Search

Aim: To systematically appraise the available evidence on vertical ridge augmentation (VRA) techniques and estimate a treatment‐based ranking on the incidence of complications as well as their clinical effectiveness. Materials and Methods: Searches were conducted in six databases to identify randomized clinical trials comparing VRA techniques up to November 2022. The incidence of complications (primary) and of early, major, surgical and intra‐operative complications, vertical bone gain (VBG), marginal bone loss, need for additional grafting, implant success/survival, and patient‐reported outcome measures (secondary) were chosen as outcomes. Direct and indirect effects and treatment ranking were estimated using Bayesian pair‐wise and network meta‐analysis (NMA) models. Results: Thirty‐two trials (761 participants and 943 defects) were included. Five NMA models involving nine treatment groups were created: onlay, inlay, dense‐polytetrafluoroethylene, expanded‐polytetrafluoroethylene, titanium, resorbable membranes, distraction osteogenesis, tissue expansion and short implants. Compared with short implants, statistically significant higher odds ratios of healing complications were confirmed for all groups except those with resorbable membranes (odds ratio 5.4, 95% credible interval 0.92–29.14). The latter group, however, ranked last in clinical VBG. Conclusions: VRA techniques achieving greater VBG are also associated with higher incidence of healing complications. Guided bone regeneration techniques using non‐resorbable membranes yield the most favourable results in relation to VBG and complications. [ABSTRACT FROM AUTHOR]

The reconstruction of deficient alveolar ridges using vertical and/or horizontal guided bone regeneration techniques allows for ideal implant placement, which is crucial for function and also for esthetically successful outcomes. Unlike in the past, when meeting a patient's functional demands was sufficient, many patients now have greater expectations from their implant restoration. Hence, it is no longer enough simply to restore the edentulous space with a functioning tooth or teeth. It has been suggested that patients now measure their final restoration using the contralateral natural tooth as the gold standard. Both subjective and objective levels of patient information on dental implants have increased significantly in the last decade. As a result of this demand, implant literature has inherited and developed specific esthetic parameters and patient-centered outcomes from studies in the restorative field. Unfortunately, studies reporting on guided bone regeneration in the esthetic zone entirely lack such parameters and outcomes. Currently, there is a strong need for a consensus on objective and well-defined parameters to assess the esthetics in bone regeneration and subsequently on implant dentistry. [ABSTRACT FROM AUTHOR]

Background Vertical ridge augmentation with the use of solid bone blocks or particulate bone autograft, exposed or covered by a nonresorbable expanded polytetrafluoroethylene ( ePTFE) membrane, are well known in the literature and have been shown to be effective in treating bone atrophy. Purpose The aim of our study was to assess the two techniques in respect to biological properties of transplanted bone in graft revascularization and bone remodeling in conjunction with dental implants. Materials and Methods Ten patients were treated within the study, with a total of 12 sites with posterior mandibular edentulous ridges with insufficient bone to allow implant placement. Bone regeneration was performed using autogenous intraoral block graft or autogenous particulate graft with an ePTFE barrier membrane. At 6-10 months, reentry surgery was performed; bone biopsies, including microscrews, were harvested; and implants were placed. Results Eleven sites out of 12 healed uneventfully. A mean height gain of 5.03 mm was achieved. Mean bone-to-implant contact and bone fill were assessed by means of histomorphometric analysis. The block specimens revealed a bone-to-implant contact of 42.34%, and the particulate grafts had a bone-to-implant contact of 26.62% ( p < .012). Bone fill values reported were 68.32% and 48.28% ( p < .019) for block specimens versus particulate grafts. Conclusions The results clearly showed that both techniques were clinically successful for subsequent implant placement and prosthetic rehabilitation. The histological outcomes, including revascularization and bone remodeling, of the two techniques differed significantly. The block grafts outperformed the particulate grafts in terms of bone-to-implant contact and bone fill values; however, the morbidity associated with the donor site of the block must be considered. [ABSTRACT FROM AUTHOR]

Aim To assess, using a structured review, the quality of reporting (design and outcome assessment) of risk factor research using the STROBE statements. The outcome was implant loss, and the risk factors assessed were smoking, diabetes and periodontitis. Materials and Methods Literature search was performed individually for each of the risk factors and the outcome using three sets of database: (a) MEDLINE, (b) references derived from relevant reviews and (c) references derived from identified manuscripts. Only case-control and cohort studies were included and assessed using the STROBE statements. Results A total of 104 papers were retrieved, three of which were found to be cohort studies (one in the diabetes and two in the periodontitis review) and none was a case-control study. A total of 101 of 104 papers were case series or cross-sectional study. Conclusions Risk factor research in implant dentistry is mostly comprised of case series studies. These are used to generate hypotheses, but are the wrong tool to test these hypotheses. In the near future, well-designed observational studies are needed and should be reported according to the proposed checklist. [ABSTRACT FROM AUTHOR]

This article evaluates and illustrates the application of the recent-traumatic episode protocol (R-TEP) with three diverse clients: a child with chronic illness, a woman with a significant loss, and an adolescent who self-harmed. The R-TEP is an adaptation of the Eye Movement Desensitization and Reprocessing (EMDR) protocol for early EMDR intervention. Sessions are presented in detail to highlight the shifts in information processing that occur during treatment. Observed markers used to analyze the flow of processing are identified, which include distancing from the trauma; reduction in negative affect or change in reported emotions; accessing more adaptive information; changes in the Subjective Units of Disturbance scale; and the Validity of Cognition scale and Impact of Event Scale--Revised indicating shifts in perception of the traumatic memory. Pre-post R-TEP treatment gains were noted for all clients, with changes in behavior and functioning. Theoretical underpinnings of the R-TEP are discussed with respect to the reported observations. The specific contribution of the protocol is highlighted, considering its procedural components and related plausible mechanisms of change. [ABSTRACT FROM AUTHOR]

The aim of the present study was to evaluate a Ca-P coated implant surface in a rabbit model. The Ca-P surface (test) was compared to the titanium porous oxide surface (control) in terms of bone-to-implant contact (BIC) and removal torque value. Two hundred and sixteen dental implants were inserted in the tibia and in the femur of 36 rabbits. One hundred and eight were represented by Ca-P oxidized surface implant and other 108 were titanium porous oxide surface modified implants. Each rabbit received six implants. Animals were sacrificed after 2, 4 and 9 weeks of healing. Each group included 12 rabbits. The femoral implant and the proximal implant of the tibia of each animal were subjected to the histologic analysis and the distal implants of the tibia underwent removal torque test (RTQ). Histological analysis in terms of BIC and RTQ did not revealed any significant difference between the Ca-P oxidized surface and the oxidized surface at 2 and 4 weeks. At 9 weeks, the oxidized surface demonstrated better results in terms of RTQ in the tibia. In conclusion, findings from the present study suggested that the Ca-P coating had no beneficial effect in improving bonding strength at the bone-implant interface either at 2, 4 and 9 weeks. Fontana F, Rocchietta I, Addis A, Schupbach P, Zanotti G, Simion M. Effects of a calcium phosphate coating on the osseointegration of endosseous implants in a rabbit model Clin. Oral Impl. Res. , 2011; 760-766 doi: 10.1111/j.1600-0501.2010.02056.x [ABSTRACT FROM AUTHOR]

Aim: To evaluate the bone tissue response to zirconia implants with three different surface modifications in comparison with the oxidized titanium surface with the goal to optimize osseointegration in terms of strength and speed. Materials and methods: A total of 18 rabbits with 143 implants were used. One hundred and twenty-three were threaded zirconia ceramic implants with three different surface topographies and 20 modified titanium oxide implants were controls. Each rabbit received eight implants and sacrificed after 3 weeks. The removal torque test (RTQ) and histology were performed. Results: Sixteen out of 18 rabbits completed the study with a total of 110 implants. No statistical significance was observed between the chemical modification implants compared with the topographically modified zirconia implant in terms of interfacial shear strength proven by the RTQ applied. No statistical significance was also observed in the bone-to-implant contact between the zirconia implants and the control oxidized implants. Conclusions: The findings suggest that additional specific chemical modifications of the topographically modified zirconia implants do not seem to enhance the bone-to-implant contact and appear not to increase the interfacial shear strength. [ABSTRACT FROM AUTHOR]

BACKGROUND: This review addressed the focused question of what is the predictability of vertical ridge augmentation techniques for patients, who were diagnosed with insufficient alveolar bone volume for the placement of dental implants. MATERIAL AND METHODS: A systematic online review of three main databases was performed between 1966 and 1 November 2007. Four groups of vertical bone augmentation techniques have been identified and evaluated: (1) guided bone regeneration, (2) distraction osteogenesis, (3) onlay bone grafting, and (4) an array of different techniques. Data extraction was based on the following outcomes: (a) success and failure rate of the procedure (vertical bone gain/loss), (b) complication rate of the procedure, and (c) implant survival, success and failure rate. RESULTS: The initial search identified 189 papers from the electronic database. The review produced seven papers for GBR, 13 reporting distraction osteogenesis, five for onlay bone grafting and three describing different techniques. CONCLUSIONS: For the concept of vertical ridge augmentation to enable dental implant placement, there are clinical and histological data supporting its potential use. Given the confined number of investigators using these techniques and the low number of patient treatments reported in the literature, the generalizability of this approach is limited at this time. [ABSTRACT FROM AUTHOR]

Background: This review addressed the focused question of what is the predictability of vertical ridge augmentation techniques for patients, who were diagnosed with insufficient alveolar bone volume for the placement of dental implants. Material and Methods: A systematic online review of three main databases was performed between 1966 and 1 November 2007. Four groups of vertical bone augmentation techniques have been identified and evaluated: (1) guided bone regeneration, (2) distraction osteogenesis, (3) onlay bone grafting, and (4) an array of different techniques. Data extraction was based on the following outcomes: (a) success and failure rate of the procedure (vertical bone gain/loss), (b) complication rate of the procedure, and (c) implant survival, success and failure rate. Results: The initial search identified 189 papers from the electronic database. The review produced seven papers for GBR, 13 reporting distraction osteogenesis, five for onlay bone grafting and three describing different techniques. Conclusions: For the concept of vertical ridge augmentation to enable dental implant placement, there are clinical and histological data supporting its potential use. Given the confined number of investigators using these techniques and the low number of patient treatments reported in the literature, the generalizability of this approach is limited at this time. [ABSTRACT FROM AUTHOR]

Objectives To assess relevant data comparing short implants or implants associated with vertical ridge augmentation derived from RCT's and CCT's. Material and methods A Pub Med and hand search was performed to identify all RCT's and CCT's published in English language comparing short implants to implants associated with vertical ridge augmentation. Results The initial search resulted in 3387 articles. A total of 17 articles were eligible for full-text analysis and four were finally included. This review tends to demonstrate similar implant survival rates between implants placed in vertically augmented bone and short implants (95.09% vs. 96.24%, respectively) with a follow-up ranging from 1 to 5 years. In terms of prosthetic survival rates, there were no differences between the treatments. More surgical complications were reported when using implants placed in vertically augmented bone compared to short implants (56 patients with surgical complications compared to 18 patients, respectively). Conclusions This evidence should, however, be interpreted with caution as it is derived from four RCT's with limited sample size (ranging from 15 to 30 per group), limited follow-up and performed by the same research group. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the effect of using guided bone regeneration (GBR) with a titanium-reinforced e-PTFE membrane in alveolar bone defects with titanium implants. Material and methods: Following extraction of three mandibular premolars and a molar on both sides of the jaw in three dogs, alveolar bone defects (depth: 5–7 mm) were produced. After 4 months, three implants were inserted into each defect to a depth of approximately 4 mm, so that their coronal portion was protruding about 5 mm. Four sides in the dogs were assigned to a test group and the remaining two sides to a control group. The 12 implants in the test group were covered with a reinforced e-PTFE membrane. The space under the membrane was filled with peripheral venous blood from the animal, and the flaps were sutured over the membrane. The six control implants received no membrane before the suturing of the flaps to complete wound closure. The animals were sacrificed after 6 months, and non-decalcified histological specimens of the implants and surrounding tissues were prepared. Results: Histologic and histomorphometric analyses revealed a significantly (Mann–Whitney test; P=0.08) larger amount of bone fill in the test group (mean=57.42%) than in the controls (mean=11.65%), and clinical evaluation of one test site showed that the implants were completely covered with tissue resembling bone. In most of the specimens, bone had grown in height close to, or in direct contact with the membrane. However, the new bone generally was not in direct contact with the implants. Regularly, a zone of dense connective tissue was interposed between the implants and the newly formed bone. Conclusion: The formation of even considerable amounts of bone following vertical ridge augmentation with GBR and implants was not accompanied by predictable osseointegration of the implants. [ABSTRACT FROM AUTHOR]

Objectives: The task of working Group 2 at the 6th Consensus Meeting of the European Association for Osseointegration was to comprehensively assess the effects of soft tissue augmentation procedures at dental implant sites on clinical, radiographic and patient‐reported outcome measures (PROMs) including an overview on available outcome measures and methods of assessment. Materials and methods: Three systematic reviews and one critical review were performed in advance on (i) the effects of soft tissue augmentation procedures on clinical, radiographic and aesthetic outcomes, (ii) reliability and validity of outcome measures and methods of assessment and (iii) PROMs applied in clinical studies for soft tissue augmentation procedures at dental implant sites. Major findings, consensus statements, clinical recommendations and implications for future research were discussed in the group and approved during the plenary sessions. Results: The four reviews predominantly revealed: Soft tissue augmentation procedures in conjunction with immediate and delayed implant placement result in superior aesthetic outcomes compared to no soft tissue augmentation in the zone of aesthetic priority.Soft tissue augmentation procedures have a limited effect on marginal bone level changes compared to implant sites without soft tissue augmentation. Clinically relevant parameters (gingival index, mucosal recession) and plaque control improve at implant sites when the width of keratinised mucosa is increased.A variety of aesthetic indices have been described with good reliability. Pink Esthetic Score and Complex Esthetic Index are the most validated aesthetic indices for single implants, though. Superimposed digital surface scans are most accurate to assess profilometric tissue changes.PROMs following soft tissue augmentation procedures have been assessed using various forms of questionnaires. Soft tissue augmentation had a limited effect on PROMs. Conclusions: Soft tissue augmentation procedures are widely applied in conjunction with implant therapy. Depending on the indication of these interventions, clinical, radiographic and aesthetic outcomes may improve, whereas the effect on PROMs is limited. [ABSTRACT FROM AUTHOR]

Objectives: The task of working Group 2 at the 6th Consensus Meeting of the European Association for Osseointegration was to comprehensively assess the effects of soft tissue augmentation procedures at dental implant sites on clinical, radiographic and patient‐reported outcome measures (PROMs) including an overview on available outcome measures and methods of assessment. Materials and methods: Three systematic reviews and one critical review were performed in advance on (i) the effects of soft tissue augmentation procedures on clinical, radiographic and aesthetic outcomes, (ii) reliability and validity of outcome measures and methods of assessment and (iii) PROMs applied in clinical studies for soft tissue augmentation procedures at dental implant sites. Major findings, consensus statements, clinical recommendations and implications for future research were discussed in the group and approved during the plenary sessions. Results: The four reviews predominantly revealed: Soft tissue augmentation procedures in conjunction with immediate and delayed implant placement result in superior aesthetic outcomes compared to no soft tissue augmentation in the zone of aesthetic priority.Soft tissue augmentation procedures have a limited effect on marginal bone level changes compared to implant sites without soft tissue augmentation. Clinically relevant parameters (gingival index, mucosal recession) and plaque control improve at implant sites when the width of keratinised mucosa is increased.A variety of aesthetic indices have been described with good reliability. Pink Esthetic Score and Complex Esthetic Index are the most validated aesthetic indices for single implants, though. Superimposed digital surface scans are most accurate to assess profilometric tissue changes.PROMs following soft tissue augmentation procedures have been assessed using various forms of questionnaires. Soft tissue augmentation had a limited effect on PROMs. Conclusions: Soft tissue augmentation procedures are widely applied in conjunction with implant therapy. Depending on the indication of these interventions, clinical, radiographic and aesthetic outcomes may improve, whereas the effect on PROMs is limited. [ABSTRACT FROM AUTHOR]

Background and Aims: Bone augmentation procedures to enable dental implant placement are frequently performed. The remit of this working group was to evaluate the current evidence on the efficacy of regenerative measures for the reconstruction of alveolar ridge defects. Material and Methods: The discussions were based on four systematic reviews focusing on lateral bone augmentation with implant placement at a later stage, vertical bone augmentation, reconstructive treatment of peri‐implantitis associated defects, and long‐term results of lateral window sinus augmentation procedures. Results: A substantial body of evidence supports lateral bone augmentation prior to implant placement as a predictable procedure in order to gain sufficient ridge width for implant placement. Also, vertical ridge augmentation procedures were in many studies shown to be effective in treating deficient alveolar ridges to allow for dental implant placement. However, for both procedures the rate of associated complications was high. The adjunctive benefit of reconstructive measures for the treatment of peri‐implantitis‐related bone defects has only been assessed in a few RCTs. Meta‐analyses demonstrated a benefit with regard to radiographic bone gain but not for clinical outcomes. Lateral window sinus floor augmentation was shown to be a reliable procedure in the long term for the partially and fully edentulous maxilla. Conclusions: The evaluated bone augmentation procedures were proven to be effective for the reconstruction of alveolar ridge defects. However, some procedures are demanding and bear a higher risk for post‐operative complications. [ABSTRACT FROM AUTHOR]

Objectives: The task of this working group was to update the knowledge about the use of drugs and biologicals affecting healing of soft tissue and bone during implant treatment or procedures associated with it. Moreover, the impact of titanium particles and biocorrosion on complications and implant survival has been analysed. Materials and Methods: The literature in the areas of interest (platelet concentrates, antiresorptive drugs as well as implant–host interaction) was screened using systematic reviews for the former two areas, whereas a narrative critical review was performed for the latter topic. Two manuscripts on platelet concentrates, one manuscript on antiresorptive drugs and one manuscript on the effects of biocorrosion, were presented for group analysis with subsequent discussion in the plenum and final consensus approval. Results: Results and conclusions of the individual reviews of the three topics are presented in the respective papers. Conclusions of the group on strengths and weaknesses of available evidence as well as consensus statements and directions for further research are provided in this study. The following papers were subject to group discussions and formed the basis for the consensus statements: Stähli A, Strauss FJ, Gruber R. () The use of platelet‐rich‐plasma to enhance the outcomes of implant‐related therapies: a systematic reviewStrauss FJ, Stähli A, Gruber R. (2018) The use of platelet‐rich‐fibrin to enhance the outcomes of implant‐related therapies: a systematic reviewMombelli A, Hashim D, Cionca N. () What is the impact of titanium particles and bio‐corrosion on implant survival and complications? A critical reviewStavropoulos A, Bertl K, Pietschmann P, Pandis N, Morten Schiødt, Klinge B. () The effect of antiresorptive drugs on implant therapy: a systematic review. [ABSTRACT FROM AUTHOR]

Objectives: The task of this working group was to update the knowledge about the use of drugs and biologicals affecting healing of soft tissue and bone during implant treatment or procedures associated with it. Moreover, the impact of titanium particles and biocorrosion on complications and implant survival has been analysed. Materials and Methods: The literature in the areas of interest (platelet concentrates, antiresorptive drugs as well as implant–host interaction) was screened using systematic reviews for the former two areas, whereas a narrative critical review was performed for the latter topic. Two manuscripts on platelet concentrates, one manuscript on antiresorptive drugs and one manuscript on the effects of biocorrosion, were presented for group analysis with subsequent discussion in the plenum and final consensus approval. Results: Results and conclusions of the individual reviews of the three topics are presented in the respective papers. Conclusions of the group on strengths and weaknesses of available evidence as well as consensus statements and directions for further research are provided in this study. The following papers were subject to group discussions and formed the basis for the consensus statements: Stähli A, Strauss FJ, Gruber R. () The use of platelet‐rich‐plasma to enhance the outcomes of implant‐related therapies: a systematic reviewStrauss FJ, Stähli A, Gruber R. (2018) The use of platelet‐rich‐fibrin to enhance the outcomes of implant‐related therapies: a systematic reviewMombelli A, Hashim D, Cionca N. () What is the impact of titanium particles and bio‐corrosion on implant survival and complications? A critical reviewStavropoulos A, Bertl K, Pietschmann P, Pandis N, Morten Schiødt, Klinge B. () The effect of antiresorptive drugs on implant therapy: a systematic review. [ABSTRACT FROM AUTHOR]

Background Different therapeutic concepts and methods have been proposed for improving dental implant outcomes in three specific clinical situations: (i) the fresh extraction socket with alveolar ridge preservation protocols; (ii) the posterior maxilla with limited bone height with either the placement of regular-sized implants after sinus elevation and grafting or short dental implants and; (iii) the posterior mandible with limited bone height with either vertical bone augmentation and placement of implants or short dental implants. Materials and methods Three systematic reviews, based on randomized and controlled clinical trials have evaluated the efficacy of these different therapeutic modalities in terms of dental implant outcomes. Results and conclusions Interventions aimed for alveolar ridge preservation have shown efficacy in terms of allowing the placement of dental implants and for reducing the need of further augmentation procedures at implant placement. Both therapeutic options, the placement of implants after sinus elevation and grafting or short dental implants, were valid alternatives in the treatment of the posterior maxilla with deficient bone availability, although short implants resulted in fewer complications. Similarly, the placement of implants in vertically augmented bone rendered comparable outcomes with those of short implants in the treatment of the posterior mandible, but short implants resulted in fewer complications. [ABSTRACT FROM AUTHOR]

Aim: The purpose of the EAO summer camp was to create visions and ideas for future developments in the field of implant dentistry. An additional goal was the installation of a young, strong and enduring network for scientific exchange among participants. Summer camp activity: Forty participants younger than 40 years of age, from 16 different European countries, discussed potential future developments of implant dentistry in a professionally moderated workshop. Participants worked in a competitive manner over 3 days in small teams on four topics: future teaching and education, surgery in 2030, prosthetics in 2030 and futuristic tissue development related to the field of implantology. Various innovative conference and moderation techniques were applied to achieve a maximum output from the creative potential present. Results: Plenum consensus was obtained for several key factors potentially influencing future development in implant dentistry. In particular, teaching and education will be improved by the establishment of curriculum standards and novel teaching technologies. Surgery in 2030 will benefit from an improved cost-effectiveness of new technologies and biomaterials. A more comprehensive knowledge on host susceptibility will have an impact on treatment planning and the predictability of implant therapy. A virtual patient concept and tissue engineering will influence Prosthodontics in 2030. Futuristic tissue development will set a 'platinum standard' for tissue regeneration. Summary: Visions on all four topics were generated and discussed intensively during the conference. 'Future teaching and education' was voted unanimously as the winning team based on the presented ideas and the special interest this topic generated. The EAO Junior Committee members, Jung RE, Kapos T, Nicol A, Nisand D, Palarie V, Payer M, Rocchietta I, Schwarz F. EAO Summer Camp: a Facilitated sharing experience. Clin. Oral Impl. Res. 23, 2012; 257-260. doi: 10.1111/j.1600-0501.2011.02221.x [ABSTRACT FROM AUTHOR]