement of four implants 6 months post operation. The implants were successfully integrated, as confirmed by clinical examination over 7 years of follow up. this treatment approach may be considered as a predictable and efficient treatment modality for dental implant rehabilitation in patients with a variety of fibro-osseous lesions, including fibrous dysplasia, which affect the alveolar bone.

The 3D Printing and Evaluation of Surgical Guides with an Incorporated Irrigation Channel for Dental Implant Placement.

Dental implant insertion requires the preparation of the implant bed via surgical drilling. During this stage, irrigation is essential to avoid thermal damage to the surrounding bone. Surgical guides enhance the accuracy of the implant site preparation, but they mask the drilling site, hampering coolant delivery. A variety of designs are aimed at improving the coolant access to the target site. Using standard dental implant simulation software, this paper presents an in-house design and 3D printing workflow for building surgical guides that incorporate a coolant channel directed toward the entry point of the burr. The proposed design was evaluated in terms of the bone temperature elevations caused by drilling performed at 1500 rpm, under an axial load of 2 kg, and irrigation with 40 mL/min of saline solution at 25 °C. Temperature measurements were performed on porcine femoral pieces, in the middle of the cortical bone layer, at 1 mm from the edge of the osteotomy. The mean temperature rise was 3.2 °C for a cylindrical sleeve guide, 2.7 °C for a C-shaped open-sleeve guide, and 2.1 °C for the guide with an incorporated coolant channel. According to a one-way ANOVA, the differences between these means were marginally insignificant (p = 0.056). The individual values of the peak temperature change remained below the bone damage threshold (10 °C) in all cases. Remarkably, the distribution of the recorded temperatures was the narrowest for the guide with internal irrigation, suggesting that, besides the most effective cooling, it provides the most precise control of the intraosseous temperature. Further studies could test different design variants, experimental models (including live animals), and might involve computer simulations of the bone temperature field.

Fence Technique: Reconstruction on the Aesthetic Zone after Cyst Enucleation—Case Report

Odontogenic cysts can lead to bone destruction that can hamper the dental implant placement in the ideal 3D position. Different biomaterials and techniques that allow bone regeneration are described in the literature, each with its advantages and disadvantages. This clinical case with 18 months of follow-up aims to show the enucleation of an odontogenic cyst following the guided bone regeneration with the fence technique, which allows the placement of the dental implants in the ideal 3D position, reducing morbidity and the number of surgeries. It involved a fifty-year-old male patient with a cyst in the second sextant who needed implant rehabilitation. During the first surgery, the odontogenic cyst (proven by histological analysis where there was reported a non-keratinized stratified squamous epithelium) was enucleated and a guided bone regeneration using the fence technique was performed. The fence technique combines the xenograft, the collagen membrane and an osteosynthesis plate that is molded and fixed to the intervention area to ensure sufficient space for bone tissue regeneration. After six months, two dental implants were placed in the region of tooth 11 and 21, then rehabilitated nine weeks later. The fence technique guaranteed the recovery of the bone morphology and the placement of the dental implants in the ideal 3D position. This technique allows for the handling of complex cases, avoiding the need of autologous bone.

Alveolar Ridge Preservation Using Different Biomaterials: Report of Two Cases

Background: The underlying bone framework always determines the soft tissue contours. Numerous aetiologies are linked to tooth loss, which frequently causes abnormalities of the alveolar ridge. Alveolar bone changes in volume as a result of physiologic bone remodelling after tooth extraction, which impacts the way how edentulous area is treated with prosthetic rehabilitation. By limiting the natural post-extraction resorption process, socket preservation methods following tooth extraction will lessen the need for additional ridge augmentation techniques before implant placement while maintaining the existing bone. Case Report: Two male patients, ages 36 and 32, were referred for the extraction of their severely deteriorated first molars in the mandible and for the placement of dental implants to restore the area. Patients were identified as having periodontitis and root caries respectively. In one example, the socket was promptly grafted with Platelet Rich Fibrin with xenograft, and in the other with a collagen sponge, after the irreparable tooth was “atraumatically” excised without creating a flap. After suturing the region, a periodontal dressing was applied and no membrane was employed. Conclusion: After six months, the ridge’s architecture was preserved, and clinical examination showed outstanding soft tissue healing. At six months, a clinical and radiological follow-up evaluation demonstrated consistent and positive outcomes. This article discusses and emphasises the significance of socket preservation after tooth extraction utilising different biomaterials in different case scenarios.

Comparative Study of Autogenous Fresh Tooth Graft and Platelet Rich Fibrin Mixture versus Autogenous Fresh Tooth Graft Only For Immediate Dental Implant Placement

Comparative Study of Autogenous Fresh Tooth Graft and Platelet Rich Fibrin Mixture versus Autogenous Fresh Tooth Graft Only For Immediate Dental Implant Placement

The Accuracy of Dental Implant Placement Using Conventional versus Stereolithographic Tooth Supported Surgical Guide; (Randomize Control Trial)

The Accuracy of Dental Implant Placement Using Conventional versus Stereolithographic Tooth Supported Surgical Guide; (Randomize Control Trial)

Application of virtual reality in dental implants: a systematic review

Background and objectiveA treatment approach that is widely used as a permanent and natural replacement for missing or extracted teeth is dental implants .VR is a computer-generated simulation that creates a three-dimensional (3D) image or environment. Advances in VR -based learning allow learners and students to practice and also help professionals plan a wide variety of surgical procedures, including the correct placement of dental implants. Therefore, in this systematic review, our aim was to investigate and evaluate the available virtual reality tools for dental implants and their effectiveness.Materials and methodsStudies published up to 01/30/2023 which report the applications of using virtual reality technology in dental implants, were reviewed in three databases, including PubMed, Web of Science, and Scopus. All studies with evidence reporting the role of virtual reality technology in the field of dental implants were included in our analyses, written in English and published in peer-reviewed form, are included. Theoretical articles, and letters that did not provide original data, as well as studies that reported incomplete information, were excluded. Two reviewers independently assessed search results, extracted data, and assessed the quality of the included studies, and decisive agreement was reached by discussion and consultation with the third researcher. Narrative synthesis was undertaken to summarize and report the findings.ResultsOut of 1633 initial search results, nine were included in the present study based on the inclusion criteria. The focus of seven studies was on teaching and learning, and two studies have examined the implant planning procedure. The most commonly used hardware and software were head-mounted display and Unity3D, respectively. In almost all studies, the results showed that the use of virtual reality-based systems improves and enhances the skills of users, including dental students and specialists.ConclusionsOur findings showed that VR is an effective method for teaching and planning the implant process. Although the use of VR technology is limited for various reasons such as cost, it can increase the skills of dental professionals in performing dental implants.

Dental implants in growing patients: A quality assessment of systematic reviews

BackgroundDental implants in the recent past have become indispensable in restoring loss of space and support as well as aiding the aesthetics. Although in practice for a few years there is no consensus on the protocols for placement and usage of dental implants in growing jaws. ObjectiveThe present study aims to evaluate evidence-based literature on single or multiple dental implant placements in children(up to 17 years) and to identify areas lacking and gaps in knowledge. The quality assessment tool,namely AMSTAR-2, will also aim to evaluate the quality of said research around paediatric dental implants. DesignThe study was prospectively registered on the Open Science Framework https://osf.io/e59bt/?view_only=ec8fb69455c240ecbfc7379734784bf7.For source selection, electronic searches were performed on MEDLINE, EMBASE, Scopus databases as well as Google Scholar for all English language systematic reviews and meta analysis on dental implants placed on children up to 17yrs of age by 2 reviewers, wherein the publications until December 2020 were included. A final dataset of 4 systematic reviews were incorporated and analysed using the AMSTAR-2 grading tool. ResultsIt was seen that only one study showed moderate overall confidence while one low overall confidence as per the AMSTAR-2. The other 2 systematic reviews were of critically low confidence levels. Hence, the existing systematic reviews on the subject are not of high quality. Most of the reviews have no consensus regarding use and placement of implants in growing patients. ConclusionMore research and stricter adherence to the quality assessment guidelines is recommended for all future systematic reviews regarding dental implant in children.

The Potential Value of Probiotics after Dental Implant Placement.

Dental implantation is currently the optimal solution for tooth loss. However, the health and stability of dental implants have emerged as global public health concerns. Dental implant placement, healing of the surgical site, osseointegration, stability of bone tissues, and prevention of peri-implant diseases are challenges faced in achieving the long-term health and stability of implants. These have been ongoing concerns in the field of oral implantation. Probiotics, as beneficial microorganisms, play a significant role in the body by inhibiting pathogens, promoting bone tissue homeostasis, and facilitating tissue regeneration, modulating immune-inflammatory levels. This review explores the potential of probiotics in addressing post-implantation challenges. We summarize the existing research regarding the importance of probiotics in managing dental implant health and advocate for further research into their potential applications.

Effect of Er:YAG Laser Exposure on the Amorphous Smear Layer in the Marginal Zone of the Osteotomy Site for Placement of Dental Screw Implants: A Histomorphological Study.

The placement of dental screw implants typically involves the use of rotary techniques and drills to create a bone bed. This study explores the potential benefits of combining this method with an Er:YAG laser. Split osteotomies were performed on 10 jaws of euthanized domestic pigs (Sus scrofa domestica), with 12 mandibular implant osteotomies in each jaw, divided into 4 groups. In order to make a comprehensive assessment of the effect of Er:YAG lasers, histomorphological techniques were used to measure the reduction in amorphous layer thickness after Er:YAG laser treatment, both with and without the placement of dental screw implants from different manufacturers. Following bone decalcification and staining, the thickness of the amorphous layer was measured in four groups: Group A-osteotomy performed without Er:YAG laser treatment-had amorphous layer thicknesses ranging from 21.813 to 222.13 µm; Group B-osteotomy performed with Er:YAG laser treatment-had amorphous layer thicknesses ranging from 6.08 to 64.64 µm; Group C-an implant placed in the bone without laser treatment-had amorphous layer thicknesses of 5.90 to 54.52 µm; and Group D-an implant placed after bone treatment with Er:YAG laser-had amorphous layer thicknesses of 1.29 to 7.98 µm. The examination and photomicrodocumentation was performed using a LEICA DM1000 LED microscope (Germany) and LAS V 4.8 software (Leica Application Suite V4, Leica Microsystems, Germany). When comparing group A to group B and group C to D, statistically significant differences were indicated (p-value = 0.000, p < 0.05). The study demonstrates the synergistic effects and the possibility of integrating lasers into the conventional implantation protocol. By applying our own method of biomodification, the smear layer formed during rotary osteotomy can be reduced using Er:YAG lasers. This reduction leads to a narrower peri-implant space and improved bone-to-implant contact, facilitating accelerated osseointegration.

Transforming public health dentistry: Exploring the digital foothold for improved oral healthcare

Digital technologies have revolutionized the field of dentistry, offering numerous advantages in diagnosis, treatment planning, education, and patient care. This review article provides a comprehensive overview of the current state of digital technologies in dentistry, highlighting their applications, benefits, and future prospects. Technologies allow for precise 3D imaging of dental structures, facilitating virtual treatment planning and guiding the placement of dental implants. Additionally, digital imaging techniques enable the creation of highly accurate digital impressions, eliminating the need for traditional impression materials and improving patient comfort. The review article concludes with a discussion on the challenges and future prospects of digital technologies in dentistry. While digital technologies offer numerous benefits, including improved accuracy, efficiency, and patient outcomes, there are considerations regarding cost, training, and data security that need to be addressed. Nevertheless, with ongoing advancements in digital technologies, the future of dentistry holds immense potential for further innovation and improved patient care.

Influence of implant protrusion length and initial bone height on intrasinus bone gain in transalveolar sinus floor elevation without bone graft: a 2-year retrospective study.

This retrospective cohort study was carried out on patients who had reported to the department of oral and maxillofacial surgery at Tishreen University between January 2020 and September 2022. The sample consisted of patients who had a transalveolar sinus lift with simultaneous dental implants placement. TSFE was performed using motorized threaded bone expanders. The IBH, the IPL, and the IBG height were analyzed using CBCT scans that were taken preoperatively and 6 months postoperatively. Statistical analysis was performed to assess the relationship of the IBG with the IPL and the IBH. The P values < 0.05 were considered to be statistically significant. A total of 34 implants were placed using motorized threaded bone expanders in 29 patients who were included in the study. Three membrane perforations were observed out of 34 procedures (8.82%). The survival rate for all implants was 100%. The mean IBH was 6.37±0.85mm, the mean IPL was 2.01±0.55mm, and the mean IBG was 1.69±0.44mm. A strong positive correlation was found between bone gain and IPL. No correlation was found between bone gain and IBH. According to the result of this study, the IPL is a critical factor in TSFE and dental implant placement simultaneously without bone graft procedures.

Supplementation of Platelet-Derived Products in Distraction Osteogenesis for Alveolar Ridge Augmentation: A Systematic Review

Background: Distraction osteogenesis (DO) is one of the recent tissue engineering techniques which have been utilized for alveolar ridge augmentation procedures. It makes use of tensional strains created within the fractured segments to initiate a cascade of responses ultimately resulting in the formation of new mature bone. Supplementation of platelet-derived products such as platelet-rich plasma and platelet-rich fibrin in DO could stimulate this cascade and accelerate the formation of new bone with improved quality. Materials and Methods: Literature search was performed on eminent databases for studies using platelet-derived products with DO in alveolar ridge augmentation. Data relating to bibliographic information, and study outcomes were extracted. A risk of bias assessment was performed for each study. Measures of outcome included increase in bone height, and any reported postoperative complications. Results: Planned alveolar height was reached in all the studies with an adequate amount of bone formation for the placement of dental implants. Studies reported long-term implant survival. Postoperative complications included displacement of fractured segments, temporary paresthesia, and scar formation. Conclusion: DO supplemented with platelet-derived products provides an ideal micro-environment for the recruitment of various signaling molecules and stem cell precursors inducing the formation of new bone. It circumvents the unpredictable outcomes and complications such as donor site morbidity, which is associated with conventional placement of bone grafts. However, the available literature is scarce in this area and further randomized studies are required to form a conclusive body of evidence to support the translatability of this innovative technique into clinical practice.

Effect of Age on Transalveolar Sinus Floor Elevation with Simultaneous Placement of Dental Implants: A Retrospective Study.

Purpose: To analyze the effects of age on the sinus graft remodeling of transalveolar sinus floor elevation (SFE) with simultaneous placement of dental implants. Materials and Methods: A retrospective study design was adopted. A total of 222 sites in 216 patients who underwent transalveolar SFE with immediate implant placement were included. The clinical and radiographic data were collected at preoperative, postoperative, and postloading time points. Age was divided into three groups: < 30 years, 30 to 50 years, and > 50 years. The ratio of sinus graft resorption (Ratio) was used to evaluate the outcomes of the surgery and loading. ANOVA was applied to explore the correlation of total elevation height (TEH) with implant loading. The Ridge regression model was used to explore the relationship between Ratio and age and other possible factors. Results: A total of 222 implants in 216 patients were included for implant-based analysis. The TEH averaged 6.983 ± 2.251 mm on the day after surgery (T1), and sinus graft resorption was found during the healing period and after implant loading (P < .01). Age was found to be a reliable correlation with the Ratio (P < .01). A significantly decreased bone formation efficiency was found with aging. Conclusion: According to the results of this retrospective chart review, age was the main factor affecting the outcomes when applying transalveolar SFE with simultaneous implant placement. This finding could be a guide for clinical treatment.

Management of Perioperative Pathologic Conditions Involving Maxillary Sinus for Dental Implant Placement and Sinus Augmentation: Report of Case Series and Literature Review

Management of Perioperative Pathologic Conditions Involving Maxillary Sinus for Dental Implant Placement and Sinus Augmentation: Report of Case Series and Literature Review