Park, Ja-young;Bae, Ahran;Kim, Hyung-Seub;Kwon, Yong-Dae;Lee, Baek-Soo;Kwon, Kung-Rock
Journal of Dental Rehabilitation and Applied Science
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v.25
no.2
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pp.139-155
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2009
Objective : To assess the biological stability of immediate transmucosal placement of tapered implants into tooth extraction sockets. Material and methods : Following tooth extraction, tapered implants were immediately placed into the sockets. Teeth with evidence of acute periapical pathology were excluded. After implant placement, sutured allowing a non-submerged, transmucosal healing. Standardized radiographs were obtained every visiting from baseline to 32 weeks after implant placment. Changes in depth of the distance from the implant shoulder (IS) and from the alveolar crest (AC) to the bottom of the defect (BD) were assessed. Results : Thirteen patients (10 males and 3 females) were enrolled and followed. They contributed with 15 tapered implants. extraction iste displayed sufficient residual bone volume to allow primary stability of all implants. The mean surgery time was $41{\pm}10.0$ mins. All implants healed uneventfully yielding a survival rate of 100%. Mean ISQ values were relatively stable. Interproximal crestal bone decreased $1.69{\pm}1.2mm$ (mesial), $1.65{\pm}1.2mm$ (distal) from baseline to 32-week follow-up. No statistically significant changes with respect to FMPS, FMBS, PPD and width of KG were observed. Conclusions: Immediate transmucosal implant placement represented a predictable treatment option for the replacement of teeth lost due to reasons including fractures, endodontic failures and caries.
Purpose: The aim of the present study was to evaluate the in vivo accuracy of flapless, computer-aided implant placement by comparing the three-dimensional (3D) position of planned and placed implants through an analysis of linear and angular deviations. Methods: Implant position was virtually planned using 3D planning software based on the functional and aesthetic requirements of the final restorations. Computer-aided design/computer-assisted manufacture technology was used to transfer the virtual plan to the surgical environment. The 3D position of the planned and placed implants, in terms of the linear deviations of the implant head and apex and the angular deviations of the implant axis, was compared by overlapping the pre- and postoperative computed tomography scans using dedicated software. Results: The comparison of 14 implants showed a mean linear deviation of the implant head of 0.56 mm (standard deviation [SD], 0.23), a mean linear deviation of the implant apex of 0.64 mm (SD, 0.29), and a mean angular deviation of the long axis of $2.42^{\circ}$ (SD, 1.02). Conclusions: In the present study, computer-aided flapless implant surgery seemed to provide several advantages to the clinicians as compared to the standard procedure; however, linear and angular deviations are to be expected. Therefore, accurate presurgical planning taking into account anatomical limitations and prosthetic demands is mandatory to ensure a predictable treatment, without incurring possible intra- and postoperative complications.
Di Stefano, Danilo Alessio;Arosio, Paolo;Piattelli, Adriano;Perrotti, Vittoria;Iezzi, Giovanna
The Journal of Advanced Prosthodontics
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v.7
no.1
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pp.51-55
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2015
PURPOSE. Bone density at implant placement site is a key factor to obtain the primary stability of the fixture, which, in turn, is a prognostic factor for osseointegration and long-term success of an implant supported rehabilitation. Recently, an implant motor with a bone density measurement probe has been introduced. The aim of the present study was to test the objectiveness of the bone densities registered by the implant motor regardless of the operator performing them. MATERIALS AND METHODS. A total of 3704 bone density measurements, performed by means of the implant motor, were registered by 39 operators at different implant sites during routine activity. Bone density measurements were grouped according to their distribution across the jaws. Specifically, four different areas were distinguished: a pre-antral (between teeth from first right maxillary premolar to first left maxillary premolar) and a sub-antral (more distally) zone in the maxilla, and an interforaminal (between and including teeth from first left mandibular premolar to first right mandibular premolar) and a retroforaminal (more distally) zone in the lower one. A statistical comparison was performed to check the inter-operators variability of the collected data. RESULTS. The device produced consistent and operator-independent bone density values at each tooth position, showing a reliable bone-density measurement. CONCLUSION. The implant motor demonstrated to be a helpful tool to properly plan implant placement and loading irrespective of the operator using it.
Purpose: The aims of the present study were 1) to quantitatively evaluate the extent of sinus pneumatization and 2) to determine the factors affecting sinus pneumatization. Methods: Based on implant treatment records, a list of patients who underwent implant placement on the posterior maxilla was obtained. Among them, patients with pre-extraction and post-extraction (before implant placement) panoramic radiographs were selected. After excluding radiographs with low resolution and image distortion, the radiographs before and after extraction were superimposed using computer software. Subsequently, the extent of sinus pneumatization (the vertical change of the sinus floor) was measured. Simple and multiple mixed models were used to determine the factors affecting sinus pneumatization. Results: A total of 145 patients were eligible for the present investigation. The average extent of sinus pneumatization was 1.56±3.93 mm at 176 tooth sites. Male sex, single tooth extraction, extraction of an endodontically compromised tooth, a class I root-sinus relationship, and sinus membrane thickening >10 mm favored pneumatization, but without statistical significance. The maxillary second molar presented the greatest pneumatization (2.25±4.39 mm) compared with other tooth types. This finding was confirmed in the multiple mixed model, which demonstrated a statistically significant impact of the extraction of a second molar compared with the extraction of a first premolar. Conclusions: Maxillary sinus pneumatization was 1.56±3.93 mm on average. The extraction of a second molar led to the greatest extent of pneumatization, which should be considered in the treatment plan for this tooth site.
Purpose: This study evaluated the clinical applications of implant placement and guided bone regeneration using a mineralized bone allograft and a barrier membrane derived from ox pericardium Methods: From January 2007 to June 2009, among the patients who received an implant at Chosun University Dental Hospital, patients were selected if they were treated with guided bone regeneration (GBR) with simultaneous implant placement or GBR prior to implant placement. The selected patients were sorted according to the materials and membranes used in GBR, and the implant survival rate was recorded by clinical examination and reviewing the medical records and the radiographs. Each study list was analyzed by SPSS (version 12.0, SPSS Inc., USA) software and the survival rate was verified by Chi-square tests. $P$ values less than 0.05% were deemed significant. Results: 278 implants were placed on a total of 101 patients and 8 implants resulted in failure. Three implants failed among 15 implants with only a mineralized bone allograft. No failure was shown among the 74 implants placed with mineralized bone allograft and a barrier membrane derived from ox pericardium. One group of 4 implant placements showed failure among the 102 implants placed with a mineralized bone allograft and another bone graft material. The group that had a barrier membrane derived from ox pericardium with a mineralized bone allograft or other bone materials showed no implant failure. Three failures were shown among the 21 implants placed with only bone graft and not using a membrane. The group with membranes other than a barrier membrane derived from ox pericardium showed 5 failures among 170 implants. Conclusion: The implant survival rate of the group with GBR using a mineralized bone allograft was 96.3%, which meant there was little difference compared to the groups of another bone graft materials (98.9%). The implant survival rate of the group without a membrane-was 85.7% and it showed a significant difference compared to the group using a barrier membrane derived from ox pericardium (100%) and the group using another membrane (97.1%).
Implant assisted removable partial denture (IARPD) has been practiced in various forms for a long time, and among them, implant surveyed crown RPD is gaining predictability as well as being considered as a treatment option for patients with anatomical and financial disadvantages. The position of implant could be divided as posterior placement or anterior placement according to the purpose of the treatment and should be planned in consider to the alveolar ridge of patient, anticipated prognosis of remaining teeth, and opposing dentition. This case report describes a treatment for mandibular Kennedy class I partial edentulous patient with two implant-supported surveyed crown and implant assisted removable partial denture. Given the difficulty of posterior placement in this patient and the prognosis of the residual teeth, the plan was to place two implants in close proximity to the residual teeth, which were placed in the planned position, angle, and depth using guided surgery. The process of fabricating the fixed prosthesis was carried out in parallel with the maxillary edentulous tooth arrangement process to increase predictability, and when fabricating the localized tooth, the implant was designed in a form that allows the patient to perform functional movements by preventing excessive loading as the last supporting tooth, and was fabricated through a secondary impression process. Each treatment procedure was proceeded as planned, with aesthetically and functionally satisfactory results for both patient and operator.
The aim of this study was to analyze various data of 120 non-submerged ITI implants placed in 64 korean adults. The data were retrieved from patients' charts and registered in the computer and coded for a statistical analysis. The results revealed that the most common type of edentulism was a distal extension case, and the largest number of implants were placed in the mandibular first molar position. Implants were placed more frequently in mandibular, posterior position than maxillary, anterior position, respectively. With respect to the implant diameter and length, an implant with 4.1mm in diameter and more than 10mm in length was the most common. Since a molar position was the most prevalent position for implant placement in korean patients, clinicians should be careful about implant diameter which can resist a strong occlusal force expected in the molar position. In addition, the distance to the mandibular canal and the floor of maxillary sinus should be considered to avoid possible damages, such as nerve injury and sinus perforation in selecting a proper implant length.
Purpose: During guided bone regeneration procedures for the augmentation of deficient alveolar ridge, primary closure of flap is necessary. For primary flap closure, flap is repositioned coronally and the zone of attached keratinized mucosa may decreased. The need for attached keratinized mucosa around dental implants is still controversial, but sufficient peri-implant attached keratinized mucosa would be beneficial for functional and esthetic aspects. This case report presents three cases that demonstrated free gingival graft for increasing the zone of peri-implant attached keratinized mucosa which was decreased after guided bone regeneration. Materials and Methods: In first case, maxillary incisors were extracted and guided bone regeneration was performed simultaneously. Because the membrane was exposed at 3 weeks after operation, the membrane was removed and free gingival graft was performed for primary flap closure. Free gingival graft was performed again at implant placement for the increase of attached keratinized mucosa. In second case, guided bone regeneration was performed on lower right first molar area, and implant was placed with free gingival graft. In third case, lower right molar area showed insufficient attached keratinized mucosa after implant placement with guided bone regeneration. When abutments were connected, free gingival graft with apically positioned flap was performed. Result: In these three cases, the zone of attached keratinized mucosa around dental implants was decreased after guided bone regeneration. And the increase of peri-implant attached keratinized mucosa could be obtained effectively by free gingival graft. Conclusion: Free gingival graft could be a effective treatment method increasing the zone of attached keratinized mucosa which was decreased after guided bone regeneration procedures.
PURPOSE. The purpose of this study was to evaluate the amount of resorption and thickness of labial bone in anterior maxillary implant using cone beam computed tomography with Hitachi CB Mercuray (Hitachi, Medico, Tokyo, Japan). MATERIALS AND METHODS. Twenty-one patients with 26 implants were followed-up and checked with CBCT. 21 OSSEOTITE $NT^{(R)}$. (3i/implant Innovations, Florida, USA) and 5 $OSSEOTITE^{(R)}$. implants (3i/implant Innovations, Florida, USA) were placed at anterior region and they were positioned vertically at the same level of bony scallop of adjacent teeth. Whenever there was no lesion or labial bone was intact, immediate placement was tried as possible as it could be. Generated bone regeneration was done in the patients with the deficiency of hard tissue using $Bio-Oss^{(R)}$. (Geistlich, Wolhusen, Switzerland) and $Bio-Gide^{(R)}$. (Geistlich, Wolhusen, Switzerland). Second surgery was done in 6 months after implant placement and provisionalization was done for 3 months. Definite abutment was made of titanium abutment with porcelain, gold and zirconia, and was attached after provisionalization. Two-dimensional slices were created to produce sagittal, coronal, axial and 3D by using OnDemand3D (Cybermed, Seoul, Korea). RESULTS. The mean value of bone resorption (distance from top of implant to labial bone) was $1.32 \;{\pm}\; 0.86\; mm$ and the mean thickness of labial bone was $1.91 \;{\pm}\; 0.45 \;mm$. CONCLUSION. It is suggested that the thickness more than 1.91 mm could reduce the amount and incidence of resorption of labial bone in maxillary anterior implant.
Purpose: The objective of this study was to compare the outcomes of surgical mini-implant placement when potential mini-implant sites were scanned using a lower-dose $180^{\circ}$ acquisition protocol versus a conventional $360^{\circ}$ acquisition protocol. Materials and Methods: Ten dentate human skulls were used to provide sites for potential mini-implant placement. The sites were randomly divided into 2 groups: $360^{\circ}$ and $180^{\circ}$ cone-beam computed tomography (CBCT) acquisition protocols. A small-volume $180^{\circ}$ CBCT scan and a $360^{\circ}$ CBCT scan of each site were acquired using a Morita Accuitomo-170 CBCT machine and then a mini-implant was placed. A follow-up $360^{\circ}$ CBCT scan was done as a gold standard to evaluate the location of the mini-implant and root perforation. Two raters evaluated the scans. Results: Ninety-eight percent of the mini-implants placed did not perforate any root structure. Two percent of the sites had an appearance suggestive of perforation. On a Likert scale, both raters agreed that their subjective evaluation of the diagnostic quality of the protocols, ability to make and read measurements of the sites, and preferences for the specified diagnostic task were comparable. The Cohen kappa showed high inter-rater and intrarater agreement. Conclusion: In this ex vivo study, we found that the $180^{\circ}$ rotational acquisition was as effective as the conventional $360^{\circ}$ rotational acquisition for the preoperative evaluation of potential mini-implant sites.
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