Single Implants Research Articles

PO0402: Two-Fraction High Dose Rate Brachytherapy as Monotherapy: A Comparative Study of Single and Dual Implant Techniques

PO0402: Two-Fraction High Dose Rate Brachytherapy as Monotherapy: A Comparative Study of Single and Dual Implant Techniques

VANTAGENS DOS IMPLANTES UNITÁRIOS COM CARGA IMEDIATA EM REGIÃO ANTERIOR DE MAXILA: REVISÃO DE LITERATURA

Among the various teeth that can be lost, the front ones are the most relevant in terms of aesthetics, since they represent an individual’s calling card. In this scenario, implantology is one of the main forms of oral rehabilitation in dentistry. Dental implants can be installed with immediate or delayed loading. Immediate loading implants arose from the need for faster results and in situations where aesthetics are the main objective, such as the front region of maxilla, representing a huge technological advance in implantology. The present study aimed to conduct a literature review on the advantages of single immediate loading implants in the front of maxilla. Through a search in the online databases Google Scholar, Pubmed and Scielo, 25 scientific articles were selected to compose the review, divided into the following topics: mediate loading vs. immediate loading; requirements for the application of immediate loading in single implants; immediate loading in the front of maxilla and its advantages; and the success rates. After explaining and discussing the data, it was concluded that single immediate loading implants in the front of maxilla is considered effective, especially due to advantages such as immediate aesthetic restoration and reduced treatment time, benefits considered extremely important by most patients. However, it is important to emphasize that the professional must evaluate each case individually and decide whether the patient is suitable for the technique.

Monolithic Hybrid Abutment Crowns (Screw-Retained) Versus Monolithic Hybrid Abutments With Monolithic Crowns (Adhesively Cemented): Three-Year Data of a Prospective Clinical Split-Mouth Study.

This study compares the restoration of single-tooth implants with screw-retained lithium-disilicate hybrid-abutment crowns and single-tooth lithium-disilicate crowns adhesively bonded to hybrid abutments with regard to objective clinical and subjective patient-specific evaluation criteria over a time of observation of 3 years. Two bone-level implants were placed in contralateral sides of the same jaw in 10 patients, each with two single-tooth gaps. After osseointegration, implants were uncovered and an impression was taken. In accordance with the split-mouth design, one implant in each patient was restored with a screw-retained hybrid abutment crown and the other implant with a hybrid abutment and an adhesively bonded single-tooth crown. The restorations were randomly allocated to the implants. Prefabricated titanium bases were used. The ceramic abutments and restorations were fabricated monolithically with pressed lithium-disilicate ceramic. An objective evaluation (survival, technical, or biological complications, FIPS) by the practitioner and a subjective evaluation (satisfaction, OHIP) by the patient were carried out after 3, 6, 12, 24, and 36 months after restoration placement. Both restoration types showed a survival rate of 100% after 3 years of observation. No technical or biological complications occurred. No significant difference was observed between the two types of restoration neither for objective (survival, technical or biological complications, FIPS) nor subjective (satisfaction, OHIP) evaluation criteria (p > 0.05). No statistically significant differences were observed between screw-retained and cemented pressed lithium-disilicate restorations on bone-level implants for both objective and subjective evaluation criteria, respectively. Monolithic hybrid-abutment crowns (screw-retained) and monolithic hybrid abutments with single-tooth crowns (cemented) made of pressed lithium disilicate can be used to successfully restore single implants.

Investigating the Impact of Various Abutment Materials on Peri-Implant Tissue Health at Tripoli-Libya

This research investigates the impact of different abutment materials, including titanium, zirconia, and hybrid materials, on peri-implant tissue health in dental implantology. A prospective cohort study design was employed, involving 150 participants who received single or multiple dental implants from Banzi & Bianco s.r.l. (B&B) a dental implant company based in Italy. Clinical parameters, such as peri-implant probing depth, bleeding on probing, and radiographic analysis, were measured at baseline and at 3-, 6-, and 12-months post-abutment placement. Statistical analyses, including ANOVA and regression, were conducted to identify significant associations between abutment materials and peri-implant tissue health parameters. The results revealed nuanced relationships among the abutment materials and their impact on peri-implant tissue health. Interestingly, the hybrid material group exhibited more favorable outcomes in maintaining optimal tissue health compared to the titanium and zirconia groups. This finding suggests that the choice of abutment material can significantly influence the long-term health of peri-implant tissues. This study contributes valuable insights for clinicians in selecting abutment materials for dental implant restorations, highlighting the importance of considering hybrid materials as a potential option for better clinical outcomes (p< 0.001).

Single mandibular implant study - impact on dietary habits after 5 years of observation in patients with immediate and delayed loading protocols

ObjectivesSingle midline implants in the edentulous mandible can be used to support existing complete dentures to improve patients’ satisfaction and masticatory efficiency. The impact on patients’ dietary habits and the influence of the loading protocol of the implants was the subject of this study.Materials and methodsIn this prospective randomized clinical trial, edentulous patients with existing complete dentures in both jaws were treated with a single midline implant in the mandible. In group A, the implants were loaded immediately, in group B the loading was delayed after three months. Patients were asked to report on their nutritional intake before implant placement and 12, 24 and 60 months after loading using a standardized two-part questionnaire.ResultsNutritional intake regarding the frequency of consumption of the requested food items did not change significantly during the 60-months study period, regardless of the loading protocol. In contrast, the second part of the questionnaire revealed that after 60 months, there was a significant decrease in avoidance of food, that had a coarse and hard texture in both groups. This significant decrease was observable in the group A in the first 12 and 24 months and in the group B after 60 months.ConclusionA change in the patients’ dietary habits due to the insertion of a single midline implant in the mandible to support the existing complete denture cannot be observed, independently to the loading protocol.Clinical relevanceImproving the chewing efficiency by single midline implants in the edentulous mandible does not lead to a change in dietary habits.

Comparing Small Buccal Dehiscence Defects Treated with or without Guided Bone Regeneration. A Sub-Analysis of a RCT.

to assess clinical and radiographical outcomes of single tooth posterior implants with a dehiscence defect treated with or without guided bone regeneration (GBR). In a randomized clinical trial of 59 patients, single-tooth posterior implants were placed. For the subanalysis of 16 patients with a buccal dehiscence defect (≤ 5mm), the implants were randomly assigned to GBR or spontaneous healing (SH). In 8 patients, the implants were surrounded by native bone (Native bone). A transmucosal healing approach was chosen for all sites. Patients were examined at restoration delivery (RD) and at one year (1y). Measurements included: soft tissue thickness (STT), bone tissue thickness (BTT) and buccal contour, based on cone-beam computed tomography (CBCT), optical scans, clinical parameters. All data were analyzed descriptively. The mean STT at implant shoulder (IS) showed a gain of 0.15 mm (Q1: - 0.16, Q3: 0.49) for the GBR group and 0.03 mm (Q1: -0.49, Q3: 0.13) for the SH group. The mean BBT 1 mm below IS showed a loss of 0.25 mm (Q1: -0.85, Q3: -0.09) for the GBR group and 0.04 mm (Q1: -0.14, Q3: 0.17) for the SH group. All peri-implant soft tissue parameters indicated healthy peri-implant tissues with no clinically relevant differences between the groups. Patient-reported outcomes regarding pain one day after surgery were similar among the study groups. The present sub-analysis resulted in a similar buccal contour and similar radiographic outcomes as well as peri-implant health for sites treated with or without GBR.

Accuracy of scanning stock abutments versus scan bodies using different intraoral scanners for single implants. An in vitro study

Accuracy of scanning stock abutments versus scan bodies using different intraoral scanners for single implants. An in vitro study

Comparison of Clinical and Radiographic Outcomes Between Single Symphyseal and Parasymphyseal Implants Versus Two Implant-Assisted Complete Mandibular Overdentures.

This study aimed to compare the efficacy of single implants in the symphyseal and parasymphyseal regions with that of two implants in complete mandibular overdentures. Fifteen completely edentulous male patients (50-65 years) were chosen and randomly grouped into three equal groups (five patients in each) according to the position and number of the received implants to assist mandibular complete overdentures: group I: single median implant; group II: single parasymphyseal implant; and group III: two implants were inserted in the canine area bilaterally. After three months of osseointegration, the lower denture was transformed into an implant-assisted complete mandibular overdenture. Clinical observations were documented on the day of loading, and three, six, and nine months later for each implant. Follow-up cone beam computed tomography scans were performed to assess marginal bone loss on the day of loading, and six and twelve months later. The masticatory efficiency evaluation was conducted one and three months after loading. The obtained results demonstrated insignificant differences between the three groups concerning marginal bone loss, plaque index, pocket depth, and bleeding index. Regarding the masticatory efficiency, the results revealed a significantly higher masticatory efficiency in group III than in groups I and II. Using two implants to retain mandibular overdentures is the first choice due to their higher masticatory efficiency than a single implant. However, a single implant may be a viable treatment alternative, especially in cases where there are any limitations that restrict the use of additional implants.

Immediate Insertion and Restoration of a Single Implant to Replace Two Adjacent Periodontally Compromised Lower Incisors: A Technique Report with up-to-8 Years Follow-up.

The study investigated the cumulative survival rate (CSR) and marginal bone loss (MBL) of single implants immediately placed and restored with two-unit cantilevered fixed dental prostheses after extraction of two adjacent mandibular incisors with a compromised periodontal condition. Patients in need of extraction and replacement of two adjacent mandibular incisors due to advanced periodontal loss of attachment were treated consecutively. Following a flapless procedure, a single implant was inserted at the time of extraction in one of the two fresh alveoli sockets and immediately restored with a screw retained two-unit provisional FDP. The area of extraction was grafted using xenograft particulate material. Peri-implant soft tissue and hard tissue condition at the last follow-up appointment, marginal bone loss at the last follow-up appointment at least 1 year after the delivery of the final prosthesis, and the final aesthetic result were evaluated. Twenty patients were recruited between January 2014 and December 2019 in a single private practice and each received single implants and immediate provisional restoration with a two-unit cantilevered fixed dental prosthesis. Patients were followed for 22 to 94 months (average follow-up = 4 years) and none of the implants failed resulting in 100% CSR. Cumulative MBL -measured using the VixWin Platinum software -was 1.08 +/- 0.35. A lower MBL was observed in the presence of platform switching (0.63 +/- 0.11 mm) compared to the absence of platform switching (1.27 +/- 0.20 mm). The preliminary results obtained from this study suggest that patients in need of replacing two adjacent periodontally compromised mandibular incisors can be treated with an immediately inserted and restored single implant.

Surface morphology and chemical composition analysis of titanium dental implants using SEM and EDX.

The chemical content and surface morphology of titanium implants have a greater impact on the osseointegration characteristic of dental implants. Therefore this study was done to examine the surface morphology and chemical composition of commercially available titanium dental implants. (BioLine Dental Implants Series-single piece (A) and spiral implants (B)). The chemical composition was determined by the Energy Dispersive X-ray Spectroscopy (EDX) method and the surface morphology was performed by Scanning Electron Microscopy (SEM) method. The results for chemical composition of titanium implants using EDX method revealed that titanium (Ti) constitutes the major surface components on the plain and top land area of the single piece compressive implants which is 89.71 weight% and 71.55 weight % respectively. Iron (Fe)-66.60 weight % is considered as major element along with chromium (Cr)-18.34 weight %on the plain area of spiral implants and O (19.90 weight %) and Al (12.43 weight %) on the top land area of spiral implants. The surface morphology and impact of the manufacturing process on the implant surface using SEM method revealed that the similar surface irregularities with diameter ranging from 10 µm to 20 µm on the side view of the top land area and diameter of 10 µm on the side view of plain area for both the samples. Sample A showed some amorphous structures with grainy marks on the apical view whereas Sample B showed heavy grinding and shear marks on the apical view at diameter ranging from 10 µm to 20µm.

Long-Term Assessment (5 to 19-Year Follow-up) of the Incisal Level Changes in Single Implants Placed in the Anterior Maxillary Region. An Observational Clinical Study.

Long-Term Assessment (5 to 19-Year Follow-up) of the Incisal Level Changes in Single Implants Placed in the Anterior Maxillary Region. An Observational Clinical Study.

Biomechanical Effect of Different Abutment and Crown Restoration Materials in a Single Anterior Dental Implant and Surrounding Bone: A 3D-FEA.

Biomechanical Effect of Different Abutment and Crown Restoration Materials in a Single Anterior Dental Implant and Surrounding Bone: A 3D-FEA.

Effect of immediate all-digital restoration of single posterior implants: The SafetyCrown concept on patient-reported outcome measures, accuracy, and treatment time-A randomized clinical trial.

The SafetyCrown workflow facilitates the immediate restoration of posterior single sites with the one-abutment/one-time concept. This randomized clinical trial aimed to assess the direct effect of immediate restoration on dental patient-reported outcomes (dPROs), feasibility, implant accuracy, and time. Participants with a single posterior edentulous site for late implant placement underwent optical impressions, shade selection, and cone beam computed tomography. After virtual treatment planning, they were randomized into the test group and the control group. For the test group, individual definitive hybrid abutments were prefabricated. The next step was a fully guided surgery with printed guides. After the implant was placed using guided surgery, the abutment was inserted. A chairside CAD/CAM workflow was used to provide the patient with a provisional restoration. Implants in the control group were left submerged to heal. Oral health-related quality of life (OHRQoL) was assessed using the OHIP-G14, and dPRO was measured using a 10-item visual analog scale (VAS) questionnaire. Additional measurements of implant accuracy and time were performed. Follow-up was performed 7 to 10 days after implant placement. Thirty-nine participants with 45 restorations were included (test group: 23, control: 22). Immediate restoration was successful in 21 out of 23 implants (91.3%) in the test group. Both groups exhibited decreased OHRQoL without significant intergroup differences, while patient satisfaction was high overall. Test group participants perceived higher benefits and satisfaction with immediate loading than participants in the control group. Implant accuracy averaged 0.60 mm at the shoulder and 0.95 mm at the apex. Operative time was longer in the immediate loading group (61.9 min) than in the control group (32.1 min) (p < 0.001). Considering the limitations, the immediate restoration of late placed posterior implants using the described workflow proved feasible in 21 out of 23 cases. Both groups achieved high patient satisfaction with no differences in OHRQoL during the first week. Patients who received immediate loading rated the benefits very highly and were satisfied with the provisional restoration during the healing period.

Characterization of oral biomarkers during early healing at augmented dental implant sites.

The aim of this study is to assess early wound healing expression of local angiogenic biomarkers following connective tissue graft (CTG) at dental implant sites. Twenty-eight subjects with single dental implants exhibiting a soft tissue dehiscence were included and randomly treated with CTG, either with coronally advanced flap (CAF) or with tunnel technique (TUN). Peri-implant crevicular fluid (PICF) was collected at the midfacial and midlingual aspect of the implant sites at baseline and at 3, 7, 14, 30, and 90 days after the surgical intervention. The expression of angiogenin (ANG), fibroblast growth factor-2 (FGF-2), platelet-derived growth factor (PDGF), tissue inhibitor of metalloproteinases-2 (TIMP-2), and vascular endothelial growth factor (VEGF) was investigated over a period of 3 months. Patient-reported outcomes, clinical measurements, and ultrasonography scans at multiple time points were also evaluated. The longitudinal regression revealed a significant difference in the expression of VEGF and TIMP-2 between CAF- and TUN-treated sites over 3 months (p = .033 and p = .004, respectively), whereas no significant differences were observed for ANG, FGF-2 and PDGF between the two groups. At 7 days, a direct correlation was observed between ANG levels and ultrasonographic color velocity in the CAF group (p < .001) and between ANG levels and ultrasonographic color power in the TUN group (p = .028). VEGF levels and ultrasonographic mean perfused area of the CTG were significantly correlated at the 7-day time point (p < .001 for both CAF and TUN). The expression of VEGF at 7 days was directly associated with mucosal thickness gain at 1 year (p < .001 for both groups). Early TIMP-2 expression showed an inverse correlation with time to recovery (p = .002). TIMP-2 levels at 3 months exhibited inverse correlations with mean dehiscence coverage (p = .004) and the rate of complete dehiscence coverage (p = .012). PICF biomarkers can be used to monitor early wound healing events following soft tissue grafting at implant sites. VEGF and TIMP-2 showed correlations with the 1-year clinical and volumetric outcomes, as well as with post-operative patient-reported outcomes and Doppler Ultrasonographic tissue perfusion-related parameters.

Collagen Matrix for Increasing Peri-implant Mucosal Thickness in Smokers: A Prospective Case Series.

This prospective case series aimed to evaluate the feasibility of using a volume collagen matrix for soft tissue augmentation to increase mucosal thickness in single implants in smokers who consume more than 10 cigarettes per day. Participants had single submerged implants necessitating soft tissue thickening. Soft tissue augmentation was done using a collagen matrix in the second-stage surgery. The primary outcome was soft tissue thickness at 90 days post-surgery. Secondary outcomes included median thickness at 30 and 60 days, changes in buccal soft tissue profile (digital measurements) at 30, 60, and 90 days, and oral health-related quality of life using OHIP-14 up to 90 days post-surgery. Pain levels via VAS scale and adverse effects were also assessed. Ten participants (4 men, 6 women) aged 45.2 ± 13.18 years initially smoked 10-20 cigarettes daily (average: 14.70 ± 3.47 cigarettes/day). After 90 days, median soft tissue thickness increased to 3.00 (2.00;3.00) mm. Buccal soft tissue profile (median change in ROI) increased by 0.40 (0.25;0.62) mm at 90 days. Pain levels decreased, and oral health-related quality of life improved significantly. No complications were reported. The collagen matrix significantly augmented buccal soft tissue thickness at implant sites in smokers (>10 cigarettes/day), with favorable outcomes and no complications.

Dental Autotransplantation or Immediate Single Implant for the Replacement of a Hopeless Molar: A Comparative Case Series Study.

Dental autotransplantation (ATT) of mature teeth in adult patients has recently been supported by a growing body of evidence. Thus, ATT can be considered as an alternative to single implants for the replacement of a compromised tooth. This case series study aims to provide an initial comparison between ATT (test group) and immediate implant treatment (IIT standard group), in terms of volumetric changes and patient-related outcome measures (PROMs). Thirty-one interventions (29 patients) were grouped into two similar cohorts. Measurements were made on the superimposed STL files before and at least six months after treatment, and PROMs were obtained from a questionnaire in two follow-up checks. Data were analyzed using descriptive and inferential statistics. Adverse events and complications were also recorded. Volume reduction was 3 to 4 times less in the ATT group than in the ITT group (p<0.05). Patients in the ATT group reported higher levels of perceived inflammation than the IIT group (p&#61;0.015), although patients rated satisfaction similarly between the two treatments, above 9 on a scale of 1-10. Although this research should be considered an initial step requiring larger samples and follow-up, it supports the trend of including ATT as an alternative option to IIT in molar replacement.

IMMEDIATE SINGLE IMPLANT PLACEMENT WITH FLAPLESS SURGERY MAY BETTER PRESERVE BUCCAL BONE THAN FLAP SURGERY, BUT CLINICAL SIGNIFICANCE IS UNCLEAR

Immediate implant placement with flap or flapless surgery: a systematic review and meta-analysis. Pitman J, Christiaens V, Callens J, Glibert M, Seyssens L, Blanco J, et al. J Clin Periodontol. 2023;50:755-64. The present study was funded by the authors and their institutions. The authors have no actual or potential conflicts of interest. Systematic review and meta-analysis.

Crestal Sinus Lift with the Hydrodynamic Technique: Prospective Clinical Study at 3 Years Follow-Up

Aim: This study aimed to evaluate the implant survival rate, marginal bone loss (MBL), and surgical complications in single dental implants placed in the atrophic posterior maxilla using a transcrestal sinus lift with injectable graft materials. Materials and Methods: A prospective longitudinal study was conducted at IRCCS San Raffaele, Milan, Italy. Fifty-four patients with single edentulous sites and residual bone heights &lt; 5 mm were included. A transcrestal sinus lift was performed using non-cutting drills (Cosci’s technique) and xenogenic bone graft in gel form (Gel40, Tecnoss, Italy). Follow-up visits were at 1 week, 3 and 6 months, and annually for 3 years. Results: The implant survival rate was 98.04%, with one implant lost. MBL values were 0.71 ± 0.94 mm at 6 months, 1.00 ± 0.99 mm at 1 year, 1.03 ± 1.00 mm at 2 years, and 1.02 ± 1.01 mm at 3 years. Our ANOVA showed a significant MBL increase from 6 months to 1 year (p = 0.015), with no significant changes thereafter. Minimal surgical complications were observed, each occurring in 1.85% of cases. Conclusion: Transcrestal sinus lifts with injectable graft materials demonstrate high implant survival, acceptable MBL, and minimal complications, making it a reliable option for posterior maxilla rehabilitation.

Fracture strength of poly ether ether ketone abutment over short implant after fatigue

Abstract Background Poly ether ether ketone (PEEK) crowns and abutments can be used to fabricate esthetic and stable implant supported single tooth abutment and short implants can be used to avoid problems and contraindication of standard implants. The aim of this work was to evaluate fracture strength of PEEK abutment over short implant after fatigue. Methods This experimental laboratory study was carried out on 40 implants. Implants were categorized into two equal groups: group I: short implants which subdivided into two equal groups (group IA: PEEK abutments and group IB: Titanium abutments), and group II: standard implants which subdivided into two equal groups (group IIA: PEEK abutments and group IIB: Titanium abutments). Zirconia crowns were fabricated and cemented to abutments with resin cement and artificially aged through dynamic loading by chewing simulator to stimulate 3 months clinically. Results All test specimens survived the artificial aging process using simulated oral conditions. Group (GIIA) show the highest fracture resistance with the mean value (1526.81 ± 2.91) followed by group (GIA) (1265.32 ± 1.06) then group (GIIB) (1095.44 ± 0.84) and finally group (GIB) (1086.99 ± 1.52), there was highly significance difference between short and standard implants. The effect of abutment material there was also highly significant difference between PEEK and titanium Abutments, group (GIIA) under electron microscope showed unfavorable fracture while all other groups showed favorable fracture only. Conclusions The highest fracture strength was found in zirconia crowns cemented to PEEK abutment over standard implant, The lowest fracture strength was found in zirconia crowns cemented to titanium abutment over short implant and Standard implants have favorable stress distribution than short implants under loading.

Volumetric assessment of volume stable collagen matrix in maxillary single implant site development: A randomized controlled clinical trial.

The stability of soft tissue volume around dental implants is an important factor for the final esthetic outcome. The main objective of this study was to compare volume stable collagen matrix (VCMX) versus connective tissue graft (CTG) in the augmentation of soft tissue profiles in single implant sites with a class I Siebert ridge defect. Twenty patients (14 females and 6 males) were enrolled in the present study. After implant placement and augmentation of the buccal defect by VCMX or CTG, post-operative evaluation of the volumetric changes at the augmented implant site was carried out at 3, 6, and 9 months as primary outcome, clinical and radiographic soft tissue thickness were carried out at baseline and 9-month intervals, visual analog scale (VAS) and oral health impact profile-14 (OHIP14) were recorded 2 weeks after the surgery. A statistically significant difference in soft tissue volume was found between baseline and 3, 6, and 9 months postoperatively in both groups with the highest value at 9 months (136.33 ± 86.80) (mm3) in VCMX and (186.38 ± 57.52) (mm3) in CTG. Soft tissue thickness was significantly increased in both groups at 9 months in comparison to baseline. However, there was a significantly higher increase in soft tissue thickness at 9 months in CTG (3.87 ± 0.91) than in VCMX (2.94 ± 0.31). Regarding the radiographic soft tissue thickness, there was a statistically significant increase in both groups at 9 months in comparison to baseline. However, there was a statistically higher increase in the radiographic soft tissue thickness at 9 months in CTG (3.08 ± 0.97) than in VCMX (2.37 ± 0.29). VAS showed a statistically lower value in VCMX (0.4 ± 0.7) than CTG (2.8 ± 1.48). The OHIP recorded lower values in the VCMX group than the CTG group with no statistical significance. In addition, there was no difference in the PES between the two groups. The present study showed that CTG and VCMX were both effective in soft tissue augmentation around implants in the esthetic zone. However, CTG proved more efficient in increasing peri-implant soft tissue volume and mucosal thickness around single implants at a 9-month follow-up period. VCMX was associated with less pain or discomfort and reduced patient morbidity, as reflected by the significantly reduced VAS value in the VCMX group.