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Background: Implant placement is often difficult to achieve in the atrophic maxillae due to limited ridge height. The use of short implants has been suggested as an alternative treatment option to vertical bone augmentation. However, there is still a lack of information concerning the long-term predictability of short implants.Aim: The aim of this retrospective study is to evaluate the survival rate of short SLA-surfaced implants with 6- and 8 mm lengths and at least 1-year follow up.Materials and Methods: All patients that had dental implant therapy with short implants between 01 January 2015 and 31 December 2018 that complied with mandatory follow ups were included in this retrospective study. Following ethic committee approval, data was retrieved from treatment records concerning patient characteristics, total or partial edentulism, implant characteristics, anatomical location of the implant, type of regeneration procedure, time of loading, date of placement, failure and final follow-up appointment. All patients in the study were treated by 3 experienced surgeons with Straumann Tissue Level comprising 6- (TL6) or 8 mm (TL8) implants, using a standardized surgical procedure. Early failure was defined as an implant that failed to integrate and was removed before 6 or 3 months for implants placed with and without regenerative procedures, respectively. Late failure was defined as implant removal with prosthetic loading following the osteointegration period.Results: A total of 199 patients received 191 TL6 and 156 TL8 dental implants with a follow up that ranged between 1 and 4 years. Most of the implants (93.7%) had a diameter of 4.1 mm, with the others (6.3%) having a diameter of 3.3 mm. The most frequent indication for short implant placement was the restoration of a partially edentulous arch (59.8%). The most common locations were the posterior mandible (63.4%) and the posterior maxilla (32.6%). The success rates for early failure were 98.4% and 99.4%, and for late failure (n=326) 99.4% and 99.3% for TL6 and TL8, respectively. No significant statistically differences were found regarding the different lengths for early and late failure (P>0.05).Conclusions and Clinical Implications: Within the limitations of this retrospective study, the 6- and 8 mm SLA implants evaluated demonstrated an overall medium-term survival rate with no significant differences between them, which may be compared to that of standard-length implants.
Background: Short implants have been described as a treatment option to avoid complementary surgical procedures in cases of limited bone height. In order to increase the biomechanical properties of short implants, implant manufacturers have developed different implant surfaces and macroscopic topographies. More recently, bone level short dental implants with SLA surfaces have been launched into the market, but still there is a lack of information regarding medium-long-term survival rates.Aim: Retrospective study to evaluate the medium-term survival rates of 8-mm length bone level SLA-surfaced implants with at least 1-year follow-up.Methods and Materials: This single center retrospective study was based on the clinical records of patients who underwent dental implant therapy with Straumann Bone Level Tapered 8mm (BLT8) implants between January 2017 and April 2018 and complied with the mandatory follow-up visits. All patients were treated by a skilled surgeon with BLT8 implants using a standardized protocol. Data regarding maxillary location, regeneration procedure, date of surgery, date and time of loading, final follow- up appointment as well as patient rehabilitation (single unit, partial, total) were obtained following ethics committee approval.Early failure was defined as an implant that failed to integrate and was removed before 6 or 3 months for implants placed with and without regenerative procedures, respectively. Late failure was defined as implant removal with prosthetic loading following the osteointegration period.Results: A total of 214 BLT8 implants were inserted in 99 patients. 115 (53.7%) implants had a regular diameter of 4.1mm and 99 (46.3%) a narrow diameter of 3.3mm. The posterior mandible (36.0%) and the posterior maxilla (29.9%) were the most frequent locations, as opposed to the anterior mandible, which presented the lowest percentage of short implants placed (13.1%).Immediate loading was performed in 75 (35.0%) implants and mostly used as posterior implants in full arch rehabilitations. 212 implants received prosthetic load, of which 86.0% were over splinted implants and 14.0% over single unit implants.214 implants were evaluated for early failure and 212 for late failure. Of those, one implant failed in each evaluated period, which resulted in a survival rate of 99.5% for early and late failure with no statistical differences between them (p>0.05). Conclusions and Clinical Implications: Within the limitations of this study the Bone Level SLA-surfaced 8 mm length implants showed high survival rates within the evaluated follow up period, comparable to those described in the literature for the standard-length implants. Further follow-up studies with larger samples and longer follow-ups are required to identify factors that could interfere in the survival and success rates of short dental implants.
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.
Clinical Cases in Implant Dentistry presents 49 actual clinical cases, accompanied by academic commentary, that question and educate the reader about essential topics in implant dentistry, encompassing diagnosis, surgical site preparation and placement, restoration, and maintenance of dental implants. Unique case-based format supports problem-based learning Promotes independent learning through self-assessment and critical thinking Highly illustrated with full-color clinical cases Covers all essential topics within implant dentistry
Purpose: The main objective of this retrospective study was to compare the clinical outcomes of 6mm implants (Test group) vs. 8mm implants (Control Group) in terms of success, survival, marginal bone loss and periodontal parameters.Material & Methods: Implants placed in the Clinica Universitaria Odontologica at Universitat Internacional de Catalunya between 2005 and 2015 were evaluated. Control visits were performed evaluating the following parameters (present complications, periodontal parameters, probing depth, bleeding on probing, plaque index, suppuration), periapical radiographs were performed to determine bone loss from prosthesis delivery to check-up visits, and clinical records were reviewed for possible complications. Results: A total of 114 implants were reviewed, 68 implants of 6mm and 46 implants of 8 mm. Total survival rate of the test group was is 94,1%, having 4 failures. A single failure was found in the control group, corresponding to a survival of 97,8%. Regarding success rates, according to Buser criteria, in the control group 87,5% of the the implants meet the requirements to be considered successful vs only 64,2% of implants in the test group. The mean marginal bone loss in the control group was 0,43 u00b1 0,24 mm in mesial and 0, 59 u00b1 0,44 mm in distal, while 0,81 u00b1 0,33 mm in mesial and 0.59 u00b1 0,36 mm in distal were found in the test group. All factors were analyzed with a mean follow-up period of 4.5 and 5 years respectively between test and control group. Conclusions: Within the limitations of the study, 6mm implants show more unfavorable results regarding survival, success and levels of marginal bone loss compared to 8mm implants in an average follow-up time of of 4.5 and 5 years respectively between test and control group. 8mm implants could be considered a more valid therapeutic option.
Background : Short implants are considered to be the simpler and more effective alternative to complicated bone graft surgery in clinical situations with reduced alveolar bone height. But, a considerable number of clinicians still hesitate to use short implants questioning about their prognoses mainly due to the reduced contact area between the bone and implant and unfavorable crown to implant ratio compared to longer implants. Aim : The aim of the study is to evaluate the clinical and radiographic outcomes of short implants supporting fixed prostheses in posterior regions. Methods : A retrospective study design was adopted. 69 short implants(intra-bony length u2264 8 mm) supporting fixed prostheses in posterior regions of 56 patients were included. The implant success rate and periimplant marginal bone loss were evaluated. The effects of associated factors on the implant performance were analyzed. Results : A total of 3 implants failed. 2 implants were lost before loading and 1 implant was lost at 7 months after loading. The mean follow up was 30.1 months(SD=11.8 months). Success rate was 95.7% and 94.6% for the implant and patient-based analysis respectively. The average marginal bone loss after 1 year of follow-up was 0.02 u00b1 0.16 mm at mesial and 0.03 u00b1 0.14 mm at distal aspect. No relationship was observed between the studied variables and the marginal bone loss. Conclusions: High survival rates for short implants in posterior regions could be achieved with minimal marginal bone loss in this study. Within the limits of the short term follow up, a short implant (u2264 8 mm ) may be considered as a predictable treatment modality for posterior region with reduced bone height.
From basic science and fundamental procedures to the latest advanced techniques in reconstructive, esthetic, and implant therapy, Newman and Carranza's Clinical Periodontology, 13th Edition is the resource you can count on to help master the most current information and techniques in periodontology. Full color photos, illustrations, and radiographs show you how to perform periodontal procedures, while renowned experts from across the globe explain the evidence supporting each treatment and lend their knowledge on how to best manage the outcomes. UNIQUE! Expert Consult platform offers a versatile print and digital resources that help bring text information to life. UNIQUE! Bonus content on Expert Consult includes multiple-choice self-assessment questions with instant feedback, chapter review PowerPoint slides, videos clips, case studies, and more. UNIQUE! Periodontal Pathology Atlas contains the most comprehensive collection of cases found anywhere. Full-color photos and anatomical drawings clearly demonstrate core concepts and reinforce important principles. UNIQUE! Chapter opener boxes in the print book alert readers when more comprehensive coverage of topics is available in the online version of the text. NEW! Chapters updated to meet the current exam requirements for the essentials in periodontal education. NEW! Case-based clinical scenarios incorporated throughout the book mimic the new patient case format used in credentialing exams. NEW! Additional tables, boxes, and graphics highlight need-to-know information. NEW! Virtual microscope on Expert Consult offers easy access to high-resolution views of select pathology images. NEW! Two new chapters cover periimplantitis and resolving inflammation. NEW! Section on evidence-based practice consists of two chapters covering evidence-based decision making and critical thinking.
BackgroundRecently, the use of short implants in anatomically restricted regions has been attracting the attention of many clinicians around the world, as it represents an excellent minimally-invasive treatment option. Nevertheless, when selecting short implants the prevalence of peri-implant bone resorption still remains to be elucidated. The DENTSPLY ASTRATECH IMPLANT EV SYSTEM used in this study is a system in which the operator is able to select the drilling protocol according to the bone quality.AimWe aim to analyze the clinical benefits of short implants (6mm) and at the same time we believe that the key to minimizing bone resorption is to obtain an appropriate initial stability taking into account the placement torque and at the same time by optimizing the bone quality and drilling protocol.Materials and Methods Twenty-six 6 mm short implants (DENTSPLY SIRONA Astra Tech Implant System EV) were placed in 16 patients. Among the 16 patients, 7 were treated with 6 mm implants in multiple sites. Bone quality, drilling protocol together with the placement torque were recorded. Then, changes in the degree of bone resorption, and the state of the peri-implant mucosal sulcus were measured from the time of delivery of superstructures to 2 years after setting. Of the twenty-six implants, ten were inserted in the maxilla and sixteen were inserted in the mandible. The diameter of nineteen implants was 4.2 mm and that of seven implants was 4.8 mm, all of straight type.ResultsBone quality of all the alveolar processes was type I for 3, type II for 8, and type III for 15. The mean placement torque was 34.2 Ncm. (Standard deviation [SD]: 8.16, range [r] 20 to 45 Ncm). The retention type of the superstructures was cement-retained for six implants (1 single crown, 5 splinted crowns), and screw-retained for twenty implants(6 single crowns and 14 splinted crowns). During the 2 years of follow-up after setting the superstructures, all implants were stable. The mean mesial Bone Level (BL) at the superstructure setting time was -0.05 mm. (SD: 0.62, r: −1.33 to 1.73 mm), the mean distal BL was 0.37 mm (SD: 0.74, r: -0.63to 2.26 mm). The mean mesial BL after 2-years was 0.33 mm (SD: 0.65, r: -0.96 to 1.52 mm), the mean the distal BL was 0.53 mm (SD: 0.63, r:-0.5 to 2.23 mm). The mean BL differences between the setting time and after 2-years were 0.38 mm on the mesial side (SD: 0.49, r: -0.25 to 1.88 mm) and 0.15 mm in the distal side (SD: 0.42, r: -0.98 to 84 mm)ConclusionsIn this retrospective study, we examined the clinical peri-implant tissue stability after placing 6 mm implants. Measurement of peri-implant bone levels showed that in most cases the bone-implant junction moved coronally. This phenomenon appeared to have resulted from continuous bone remodeling. There were no significant differences in bone levels variations depending on region,u3000superstructure extension or retention-type. This suggests that short implants are beneficial in clinical practice.
BackgroundVariable-thread tapered implants are designed to achieve high primary stability in demanding situations, such as fresh extraction sitesor regions of low bone quality. In addition to their specialized thread design, these implants can be placed at torques up to 70 Ncm.Continued investigation of these implants placed in challenging situations is necessary to evaluate their long-term survival and clinicalperformance.Aim/HypothesisThe main objective of this retrospective analysis was to evaluate the bone remodeling as a measure of safety and efficacy in patientindications with single crowns or partial bridges restored on variable-thread tapered implants after up to 6.7 years of function.Materials and MethodsPatients with single or partial tooth restorations, who received at least one variable-thread tapered implant (NobelActive, NobelBiocare) between January 2008 and July 2009 were retrospectively evaluated. Bone quality was assessed (Lekholm and Zarb (1985))at time of surgery. Marginal bone levels (MBL) were measured from radiographs at baseline (implant insertion), at 1-year follow-up,and at last follow-up (mean 6.0 years, range 4.7 - 6.7 years). Marginal bone remodelling (MBR) was calculated for paired radiographsfrom baseline to 1-year follow-up, baseline to 6-year follow-up, and from 1-year to 6-year follow-up. Secondary measures reportedinclude presence of plaque, Jemtu2019s papilla index, and implant stability. Statistical analysis was performed with the software SPSSStatistics 24 (IBM, Armonk, NY, USA).ResultsTwenty-four patients (14 female, 10 male; mean age 58 u00b19.9 years) received 35 implants. 94% of implants were placed in the maxilla(n=33). 20 implants were placed in extraction sockets and 15 in healed sites. 32 implants were tightened to torques >35 Ncm (mean59.6 u00b113.2 Ncm). Bone quality was reported as 2 (n=9), 3 (n=18), and 4 (n=8). Graft material was used at time of implant insertion for9 of the 20 extraction sites. Sinus lift was performed in 3 implant sites. All patients received an acrylic provisional prosthetic and 23received final prosthetics at a mean of 1.5 years after implant insertion. Mean MBL were -0.54 u00b10.62 mm, -1.04 mm u00b10.68 mm, and-1.04 u00b10.98 mm at baseline, 1-year follow-up, and 6-year follow-up, respectively. Mean MBR was -0.47 u00b10.64 mm, -0.38 u00b11.22 mm,and -0.11 u00b11.01 mm from baseline to 1-year, baseline to 6-years and 1-year to 6-years, respectively. No adverse events werereported and all implants were stable at final follow-up.Conclusions and Clinical implicationsThis 6-year retrospective analysis showed that variable-thread tapered implants show good long-term outcomes, in terms of survival,stability and MBR, when placed in demanding situations such as extraction sockets or low density bone sites (i.e. in the maxillaryposterior area). Additionally, high insertion torques (>35 Ncm) could be achieved with this protocol with only minor MBR from baselineto 1-year follow-up and stable bone levels from 1-year to up to 6 years of function.
AIM: To compare, clinically and radiographically, short dental implants (6 mm) to long implants (11-15 mm) placed with sinus grafting. METHODS: Participants with 5-7 mm of bone height in the posterior maxilla were randomly allocated to receive short implants (GS) or long implants with sinus grafting (GG). Implants were loaded with single crowns 6 months after placement (PR). Patients were re-evaluated up tp 60 months after loading (FU-5 years). Outcome variables included: marginal bone level alteration (MBL), implant success and survival rate, periodontal probing depth (PPD), bleeding on probing (BoP), plaque control record (PCR) and crown-to-implant ratios (C/I). Statistical analysis was performed using non-parametric tests. RESULTS: 13 patients, 15 implants were re-evaluated at FU-5 years. Intergroup comparison reported no statistical differences in marginal bone loss from baseline to 5 years (GS,-0.33 ± 0.29/GG, +0.32 ± 0.9, p=0.233). No statistical differences were found for PD, BoP and PCR. CONCLUSION: Both treatment modality provided similar outcomes.