Implant Placement In Patients Research Articles

Comparing the Long-term Success Rates of Immediate Implant Placement vs. Delayed Implant Placement in Patients with Periodontally Compromised Teeth

ABSTRACT Background: This study aims to compare the long-term success rates of immediate implant placement and delayed implant placement in patients with periodontally compromised teeth. Materials and Methods: A total of 30 patients presenting with periodontally compromised teeth requiring extraction and subsequent implant placement were enrolled in this retrospective study. Patients were divided into two groups based on the timing of implant placement: Group A (immediate implant placement) and Group B (delayed implant placement). Implants were placed according to standard protocols. Patient records were reviewed for implant survival, peri-implant bone loss, and prosthetic complications. Data were statistically analyzed using appropriate tests. Results: The mean follow-up period was 5 years. In Group A, the implant survival rate was 90%, while in Group B, it was 83%. The mean peri-implant bone loss was 1.5 mm in Group A and 2.2 mm in Group B. Prosthetic complications were observed in three cases in Group A and five cases in Group B. The differences in implant survival and bone loss between the two groups were not statistically significant (P > 0.05). Conclusion: Both immediate implant placement and delayed implant placement demonstrated comparable long-term success rates in patients with periodontally compromised teeth

Is a Novel Fluoroscopic Intraoperative Reference System Superior to Conventional Management for Distal Radius Fracture Reduction? A Propensity-matched Comparative Study.

Is a Novel Fluoroscopic Intraoperative Reference System Superior to Conventional Management for Distal Radius Fracture Reduction? A Propensity-matched Comparative Study.

Group 3 ITI Consensus Report: Materials and antiresorptive drug-associated outcomes in implant dentistry.

The aim of Working Group 3 was to address the influence of both material- and anti-resorptive drug- related factors on clinical and biological outcomes and complications in implant dentistry. Focused questions were addressed on (a) implant materials other than titanium (alloy)s, (b) transmucosal abutment materials and (c) medications affecting bone metabolism were addressed. Three systematic reviews formed the basis for discussion in Group 3. Consensus statements and clinical recommendations were formulated by group consensus based on the findings of the systematic reviews. Patient perspectives and recommendations for future research were also conveyed. These were then presented and accepted following further discussion and modifications as required by the plenary. Zirconia is a valid alternative to titanium as material for implant and transmucosal components, allowing soft and hard tissue integration with clinical outcomes-identified by implant survival, marginal bone loss and peri-implant probing depths-up to 5-years comparable to titatnium. However, most of the evidence for zirconia implants is based on 1-piece implants limiting the indication range. Furthermore, based on expert opinion, zirconia transmucosal components might be preferred in the esthetic zone. In patients receiving low-dose bisphosphonate therapy, the rate of early implant failure is not increased, while the long-term effects remain poorly studied. Although it has not been sufficiently addressed, similar outcomes can be expected with low-dose denosumab. A drug holiday is not recommended when considering implant placement in patients treated with low-dose ARD. However, the specific therapeutic window, the cumulative dose and the administration time should be considered. Access to peri-implant supportive care is mandatory to prevent peri-implantitis-related medication-related osteonecrosis of the jaw (MRONJ) or implant-related sequestra (IRS). In patients receiving low-dose anti-resorptive drugs (ARD) therapy, the risk of complications related to implant placement is high, and implant procedures in this specific population should be strictly treated in a comprehensive multidisciplinary center. Finally, healthy dental implants should not be removed before low or high-dose ARD. Zirconia implants can be an alternative to titanium implants in selected indications. However, the current state of evidence remains limited, especially for 2-piece implant designs. Administration of low-dose ARD did not show any negative impact on early implant outcomes, but careful follow-up and supportive care is recommended in order to prevent peri-implant MRONJ and IRS. Implant placement in high-dose patients must be strictly considered in a comprehensive multidisciplinary center.

Immediate versus Delayed Implant Placement in Patients with Tooth Agenesis: An In-Line Retrospective Pilot Study Comparing Clinical and Patient-Related Outcomes

This retrospective study compared clinical, radiological, and patient- and clinician-reported outcomes between immediate and delayed implants placed in patients with tooth agenesis as part of one-stage implant therapy with a split-mouth design. A total of 12 sites of permanent tooth agenesis in five patients received 12 implants (2.4 implants per patient), six being immediate implants in deciduous teeth post-extraction sites, and six being late implants replacing already extracted or spontaneously lost deciduous teeth. Data reporting was performed descriptively without statistical comparative analysis between study groups. Radiographic crestal bone level changes between the time of surgery and 1-year post-surgery did not indicate any marked difference between treatment groups. Patient-reported outcomes related to post-surgical pain and patient preference indicated less pain in immediately treated sites, resulting in a corresponding patient preference related to this treatment modality. Clinician-rated satisfaction levels did not differ. The results of this pilot study support the use of immediate implant placement as a suitable procedure in cases of tooth agenesis.

The Best Time to Dental Implant Placement in Patients with Head and Neck Cancers: An Ever-going Debate

With 500,000 new cases diagnosed each year, head and neck cancers (HNC) are among the most prevalent cancers in the world. The most effective organ-sparing therapy for patients with locally advanced HNC is concurrent chemoradiotherapy (C-CRT). Many HNC patients lose multiple teeth and develop soft and hard tissue defects over the course of the disease and treatment, leading to functional limitations and cosmetic deformity. Such devastating effects harm the patient's ability to eat, chew, and swallow as well as their psychological, financial, and social well-being. Additionally, multiple tooth losses and subpar oral rehabilitation services can cause cachexia, rapid weight loss, and weakened immunity. The use of conventional prostheses to address tooth losses may not be permitted due to detrimental changes in the structure of the oral cavity. Conventional prostheses may aggravate the harmful side effects of radiotherapy, including xerostomia, mucositis, and a deterioration of bone healing processes. Dental implants may be a better choice for oral rehabilitation. However, because the area of bone involved in implant placement is frequently within the irradiation zone, dental implant planning and timing in HNC patients can be extremely difficult. Additionally, the placement of dental implants may precipitate some specific side effects of cancer treatments, such as osteoradionecrosis. Because the best time to use dental implants is one of the essential components of successful dental rehabilitation for HNC survivors and has not yet been clarified in the literature, this review article aims to gather and provide information in the head and neck region by reviewing the available literature.

Comparative Evaluation of the Accuracy, Operator Comfort and Time Taken for Implant Placement among Different Practitioners under Dynamic Navigation

Introduction: Dynamic Navigation (DN) can be an effective alternative in cases where there are anatomical limitations. It can serve as an advanced training tool for young practitioners in implantology. The learning curve with the DN system can be steep; however, with practice and proper protocol implementation in an institutional set-up, DN can become an invaluable tool for implant placement in challenging situations. Aim: To evaluate operator comfort, accuracy, and time taken for implant placement among different practitioners using DN. Materials and Methods: This prospective cohort study was conducted at the Department of Implantology, Saveetha Dental College and Hospitals, Chennai, Tamil Nadu, India, from October 2022 to February 2023. Three groups, each consisting of five practitioners, were included: Group 1 (experienced practitioners), Group 2 (intermediate practitioners), and Group 3 (beginners in the field of implantology). The practitioners underwent orientation to the DN system through lectures and digital planning sessions. They performed hands-on in-vitro implant placement on 3D printed models and one implant placement each on live patients. Surgical time, operator comfort, and accuracy of implant placement were assessed among the three groups. Statistical analysis was performed using the Kruskal-Wallis test. Results: In comparison to the digitally planned position, beginners in implantology showed the least variation in implant placement position. The apico-coronal variation was 0.494±0.428 mm in implant placements for patients in the beginners group, while the maximum variation was 2.140±1.355 mm in the experienced practitioners group. There was a sequential increase in accuracy and lesser deviation from the originally planned implant sites when comparing the virtual simulation device, model, and patient implant placement. Beginners took significantly less time for implant placement in patients (p=0.004). Conclusion: There was a sequential improvement in the accuracy in implant angulation from virtual simulation to placement of implants in patients. The beginners group exhibited the shortest implant placement time in patients.

Oral Rehabilitation of Down Syndrome Patients by Dental Implants: A Systematic Review

Objectives: Down Syndrome patients are a particularly vulnerable group to teeth loss and periodontal disease. Therefore, the need for prosthetic rehabilitation is only a matter of time. The aim of this systematic review is to assess and summarize the available literature regarding the outcome of dental implants in patients with Down Syndrome. Materials and Methods: An electronic search was performed in Pubmed-Medline, Lilacs, and Cochrane Library. Search terms used were: “dental implant” OR “implant rehabilitation” AND “down syndrome”. Articles reporting the placement of implants in patients with down syndrome up until 2022 were included. Results: A total of 15 studies (10 case reports, 4 retrospective studies and 1 prospective study) comprising 234 implants placed in 61 patients were included. Implant failure occurred for 45 implants, leading to a survival rate of 80.7%. 12 studies out of 15 reported their results after a follow up period of 6 months to 4 years. Conclusion: The limited body of evidence suggests a survival rate of implants in Down Syndrome patients that is lower than among the general population. While several risk factors could explain these failures, there is still much to be answered regarding the mechanisms leading to implant rejection. A careful approach by dental practitioners should be the norm until better designed future studies with longer follow up periods can further shed light on the outcomes of implant therapy in Down Syndrome patients.

The role of systemic diseases and local conditions as risk factors.

The role of systemic diseases and local conditions as risk factors.

Outcome of healing after dental implant placement in patients with cancer on high-dose antiresorptive medications: a prospective feasibility study.

Implant placement in patients with cancer receiving high-dose antiresorptive medication (HDAR) is considered contraindicated. This prospective, feasibility study tested the hypothesis that dental implants can be placed in such patients by applying a staged implant placement protocol with submerged healing. Three groups of patients on HDAR were included as follows: group 1: patients who underwent tooth extraction, without the development of medication-related osteonecrosis of the jaws (MRONJ); group 2: patients with surgically treated MRONJ who had demonstrated clinical healing for at least 3months; group 3: patients with established MRONJ who was planned for surgical resection and simultaneous implant placement. A total of 49 implants were placed in 27 patients (group 1: 12, group 2: 7 and group 3: 8). HDAR included bisphosphonates and denosumab. The mean HDAR time was 25months (SD: ± 18.4, range 3-68months). An abutment operation was performed 4months following the implant placement (SD: ± 1.9, range 3-14months). All patients healed uneventfully. This study demonstrated that it is feasible to insert dental implants and perform an abutment surgery in patients with cancer on HDAR, without the development of MRONJ. gov Identifier: NCT04741906.

RESTORATION OF ALVEOLAR DEFECTS USING ALLOGENIC BONE BLOCKS

Dental manipulation is often associated with the placement of implants in patients with partial or complete tooth loss. Before implants are placed, the dental surgeon is most often faced with a bone deficit in the alveolar ridge area. With any technique, the main disadvantage of autologous bone extraction is the additional trauma to the patient. Reducing the invasiveness of the surgical steps is particularly relevant in elderly patients with comorbidities [1, 2, 3]. In this article, the authors propose to use bone blocks of allogenic origin when restoring defects of the alveolar ridge of the jaw bones.

Dental Implants in A Patient with History of Zoledronate Therapy: A Challenging Case

Implant placement in patient with history of bisphosphonate therapy is still controversial due to the risks of osteointegration failure and Biphosphonate related osteonecrosis of the jaws. Very few cases are reported. This paper aimed to report the success at 3 years follow up of 4 implants placed in a female patient with history of breast cancer and zoledronate infu-sions ( twice yearly for 2 years).

What is the impact of drug therapy with antiresorptive agents on the success of dental implants? a literature review

Objective: To review the current literature and provide the latest information on anti-resorptive agent-induced osteonecrosis of the jaw (ARONJ), including our basic and clinical research findings, as well as discuss the risks of developing osteonecrosis in patients undergoing dental implant surgery in use of anti-resorptive drugs (ARDs). Methods: A literature review was performed using articles published in indexed journals based on Pubmed, Web of Science, Embase and Scopus databases. Results: Our results show that the placement of dental implants in patients treated with ARDs should be carefully evaluated, these patients are not free from complications and, therefore, the risk assessment should be done individually, as one of the most serious complications, although rare, is the ARONJ. Conclusion: Thus, all patients treated with this type of drug should be informed about the risk of implant loss or the possibility of osteonecrosis, being necessary to inform about the increased risk also patients who already have osteointegrated implants and will start therapy with bisphosphonates (BPT). And, in addition, establishing a relationship and collaboration between doctor, dentist and patient is essential for the good prognosis of these cases.

Prospective observational study on the clinical behaviour of dental implants in patients with haemophilia. Preliminary results

Haemophilia is a recessive congenital hereditary haemorrhagic disorder characterised by the decrease in, or absence of, the functional activity of factor VIII (Haemophilia A) or factor IX (Haemophilia B). The haematological medical treatment for these patients is systemic replacement therapy with factor VIII or factor IX concentrates. Dental implants are considered the gold standard for the replacement of missing teeth. There is no evidence or safe protocol for their use in patients with haemophilia. The objective of this study was to evaluate the clinical osseointegration and the incidence of postoperative bleeding in patients with haemophilia. The patients included in this study were over 18 years old with a diagnosis of haemophilia. A surgical implant protocol was implemented, supported by systemic and local haemostatic measures. Age, type of haemophilia, pre- and post-factor levels, gingival index, surgical duration, oedema, and pain were recorded for each case. In the event of haemorrhage, the bleeding index was determined. At four months, the success of the implant was evaluated using the absence of pain, suppuration, and clinical mobility as parameters. Fifteen surgeries were performed and 21 implants were placed in 10 patients. All the implants were successful in terms of the evaluated parameters. Among the 15 surgeries performed, bleeding was detected in three. The preliminary results found in this study seem to establish that the proposed surgical implant and haemostatic protocol is a predictable treatment for the placement of dental implants in patients with haemophilia.

Cone Morse Implant Placement in Patients With Aids Who Use Highly Active Antiretroviral Therapy Report of Clinical Cases

Introduction: The Acquired Immune Deficiency Syndrome (AIDS) is a condition that manifests itself after the infection of the human organism by the Human Immunodeficiency Virus (HIV). In 1996, the Highly Active Antiretroviral Therapy (HAART) was introduced, with the aim of slowing down the immunodeficiency and restoring the immunity of these patients, extending their life expectancy. Consequently, the need for rehabilitating dental treatments arose, aiming to improve oral health, self-esteem and the quality of life of these patients. This current study was designed to assess vertical dimensional changes in the peri-implant bone level around the placement of dental implants in AIDS patients using HAART. Materials and Methods: For the bone level evaluation, at first cone-beam computed tomography, panoramic radiography and periapical radiographs were used during the periods at baseline, 2, 4 and 6 months after the implant installation. The images were digitized and analyzed on programs Adobe Photoshop CS5 and Digimizer 3.1.1.0. Results: Were installed 13 implants that presented a peri-implant bone loss average of 0.26 mm in the first bimester, 0.13 mm in the second and 0.18 mm in the third, totalizing a peri-implant bone loss average of 0.57 mm in the semester. Conclusion: Despite the several metabolic changes that can affect these patients due to infection, drug therapy, immune response and the absence of an adequate stability quotient and insertion torque, all implants showed osseointegration, as well as the parameters of clinical success after the installation of the implant, and the degree of bone loss in this period is within the expected according to the research. Clinical Relevance: Oral health professionals should be aware of the possible complications that future HIV patients may have due to their systemic and drug-related condition in association with osseointegration.

Dental Implant Placement in Patients With a History of Medications Related to Osteonecrosis of the Jaws: A Systematic Review.

The present systematic review evaluates the safety of placing dental implants in patients with a history of antiresorptive or antiangiogenic drug therapy. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed. PubMed, Cochrane Central Register of Controlled Trials, Scopus, Web of Science, and OpenGrey databases were used to search for clinical studies (English only) to July 16, 2019. Study quality was assessed regarding randomization, allocation sequence concealment, blinding, incomplete outcome data, selective outcome reporting, and other biases using a modified Newcastle-Ottawa scale and the Joanna Briggs Institute critical appraisal checklist for case series. A broad search strategy resulted in the identification of 7542 studies. There were 28 studies reporting on bisphosphonates (5 cohort, 6 case control, and 17 case series) and 1 study reporting on denosumab (case series) that met the inclusion criteria and were included in the qualitative synthesis. The quality assessment revealed an overall moderate quality of evidence among the studies. Results demonstrated that patients with a history of bisphosphonate treatment for osteoporosis are not at increased risk of implant failure in terms of osseointegration. However, all patients with a history of bisphosphonate treatment, whether taken orally for osteoporosis or intravenously for malignancy, appear to be at risk of "implant surgery-triggered" medication-related osteonecrosis of the jaw (MRONJ). In contrast, the risk of MRONJ in patients treated with denosumab for osteoporosis was found to be negligible. In conclusion, general and specialist dentists should exercise caution when planning dental implant therapy in patients with a history of bisphosphonate and denosumab drug therapy. Importantly, all patients with a history of bisphosphonates are at risk of MRONJ, necessitating this to be included in the informed consent obtained before implant placement.

Implant Placement in Patients under Treatment with Rivaroxaban: A Retrospective Clinical Study.

The management of patients under treatment with Direct Oral Anticoagulants (DOACs) has led clinicians to deal with two clinical issues, such as the hemorrhagic risk in case of non-interruption or the risk of thromboembolism in case of suspension of the treatment. The primary aim of this retrospective study was to evaluate the incidence of perioperative bleeding events and healing complications in patients who were under treatment with Rivaroxaban and who received dental implants and immediate prosthetic restoration. Patients treated with Rivaroxaban (Xarelto 20 mg daily) and who needed implant rehabilitation were selected. Four to six implants were placed in mandibular healed sites or fresh extraction sockets. All patients, in agreement with their physicians, interrupted the medication for 24 h and received implants and immediate restorations. Twelve patients and 57 implants were analyzed in the study. No major postoperative bleeding events were reported. Three patients (25%) presented slight immediate postoperative bleeding controlled with compression only. The implant and prosthetic survival rate were both 100% after 1 year. Within the limitations of this study, multiple implant placement with an immediate loading can be performed without any significant complication with a 24 h discontinuation of Rivaroxaban, in conjunction with the patient’s physician.

Progressive Hemifacial Atrophy After Implant Placement in Patients Taking Immunosuppressive Agents: Case Report

Progressive hemifacial atrophy (PHA) is a rare disorder characterized by acquired unilateral facial atrophy. This disease mainly affects the skin and the craniofacial tissue below forehead. It also involves dermatomes of the fifth cranial nerve. Atrophy of subcutaneous tissue, fat, muscle and osseocartilaginous structures were seen. It resulted in a sunken hemifacial appearance. Although epidermal cutaneous tissue was minimally involved, the tongue, gingiva, teeth, and palate may also be affected. The purpose of this study is to report a case of progressive hemifacial atrophy in a patient taking immunosuppressive drugs after implant and sinus graft surgery.

Rehabilitation of Lower Anterior Teeth with Implant Therapy in Localized Aggressive Periodontitis

Periodontitis is the most common, destructive, inflammatory diseases of supporting tissues of the teeth in humans, with profound effects on general health. Aggressive periodontitis (AgP) comprises a rare, rapidly progressing form of periodontitis, characterized by severe destruction of periodontal attachment apparatus and tooth loss at an early age. Considering the psychological problems which these patients have during the early stages of their life, the chief aim of the treatment is to achieve functional, esthetic, and phonetic rehabilitation. Dental implant is a widely used treatment option that provides functional and esthetic resolution. Implant placement in patients with a history of AP might be considered a viable option to restore oral function; however, the risk for implant failure is significantly higher. This report presents rehabilitation of lower anterior teeth with implant therapy in a 24-year-old systemically healthy male with a history of localized AP, who had previously received complete periodontal therapy for periodontal stabilization

Group 4 ITI Consensus Report: Risks and biologic complications associated with implant dentistry.

The aim of Working Group 4 was to address topics related to biologic risks and complications associated with implant dentistry. Focused questions on (a) diagnosis of peri-implantitis, (b) complications associated with implants in augmented sites, (c) outcomes following treatment of peri-implantitis, and (d) implant therapy in geriatric patients and/or patients with systemic diseases were addressed. Four systematic reviews formed the basis for discussion in Group 4. Participants developed statements and recommendations determined by group consensus based on the findings of the systematic reviews. These were then presented and accepted following further discussion and modifications as required by the plenary. Bleeding on probing (BOP) alone is insufficient for the diagnosis of peri-implantitis. The positive predictive value of BOP alone for the diagnosis of peri-implantitis varies and is dependent on the prevalence of peri-implantitis within the population. For patients with implants in augmented sites, the prevalence of peri-implantitis and implant loss is low over the medium to long term. Peri-implantitis treatment protocols which include individualized supportive care result in high survival of implants after 5years with about three-quarters of implants still present. Advanced age alone is not a contraindication for implant therapy. Implant placement in patients with cancer receiving high-dose antiresorptive therapy is contraindicated due to the associated high risk for complications. Diagnosis of peri-implantitis requires the presence of BOP as well as progressive bone loss. Prevalence of peri-implantitis for implants in augmented sites is low. Peri-implantitis treatment should be followed by individualized supportive care. Implant therapy for geriatric patients is not contraindicated; however, comorbidities and autonomy should be considered.

Dental Implant Placement in Patients on Bisphosphonate Therapy: a Systematic Review.

ABSTRACTObjectivesThe review aims to study dental implant placement purposefulness for patients who have been treated or are on treatment with bisphosphonate medication.Material and MethodsStructured search strategy was applied on electronic databases: MEDLINE, PubMed, PubMed Central and ResearchGate. Scientific publications in English between 2006 and 2017 were identified in accordance with inclusion, exclusion criteria. Publication screening, data extraction, and quality assessment were performed. Outcome measures included implant failure or implant-related osteonecrosis of the jaw.ResultsIn total, 32 literature sources were reviewed, and 9 of the most relevant articles that are suitable to the criteria were selected. Heterogeneity between the studies was found and no meta-analysis could be done. Five studies analysed intraoral bisphosphonate medication in relation with implant placement, three studies investigated intravenous bisphosphonate medication in relation with implant placement and one study evaluated both types of medication given in relation with implant placement. Patients with intraoral therapy appeared to have a better implant survival (5 implants failed out of 423) rate at 98.8% vs. patients treated intravenously (6 implants failed out of 68) at 91%; the control group compared with intraoral bisphosphonate group appeared with 97% success implant survival rate (27 implants failed out of 842), showing no significant difference in terms of success in implant placement.ConclusionsPatients treated with intravenous bisphosphonates seemed to have a higher chance of developing implant-related osteonecrosis of the jaw. The intraorally treated patient group appeared to have more successful results. Implant placement in patients treated intraorally could be considered safe with precautions.