Simultaneous Implant Placement Research Articles

Outcomes Following Hydraulic Pressure Indirect Sinus Lift in Cases of Simultaneous Implant Placement With Platelet-Rich Fibrin.

BackgroundTo achieve a better long-term prognosis in the posterior maxilla with poor quality of bone, the sinus lift must ensure bone regeneration till the apex of the dental implant for osseointegration. An indirect sinus lift is a minimally invasive procedure where simultaneous bone condensation is achieved. During the sinus lift procedures, different graft materials are used to gain the height of the bone in the sinus. The present study aimed to evaluate the outcomes of indirect sinus lift with hydraulic pressure and the simultaneous placement of implant using platelet-rich fibrin (PRF).MethodologyIn total, 24 subjects aged 18-74 years with missing maxillary premolars and first and second molars who opted for dental implants placed with indirect sinus lift with hydraulic pressure and had low sinus with less residual ridge height, bone density, and bone height were assessed at one day, one week, one month, three months, and six months.ResultsThe average mean height preoperatively was 5.573 ± 0.66 mm which showed a significant increase postoperatively to 9.603 ± 0.78 mm (p < 0.001). Mean sinus membrane lift was 4.8 ± 2.2 mm at six months. The implant stability quotient increased significantly at six months postoperatively from 69.07 ± 3.39 at the immediate postoperative time to 72.92 ± 2.714 at six months postoperatively (p < 0.001).ConclusionsThe current study suggests that minimally invasive indirect sinus lift with bone augmentation utilizing PRF increased residual alveolar ridge height and implant stability with fewer problems than previous sinus lift procedures in the posterior maxillary area.

Shortened Treatment Time for Maxillary Sinus Grafting with Simultaneous Implant Placement: Retrospective Analysis with 10-Year Follow-Up.

The aim of the present retrospective clinical study was to evaluate the outcome of a maxillary sinus lateral window augmentation protocol, which sought to shorten the treatment time. This protocol entailed sinus augmentation with deproteinized bovine bone minerals (DBBM) and simultaneous implant placement in patients with minimal residual bone height. A total of 89 sinus augmentation procedures were performed in 74 patients, in whom 160 implants were placed between 2005 and 2013. The mean residual bone height was 2.6 ± 0.6 mm. The healing time before loading was 4.18 ± 0.63 months. In a first evaluation in 2014 the early implant survival rate (EIsR) was 96.8% after a mean period of 5.4 ± 2.2 years. A second evaluation in 2019 after a mean period of 10.4 ± 2.2 years showed a late implant survival rate (LIsR) of 83.1%. The failures after 2014 were all caused by peri-implantitis, which affected 14.6% and 16.8% of patients and implants, respectively. This prevalence of peri-implantitis does not appear to be higher than that usually observed in nonaugmented sites. This reduction in the duration of treatment compared to the usual duration of 9 to 12 months does not seem to affect the predictability of the technique.

Ethoss versus Mineralized Plasmatic Matrix for Maxillary Lateral Sinus Lifting with Simultaneous Implant Placement

Ethoss versus Mineralized Plasmatic Matrix for Maxillary Lateral Sinus Lifting with Simultaneous Implant Placement

Ethoss versus Mineralized Plasmatic Matrix for Maxillary Lateral Sinus Lifting with Simultaneous Implant Placement

Ethoss versus Mineralized Plasmatic Matrix for Maxillary Lateral Sinus Lifting with Simultaneous Implant Placement

Simultaneous GBR and Implant Placement with Resorbable Membranes in the Rehabilitation of Partially Edentulous and Horizontally Atrophic Dental Arches: A Retrospective Study on 97 Implants with a 3- to 7-Year Follow-up

This retrospective study evaluates the clinical and radiographic outcomes of simultaneous guided bone regeneration (GBR) and implant placement procedures in the rehabilitation of partially edentulous and horizontally atrophic dental arches using resorbable membranes. A total of 49 patients were included, and 97 implants were placed. Patients were followed up for 3 to 7 years after loading. The data indicate that GBR with simultaneous implant placement and resorbable membranes can be a good clinical choice, and the data suggest that it could be better to horizontally reconstruct no more than 3 mm of bone in order to reduce the number of complications and to obtain stable results. However, this technique remains difficult and requires expert surgeons.

Radiographic Analysis of Graft Dimensional Changes after Lateral Maxillary Sinus Augmentation with Heterologous Materials and Simultaneous Implant Placement: A Retrospective Study in 18 Patients.

Background: This investigation aimed to radiographically assess the variations of graft dimension following maxillary sinus augmentation by the lateral approach. Methods: Eighteen patients (seven males), with a mean age at surgery of 66.5 ± 9.8 (range 52–82) years, were unilaterally treated. Thirty-five dental implants were positioned in the posterior maxilla simultaneously to grafting with heterologous biomaterials. Intraoral radiographs taken at the time of surgery, after six months, and at the longest follow-up (up to nine years after implant placement) were analyzed. The following distances were measured: mesio-distal width of the graft, vertical distance from implant apex to most coronal level of the graft, distance from the mesial aspect of the (mesial) implant to the mesial graft extension; distance from the distal aspect of the (distal) implant to the distal graft extension, and graft height along the implant axis. The dimensional changes with respect to baseline, after six months and at the longest follow-up were calculated. Results: The patient-based mean follow-up was 38.3 ± 30.1 months (range 12–108 months). The mean residual bone height at the mesial and distal aspect of the implants was 3.19 ± 2.05 mm and 2.65 ± 1.60 mm, respectively (p = 0.38). The mean graft width at baseline was 27.95 ± 5.23 mm, and the mean graft width reduction was 10.2 ± 12.7% (2.98 ± 3.62 mm) and 11.3 ± 14.4% (3.36 ± 4.08 mm) at six months and at the latest follow-up. The change was significant at six months (p = 0.005), but did not show significant further variation (p = 0.11). On the mesial and distal aspect, the mean graft extension decreased by 1.56 ± 2.67 mm and 0.84 ± 2.71 mm at the latest follow-up. No significant difference between mesial and distal changes was found (p = 0.24), suggesting that the biomaterial is resorbed homogeneously on both sides. The mean graft height was 11.92 ± 2.53 mm at baseline and decreased by 9.3 ± 9.05% (1.11 ± 1.09 mm) at six months (p < 0.001). Non-significant further changes were found at the latest follow-up (p = 0.10). Conclusions: after early remodeling, heterologous bone substitutes showed a good dimensional stability in the mid-term for maxillary sinus augmentation.

Retrospective Analysis of Risk Factors Related Implant Loss in Patients with Maxillary Sinus Augmentation and Simultaneous Implant Placement

Retrospective Analysis of Risk Factors Related Implant Loss in Patients with Maxillary Sinus Augmentation and Simultaneous Implant Placement

Evaluation of PRF Membrane in Alveolar Ridge Splitting with Simultaneous Implant Placement (Randomized Case Control Study)

Evaluation of PRF Membrane in Alveolar Ridge Splitting with Simultaneous Implant Placement (Randomized Case Control Study)

Geriatrik Hasta Popülasyonunda Ciddi Atrofik Posterior Maksillaya Dental İmplant Yerleştirmesini Takiben Trombositten Zengin Fibrin ve Allojenik Kemik Grefti Karışımı Kullanılarak Yapılan Sinüs Tabanı Ögmentasyonunun Hacimsel Değerlendirmesi Kohort Araştırması (Retrospektif)

Objective: We aimed to retrospectively evaluate the volume of new bone formed following sinus floor augmentation with simultaneous dental implant placement in severely atrophied residual alveolar ridges using a combination of platelet-rich fibrin and demineralized cortico-cancellous bone allograft in a geriatric population. Material and Methods: The clinical and radiological data of patients who underwent sinus floor augmentation using a combination of platelet-rich fibrin and demineralized cortico-cancellous bone allograft with simultaneous dental implant placement between 01 April 2013 and 01 August 2020 were retrieved from the archives. The main inclusion criteria for the study were age >60 years and a residual ridge height <2 mm. For each patient, cone-beam computed tomography (CBCT) scans were performed preoperatively, and 6 months after surgery. The volume of the maxillary sinus cavity preoperatively and postoperatively was measured using CBCT. The volume of the newly regenerated bone was calculated by subtracting the post-operative total sinus volume from the pre-operative total sinus volume. Residual and postoperative ridge heights were measured on the mid-coronal and mid-sagittal sections of preoperative and postoperative cone beam computed tomography images, respectively. Results: Fourteen patients with 19 sinus augmentations were included in the study. Thirty-two dental implants were placed with simultaneous sinus floor augmentation. All cases showed new bone formation on axial, coronal, and sagittal sections of postoperative CBCT scans. Conclusion: The combination of plateletrich fibrin and demineralized cortico-cancellous bone allograft used in sinus flor augmentation may promote the formation of healthy new bone that supports the simultaneous placement of dental implants in the elderly population with severely atrophic alveolar ridges.

Clinical Assessment of the Bone Width Following Lateral Ridge Expansion in Augmentation of Narrow Alveolar Ridges for Placing Immediate Dental Implants.

Background:Less residual alveolar bone at extraction site at esthetic and functional tooth position is the main limitation in placing a dental implant, especially at long-span edentulous ridges. This needs ridge augmentation.Aims:To assess bone width gain and implant stability following narrow ridge augmentation using the vertical ridge split technique.Materials and Methods:In 22 subjects within the age group of 20–60 years and the mean age of 38.46 years. The vertical ridge split technique was done in all subjects for horizontal ridge augmentation. Paraesthesia, pain/discomfort, mobility, and radiographic crestal bone width were assessed 6 months postoperatively. The data were described as mean and standard deviation along with number and percentage. Paired t-test was also used keeping the level of significance at P < 0.05.Results:Implant stability was seen in 86.36% (n = 19) study subjects and were not stable in 13.63% (n = 3) subjects. Bone width preoperatively was in the range of 3.1–4.4 mm with the mean value of 3.64 ± 0.41. Postoperatively, the bone width increased and was in the range of 5.2–6.3 mm with the mean value of 5.62 ± 0.45 mm. This increase postoperatively was statistically significant with a P value of <0.001Conclusion:The present study concludes that acceptable success results are seen using the ridge split technique with simultaneous dental implants placement in both atrophic maxilla and mandible.

Short-Term Evaluation of Prosthetic Rehabilitation of Thin Wiry Ridge by Ridge Splitting and Simultaneous Implants Placement: Non-randomized Control Trial.

Objective This article evaluates the success of prosthetic rehabilitation of thin wiry ridge and implants placed simultaneously in splitted ridge both clinically and radiographically. Materials and Methods Twenty-one participants were enrolled of which 13 patients (8 females and 5 males) were suffering from maxillary ridge atrophy and 8 patients (5 females and 3 males) had mandibular ridge atrophy; a total of 42 implants were performed using the ridge expansion technique. The expansion was performed using the conventional disk technique, piezoelectric corticotomy, and self-threading expanders. Implants were placed and loaded with fixed partial denture after 4 months for the mandible and 6 months for the maxilla. Implant stability quotient (ISQ) was measured at T0 (implant placement) and TL (loading). Crestal bone levels were measured at different times: T0, TL, and T12 (12 months). Evaluation of prosthetic and surgical complications was carried out. Data were analyzed and compared using analysis of variance and paired t -tests at a significance level of 5%. Results All implants met the criteria for success. All implants showed a higher mean bone loss from T0 to TL (1.259 ± 0.3020) than from TL to T12 (0.505 ± 0.163) with a statistically significant difference ( p < 0.0001). ISQ values sharply increased at the time of loading (72.52 ± 2.734) than at implant insertion (44.5 ± 4.062) with a significant difference ( p < 0.0001). Minor prosthetic and surgical complications were reported. Conclusion The results from this study support the efficacy of prosthetic rehabilitation of thin wiry ridge using split ridge technique and the success of implants placed simultaneously in splitted ridge.

EVALUATION OF MINERALIZED PLASMATIC MATRIX DURING SINUS LIFT WITH THE SIMULTANEOUS PLACEMENT OF DENTAL IMPLANTS

Objectives:Mineralized plasmatic matrix is reported to improve the quality of the bone/fibrin mixture, creating a stable and easy to handle homogeneous material. However, few studies evaluate the use of the mineralized plasmatic matrix during sinus lift with the simultaneous placement of dental implants. Purpose: This study evaluated the efficiency or not of MPM compared to the xenograft bone grafting in the maxillary sinus lift. Patients and methods:This study was conducted randomly on patients selected for treatment with a total of sixteen lateral windows sinus lift with simultaneous implant placement. Their ages ranged between 20 and 60 years old. Participating patients were divided into two groups equally and randomly The control group: eightsinus floor elevation was performed using simultaneous implant placement. As a grafting material, Xenograft was used. The study group: eight Sinus floor elevation was achieved with simultaneous implant placement. Xenograft has been used in the form of MPM as a grafting material. CBCT taken before and after sinus augmentation to measure bone volume and height after 1 week of baseline (T0), after 6 months (T1), and after 12 months of baseline (T0) (T2). The Osstell(PT) was used for assessment implant stability at implant insertion (PT0) as well as for loading visit (PT1). Result:A significant difference was observed between the two groups in bone volume (p=0.049). No significant difference was observed between the two groups (p=0.129) in height of graft. Conclusion:MPM eliminated the need for barrier membranes when a guided bone regeneration procedure is considered.The useofMPM as a grafting bone offered greater graft stability and handling.

Minimally Invasive Lateral Approach through Circular Window with a Diameter of 5 to 6 mm for Maxillary Sinus Floor Elevation with Simultaneous Implant Placement: Retrospective Study

The aims of this study were to propose a minimally invasive lateral approach technique for maxillary sinus floor elevation (MSFE) with simultaneous implant placement and to evaluate the surgical outcome and complications of this technique. This study reviewed 49 surgeries of MSFE with simultaneous implant placement (n = 83) using a minimally invasive lateral approach. A circular shape window with a diameter of 5 to 6 mm and an area of 20–30 mm2 was made on the lateral wall of the maxillary sinus. After elevation of the Schneiderian membrane, the xenograft was used for bone grafting. The MSFE was possible with a minimum-sized window in 47 of 49 cases. For the remaining 2 cases, MSFE with a minimum-sized window was failed. In one case, it was expanded to be more than 30 mm2 to repair the membrane perforation. In another case, MSFE was performed by forming two minimum-sized windows. Post-operative bleeding after MSFE occurred in one anticoagulant-treated patient. There was no failed implant during the follow-up period (mean 22 months). A minimally invasive lateral approach through a small circular window with a diameter of 5 to 6 mm is a feasible and safe technique for MSFE with simultaneous implant placement.

Vertical Alveolar Ridge Augmentation: A Technique for Stabilizing Bone Grafts in the Atrophic Maxilla with Simultaneous Implant Placement

Achieving adequate fixation of bone blocks harvested from the mandibular symphysis and used in conjunction with dental implants has been a continuing challenge. In response, the Authors developed a method of using the implant itself to stabilize the graft material in single-implant sites in severely resorbed alveolar ridges. This technique was utilized to place 19 standard implants in 15 patients. After 12 to 60 months of clinical and radiological follow-up, all implants had survived, a success rate of 100%. Measurements of the radiographs showed bone loss of 1.70 mm ± 0.4 mm.

"Vertical Alveolar Ridge Augmentation: A Technique for Stabilizing Bone Grafts in the Atrophic Maxilla with Simultaneous Implant Placement"

"Vertical Alveolar Ridge Augmentation: A Technique for Stabilizing Bone Grafts in the Atrophic Maxilla with Simultaneous Implant Placement"

Synthetic Putty and Simultaneous Short Implant Placement in Crestal Sinus Lifting Procedures: 13–36 Months Follow-Up: A Case Series

Introduction: Aim of this investigation is to show that in sites with less than 4 mm of bone height of the sinus floor, synthetic putty bone graft and simultaneous short implant placement in crestal sinus lifting procedures result in sufficient bone gain, and is a valuable option to the more invasive lateral-window approach. Case presentation: Four patients missing a single tooth or more in the posterior maxilla with remaining alveolar ridge height of less than 4mm underwent crestal sinus lift procedures with bone grafting using a synthetic putty material simultaneously. Loading of the short implants was done with a minimum of 4 months after placement showing bone growth around the implant and lift of the Schneiderian membrane between 2.3mm-7.3mm. Conclusion: Crestal sinus lift, in combination with a short implant and a synthetic putty bone graft, is a good alternative for lateral more invasive sinus lift when the thickness of the sinus floor is less than 4mm.

EVALUATION OF INTERCHANGEABLE GUIDE IN MINIMALLY INVASIVE RIDGE SPLITTING WITH SIMULTANEOUS IMPLANT PLACEMENT (A PROSPECTIVE CLINICAL STUDY)

Background: The conventional ridge splitting technique offers a feasible and more consistent approach for the challenging narrow alveolar ridge. However, this entails raising of a complete flap to allow an adequate visibility of the osseous defect resulting in disturbance of vascular supply and risk of bone resorption. Stereolithography helps the manufacture of surgical guides using 3D generated models for an accurate placement of implants with minimal invasiveness thus preserving the periosteum. Objectives: To assess the precision of dental implant placement in narrow ridges after ridge splitting minimally invasive technique using an interchangeable guide. Materials and Methods: A prospective study was including 5 patients with anterior maxillary narrow ridge. All patients were selected to suit the proposed inclusion and exclusion criteria. Ridge split procedure was performed for all selected subjects assisted with the surgical guide with simultaneous placement of implants. Patients were evaluated by clinical and radiographical assessments with an average of 6 months follow up. Results: 8 implants were placed. Angular deviations with an average of 2.61 ± 1.46 degrees. The mean values of the horizontal deviation at the coronal and apex sides of the implant were 0.70 ± 0.46 mm and 0.98 ± 0.35 mm. While the Vertical deviations (V) with an average of 0.39 ± 0.29 mm. There were statistically significant differences between preoperative, immediate postoperative and 6 months postoperative values of bone width and density. Conclusions: Alveolar ridge split technique assisted with an interchangeable surgical guide is a feasible and reliable method for placement of dental implants

Optimizing complex full arch rehabilitation by initial provisional and final CAD/CAM suprastructures

Background: The concepts to treat patients with failing dentition show a high variation. Depending on remaining bone volume the placement of a reduced number of implants without major grafting or the reconstruction of the atrophied jaw by intensive grafting procedures is recommended. All these cases require a reestablishment of the chewing and speech function. Most of the patients are adapted to the compromised situation for many years. After an ideal reconstruction quite often functional disorders appear. Aim/Hypothesis: Various procedures are recommended to reestablish the vertical dimension and to design the lingual appearance of implant borne prosthesis. Can CAD/CAM technologies improve the prosthetic workflow to minimize clinical problems like chipping, screw loosening, framework fractures and speech problems? Materials and Methods: A retrospective analysis of 30 cases which received a removable prosthesis during the healing phase of the implants was performed regarding the possible functional and technical problems of the final superstructure. 12 patients received two stage grafting procedures (TSG) with removable prosthesis TSG. 18 patients were treated with local grafting procedures and simultaneous implant placement (SIP). 15 (5 TSG, 10 SIP) patients received the final fabrication of the suprastructure consequently after implant impression taking within a period of 4.2 ÷ 4.5 week (Group A). The other 15 patients received a CAD/CAM milled provisional superstructure after impression taking within a period of 2.8 ± 3.8 weeks (Group B). These provisional suprastructures were used between 6 and 32 weeks. Results: Patients of group A had to wait longer after second stage surgery to receive a suprastructure with a higher number of consultations to adapt the bite and the vertical. In two cases the framework need to be redone, due to changes between initial bite registration and final try in of the restorations. 5 patients required a remounting after the final delivery with the discomfort of missing the implant borne prosthesis for a least one day. Patients of group A showed a higher occurrence of chipping and relining to improve speech function. Patient of Group B received the necessary adaptation of the provisional suprastructure always chairside without a absende of the restoration. After the adaptation phase the appointments for the final fabrication were reduced, due to the possibility to use the CAD/CAM data of the initial impression taking and matching of the data of the adapted provisional suprastructure. Conclusions and Clinical Implications: The use of a CAD/CAM produced provisional fixed prosthesis improves the digital work flow for the final suprastructure. The patients receive a restoration shortly after second stage surgery. Adaptation are much easier to be performed and corrections on the final restorations are not necessary. Due to the adaptation period significantly less chipping were observed. The use of CAD/CAM technologies allows cost effective prosthetic rehabilitation with a high patient satisfaction. Keywords: full arch rehabilitation, provisional suprastructure, CAD/CAM technologie, Improvement workflow, digital workflow

Evaluation of Resorption and Osseointegration of Autogenous Bone Ring Grafting in Vertical Bone Defect With Simultaneous Implant Placement in Dogs.

The aim of this research was to evaluate the resorption and osseointegration of an autogenous bone ring, which was grafted in a local vertical alveolar defect with simultaneous implant placement. Six Beagle dogs were enrolled in the study; their 4 nonadjacent mandibular premolars were extracted, and the buccal plate was removed to create bone defects in 2 of the 4 sites. Three months after extraction, Straumann implants (Ø 3.3 mm, length of 8 mm) were placed in the bone defect sites with simultaneous autogenous bone ring grafting and in the conventional extraction sites. After a 3-month healing period and a 3-month loading period, the animals were euthanized. The harvested samples were analyzed using micro-computed tomography (CT) scanning and histological analysis. From the micro-CT measurements, the average vertical bone resorption of the bone ring was 0.23 ± 0.03 mm, which was not significantly different from that around the conventional implant, 0.24 ± 0.12 mm (P > .05). The ratio of the bone volume to the total volume of the bone ring group was 91.11 ± 0.02, which was higher than that of the control group, 88.38 ± 2.34 (P < .05). From the hard tissue section, the bone rings developed fine osseointegration with the implants and the base alveolar bone. The results suggest autogenous bone ring grafting with simultaneous implant placement can survive in a local vertical bone defect with little bone resorption and good osseointegration in dogs with strict management. A bone ring graft must be compared with guided bone regeneration, and a larger and longer observation must be confirmed in clinical patients.

New Incision and Flap Designs in Autogenous Bone Ring Grafting with Simultaneous Implant Placement and an Evaluation of the Effect of First-Stage Wound Dehiscence in Dogs

The aim of this study was to explore the effect of preventing first-stage wound dehiscence with new types of incision and flap design and to evaluate the effect of wound dehiscence on the bone resorption of the autogenous bone ring graft. In six beagle dogs, the second and fourth premolars on the bilateral mandible were extracted. After 3 months, on the left extraction sites, conventional alveolar crest incisions were made and the full-thickness flaps were elevated. However, on the right sites, the incisions were made at the mucogingival junction, the split-thickness flaps were elevated toward the lingual side, and the periosteum was elevated toward the buccal side. Then, Straumann implants (. 3.3, length 8 mm) were placed with simultaneous autogenous bone ring grafting. Next, the wounds on the left side were closed with periosteal releasing on buccal flaps conventionally, but the semi-thickness flaps on the right side were sutured with the elevated periosteum. After 3 months, the animals were euthanized, and the harvested samples were analyzed using microcomputed tomography and histology. The incidence rate of wound dehiscence in the new incision group was 16.7%, which was significantly lower than that in the conventional incision group (75%). There was hardly any vertical bone loss of the bone ring in the samples without wound dehiscence, but in wound dehiscence samples, severe bone loss, 2.47 ± 0.17 mm, was found on the buccal side of the bone ring, which was significantly higher than that on the lingual, mesial, and distal sides, 1.37 ± 0.14 mm, 1.00 ± 0.15 mm, and 1.03 ± 0.05 mm, respectively. The use of a mucogingival junction incision and split-thickness flap design can effectively prevent first-stage wound dehiscence in autogenous bone ring grafting, which plays a key role in bone resorption of the graft.