Implant Survival Rate Research Articles

The influence of two distinct surface modification techniques on the clinical efficacy of titanium implants: A systematic review and meta-analysis

PurposeTo compare the effectiveness of anodized and sandblasted large-grit acid-etched surface modification implants in clinical applications. MethodsThis systematic review has been registered at PROSPERO (CRD42023423656). A systematic search was performed using seven databases. The meta-analysis was performed using the RevMan 5.4 program and Stata 17.0 software. An analysis of the risk of bias in the included studies was conducted using the Cochrane Handbook for Systematic Reviews of Interventions and the Newcastle-Ottawa scale. ResultsA comprehensive analysis of 16 studies, which collectively encompassed a total of 2768 implants, was finished. Following a five years follow-up, the meta-analysis showed that the cumulative survival rate of implants was lower in the anodized group compared to the sandblasted large-grit acid-etched group (RR, 3.47; 95 % confidence interval [CI], 1.23 to 9.81; P = 0.02). Furthermore, the anodized group and the sandblasted large-grit acid-etched group had similar marginal bone loss over the one to three years follow-up period. However, it was observed that the marginal bone loss increased at the five years follow-up period in the anodized group in comparison to the sandblasted large-grit acid-etched group (SMD, 2.98; 95 % CI, 0.91 to 5.06; P = 0.005). In terms of biological complications, plaque index, bleeding on probing, and probing pocket depth, we found no statistically significant differences between the anodized and sandblasted large-grit acid-etched group. ConclusionsThe sandblasted large-grit acid-etched group exhibited higher implants cumulative survival rate and less marginal bone loss compared to the anodized group. Moreover, both groups demonstrated similar incidences of biological complications, plaque index, bleeding on probing, and probing pocket depth, suggesting overall equivalence in these aspects.

Long-Term Outcomes of Cementless Bipolar Hemiarthroplasty in Young Patients With Osteonecrosis of the Femoral Head: The Impact of Implant Improvements and Preoperative Stage.

Introduction Advancements in bipolar hemiarthroplasty (BHA) implants in the mid-1990s contributed to favorable short-term outcomes for osteonecrosis of the femoral head (ONFH), particularly in cases without acetabular cartilage lesions. Nevertheless, long-term results remain unclear. In this study, we investigated (i) the impact of new-generation BHA implants and (ii) the effect of the preoperative stage on long-term outcomes in young patients with ONFH. Methods The records of consecutive patients with ONFH who underwent cementless BHA were retrospectively reviewed. Patients aged ≥60 years, with <10 years of follow-up, or who underwent acetabular reaming during surgery were excluded. Radiographical and clinical outcomes of patients who received first-generation BHAs and new-generation BHAs (developed after 1998) were compared by stratifying based on preoperative stage 2/3A and 3B/4, according to the Japanese Investigation Committee classification. Results Overall, 50 hips from 39 patients (mean age: 44.6 years; 64% male) with an average follow-up of 18.6 years were included. The frequency of advanced-stage patients was significantly higher in the first-generation BHA group than in the new-generation group. Regarding postoperative outcomes, the first-generation BHA group had higher acetabular erosion grades (p<0.001) and more femoral component loosening than those in the new-generation group (p<0.001). Revisions were performed in eight hips (seven in the first-generation and one in the new-generation BHA groups, p<0.001). In the new-generation BHA group, there were no significant differences in patient background between stage 2/3A and 3B/4 groups, and only one case in the stage 3B/4 group required revision. In the new-generation group, the grade of acetabular erosion was significantly higher for stage 3B/4 than stage 2/3A (p<0.001); other radiographical and clinical outcomes did not differ significantly between stages. Conclusion New-generation BHAs have significantly better implant survival rates for early-stage ONFH than those of first-generation BHAs. These findings indicate that BHA is an acceptable treatment option for early-stage ONFH in young patients.

Single-Center, Early Experience with the First 3D-Printed Surface, Fixed Bearing, Total Ankle Arthroplasty: A Minimum of 2-Year Follow-Up

Introduction/Purpose: As the fourth generation of total ankle arthroplasty (TAA) implants evolve, treatment solutions for end- stage ankle arthritis continue to improve. Technological advancements in CT guided planning and 3-D printing offers surgeons the ability to perform TAA with patient specific instrumentation and implants. 3-D printed components are designed to act as scaffold in hopes to facilitate early in-growth, to increase implant stability, to support long-term survivorship, and ultimately to improve the quality of life our patients. We present our early experience at a single academic center with a minimum of 2-year follow up data on the first 3-D printed, fixed bearing, TAA in the United States. We hypothesize that 3-D printed technology will demonstrate improved long-term survival and increased bony in-growth on the implant-bone interface. Methods: A retrospective review was performed on patients who underwent TAA with a minimum of 2-year clinical and radiographic data in which this 3-D printed TAA was utilized at our single academic center. Patient demographic, radiographic, and functional outcome scores were collected preoperatively, at 6 months, 1 year, and 2 years. The severity of ankle arthritis and associated deformities in patients were stratified using the COFAS classification. The primary outcomes of this study were implant survivorship, comparative analysis of preoperative and postoperative Patient Reported Outcomes Measurement Information System (PROMIS) physical function scores, VAS pain scores, radiographic development of linear radiolucency &gt;2 mm, cystic radiolucency &gt; 5mm, subsidence, and adverse events within 2 years of surgery. Results: Thirty patients were included with a median follow-up of 26 months (range, 24-36 months). Implant survival rate was 90%. One patient was revised to a stemmed TAA secondary to tibial subsidence. One patient required a TTC fusion secondary to Charcot collapse. One patient was revised to a staged ankle fusion secondary to periprosthetic joint infection. Two patients (6.7%) experienced linear radiolucency &gt;2mm with tibial subsidence in which one patient required a revision TAA (mentioned above) and another who was asymptomatic. No significant cystic radiolucency &gt;5 mm were identified. Five patients required re-operation from complications unrelated to the implant. VAS scores decreased significantly from 6 (IQR, 4-8) to 1 (IQR, 2-4) (P &lt;.001; r=0.55). PROMIS Physical scores increased significantly from 43.6 (IQR, 33-47.7) to 50.8 (44.8-57.7)(P &lt;.001; r=0.60). Conclusion: The utilization of this new 3-D printed, fixed bearing TAA demonstrated a ninety percent overall implant survival rate in our small cohort of patients. Further data will be required to determine the long term efficacy of this new 3-D printed implant on patient outcomes. Our early experience and complications presented in our study demonstrate that this 3-D printed TAA implant is safe and effective in the treatment of end-stage ankle arthritis.

Improved Survival Rates with Fixed Bearing Total Ankle Arthroplasty

Introduction/Purpose: With increasing total ankle arthroplasty (TAA) being performed and a plethora of new survivorship data available, an updated literature review is needed to better understand the impact of different types of implants on the outcomes of TAA. The purpose of this study is to compare the outcomes of fixed vs mobile bearing TAAs in the literature. Methods: A comprehensive search of MEDLINE for all articles published between 2004 and 2023 was conducted with a minimum two-year mean follow-up. Two reviewers evaluated each study to determine whether it was eligible for inclusion and abstracted the data of interest. Meta-analytic pooling of group results across studies was performed, examining implant survival and component failure. Seventy-three implant groups met inclusion criteria (only 3rd and 4th generation implants), composed of STAR (20), Salto (mobile bearing) (10), Salto Talaris (11), Hintegra (8), Zimmer (6), INBONE II (6), INBONE I (4), Infinity (4), Cadence (4). 41 groups (56.2%) were implanted with mobile bearing devices, and 32 (43.8%) with fixed bearing implants. In total, 6498 subjects were included, with a mean age of 61.77 years and a mean BMI of 28.5 kg/m2. At a mean follow-up of 62.2 months, the overall reoperation rate was 21.13% and the metal component revision rate was 10.16%. Results: The mean follow-up of mobile bearing TAA studies (N =41) was 77.8 (range 24-188.4) months, and that of fixed bearing studies (N =32) was 45.3 (range 24-85.2) months. Multivariate analysis of bearing type, controlling for follow-up duration, found fixed bearing implants had statistically significantly higher metal component survival rates (fixed=96.1%, mobile=87.9%, p=.001); however, there were no statistically significant differences in rates of reoperation (fixed=17.0%, mobile=24.8%, p=.768). When examining specifically tibial and talar component failure rates, there was no statistically significant difference between bearing type (fixed tibial=1.46%, mobile tibial=2.95%, p=.472) (fixed talar=2.19%, mobile talar=2.79%, p=.966). Overall implant survival rates at one, two, five, and ten years were 96.4%, 96.0%, 92.7%, and 79.4%, respectively, and did not differ by bearing type (Table 1). Conclusion: Implant survival was statistically significantly better for 3rd and 4th generation fixed bearing TAAs as compared to mobile bearing TAAs, controlling for length of follow-up. There was no statistically significant difference in total reoperation rate. This suggests that fixed bearing implants may offer improved implant survival compared to mobile bearing implants, though further research is needed to confirm these findings.

Survival Rate of Immediate Implants in Periodontally Compromised Patients: A Systematic Review

ABSTRACT Background: Immediate implant placement into a fresh extraction socket has been developed as a consistent treatment, allowing for a reduction in the duration of time necessary for prosthetic rehabilitation. The study will evaluate the clinical and radiologic outcomes of implants placed immediately for a 10-year follow-up period. Aim: The aim of this systematic review is to evaluate the durability of the immediate implant in periodontally compromised individual placement. Methods: Studies reporting clinical and radiologic implant outcomes from periodontally compromised individuals who were treated and followed periodontal and implant maintenance for ≥5 years were considered eligible for the review. Screening of the articles, data extraction, and quality assessment were conducted independently and in duplicate. Results: There were 99 papers, and of them, 55 were excluded after title/abstract assessment. The full texts of 28 potentially eligible publications were screened, but only seven studies met the inclusion criteria. Conclusions: The study confirms that immediate implant therapy is safe, effective, and predictable for successful osseointegration and long-term functioning in periodontally compromised individuals, with minimal differences in clinical and radiographic outcomes.

Survival and Success of Dental Implants in Patients with Autoimmune Diseases: a Systematic Review.

The purpose of this systematic review is to disclose the impact of autoimmune diseases and their medical treatment on dental implant survival and success. A literature search was conducted using MEDLINE (PubMed), The Cochrane Library and Embase up to December 6th, 2021. Any clinical study on patients with an autoimmune disease in whom implant therapy was performed was eligible. The quality of included studies was assessed using the Newcastle-Ottawa Scale. For each autoimmune disease group, data synthesis was divided into three groups: 1) overall results of the autoimmune disease, 2) overall results of corresponding control groups and 3) overall results of the autoimmune disease with a concomitant autoimmune disease (a subgroup of group 1). Descriptive statistics were used. Of 4,865 identified articles, 67 could be included and mainly comprising case reports and retrospective studies with an overall low quality. Implant survival rate was 50 to 100% on patient and implant level after a weighted mean follow-up of 17.7 to 68.1 months. Implant success was sporadically reported. Data on immunosuppressive medication were too heterogeneously reported to allow detailed analysis. Overall, a high implant survival rate was reported in patients with autoimmune diseases. However, the identified studies were characterized by a low quality. No conclusions could be made regarding implant success and the effect of immunosuppressants due to heterogeneous reporting.

Influence of implant length and diameter on implant failure: A retrospective study

ObjectiveDental implants are widely accepted in the dental community. Although several studies have reported high dental implant survival rates, complications can still occur. Implant failure is associated with different risk factors, including implant length and diameter. However, no clear consensus has yet been reached. This study aimed to evaluate the influence of different risk factors associated with implant failure. MethodsThis study included patients who received dental implants at Kyoto University Hospital. The inclusion criteria were dental implants placed between January 1, 2005 and December 31, 2022. Data on patient- and implant-related variables were collected. We used a marginal Cox proportional hazards models to investigate the association between the potential factors and implant failure. ResultsThis study included 147 patients who received 479 dental implants. Eleven of the 147 patients experienced implant failure, whereas 17 of the 479 implants failed. The cumulative survival rate of dental implants at the final time point was 95.3%. Multivariable marginal Cox analysis showed suggestive evidence that implant length (<10 mm) greatly increased the risk of implant failure compared with implant length (≥10 mm) (reference: <10 mm, hazard ratio, 0.07; 95% confidence interval, 0.01–0.34; p = 0.001). ConclusionsA cumulative survival rate comparable to that reported in other studies was achieved over prolonged periods of time. Although implant failure is multifactorial and implant length is only one of many factors contributing to implant loss, clinicians must be aware of the potential influence of implant length and make treatment decisions.

Clinical evaluation of bone quality of particulate cancellous bone and marrow, and implant prosthetic rehabilitation

This study aimed to subjectively evaluate bone quality in the particulate cancellous bone and marrow (PCBM) graft area and to assess the survival rates of implants.A retrospective review was conducted based on patient age, sex, diagnosis, reconstructed site, number of implants, prosthetic type, and duration of follow-up. Images from computed tomography (CT) before implant insertion were obtained and used in this study. We selected a 4.0-mm diameter × 8.0-mm length region of interest in the implant placement area, and measured the CT attenuation value.No significant correlations were seen between CT attenuation values and implant survival rates in the maxilla and mandible. On the other hand, CT attenuation values and implant survival rates were significantly lower in patients with malignancy than in non-malignant cases.Placing implants in PCBM grafted bone requires a full understanding of bone quality before surgery and drilling to ensure primary stability, along with consideration of soft tissue management and maintenance programs.

The effectiveness of dental implantation in patients with type II diabetes mellitus

The issue of the safety of dental implants in patients with diabetes mellitus, despite the increase in the number of orthopedic corrections of partial or complete adentia with their use, remains open [1].&#x0D; In such a situation, the most urgent question is the development of new, safe and less traumatic methods of dental implantation, which would expand the indications for prosthetics on implants for this category of persons and improve the quality of life of such patients through full-fledged correction of chewing function.&#x0D; The purpose of the study was to investigate the effectiveness and safety of the method of orthopedic rehabilitation proposed by the authors using implants in patients with type II diabetes mellitus.&#x0D; Material and methods. As part of the study, 68 patients were treated, who were divided into three groups: the main group (patients with DM operated without the formation of muco-periosteal flaps according to the protocol developed by us) — 34 patients (50 %); control group 1 (patients with DM operated according to the traditional protocol with the formation of muco-periosteal flaps) — 16 patients (24 %); control group 2 patients without diabetes, operated without formation of muco-periosteal flaps according to the protocol developed by us) — 18 patients (26 %).&#x0D; The effectiveness of dental implantation was evaluated after 2 years. Such indicators as the survival rate of dental implants and the level of bone resorption (according to the results of intraoral radiography were used as criteria. In addition, bone density was studied on the Hounsfield scale (HU).&#x0D; Results. It was found that in patients of the main group and control group 2, survival rates were 98.70 % and 98.72 %, respectively, in patients of control group 1, the survival rate of dental implants was 89.48 %, which is also comparable with literature data on dental implantation in patients with diabetes mellitus [2, 8, 9]. Possibly greater effectiveness in the main group and control group 2 is associated with a new method of dental implantation (RF Patent No. 2794843 dated 25.04.2023) [7] and the use of a collapsible navigational surgical template (Patent RU No. 2796749 dated 29.05.2023) [6], which allowed the main group and the control group to fix individual trajectories of articulation of the mandible (which further allowed to avoid incorrect orthopedic rehabilitation, which could lead to uneven or excessive load on dental implants), to avoid reduction of the alveolar ridge, to plan in advance the exact position of dental implants, and also eliminated the need for the formation of muco-periosteal flaps and further suturing.&#x0D; Conclusion. The use of the technique developed by us (RF patent No. 2794843 dated 25.04.2023) allows us to increase the effectiveness of treatment of patients with type II diabetes mellitus and bring it closer to the results of practically healthy people (according to retrospective observation for two years).

Prevalence of Peri-Implant Mucositis, Peri-Implantitis and Associated Risk Indicators of Implants with and without Laser-Microgrooved Collar Surface: A Long-Term (≥20 Years) Retrospective Study.

The aim of the current study was to retrospectively investigate the prevalence of peri-implant mucositis (PIM) and peri-implantitis (P) in a long-term follow-up (≥20 years) of implants with the same body design and body surface but different collar surfaces with laser-microtextured grooves (LMGSs) vs. no laser-microtextured grooves (no-LMGSs) in private practice patients. Furthermore, several patient-related, implant-related, site-, surgical-, and prosthesis-related potential disease risk factors were analyzed. A chart review of patients receiving at least one pair of implants (one with an LMGS and the other without LMGS) in the period 1993-2002 was used. Chi-square analysis was used to determine if a statistically significant difference between the investigated variables and PIM/P was present. Possible risk factors were statistically evaluated by a binary logistic regression analysis. A total of 362 patients with 901 implant-supported restorations (438 with LMGS and 463 no-LMGS) were included in the study. The cumulative survival rates of implants at 5, 10, 15, and 20 years were 98.1%, 97.4%, 95.4%, and 89.8%, respectively, for the LMGS group, and 93.2%, 91.6%, 89.5%, and 78.3% for the no-LMGS group. The difference was statistically significant at all timepoints (p < 0.05). In total, at the end of the follow-up period, 45.7% of patients and 39.8% of implants presented PIM, and 15.6% of patients and 14% of implants presented P. A total of 164 LMGS implants (37.4%) and 195 no-LMGS implants (42.1%) presented peri-implant mucositis, while 28 (6.3%) of LMGS implants and 98 (21.1%) no-LMGS implants demonstrated peri-implantitis. Differences between LMGS implants and no-LMGS implants were statistically significant (p < 0.05). The binary logistic regression identified collar surface, cigarette smoking, histories of treated periodontitis, and lack of peri-implant maintenance as risk factors for P. After at least 20 years of function in patients followed privately, LMGS implants compared to no-LMGS implants presented a statistically and significantly lower incidence of P. Implant collar surface, cigarette smoking, previously treated periodontitis, and lack of peri-implant maintenance are factors with significant association to P.

Implant survival rate and marginal bone loss of 174 implants with different variables associated over a minimum observational period of 20 years: A retrospective study.

To investigate the long-term implant survival rate and marginal bone loss (MBL) of implants with different variables associated over an observational period of at least 20 years. Patients with at least one implant placed prior to 2001 were recalled and visited. Data on implant macro-design, prosthetic aspects, site distribution, and patient-related factors were collected. MBL was evaluated on intraoral X-rays and peri-implant soft tissue parameters were recorded. The patients were asked to fill out a questionnaire to evaluate their satisfaction with the treatment received. Descriptive statistics indicators were estimated. Analysis of variance and analysis of covariance models were used to investigate any differences in the MBL and peri-implant probing depth (PPD) among the variables. A chi-square analysis was performed to investigate any association between different types of prosthetic implant-supported rehabilitations and survival/success outcomes. Forty-one (41) patients and 174 implants were included with a mean observational period of 23.3±2.8 years. The implant survival and success rates were 96.5% and 83.3% respectively, while 3.5% of early failures were detected. The lowest success rates were observed for implants supporting fixed full-arch rehabilitations (71.05%) and overdenture rehabilitations (86.11%). A mean MBL of 1.81±0.71mm and a mean PPD of 3.38±1.62mm were recorded. The interaction between the collected data with MBL and PPD did not reveal any statistically significant differences between the variables (p>0.05). A statistically significant difference was recorded when analyzing the association between the different types of prosthetic implant-supported rehabilitations and success rates (p=0.014), with fixed and removable full-arch rehabilitations presenting with lower success rates. Answers to the questionnaire showed a generally high level of satisfaction. Within the limits of this retrospective study and based on the results, an implant survival rate higher than 96% was observed after a mean observational period of 23.3±2.8 years. Both the implant survival rate and MBL seemed stable after a mean observational period of 23.3±2.8 years. Implants supporting fixed and removable full-arch rehabilitations seemed to present lower success rates over time. Implant rehabilitation seemed to provide patients with optimal long-term outcomes in terms of functional and psychological aspects.

Evaluation and assessment of the survival of tooth implant supported prosthesis in tooth and implant supported rehabilitation cases with metal frameworks

IntroductionOver the years, implant therapy has been a commonly used treatment option for individuals who are partially or totally edentulous, with a long-term success rate of over 90%. With significant advancements in biomaterials and technology, implant dentistry can now conduct prosthetic rehabilitations in the majority of patients catering to all types of needs. However, in order to meet the demands of a patient base that is always growing, new trends in implantology are emerging in recent years that are focused on minimally invasive surgery and financial sustainability. In certain clinical scenarios, connecting teeth and implants to support fixed partial prosthesis (FPPs) may be a predictable and workable course of treatment.Materials and methods22 patients were selected for this study who had tooth and implant supported prosthesis placed as a final restoration. Out of these 22 patients; 12 were male and 10 were female patients. Implants were placed following proper protocol and if grafting procedures were required they were carried out. A second stage surgical procedure was carried out and delayed loading protocols were followed. The statistical analysis was done using the IBM SPSS 24.0, Chicago, USA. The survival of the implants and teeth were measured by the Kaplan Meier survival scale. Bone loss was assessed at baseline(upon loading), 12 months and 24 months.ResultsThe implant survival rate was measured at 6 months, 12 months, 18 months and 24 months. At 24 months, one implant showed failure, so the survival rate of the implants were 95.4%. Bone loss of 1 mm was seen around one implant at 12 months. Bone loss of 1 and 2 mm was present around two implants and one implant respectively at 24 months.ConclusionFrom the results of this study, we can conclude that tooth implant supported prosthesis show very good survival when used in rehabilitation cases.

Clinical evaluation of maxillary sinus floor elevation with or without bone grafts: a systematic review and meta-analysis of randomised controlled trials with trial sequential analysis.

Our goal was to systematically review the current evidence comparing the relative effectiveness of two maxillary sinus floor elevation (MSFE) approaches (internal and external) without bone grafts with that of conventional/grafted MSFE in patients undergoing implantation in the posterior maxilla. Medical databases (PubMed/Medline, Embase, Web of Science, and Cochrane Library) were searched for randomised controlled trials published between January 1980 and May 2023. A manual search of implant-related journals was also performed. Studies published in English that reported the clinical outcomes of MSFE with or without bone material were included. The risk of bias was assessed using the Cochrane Handbook Risk Assessment Tool. Meta-analyses and trial sequence analyses were performed on the included trials. Meta-regression analysis was performed using pre-selected covariates to account for substantial heterogeneity. The certainty of evidence for clinical outcomes was assessed using GRADEpro GDT online (Guideline Development Tool). Seventeen studies, including 547 sinuses and 696 implants, were pooled for the meta-analysis. The meta-analysis showed no statistically significant difference between MSFE without bone grafts and conventional MSFE in terms of the implant survival rate in the short term (n = 11, I2 = 0%, risk difference (RD): 0.03, 95% confidence intervals (CI): -0.01-0.07, p = 0.17, required information size (RIS) = 307). Although conventional MSFE had a higher endo-sinus bone gain (n = 13, I2 = 89%, weighted mean difference (WMD): -1.24, 95% CI: -1.91- -0.57, p = 0.0003, RIS = 461), this was not a determining factor in implant survival. No difference in perforation (n = 13, I2 = 0%, RD = 0.03, 95% CI: -0.02-0.09, p = 0.99, RIS = 223) and marginal bone loss (n = 4, I2 = 0%, WMD = 0.05, 95% CI: -0.14-0.23, p = 0.62, no RIS) was detected between the two groups using meta-analysis. The pooled results of the implant stability quotient between the two groups were not robust on sensitivity analysis. Because of the limited studies reporting on the visual analogue scale, surgical time, treatment costs, and bone density, qualitative analysis was conducted for these outcomes. This systematic review revealed that both non-graft and grafted MSFE had high implant survival rates. Owing to the moderate strength of the evidence and short-term follow-up, the results should be interpreted with caution.

Survival Rate of Implants and Mechanical Complications of 64 Implant-Supported Complete Arch Prostheses in Maxillary Edentulous Patients with a Follow-Up of up to 12 years: A Cross Sectional Analytical Study.

This study aimed to identify the technical complications associated with maxillary complete-arch implant-supported fixed prostheses (ISFPs) and to evaluate the survival rates of both implants and prostheses. Additionally, we sought to analyze the impact of the presence of cantilevers, the type of prosthetic abutment, and the number of implants on the occurrence of complications. Data were obtained from standardized clinical assessments carried out in a single appointment by two calibrated professionals using information from dental records. The sample consisted of 64 patients rehabilitated with ISFPs classified as hybrid prostheses (metal-resin). The survival rate for implants was 98.6% after 1 to 12 years (5.2 years ± 36.6 months) and was 100% for the prostheses after a follow-up period of 12 to 144 months (mean 48.1 ± 33.94 months). The most frequent complications were occlusal wear (82.8% of patients) and loosening of prosthetic screws (16.6%) and abutments (8.1%). Screw loosening frequency was significantly greater in 30-degree abutments compared with straight abutments (P=0.008), but no significant difference was found between 17-degree and 30-degree abutments. Prostheses with a higher occurrence of screw loosening had a greater average CL/AP spread ratios (0.9 􀀀 0.5). In addition, abutments installed on distal implants were more likely to loosen (P<0.001). The absence of mutually protected occlusion did not significantly influence the loosening of screws and prosthetic abutments. Implantsupported fixed maxillary complete-arch rehabilitations have high survival rates but are subject to technical complications.

Immediate Versus Non-immediate Loading Protocols for Reduced-Diameter Implants Supporting Overdentures: A Systematic Review and Meta-analysis.

To compare the influence of immediate loading (IL) and non-immediate loading (NIL) protocols on overdentures retained by reduced-diameter implants (≤ 3.5 mm). Electronic databases including MEDLINE (via PubMed), Embase, and the Cochrane Central Register of Controlled Trials were searched for randomized controlled trials (RCTs) comparing clinical outcomes of immediately loaded and non-immediately loaded reduced-diameter implants supporting overdentures. The risk of bias within and across the studies and the certainty of evidence were assessed by RoB 2.0 and GRADE, respectively. A sensitivity analysis was performed by eliminating studies at high risk of bias and repeating the data synthesis employing the random effects model. Subgroup analyses were conducted based on the implant diameter and the length of follow-up. Overall, six RCTs with 255 patients were included in this systematic review. The meta-analyses found similar implant survival rates between immediately loaded and non-immediately loaded implants in the mini-implant (RR &#61; 0.98; 95% CI &#61; 0.95, 1.01; P &#61; .12) and narrow-diameter implant subgroups (RR &#61; 0.99; 95% CI &#61; 0.94, 1.03; P &#61; .56) as well as in short-term (RR &#61; 0.98; 95% CI &#61; 0.97, 1.00; P &#61; .11) and long-term (RR &#61; 0.97; 95% CI &#61; 0.93, 1.01; P &#61; .09) follow-up subgroups. Additionally, marginal bone loss (MBL) showed no statistically significant difference between the loading protocols in the subgroup of long-term follow-up (MD &#61; 0.03; 95% CI &#61; -0.16, 0.23; P &#61; .74). Three RCTs investigating peri-implant parameters found relatively higher modified plaque index (PI) and probing depth (PD) in reduced-diameter implants under IL. Compared with NIL, the IL protocol can achieve comparable survival rates and MBL in reduced-diameter implants supporting overdentures.

Survival analysis of dental implants placed in horizontally severely resorbed maxillae after reconstruction with xenogeneic graft: a case series.

To evaluate the survival rates of dental implants with a hybrid macrostructure and the surface biomimetically coated with nanohydroxyapatite, placed in horizontally atrophic maxillae previously submitted to the guided bone regeneration (GBR) procedure, associated with the use of a deproteinized bovine bone graft (DBB). Twenty-five patients who received 196 implants were involved in this study. First, these patients were submitted to GBR procedures and maxillary sinus lift, where DBB was used as the grafting material. The dental implants were placed after a minimum period of 6 months of the grafting procedures. The patients were followed up every six months and clinical/radiographic examinations were performed to assess the implants, using the following indicators as a reference: (1) Absence of mobility; (2) Absence of pain. Data about the age, surgery time, smoking status, implant size, and time between the grafting procedure and implant placement were correlated with implant failures. Twelve implants failed, generating a survival rate of 94.23%. None of the variables analysed correlated with the implant failures. Implants with a hybrid macrostructure and surface biomimetically coated with nanohydroxyapatite present good survival rates in horizontally atrophic maxillae grafted with DBB.

Functional outcomes and survivorship following aseptic revision shoulder arthroplasty

BackgroundRevision shoulder arthroplasty (SA) is a surgical procedure performed to address complications or failures of primary total SA. However, limited evidence exists regarding the functional outcomes and longevity of implants following revision. MethodsA retrospective analysis was conducted on patients who underwent revision SA for failed primary arthroplasty at a single institution between 2009 and 2021 with a minimum of 2-years follow-up. Data was collected from medical records, including type of arthroplasty (anatomic total SA [TSA], reverse total SA [RSA], or hemi-SA [HSA]), demographics and patient-specific information, functional measurements, and implant survival. Patient reported outcomes were obtained during follow-up by phone. ResultsThe mean age at index and revision surgeries was 60.5 ± 12.1 years and 64.8 ± 11.1 years, respectively, and average total follow-up was 5.5 ± 3.5 years. The average time to revision was 4.5 ± 5.2 years (range 0.01–24.5 years). Among 99 revision shoulder arthroplasty procedures, 28 were TSA/HA to TSA/HA, 51 were TSA/HA to RSA, 18 were RSA to RSA, and 2 were RSA to HA. Revision surgery significantly improved functional outcomes in forward elevation (preoperative: 79.8 ± 41.0 vs postoperative: 118.5 ± 38.3; p < 0.001), external rotation (preoperative: 27.8 ± 19.3 vs postoperative: 34.3 ± 16.2; p = 0.028), internal rotation (preoperative: glute vs postoperative: S1; p = 0.002), and forward elevation strength (preoperative: 4+/5 vs postoperative: 5/5; p = 0.002). Postoperative patient reported outcomes included: VAS pain (2.2 ± 2.9), SANE (72.6 ± 21.5), ASES (73.3 ± 20.4), and SST (7.7 ± 2.8) scores. The overall 2-, 5-, and 10-year post-revision implant survival rate was 85.48%, 83.06%, and 79.84%, respectively. Patients who had an initial RSA and were revised to RSA were at higher risk of implant failure and subsequent re-revision (RSA to RSA: 1.5 ± 2.5 years vs. TSA/HA to RSA: 2.5 ± 2.1 years vs. TSA/HA to TSA/HA: 4.0 ± 3.5 years; p = 0.0046) ConclusionRevision shoulder arthroplasty improved patient outcomes post-index arthroplasty failure. Revisions were more likely to be successful when revising from TSA/HA to RSA. Level of evidenceLevel III – retrospective comparative study.

Limb Salvage and Pelvic Reconstruction With Endoprosthesis After Pelvic Tumor Resection: A Narrative Review.

Periacetabular defects following tumor resection present formidable challenges in reconstruction and continue to pose clinical difficulties. Historically, treatment approaches leaned towards hindquarter amputation; however, due to associated morbidities and functional limitations, limb-sparing procedures gained prominence in the 1980s. Nevertheless, the intricacies of pelvic anatomy and the imperative of achieving wide surgical margins while preserving essential structures make pelvic tumor resection and subsequent reconstruction inherently complex. Various reconstruction modalities have been explored, including non-vascularized fibular grafts and prosthetic implants. Among these options, the LUMiC® endoprosthesis stands out as a promising solution for pelvic reconstruction post-tumor resection. Characterized by a modular design featuring a hydroxyapatite-coated stem and acetabular cup, this device has shown favorable implant survival rates in studies, despite encountering complications primarily associated with soft tissue failure, dislocation, and infection. Notably, the incidence of complications varies across studies. The Henderson classification system delineates these complications, encompassing soft tissue issues, aseptic loosening, periprosthetic fractures, infections, and tumor recurrence. Despite the encouraging functional outcomes associated with the LUMiC® endoprosthesis, it is not immune to limitations. Concerns persist regarding complications such as dislocation and infection, underscoring the imperative for further research to evaluate the long-term durability and reliability of this reconstructive approach. Moreover, advancements in surgical techniques, perioperative management, and the advent of navigation-assisted procedures hold promise for enhancing outcomes and mitigating complication rates in pelvic reconstruction surgeries.

Immediate rehabilitation of severely atrophic maxillae using conventional and extended length subcrestal angulated (ELSA) implants: A retrospective analysis of 187 implants in 33 patients with up to three years of function.

The purpose of this study was to evaluate and determine clinical outcomes and survival rates of straight and extended length subcrestal angulated (ELSA) implants (20-24mm lengths) placed for immediate (up to 72h post-operative) or delayed rehabilitation (4 months post-operative) of severely atrophic maxillae. Prosthetic treatment consisted of interim and definitive implant-supported fixed implant-supported prostheses with up to 3 years of function. A retrospective analysis was conducted of 38 patients (five dropped out; final total was 33), treated between 2017 and 2019 in a private practice. Extended length subcrestal angulated (ELSA) implants and conventional endosseous straight implants (Southern Implants, Irene, South Africa) with (fixed) full arch prostheses were used to restore patients with edentulous maxillae immediately (within 72hs) or delayed (4 months). ELSA implants have subcrestal angulations of 24° and 36° of the restorative platforms, external hexagon crestal anti-rotation abutment connections, and lengths between 18 and 26mm. Implant loading was determined by implant insertion torque values (as determined on the surgical units); 120Ncm was the threshold level for immediate loading. Clinical and radiographic examinations were done that recorded the clinical outcomes of implants and prostheses. SPSS was used to process the data. Thirty-three patients and 187 implants were included with follow-up periods of at least 12 months (range 12-36 months). The mean age of the study population was 62.6 ± 8.4 years old (at the time of implant placement). Thirty-three patients (86.8%) were followed for 12 months; 13 patients (39.4%) were followed for 24-35 months; 9 patients (27.3%) were followed for 36 months. In total, 13 implants in six patients failed secondary to sinus infections. Mean bone levels (MBLs) were respectively: 0.88±2.12mm at loading, -1.53±2.03mm at 12 months, -2.26±1.45mm at 24 months, and -2.54±1.46mm at 36 months. The ELSA implants showed significantly lower (p = 0.014) MBL at 36 months than did the conventional implants. One hundred thirty-seven implants were placed and loaded within 72h; 50 implants were placed and loaded 4 months post placement. The combined implant survival rates were 93.0% at 12 months, 91.1% at 24 months, and 100% at 36 months. The ELSA implants showed significantly lower (p = 0.014) MBLs at 36 months when compared to the conventional implants. The results of this retrospective clinical chart review indicated that the use of ELSA implants placed into anterior maxillae and nasal crests with accentuated distal tilts (>30°) and simultaneous sinus augmentation provided favorable outcomes for prosthetic rehabilitation in patients with severe atrophic maxillae. ELSA implants placed with simultaneous sinus augmentation are an alternative option to zygomatic implants (ZI) when immediate loading is prescribed. Sinus infections were thought to be the proximate causes of all implant failures. Further long-term clinical studies are warranted with larger patient populations.

Guided bone regeneration for peri-implant augmentation: Aretrospective study comparing two surgical techniques with a mean follow-up of 26 months.

To introduce a modified guided bone regeneration (GBR) technique using intact periosteum and deproteinized bovine bone mineral (DBBM) for peri-implant augmentation and compare the clinical outcomes with those of conventional GBR. Patients who received peri-implant augmentation in posterior sites between 2015 and 2021 were reviewed in this study. Group A was treated with a modified GBR technique, and Group B was treated with conventional GBR. For group comparison, propensity score matching was performed with a sensitivity analysis. The implant survival rate, dimensional changes in hard tissue, marginal bone loss (MBL), and peri-implant parameters were evaluated. In total, 114 implants from 98 patients were included. The implant survival rates were 95.74% in Group A and 95.00% in Group B during the follow-up period. At 6 months, the median horizontal thickness was recorded at 0.87 mm (IQ1-IQ3 = 0.00-1.75 mm) in Group A, exhibiting a relatively lower value compared to the corresponding measurement of 0.98 mm (IQ1-IQ3 = 0.00-1.89 mm) in Group B (p = .937). Vertical height displayed no statistically significant intergroup difference between the two groups (p = .758). The mean follow-up period was 25.83 ± 12.93 months after loading in Group A and 27.47 ± 21.29 months in Group B (p = .761). MBL and peri-implant parameters were comparable between the two groups. Within the limitations of this study, the modified GBR technique using intact periosteum and DBBM grafting might be a viable alternative to correct bone defects around implants in molar and premolar sites.