| 1. |
- Bolle, C., et al.
(författare)
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4 mm long vs longer implants in augmented bone in posterior atrophic jaws: 1-year post-loading results from a multicentre randomised controlled trial
- 2018
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Ingår i: European Journal of Oral Implantology. - 1756-2406. ; 11:1, s. 31-47
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To evaluate whether 4.0 mm short dental implants could be an alternative to augmentation with xenographs in the maxilla and placement of at least 10.0 mm long implants in posterior atrophic jaws. Materials and methods: A group of 40 patients with atrophic posterior (premolar and molar areas) mandibles with 5.0 mm to 6.0 mm bone height above the mandibular canal and 40 patients with atrophic maxillas having 4.0 mm to 5.0 mm below the maxillary sinus, were randomised according to a parallel group design to receive between one and three 4.0 mm long implants or one to three implants of at least 10.0 mm long in augmented bone, at two centres. All implants had a diameter of 4.0 mm or 4.5 mm. Mandibles were vertically augmented with inter-positional equine bone blocks and resorbable barriers. Implants were placed 4 months after the inter-positional grafting. Maxillary sinuses were augmented with particulated porcine bone via a lateral window covered with resorbable barriers, and implants were placed simultaneously. Implants were not submerged and were loaded after 4 months with provisional screw-retained reinforced acrylic restorations replaced after another 4 months by definitive screw-retained metal-composite prostheses. Patients were followed up to 1 year post-loading. Outcome measures were: prosthesis and implant failures, any complication, and peri-implant marginal bone level changes. Results: Three patients dropped out; one from the maxillary augmented group, one from the mandibular augmented group, and one from the maxillary short implant group. In six augmented mandibles (30%) it was not possible to place implants of at least 10.0 mm, so shorter implants were placed instead. In mandibles, one implant from the augmented group failed vs two 4.0 mm implants in two patients from the short implant group. In maxillae, three short implants failed in two patients vs seven long implants in four patients (two long implants and one short implant dropped into the maxillary sinus). Two prostheses on short implants (one mandibular and one maxillary) were placed at a later stage because of implant failures, vs six prostheses (one mandibular and five maxillary) at augmented sites (one mandibular prosthesis not delivered, three maxillary prostheses delivered with delays, one not delivered, and one failed) at augmented sites. In particular, three patients in the augmented group (one mandible and two maxillae) were not wearing a prosthesis. There were no statistically significant differences in implant failures (P (chi-square test) = 0.693; difference in proportion = 0.03; CI 95% -0.11 to 0.17) or prostheses failures (P (chi-square test) = 0.126; difference in proportion = 0.10; CI 95% -0.03 to 0.24). At mandibular sites, nine augmented patients were affected by complications vs two patients treated with short implants (P (chi-square test) = 0.01; difference in proportion = 0.37; CI 95% 0.11 to 0.63), the difference being statistically significant. No significant differences were found for maxillae: nine sinus-lifted patients vs four short implant patients were affected by complications (P (chi-square test) = 0.091; difference in proportion = 0.25; CI 95% -0.03 to 0.53). At 1-year post-loading, average peri-implant bone loss was 0.51 mm at 4 mm long mandibular implants, 0.77 mm at 10 mm or longer mandibular implants, 0.63 mm at short maxillary implants and 0.72 mm at long maxillary implants. The difference was statistically significant in mandibles (mean difference -0.26 mm, 95% CI -0.39 to -0.13, P (ANCOVA) < 0.001), but not in maxillae (mean difference -0.09 mm, 95% CI -0.24 to 0.05, P (ANCOVA) = 0.196). Conclusions: One year after loading 4.0 mm long implants achieved similar results, if not better, than longer implants in augmented jaws, but were affected by fewer complications. Short implants might be a preferable choice over bone augmentation, especially in mandibles, since the treatment is less invasive, faster, cheaper, and associated with less morbidity. However, 5 to 10 years post-loading data are necessary before making reliable recommendations. © 2002-2018 Quintessence Publishing Group.
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| 2. |
- Cannizzaro, G., et al.
(författare)
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Early implant loading in the atrophic posterior maxilla: 1-stage lateral versus crestal sinus lift and 8mm hydroxyapatite-coated implants. A 5-year randomised controlled trial
- 2013
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Ingår i: European Journal of Oral Implantology. - 1756-2406 .- 1756-2414. ; 6:1, s. 13-25
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To evaluate the efficacy of long implants (10-16 mm) inserted in maxillary sinuses augmented according to a lateral approach versus short (8 mm) implants placed in crestally augmented sinuses, early loaded after 45 days. Materials and methods: Forty partially or fully edentulous patients having 3 to 6mm of residual crestal height and at least 4mm in thickness below the maxillary sinuses were randomised according to a parallel group design to receive either one to three 10 to 16 mm-long hydroxyapatite-coated implants (20 patients) after lateral sinus lifting with 50% anorganic bovine (Bio-Oss) and 50% autogenous bone, or 8mm implants (20 patients) after crestal sinus lifting with autogenous bone. Implants were submerged and left healing for 45 days before loading the implants. Within 1 week after abutment connection, implants were loaded with screw-retained full acrylic provisional prostheses. Definitive metal-ceramic prostheses were provisionally cemented 45 days after abutment connection. Outcome measures were prosthesis and implant failures, any complications, and radiographic peri-implant marginal bone level changes. In addition, the stability of individual implants was assessed with Osstell and Periotest at abutment connection (baseline), and at 1 and 5 years after loading by blinded outcome assessors. All patients were followed up to 5 years after loading. Results: One patient dropped out (death) from the longer implant group. One implant failed in the short implant group versus 5 implants in 3 patients of the longer implant group. The difference was not statistically significant. Four complications occurred in 4 patients of the short implant group versus 8 complications in 7 patients of the long implant group, the difference being not statistically significantly different. However, the 2 major postoperative complications occurred in the longer implant group: 1 abscess, and 1 sinusitis that led to the complete failure of the treatment in 2 patients (4 implants lost). A total of 0.72 mm of peri-implant marginal bone was lost after 5 years at long implants and 0.41 mm at short implants, the difference between the two groups was statistically significant (P = 0.028). Osstell values increased and Periotest decreased over time and there were no differences between groups at any time points. Conclusions: In atrophic maxillary sinuses with a residual bone height of 3 to 6mm, 8 mm short implants placed in a simultaneously crestally lifted sinus might be a preferable choice than a 1-stage lateral sinus lift for placing longer implants since they appear to be associated with less morbidity. If these implants are placed with an insertion torque >35 Ncm and are joined together under the same prosthesis, they can be early loaded at 6 weeks.
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| 3. |
- Cannizzaro, G., et al.
(författare)
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Immediate loading of fixed cross-arch prostheses supported by flapless-placed supershort or long implants: 1-year results from a randomised controlled trial
- 2015
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Ingår i: European Journal of Oral Implantology. - 1756-2406. ; 8:1, s. 27-36
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To compare the outcome of cross-arch prostheses supported either by supershort (5 mm) or long (11.5 mm) implants, placed flapless and immediately restored with metal-resin screw-retained cross-arch prostheses. Materials and methods: Thirty patients with edentulous (or to be rendered edentulous) mandibles and 30 with edentulous maxillas, who had sufficient bone to allow the placement of four and six implants respectively, which were at least 11.5 mm-long, were randomised according to a parallel group design into 2 equal groups, where they received either 5 mm or 11.5 mm-long implants at one centre. Implants with a diameter of 5 mm, were to be placed flapless with an insertion torque of at least 50 Ncm. Mandibles received four implants between the mental foramina. Implants were to be immediately loaded with metal-resin-definitive prostheses on the same day of implant placement. Patients were followed up to 1 year after loading and the outcome measures were: prosthesis and implant failures, complications, and pen-implant marginal bone level changes. Results: No patients dropped-out. Two prostheses were remade, one on short maxillary implants and one on long mandibular implants. Two 5 mm maxillary implants which did not achieve 50 Ncm torque in soft bone of one patient, but were immediately loaded anyway, failed after 3 weeks compared to one mandibular 11.5 mm-long implant that failed after 60 days. Two complications occurred in each group. There were no statistically significant differences for prosthesis failures, implant failures and complications. Patients with mandibular short implants lost on average 0.08 mm of pen-implant bone at 1 year and patients with long mandibular implants lost 0.51 mm. Patients with short maxillary implants lost on average 0.15 mm of pen-implant bone at 1 year and patients with long maxillary implants lost 0.62 mm. Short implants showed less bone loss when compared to long implants and the differences up to 1 year were statistically significant both in maxillae (mean difference = 0.48 mm, 95% CI 0.22 to 0.73, P = 0.0011) and in mandibles (mean difference = 0.44 mm, 95% CI 0.21 to 0.66, P = 0.0009). Conclusions: Flapless-placed 5 mm-long implants achieved similar results as 11.5 mm-long implants when supporting immediately loaded cross-arch prostheses both in maxillae and mandibles up to 1 year after loading. These preliminary results must be confirmed by other trials, and 5- to 10-year post-loading data is necessary before making reliable recommendations.
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| 4. |
- Cannizzaro, G., et al.
(författare)
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Immediate loading of two (fixed-on-2) vs four (fixed-on-4) implants placed with a flapless technique supporting mandibular cross-arch fixed prostheses: 3-year results from a pilot randomised controlled trial
- 2017
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Ingår i: European Journal of Oral Implantology. - 1756-2406. ; 10:2, s. 133-145
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To evaluate the outcome of two vs four implants placed flapless in fully edentulous mandibles and immediately restored with metal-resin screw-retained cross-arch prostheses. Materials and Methods: A total of 60 patients from two different centres were randomised: 30 to the fixed-on-2 group and 30 to the fixed-on-4 group according to a parallel group design. To be immediately loaded implants had to be inserted with a minimum torque of 40 Newton/cm (Ncm). Outcome measures were prosthesis and implant failures, complications, and marginal bone level changes. Results: Flaps were raised in 18 patients. Two implants in two patients did not reach the planned insertion torque and were replaced immediately by larger diameter ones. Three years after loading, two patients dropped out from the fixed-on-2 group and one from the fixed-on-4 group. No implant failure or prosthetic failure occurred. A total of 12 fixed-on-2 patients were affected by one complication each vs 13 fixed-on-4 patients. There were no statistically significant differences for complications between groups (difference in proportion = -0.03; 95% CI -29 to 0.22; P [Fisher's exact test] = 1.000). There were no statistically significant differences for marginal peri-implant bone loss between the two groups (mean difference = 0.14; CI 95% -0.17 to 0.45; P [ANCOVA] = 0.356), with both groups losing marginal bone in a statistically significant way (1.70 mm for fixed-on-2 implants and 1.56 mm for fixed-on-4 implants). There were statistically significant differences between the two centres, with more bone being lost for the Bologna centre (2.18 vs 1.13 mm; P (ANCOVA) < 0.001). Conclusions: Up to 3 years after loading, these preliminary results suggest that immediately loaded mandibular cross-arch fixed prostheses can be supported by only two dental implants. Longer follow-ups (about 10 years) are needed to properly evaluate this therapeutic option.
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| 5. |
- Cannizzaro, G., et al.
(författare)
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Immediate loading of two flapless placed mandibular implants supporting cross-arch fixed prostheses: A 3-year follow-up prospective single cohort study
- 2014
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Ingår i: European Journal of Oral Implantology. - 1756-2406. ; 7:1, s. 89-98
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To evaluate the clinical outcome of two implants placed flapless in fully edentulous mandibles and immediately restored with a metal-resin screw-retained cross-arch prostheses 3 years after loading. Materials and methods: Eighty consecutively patients were recruited. Implants for immediate loading had to be inserted with a minimum torque of 80 Ncm. Outcome measures, evaluated by two independent assessors, were: prosthesis and implant failures, complications, marginal bone level changes, implant stability quotient (ISQ) values and patient satisfaction. Results: Three years after loading, all prostheses were in function although one patient did not come back for the 1- and 3-year follow-ups. Two implants failed early in two patients, but were successfully replaced and their prostheses remade. Twelve complications occurred in 10 patients but were all successfully treated. After 3 years, mean marginal bone loss was 0.43 mm, mean ISO values decreased from 75.4 to 75.3, and all but four patients were fully satisfied with the therapy. Four patients were partially satisfied because, lacking molars, they could not chew as they wished. Conclusion: Immediately loaded mandibular cross-arch partial dentures can be supported by only two dental implants up to 3 years. Longer follow-ups (around 10 years) are needed to know the prognosis of this treatment modality.
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| 6. |
- Cannizzaro, G., et al.
(författare)
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Immediate loading of two flapless placed mandibular implants supporting cross-arch fixed prostheses: A 5-year follow-up prospective single cohort study
- 2016
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Ingår i: European Journal of Oral Implantology. - 1756-2406. ; 9:2, s. 165-177
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To evaluate the clinical outcome of two implants placed flapless in fully edentulous mandibles and immediately restored with metal-resin screw-retained cross-arch prostheses 5 years after loading. Materials and methods: Eighty consecutive patients were recruited. To be immediately loaded, implants had to be inserted with a minimum torque of 80 Ncm. Forty-six laser-welded titanium and 34 cast silver-palladium frameworks with resin teeth were initially delivered within 8 and 48 h, respectively. Outcome measures, evaluated by two independent assessors included prosthesis and implant failures, complications, marginal bone level changes, implant stability quotient (ISQ) values and patient satisfaction. Results: Five years after loading one patient did not return to the control and 10 prostheses were remade. Two implants failed early in two patients, but they were successfully replaced. Thirty-six complications occurred in 28 patients but were all successfully treated. After 5 years, mean marginal bone loss was 0.69 mm, mean ISQ values decreased from 75.4 to 73.8, and all patients were fully satisfied with the therapy. A post-hoc comparison between the outcome of laser-welded and cast frameworks showed that laser-welded frameworks were affected by significantly more complications (19 patients out of 46 and 6 patients out of 34, respectively; difference in proportion = 0.23, 95% CI: 0.03 to 0.43; Pearson's chi-square test, P = 0.032), therefore such a framework construction should be considered as a long-term temporary prosthesis and not a definitive prosthesis. Conclusions: Immediately loaded mandibular cross-arch prostheses can be supported by only two implants up to 5 years, if made with a robust cast framework. Longer follow-ups (around 10 years) are still needed to know the prognosis of this treatment modality.
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| 7. |
- Cannizzaro, G., et al.
(författare)
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Machined versus roughened immediately loaded and finally restored single implants inserted flapless: Preliminary 6-month data from a split-mouth randomised controlled trial
- 2016
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Ingår i: European Journal of Oral Implantology. - 1756-2406. ; 9:2, s. 155-163
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To compare the outcome of immediately loaded single implants with a machined or a roughened surface. Materials and methods: Fifty patients had two implant sites randomly allocated to receive flapless-placed single Syra implants (Sweden & Martina), one with a machined and one with a roughened surface (sand-blasted with zirconia powder and acid etched), according to a split-mouth design. To be loaded immediately, implants had to be inserted with a torque superior to 50 Ncm. Implants were restored with definitive crowns in direct occlusal contact within 48 h. Patients were followed for 6 months after loading. Outcome measures were prosthetic and implant failures and complications. Results: Two machined implants and four roughened implants were not loaded immediately. Six months after loading no dropout occurred. One implant loaded late, which had a rough implant surface, failed 20 days after loading (P (McNemar test) = 0.625; difference in proportions = -0.04; 95% CI: -0.15 to 0.07). Three crowns had to be remade on machined implants and four on roughened implants (P (McNemar test) = 1.000; difference in proportions = -0.02; 95% CI: -0.12 to 0.08). Three machined and five roughened implants experienced complications (P (McNemar test) = 0.625; difference in proportions = -0.04; 95% CI: -0.15 to 0.07). There were no statistically significant differences between groups for crown and implant losses as well as complications. Conclusions: Up to 6 months after loading both machined and roughened flapless-placed and immediately loaded single implants provided good and similar results, however, longer follow-ups are needed to evaluate the long-term prognosis of implants with different surfaces.
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| 8. |
- Checchi, V., et al.
(författare)
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Wide diameter immediate post-extractive implants vs delayed placement of normal-diameter implants in preserved sockets in the molar region: 1-year postloading outcome of a randomised controlled trial
- 2017
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Ingår i: European Journal of Oral Implantology. - 1756-2406. ; 10:3, s. 263-278
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To compare the effectiveness of 6.0 to 8.0 mm-wide diameter implants, placed immediately after tooth extraction, with conventional 4.0 or 5.0 mm diameter implants placed in a preserved socket after a 4-month period of healing in the molar region. Materials and Methods: Just after extraction of one or two molar teeth, and with no vertical loss of the buccal bone in relation to the palatal wall, 100 patients requiring immediate post-extractive implants were randomly allocated to immediate placement of one or two 6.0 to 8.0 mm-wide diameter implants (immediate group; 50 patients) or for socket preservation using a porcine bone substitute covered by a resorbable collagen barrier (delayed group; 50 patients), according to a parallel group design in one centre. Bone-to-implant gaps were filled with autogenous bone retrieved with a trephine drill used to prepare the implant sites for the immediate wide diameter post-extractive implants. Four months after socket preservation, one to two 4.0 or 5.0 mm-wide delayed implants were placed. Implants were loaded 4 months after placement with fixed provisional restorations in acrylic, and replaced after 4 months by fixed, definitive, metal-ceramic restorations. Patients were followed to 1 year after loading. Outcome measures were: implant failures, complications, aesthetics assessed using the pink esthetic score (PES), peri-implant marginal bone level changes, patient satisfaction, number of appointments and surgical interventions recorded, when possible, by blinded assessors. Results: Three patients dropped out 1 year after loading from the immediate group vs six from the delayed group. Five implants out of 47 failed in the immediate group (10.6%) vs two out 44 (4.6%) in the delayed group, the difference being not statistically significant (difference in proportion = 6.0%, 95% CI: -8.8% to 20.8%, P = 0.436). In the immediate group 10 patients were affected by 10 complications, while in the delayed group four patients were affected by four complications. The difference was not statistically significant (difference in proportion = 12%, 95% CI: -2% to 26%, P = 0.084). At delivery of the definitive prostheses, 4 months after loading, the mean total PES score was 9.65 ± 1.62 and 10.44 ± 1.47 in the immediate and delayed groups, respectively. At 1 year after loading, the mean total PES score was 9.71 ± 2.71 and 10.86 ± 1.37 in the immediate and delayed groups, respectively. The Total PES score was statistically significantly better at delayed implants both at 4 months (mean difference = 0.79; 95% CI: 0.05 to 1.53; P = 0.03) and at 1 year (mean difference = 1.15; 95% CI: 0.13 to 2.17; P = 0.02). Marginal bone levels at implant insertion (after bone grafting) were 0.04 mm for immediate and 0.11 mm for delayed implants, which was statistically significantly different (mean difference = 0.07; 95% CI: 0.02 to 0.12; P < 0.0001). One year after loading, patients in the immediate group lost on average 1.06 mm and those from the delayed group 0.63 mm, the difference being statistically significant (mean difference = 0.43 mm; 95% CI: 0.15 to 0.61; P < 0.0001). All patients were fully or partially satisfied both for function and aesthetics, and would undergo the same procedure again both at 4 months and 1 year after loading. Patients from the immediate group required on average 7.48 ± 1.45 visits to the clinician and 2.14 ± 0.49 surgical interventions and to have their definitive prostheses delivered vs 10.30 ± 0.99 visits and 3.08 ± 0.40 surgical interventions for the delayed group, the difference being statistically significant (P < 0.001 for visits, and P < 0.001 for surgical interventions). Conclusions: Preliminary 1 year follow-up data suggest that immediate placement of 6.0 to 8.0 mm wide diameter implants in molar extraction sockets yielded inferior aesthetic outcomes than ridge preservation and delayed placement of conventional 4.0 to 5.0 mm diameter implants. Conflict of interest statement: This trial was partially funded by the manufacturer of the implants evaluated in his investigation (MegaGen Implant Co, Gyeongbuk, South Korea). However, data belonged to the authors and in no way did the manufacturer interfere with the conduct of the trial or the publication of its results. © Quintessenz.
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| 9. |
- Esposito, Marco, 1965, et al.
(författare)
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Cosci versus Summers technique for crestal sinus lift: 3-year results from a randomised controlled trial
- 2014
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Ingår i: European Journal of Oral Implantology. - 1756-2406. ; 7:2, s. 129-137
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To compare the effectiveness of two different techniques to lift the maxillary sinus via a crestal approach: the Summers versus the Cosci technique. Materials and methods: Fifteen partially edentulous patients missing bilaterally maxillary molars and/or premolars, having 4 to 7 mm of residual crestal height and at least 5 mm thickness below the maxillary sinuses measured on CT scans, were randomised to have implants placed in sinuses crestally lifted according to the Cosci or the Summers techniques, with bone substitutes according to a split-mouth design. Implants were left to heal submerged for 6 months. Implants were loaded with acrylic provisional crowns/prostheses. Screw-retained definitive metal-ceramic prostheses were delivered 4 months after provisional loading. Outcome measures were: prosthesis and implant failures; any complications; operation time; operator preference; patient preference and peri-implant marginal bone level changes assessed by a blinded outcome assessor. All patients were followed to 3 years after implant loading. Results: Nineteen study implants were placed according to each technique. Three years after loading, 3 patients dropped out and no implant failed. No discomfort/complications occurred at sites treated with the Cosci technique, whereas 12 patients reported discomfort during the augmentation procedure at the side treated with the Summers technique; this was statistically significant (P = 0.0005). In one of these patients, a perforation of the sinus membrane occurred. Postoperatively, headache was reported by 9 patients and swelling occurred in 3 of these patients at the Summers treated sides. Statistically significant less time (9.7 mins, SD = 4.0, P < 0.001, 95% CI -11.9 to -7.5) was required to place implants according to the Cosci technique (33 versus 24 mins on average). The 2 operators and 14 out of 15 patients preferred the Cosci technique 1 month after surgery (P = 0.001), and 1 year after surgery (13 out of 15 patients, P = 0.007). The ceramic layer of one prosthesis of the Summers' group and one abutment screw of the Cosci's group loosened between 1 to 3 years post-loading. After 3 years, implants inserted according to the Cosci technique lost 1.39 mm of peri-implant bone versus 1.54 mm for the implants placed with the Summers technique. There were no statistically significant differences for marginal bone level changes between the two groups (difference 0.15 mm, 95% CI -0.11 to 0.41, P = 0.24). Conclusions: Both crestal sinus lift techniques produced successful results over a 3-year follow-up period, but the Cosci technique required less surgical time, determined less intra- and postoperative morbidity and was preferred by patients.
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| 10. |
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