Early Clinical Outcomes of a New Implant Design Used in Graft-less Sinus Floor Augmentation PDF Download
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Languages : en
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Book Description
BackgroundExtraction of posterior maxillary teeth can result in severe bone resorption, which may preclude the placement of dental implants. Traditionally, techniques involving bone graft material are used to overcome this loss of bone volume. Less invasive and more cost-effective graft-less procedures have also been shown to be clinically effective. Here, we evaluated a new implant design in graft-less sinus floor elevation using both lateral and crestal approaches. AimIn this open prospective clinical study, we investigated the clinical performance of a new reverse spiral flute implant design (Nobel Biocare AB, Gothenburg, Sweden) used in lateral and crestal graft-less sinus floor elevation protocols. One-year outcomes are presented. Materials and MethodsPatients seeking implant-supported restoration of the posterior maxilla and requiring sinus floor augmentation with a residual bone height less than 8 mm at implant site were included. Implants were placed using either a lateral or crestal graft-less sinus floor elevation protocol. Crestal at residual bone height of 6 to 8 mm, Lateral in bone heights less than 6 mm. The new implant design features an anodized surface, a rounded apex and a sharp cutting flute oriented in the opposite direction of the implant threads with the aim to deliver bone chips into the sinus cavity to facilitate new bone formation. Implants were placed in healed sites and loaded with screw-retained temporary fixed restorations after 6 months of submerged healing. Final restorations were placed after 2 months of function. Clinical and radiographic data including implant and patient level cumulative survival rate (CSR), implant stability quotient (ISQ), and implant complications were assessed at regular intervals. Results132 implants were placed in 60 patients of both sexes with a mean age of 58 years. In 40 patients, 98 were placed with the lateral technique and in 20 patients, 34 implants with the crestal one. At 1 year follow up 3 implant failed, 2 in the lateral and 1 in the crestal group. CSR was 97.7% at implant level and 95.0% at patient level.u2028All surviving implants were stable at the 1year follow up (n=129). For the resonance frequency analysis, mean ISQ values were 66.4, 74.5 and 79.1 for the lateral approach and 75.3, 80.7, and 84.0 for the crestal approach at implant placement, at 6- and 8-month follow-ups, respectively. The sinus membrane was accidentally perforated during the sinus elevation procedure in 12 patients. In another 6 patients the perforation was on purpose due to simultaneously removal of intra sinusal cysts. No perforations were caused from implant insertion. Radiographic analysis of 3D bone remodeling is currently ongoing and will be reported at the time of presentation. ConclusionsIn situations of severe bone resorption in a pneumatized maxilla, the reverse spiral flute implant has excellent stability, indicated by increasing ISQ values at subsequent follow-ups, and good survival rates after 1 year of function when placed using a graft-less lateral or crestal sinus floor elevation protocol.
Author:
Publisher:
ISBN:
Category :
Languages : en
Pages :
Get Book Here
Book Description
BackgroundExtraction of posterior maxillary teeth can result in severe bone resorption, which may preclude the placement of dental implants. Traditionally, techniques involving bone graft material are used to overcome this loss of bone volume. Less invasive and more cost-effective graft-less procedures have also been shown to be clinically effective. Here, we evaluated a new implant design in graft-less sinus floor elevation using both lateral and crestal approaches. AimIn this open prospective clinical study, we investigated the clinical performance of a new reverse spiral flute implant design (Nobel Biocare AB, Gothenburg, Sweden) used in lateral and crestal graft-less sinus floor elevation protocols. One-year outcomes are presented. Materials and MethodsPatients seeking implant-supported restoration of the posterior maxilla and requiring sinus floor augmentation with a residual bone height less than 8 mm at implant site were included. Implants were placed using either a lateral or crestal graft-less sinus floor elevation protocol. Crestal at residual bone height of 6 to 8 mm, Lateral in bone heights less than 6 mm. The new implant design features an anodized surface, a rounded apex and a sharp cutting flute oriented in the opposite direction of the implant threads with the aim to deliver bone chips into the sinus cavity to facilitate new bone formation. Implants were placed in healed sites and loaded with screw-retained temporary fixed restorations after 6 months of submerged healing. Final restorations were placed after 2 months of function. Clinical and radiographic data including implant and patient level cumulative survival rate (CSR), implant stability quotient (ISQ), and implant complications were assessed at regular intervals. Results132 implants were placed in 60 patients of both sexes with a mean age of 58 years. In 40 patients, 98 were placed with the lateral technique and in 20 patients, 34 implants with the crestal one. At 1 year follow up 3 implant failed, 2 in the lateral and 1 in the crestal group. CSR was 97.7% at implant level and 95.0% at patient level.u2028All surviving implants were stable at the 1year follow up (n=129). For the resonance frequency analysis, mean ISQ values were 66.4, 74.5 and 79.1 for the lateral approach and 75.3, 80.7, and 84.0 for the crestal approach at implant placement, at 6- and 8-month follow-ups, respectively. The sinus membrane was accidentally perforated during the sinus elevation procedure in 12 patients. In another 6 patients the perforation was on purpose due to simultaneously removal of intra sinusal cysts. No perforations were caused from implant insertion. Radiographic analysis of 3D bone remodeling is currently ongoing and will be reported at the time of presentation. ConclusionsIn situations of severe bone resorption in a pneumatized maxilla, the reverse spiral flute implant has excellent stability, indicated by increasing ISQ values at subsequent follow-ups, and good survival rates after 1 year of function when placed using a graft-less lateral or crestal sinus floor elevation protocol.
Author: Stefan Lundgren (D.D.S.)
Publisher: Quintessence Publishing (IL)
ISBN: 9781850971573
Category : Bone regeneration
Languages : en
Pages : 0
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Book Description
This book includes didactic step-by-step presentations of different techniques for augmentation in all kinds of challenging bone deficiency situations and is intended for use prior to or in conjunction with endosseous implant placement. Reconstruction of severely atrophic edentulous jaws, posttrauma treatment in the anterior maxilla, and augmentation of the posterior maxilla and mandible are some of the topics covered. Clinical and experimental results of close follow-up of extensive patient groups are presented, as the book shows how careful monitoring with controlled incremental changes of the surgical protocol has led to development of new surgical methods. More than 20 scientific papers justify the methods presented in the book, representing more than 15 years of experience in reconstruction of the alveolar process.
Author: Boyd J. Tomasetti
Publisher: Springer Nature
ISBN: 3030441997
Category : Medical
Languages : en
Pages : 334
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Book Description
This comprehensive guide to short implants will take the reader through their research and development, explain the clinical indications, evaluate the outcomes achieved with various implants, and explore restorative and laboratory considerations. Short implants have steadily gained greater market share in the last decade as practitioners sought alternatives to traditional length implants in order to avoid grafting procedures. Current manufacturers offer a variety of implant lengths and widths, allowing surgeons and restorative dentists the ability to select the best implant for each clinical circumstance. Cutting edge information is provided on the research and clinical results achieved utilizing a range of implants, specifically those developed by Nobel Biocare, Straumann, Jack Hahn, and Bicon. Readers will also find an extensive description of the role of ultra-short implants involving reconstruction in both cleft patients and cancer patients who have lost portions of their mandible and/or maxilla. This book is a must-have for those interested in learning how the use of short and ultra-short implants offers both surgeons and restorative dentists an opportunity to stand out from those that use only the traditional length implants.
Author: Fouad Khoury
Publisher: Quintessenz Verlag
ISBN: 3868675914
Category : Medical
Languages : en
Pages : 1395
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Book Description
With contributions from: R. Gruber, Th. Hanser, Ph. Keeve, Ch. Khoury, J. Neugebauer, J. E. Zöller Bone and Soft Tissue Augmentation in Implantology addresses useful methods of bone grafting procedures in implant treatment based on current biologic principles and constitutes a unique reference in this field. The book describes, in over 760 pages and 2837 mostly color illustrations, the different possibilities available to augment the bone volume in width and height. The information presented includes not only the underlying scientific concepts of the different augmentation techniques with autogenous bone, but also the associated soft tissue management, from safe approaches to different possibilities for soft tissue augmentation and papilla reconstruction techniques. The book provides surgeons with a basic understanding of the biologic response to bone grafting procedures. Experienced implantologists will benefit from the in-depth background information, details of high-level surgical techniques, and scientific results, which will enable them to optimize their surgical procedures. Each chapter offers a wealth of information on the specific topic covered, with much attention given to the scientific concepts behind each one. Extensive case reports with step-by-step documentation allow readers to gain an impression of what is possible today in the 3D reconstruction procedures of the alveolar crest. Important criteria for success are presented as well as possible complications and their treatment. Bone and Soft Tissue Augmentation in Implantology is a must-read for every implantologist, oral and maxillofacial surgeon, and any dentist interested in surgery.
Author: Ole T. Jensen
Publisher: Quintessence Publishing (IL)
ISBN: 9780867153439
Category : Bone-grafting
Languages : en
Pages : 0
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Book Description
While an oral surgery resident in training at the University of Michigan in 1977, I observed a strange phenomenon in a maxillary fracture patient. A unilateral ossification of the maxillary antrum occurred following a Le Fort III fracture that had been treated the year before. I wondered how trauma around the antrum due to an impacted maxilla and the inferiorly displaced orbital rim could lead to an ossified maxillary sinus. The trauma was bilateral, yet only one side responded by ossification. Furthermore, there appeared to be no functional impairment of the sinus. This unusual finding remained a mystery to me for many years. It wasn't until 1980, when Phil Boyne published the first paper on the sinus augmentation graft, that the mystery began to be solved. He found that preservation of the elevated sinus membrane created a confined space in which bone had the potential to form. Dr Boyne went on to show, in a primate study, that bone would readily form in the sinus floor, but that the newly formed bone would completely resorb over a period of a year unless dental implants were placed to help maintain the bone. Many other workers began to experiment with various bone-grafting materials, both in animals and clinically. Remarkably, most of the materials demonstrated new bone formation in the graft sites. Because dental implants were generally used as the measure of bone graft success and since there were very few implant failures reported in the literature, confusion resulted as to which grafting material to use. It seemed they all worked. To sort this out, a few patients with 5 to 7 mm of available bone were treated with sinus elevation and Gore-Tex over the lateral osteotomy site only. Despite no graft material be used, bone formed. As long as the sinus membrane remained intact, bone formed beneath the sinus membrane that had been tented up by simultaneously placed implants. The need to use any graft material at all appeared to be brought into question. At the same time, practitioners lined up in two camps: those who placed implants in delayed fashion after graft maturation and those who preferred simultaneous implant placement. Both approaches published a high level of success seeming to substantiate their protocols, but once again the measure of success was hampered by the lack of any human evidence for efficacy. A 5-year implant retrieval study was undertaken using standard titanium mini-implants that had been placed simultaneously with grafting. Interestingly, bone did not form well around these implants in this setting despite positive reviews in animal studies. Could we conclude that the delayed approach was preferred, or was there another factor, such as the implant surface, that could be important? Hydroxyapatite-coated, titanium plasma-sprayed, and acid-etched titanium implant surfaces seemed to do well in the grafted bone. Could this be the answer for implants placed into sinus bone grafts? As these developments are progressing, new interest is generated in jump-starting the natural inductive processes of bone formation through pharmacokinetics. Early results of human studies now appear to be favorable for using bone morphogenetic protein as a graft alternative that stands to modify all of the protocols in use to date. How these various approaches work toward definitive answers to the basic biologic and clinical questions is what this book is all about. The authors attempt to answer the how, why, when, and where of sinus grafting. It is hoped that the state of the art of sinus grafting will be elucidate for the reader in the ongoing quest for scientific knowledge and its clinical appilcation that will ultimately lead to excellence in patient care.
Author: Gérard M. Scortecci
Publisher: Springer
ISBN: 3319448730
Category : Medical
Languages : en
Pages : 398
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Book Description
This manual will help oral implantologists to understand the principles that underlie the use of basal implants as a means to provide simple solutions to complex and highly demanding clinical situations without the need for prior bone grafting. It will also serve as a richly illustrated practical guide to application of the technique. The book is in three parts, the first of which discusses basic principles and related themes, including osteogenesis, osseointegration, cortical anchorage stability, biomechanics, surgical techniques, and basal implant prosthodontics. Step-by-step guidance is then offered on the application of these principles, focusing on operating techniques, 3D treatment planning, transitional and final screw-secured prostheses, and postoperative follow-up. The third part of the book addresses a wide range of clinical situations that can be treated by basal implantology, with particular attention to the treatment of high, thin alveolar ridges and the atrophic maxilla and mandible and to the correction of previous implant failures, as well as complications and postimplantation neuropathies.
Author: Krishnamurthy Bonanthaya
Publisher: Springer Nature
ISBN: 9811513465
Category : Face
Languages : en
Pages : 1965
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Book Description
This is an open access book with CC BY 4.0 license. This comprehensive open access textbook provides a comprehensive coverage of principles and practice of oral and maxillofacial surgery. With a range of topics starting from routine dentoalveolar surgery to advanced and complex surgical procedures, this volume is a meaningful combination of text and illustrations including clinical photos, radiographs, and videos. It provides guidance on evidence-based practices in context to existing protocols, guidelines and recommendations to help readers deal with most clinical scenarios in their daily surgical work. This multidisciplinary textbook is meant for postgraduate trainees, young practicing oral surgeons and experienced clinicians, as well as those preparing for university and board certification exams. It also aids in decision-making, the implementation of treatment plans and the management of complications that may arise. This book is an initiative of Association of Oral and Maxillofacial Surgeons of India (AOMSI) to its commitment to academic medicine. As part of this commitment, this textbook is in open access to help ensure widest possible dissemination to readers across the world. ; Open access Unique presentation with contents divided into color-coded core competency gradations Covers all aspects of oral and maxillofacial surgery Supplemented with videos of all commonly carried out procedures as operative video Every chapter or topic concludes with "future perspective" and addresses cutting edge advances in each area Every topic has a pull out box that provides the most relevant systematic reviews/ key articles to every topic.
Author: Stuart J. Froum
Publisher: John Wiley & Sons
ISBN: 1118976452
Category : Medical
Languages : en
Pages : 736
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Book Description
Dental implants have become one of the most popular and rapidly growing techniques for replacing missing teeth. While their predictability, functionality, and durability make them an attractive option for patients and clinicians alike, complications can arise at any stage from patient assessment to maintenance therapy. Dental Implant Complications: Etiology, Prevention, and Treatment, Second Edition, updates and expands the hallmark first edition, which was the first comprehensive reference designed to provide clinicians of all skill levels with practical instruction grounded in evidence-based research. Featuring cases from a variety of dental specialties, the book covers the most commonly occurring implant complications as well as the unique. Dental Implant Complications: Etiology, Prevention, and Treatment, Second Edition, is organized sequentially, guiding the reader through complications associated with the diagnosis, treatment planning, placement, restoration, and maintenance of implants at any stage. Complications associated with various bone augmentation and sinus lift procedures are also discussed in detail with emphasis on their etiology and prevention. Each chapter utilizes a highly illustrated and user-friendly format to showcase key pedagogical features, including a list of “take home tips” summarizing the fundamental points of each chapter. New chapters include discussions of complications from drug prescribing, implant naturalization, cemented restorations, loose implant restoration syndrome, and craniofacial growth. Readers will also find more case presentations to see how complications have been managed in real-world situations. Dental Implant Complications: Etiology, Prevention, and Treatment, Second Edition, brings together contributions from leading experts in the field under the superior editorship of Dr. Stuart Froum. With its pragmatic approach to preventing and managing implant complications, this expertly crafted text continues to serve as an indispensable clinical reference and guide for all dentists placing or restoring implants.
Author: Michael Sonick
Publisher: John Wiley & Sons
ISBN: 0470963190
Category : Medical
Languages : en
Pages : 862
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Book Description
With the desire for dental implant therapy ever escalating, clinicians are faced with the challenge of augmenting deficient natural physiology to provide effective sites for implantation. Implant Site Development helps the clinician decide if, when, and how to create a ridge site amenable to implantation. This practical book offers solutions to many implant site preservation scenarios, discussing different treatment options, timing, a variety of materials and techniques, and their application to the clinical practice. With a unique integrated clinical approach, Implant Site Development covers a range of site development techniques. Highly illustrated, Implant Site Development presents diagrams and clinical photographs to aid with clinical judgment and will prove useful for any dental professional involved in implant therapy, from general practitioners to prosthodontists, but especially surgeons. This literature-based, yet user-friendly, reference will be indispensable to the novice or veteran clinician.
Author: Ronald Younes
Publisher: Springer
ISBN: 3319114484
Category : Medical
Languages : en
Pages : 260
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Book Description
Placement of endosseous implants in the posterior maxilla is often difficult because of a lack of supporting bone. Sinus augmentation procedures have therefore been extensively used for the treatment of the edentulous atrophic posterior maxilla prior to implant placement. This book describes in detail the most widely used sinus grafting techniques as well as some innovative variations, with full coverage of both lateral and crestal approaches. A key aim is to assist the practitioner in selecting the appropriate sinus grafting technique based on the evaluation of a number of parameters that are described in detail and codified in a simple and practical way. Up-to-date information is also provided on grafting materials and on potential complications of sinus augmentation procedures and their treatment.
