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Primary failure of eruption (PFE) is a rare, nonsyndromic condition in which non-ankylosed teeth fail to erupt either fully or partially due to malfunction of the eruption mechanism. Three young patients are presented in this article with features consistent with a diagnosis of PFE. The features of this condition are described together with different modalities of treatment planning for such patients. The following is a discussion about zygoma implants as a new approach to treatment for patients with PFE requiring full-mouth rehabilitation. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate over 5 years the mesial, distal, palatal, and buccal bone levels as well as the buccal bone thickness surrounding scalloped implants that were immediately placed and loaded with provisional crowns fixed on final prefabricated abutments. Materials and Methods: A total of 18 implants were placed and immediately loaded using CAD/CAM technology in 18 patients to replace a single tooth in the anterior maxilla. The marginal bone levels around the scalloped implant necks were measured mesially and distally using intraoral standardized radiographs after crown placement as well as at the 1-, 3-, and 5-year follow-ups. CBCT para-axial cut images were used to measure the bone level buccally and palatally from the implant neck to the bone-to-implant contact (BIC) 5 years after loading. These images were used to evaluate the thickness of the buccal bone at the implant neck and 4 mm apically both immediately after implant placement (T0) and 5 years later. Results: All implants were assessed clinically and radiologically after 5 years. No implant failure was recorded, and the average marginal bone variation for mesial and distal sites was as follows: 0.114 ± 0.135 mm at crown cementation, 0.239 ± 0.158 mm 1 year later, 0.233 ± 0.182 mm 3 years later, and 0.180 ± 0.182 mm 5 years later. Our findings indicate that at T0, the average thickness of the buccal bone was 2.27 mm at the implant neck (M0; ranging from 1.9 to 2.4 mm) and 2.33 mm at 4 mm apical to the implant neck (M1; ranging from 1.9 to 2.9 mm). At 5 years postoperative (T4), the mean had decreased to 1.94 mm at M0 (ranging from 1.7 to 2.3 mm) and 2.14 mm at M1 (ranging from 1.8 to 2.4 mm). After 5 years of functional loading, the mean changes at the buccal and palatal bone for all implants were +0.187 ± 0.52 mm and +0.06 ± 0.38 mm, respectively. Minor prosthetic problems were observed over the 5 years, including incisal ceramic chipping in two crowns and replacement of two crowns due to esthetic reasons after 1 year. No loosening of crowns or abutments was reported. Conclusions: Scalloped-neck implants demonstrated a comparable behavior to regular-neck implants with similar designs in immediate placement and temporization protocol over a 5-year period. [ABSTRACT FROM AUTHOR]

Purpose: To compare the influence of immediate loading (IL) and non-immediate loading (NIL) protocols on overdentures retained by reduced-diameter implants (< 3.5 mm). Materials and Methods: Electronic databases including MEDLINE (via PubMed), Embase, and the Cochrane Central Register of Controlled Trials were searched for randomized controlled trials (RCTs) comparing clinical outcomes of immediately loaded and non-immediately loaded reduced-diameter implants supporting overdentures. The risk of bias within and across the studies and the certainty of evidence were assessed by RoB 2.0 and GRADE, respectively. A sensitivity analysis was performed by eliminating studies at high risk of bias and repeating the data synthesis employing the random effects model. Subgroup analyses were conducted based on the implant diameter and the length of follow-up. Results: Overall, six RCTs with 255 patients were included in this systematic review. The meta-analyses found similar implant survival rates between immediately loaded and non-immediately loaded implants in the mini-implant (RR = 0.98; 95% CI = 0.95, 1.01; P = .12) and narrow-diameter implant subgroups (RR = 0.99; 95% CI = 0.94, 1.03; P = .56) as well as in short-term (RR = 0.98; 95% CI = 0.97, 1.00; P = .11) and long-term (RR = 0.97; 95% CI = 0.93, 1.01; P = .09) follow-up subgroups. Additionally, marginal bone loss (MBL) showed no statistically significant difference between the loading protocols in the subgroup of long-term follow-up (MD = 0.03; 95% CI = -0.16, 0.23; P = .74). Three RCTs investigating peri-implant parameters found relatively higher modified plaque index (PI) and probing depth (PD) in reduced-diameter implants under IL. Conclusions: Compared with NIL, the IL protocol can achieve comparable survival rates and MBL in reduced-diameter implants supporting overdentures. [ABSTRACT FROM AUTHOR]

Immediate full-arch loading is a highly complex and techniquesensitive procedure. Digital impression techniques aim to replace conventional analog systems to carry out dental treatments in a more predictive, safer, and less time-consuming way. This case report describes a patient with a guarded periodontal prognosis, who was rehabilitated with implant-supported fixed prostheses after full-mouth extractions. Immediate full-arch loading was performed by means of two digital impression systems: photogrammetric technology with PIC dental in the maxillary arch, and MedicalFit in the mandible. Immediate provisional prostheses in acrylic resin (polymethyl methacrylate) were milled and placed within 12 hours after implant placement surgeries. Both provisional structures fitted properly providing adequate esthetics and function. After the implant osseointegration period, final digital impressions were registered, and definitive zirconia full-arch implant-supported prostheses were delivered. The 24-month follow-up did not show biologic or mechanical complications. [ABSTRACT FROM AUTHOR]

Background: Dental implants are becoming a popular treatment of choice. Immediate implant placement with immediate loaded full-arch fixed dental prostheses (IPILFFDP) presents an attractive solution for edentulous and partially edentulous patients because of its high success rate, reduction in overall treatment time, and improved esthetics. However, whether it can minimize the risk of temporomandibular disorder (TMD) has not been previously studied. Objective: To quantitatively evaluate the temporomandibular joint (TMJ) morphology changes before and after IPILFFDP, using cone beam computed tomography (CBCT). Methods: Twelve participants without TMJ symptoms undergoing IPILFFDP were included in the study. Preoperative and 1-year postoperative assessment of CBCT scans were performed on 18 items related to TMJ and vertical dimensions. Mimics software was used for data analysis. T-test, Pearson, and Spearman correlation analyses were performed. Results: There were no significant differences in bilateral joints between pre and post IPILFFDP. Compared with pre-treatment CBCT, post-treatment CBCT showed a significant increase in posterior joint space. There was an approximately 2 mm increase in the vertical dimension after IPILFFDP, which is correlated with an increase in the medial joint space. Conclusions: For patients without TMJ-related signs and symptoms, the IPILFFDP could keep the neuromuscular memory of patient's facial muscles and occlusion, and use adapted centric posture as a guide, which led to more precise restoration of the original jaw position and may shed light in future related clinical studies. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Purpose Materials and Methods Results Conclusions Full‐arch immediate loading rehabilitations are now a widely used rehabilitation method that guarantees predictable medium‐ and long‐term results. Numerous factors can influence its success and stability in the medium and long term. Among these the implant‐abutment connection seems to play an important role, however there is still little information on which is the most suitable in this type of treatment.The aim of the present multicenter split‐mouth controlled trial is to evaluate whether external hexagonal connections (EHC) and internal hexagonal connections (IHC) can influence success, bone resorption and peri‐implant parameters in immediate‐load full‐arch rehabilitations.Twenty patients were rehabilitated with immediately loaded fixed full‐arch rehabilitations. All the implants presented the same macro‐ and micro‐topography but different implant‐abutment connection. IHC were used in one randomly selected side of the jaw and EHC was used in the other side. Outcome measures were implant survival rate, peri‐implant marginal bone loss (MBL), plaque index (PI), probing depth (PD), and bleeding on probing (BoP) evaluated at 3, 6, 12, 36, and 72‐month post‐loading. Technical and biological complications were recorded.In 20 patients, 43 EHC and 40 IHC implants were placed. Between 32 and 72 months of follow‐up two patients withdrew (died) and no implants were lost. The cumulative survival rate (CSR) was 97.44% for EHC implants and 97.22% for IHC implants. The MBL presented a resorption of 2 mm in the EHC group and 1.9 mm in the IHC group. No statistically significant differences were found between the two groups for any of the parameters at any time. No biological or technical complications were detected between the 36th and 72nd month of follow‐up.After 72 months in function, both internal and external hexagon connections provided good clinical outcomes and were not associated with any significant difference in the clinical outcomes. [ABSTRACT FROM AUTHOR]

Background: The following case report presents the treatment of a patient with severe maxillary atrophy and failing residual dentition. The patient has been diagnosed with stage IV grade C periodontitis, making this case challenging from the very beginning. Methods: The treatment plan was based on collecting and merging digital data: CBCT, a face scan, and an intraoral scan. Due to the advancement of the periodontal disease, the treatment was divided into three stages. The entire process was conducted in a digital manner, based on the concept of prosthetically driven implantology. Additionally, all prosthetic temporaries were planned via digital smile design. Stage I included extracting the residual dentition, placing four implants in the mandible, and the delivery of a 3D-printed upper removable denture. Stage II included placing two zygomatic implants, two anchored piriform rims, and one midline implant. Both arches were immediately loaded with the intraoral welding of abutments screwed to multiunit abutments and 3D-printed shells. Subsequently, in stage III, two milled ceramic superstructures combined with a titanium milled bar were delivered as a final screw-retained restoration with the application of scan flags (horizontal scan bodies) for intraoral scanning. Results: The aforementioned technologies can all be implemented and merged into one complex treatment plan combining high predictability, successful esthetics, and a reliable and accurate end result. Even though the concept of scan flags is relatively new, this case shows its potential and merit. Conclusions: This case represents the power of the digital approach as a helpful tool in the recreation of functional and esthetic smiles in compromised conditions in periodontal patients. [ABSTRACT FROM AUTHOR]

Objectives: To assess navigation accuracy for complete‐arch implant placement with immediate loading of digitally prefabricated provisional. Materials and Methods: Consecutive edentulous and terminal dentition patients requiring at least one complete‐arch FDP were treated between December 2020 and January 2022. Accuracy was evaluated by superimposing pre‐operative and post‐operative cone beam computed tomography (CBCT), recording linear (mm) and angular (degrees) deviations. T‐tests were performed to investigate the potential effect of the registration algorithm (fiducial‐based vs. fiducial‐free), type of references for the fiducial‐free algorithm (teeth vs. bone screws), site characteristic (healed vs. post‐extractive), implant angulation (axial vs. tilted), type of arch (maxilla vs. mandible) on the accuracy with p‐value <0.05. Results: Twenty‐five patients, 36 complete‐arches, and 161 implants were placed. The overall mean angular deviation was 2.19° (SD 1.26°). The global platform and apex mean deviations were 1.17 mm (SD 0.57 mm), and 1.30 mm (SD 0.62 mm). Meaningful global platform (p = 0.0009) and apical (p = 0.0109) deviations were experienced only between healed and post‐extraction sites. None of the analyzed variables significantly influenced angular deviation. Minor single‐axis deviations were reported for the type of jaw (y‐axis at implant platform and apex), registration algorithm (y‐axis platform and z‐axis deviations), and type of references for the fiducial‐free algorithm. No statistically significant differences were found in relation to implant angulation. Conclusions: Within the study limitations navigation was reliable for complete‐arch implant placement with immediate loading digitally pre‐fabricated FDP. AI‐driven surface anatomy identification and calibration protocol made fiducial‐free registration as accurate as fiducial‐based, teeth and bone screws equal as references. Implant site characteristics were the only statistically significant variable with healed sites reporting higher accuracy compared to post‐extractive. Live‐tracked navigation surgery enhanced operator performance and accuracy regardless of implant angulation and type of jaw. A mean safety room of about 1 mm and 2° should be considered. [ABSTRACT FROM AUTHOR]

The aim of the present in vitro comparative study is to validate a novel composite polymer, named "ONLY", developed to overcome the mechanical drawbacks of conventional, metal-reinforced poly(methyl methacrylate) (PMMA) interim restoration. Ten interim restorations were designed and fabricated (five in the composite "ONLY" group, and five in the metal-reinforced PMMA group). All the samples were screwed into the prototype models, simulating a complete edentulous mandible rehabilitated with six straight implants. Outcome measures were break point (load, N) and displacement (mm) through a static compression test, and material behavior through a dynamic cyclic test method (fatigue test). A total of 20 samples were tested (10 for static and 10 for dynamic). In each group, five samples (test and control) were used. All the specimens completed the mechanical tests, as planned. There was no statistically significant difference between groups for any test. In the test group, the break point was 1953.19 ± 543.73 N, while it was 2031.10 ± 716.68 N in the control group (p = 0.775). The displacement was 1.89 ± 0.34 mm in the test group and 1.98 ± 0.75 mm in the control group (p = 0.763). Using the dynamic cyclic test method, in the control group the mean load was 2504.60 ± 972.15 N, while in the test group the mean load was 3382.00 ± 578.50 N. The difference between groups was 877.40 ± 579.30 N (p value = 0.121). Within the limitations of this in vitro study, the novel composite polymer can be used to immediately load dental implants. Further clinical research is needed to confirm these preliminary results. [ABSTRACT FROM AUTHOR]

Implant-supported immediate loading full-arch rehabilitation has been documented in the literature. More recently, computed surgical guides have frequently been used since they facilitate planning and performing surgical treatment without the need to raise a flap, thus reducing trauma and morbidity. This case report describes an immediate full-arch, fixed rehabilitation with full loading placed on four commercially available 3D-printed implants, with a 24-month follow-up. The implants were placed with the help of a digitally planned 3D-printed surgical guide. The provisional fixed prosthesis installed immediately was replaced after 3 months. At the time, the soft and hard tissue around the implants appeared stable, without signs of inflammation. The same situation was observed at the 24-month follow-up. Three-dimensional-printed implants seem to be a promising choice in this case. However, further clinical studies with longer follow-up periods are necessary to confirm their efficacy. [ABSTRACT FROM AUTHOR]

Purpose: This prospective case series aimed to investigate the effect of vertical alveoloplasty on the changes in keratinized mucosa width (KMW) following full‐arch immediate implant placement and rehabilitation. Materials and Methods: A total of 17 potential edentulous patients were enrolled and received implant placement and full‐arch implant‐supported immediate rehabilitations. The main outcome was to analyze the effect of vertical alveoloplasty on the changes in KMW. The amount of vertical alveoloplasty during implant surgery as well as the changes in KMW at buccal aspects from the day of surgery to 6 months post‐surgery were recorded on the implant‐level using a periodontal probe. The secondary outcome was to analyze the other possible factors that affected the changes in KMW. The included factors were the initial KMW, the distribution of implants in the maxilla and mandible, the distribution of implants in the anterior and posterior regions, the distribution of implants in extraction sockets and healed ridges, and gender. Mann‐Whitney non‐parametric tests and multiple linear regression adjusted by generalized estimating equations (GEE) were used to statistically analyze the data. Results: A total of 121 implant positions were analyzed. The KMW was 4.1± 2.0 mm on the day of the surgery and 4.1± 1.7 mm 6 months post‐surgery. The mean changes in KMW following 6 months were −0.1± 1.6 mm (p = 0.824). From the results of GEE, the vertical amount of alveoloplasty had no significant effect on changes in KMW. Both initial KMW and the distribution of implants in the anterior and posterior regions had significant impacts on the changes in KMW (p < 0.0001). Conclusion: The amount of vertical alveoloplasty during implant surgery has no significant impact on the KMW. The KMW remained stable from baseline to 6 months after alveoloplasty, implant placement, and immediate rehabilitations in potential edentulous arches. The initial KMW and the distribution of implants in the anterior and posterior regions were the possible factors affecting changes in KMW. [ABSTRACT FROM AUTHOR]

Copyright of Implantologie is the property of Quintessenz Verlags GmbH and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Implantologie is the property of Quintessenz Verlags GmbH and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Implantologie is the property of Quintessenz Verlags GmbH and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Background Dental implants are becoming a popular treatment of choice. Immediate implant placement with immediate loaded full-arch fixed dental prostheses (IPILFFDP) presents an attractive solution for edentulous and partially edentulous patients because of its high success rate, reduction in overall treatment time, and improved esthetics. However, whether it can minimize the risk of temporomandibular disorder (TMD) has not been previously studied. Objective To quantitatively evaluate the temporomandibular joint (TMJ) morphology changes before and after IPILFFDP, using cone beam computed tomography (CBCT). Methods Twelve participants without TMJ symptoms undergoing IPILFFDP were included in the study. Preoperative and 1-year postoperative assessment of CBCT scans were performed on 18 items related to TMJ and vertical dimensions. Mimics software was used for data analysis. T-test, Pearson, and Spearman correlation analyses were performed. Results There were no significant differences in bilateral joints between pre and post IPILFFDP. Compared with pre-treatment CBCT, post-treatment CBCT showed a significant increase in posterior joint space. There was an approximately 2 mm increase in the vertical dimension after IPILFFDP, which is correlated with an increase in the medial joint space. Conclusions For patients without TMJ-related signs and symptoms, the IPILFFDP could keep the neuromuscular memory of patient’s facial muscles and occlusion, and use adapted centric posture as a guide, which led to more precise restoration of the original jaw position and may shed light in future related clinical studies.

Purpose: To evaluate and compare the marginal bone loss (MBL), survival rates, and periodontal parameters of immediately loaded implants with either Dolder bar or Locator attachments placed in the interforaminal region of edentulous mandibles. Materials and Methods: A total of included 19 patients with edentulous mandibles each received two implants in the interforaminal area of the symphysis. Randomly allocated Dolder bar or Locator attachments were then attached immediately, and both clips and a framework were fastened to the denture by the dental laboratory within 24 hours. Results: A total of 28 subjects with 56 implants were treated in accordance with the immediate-loading study protocol. Of these, 9 patients were lost to follow-up; 1 patient reported a serious illness and 8 patients moved and couldn't be reached. The 19 subjects not lost to follow-up (11 women and 8 men; average age: 68 years) were included. Every patient received either two Locator abutments and were assigned to group A (7 patients; 36.8%) or two multiunit abutments and were assigned to group B (12 patients; 63.2%). No implant failure was detected for either group, and therefore the survival rate for both groups was 100% after 5 years. After 5 years without any symptoms, 2 implants from group A and 7 implants from group B showed > 2 mm of MBL, which makes the group A success rate 85.7% and the group B success rate 70.8%. Modified sulcular bleeding index (mSBI) did not differ significantly at any of the measurement intervals. However, the modified plaque index (mPI) of group B was significantly higher than group A at the 60-month follow-up. Conclusion: It can be concluded that either splinting or not splinting the immediately loaded interforaminal implants to retain mandibular overdentures (OVDs) does not affect marginal bone levels after 5 years and immediate loading of nonsplinted implants with Locator attachments can be safely preferred to retain mandibular OVDs. [ABSTRACT FROM AUTHOR]

Purpose: To determine the biologic and biomechanical effects of two implant drilling protocols on the cortical bone around implants subjected to immediate loading. Materials and Methods: A total of 48 implants were inserted into the mandibles of six sheep following one of two drilling protocols: undersized preparation (US; n = 24) and nonundersized preparation (NUS; n = 24). Immediately after implant insertion, an abutment was placed on each implant and 36 implants were subjected to 10 sessions of dynamic vertical loads (1,500 cycles, 1 Hz) of 25 N or 50 N. Insertion torque value (ITV) was recorded at implant installation. Resonance frequency analysis (RFA) was measured at implant insertion and at each loading session. Fluorochrome was administered at day 17, and the animals were euthanized after 5 weeks. The removal torque values (RTVs) were measured, and samples underwent histomorphometric, μCT (microcomputed tomography), and fluorescence image acquisition analyses. The bone volume density (BV/TV), bone-to-implant contact (BIC), bone area fraction occupancy (BAFO), and fluorochrome stained bone surface (MS) were calculated. A linear mixed model analysis was performed, and Pearson paired correlation was calculated. Results: Five implants from the NUS group failed, with a mean ITV of 8.8 Ncm and an RFA value of 57. The mean ITVs for US group and NUS group were 80.5 (± 14) Ncm and 45.9 (± 25) Ncm, respectively (P < .001). No differences were noted in the RFA values from the time of implant insertion until the end of the study. No differences in RTV, BV/TV, BAFO, or MS were observed between the groups. Intense new bone formation took place in the NUS group implants that were subjected to load. Conclusions: Undersized preparation of cortical bone ensured a greater BIC compared to a nonundersized preparation. Moreover, this study demonstrated that immediate loading did not interfere with the osseointegration process, but loading induced intense new bone formation in the NUS group. It is not recommended to immediately load the implants when the clinically perceived primary stability is lower than an ITV of 10 Ncm and an RFA value of 60. [ABSTRACT FROM AUTHOR]

Purpose Materials and methods Results Conclusion To evaluate the mid‐term clinical and radiographic results of immediate fixed full‐arch prosthesis supported by two anterior axial and two posterior trans‐crestally placed tilted implants in patients with severely atrophic posterior maxilla.Patients with posterior maxillary ridge less than 4 mm high and 3 mm wide were rehabilitated with an immediate fixed provisional prosthesis supported by two anterior axially placed and two trans‐crestal posterior tilted implants within 3 h after implant surgery. The final prosthesis, consisting of a CAD‐CAM titanium framework and composite teeth was delivered 6 months later. Patients were scheduled for follow‐up visits every 6 months to assess clinical and radiological parameters. Patients' satisfaction was assessed by a questionnaire up to 5 years.From April 2008 to May 2017, 56 implants (28 axial and 28 tilted) were inserted in 14 subjects (eight female and six male). The average bone loss for the anterior axial implants was 0.99 ± 0.19 mm at 1 year (n = 28 implants), 1.37 ± 0.31 mm at 5 years (n = 28), and 2.05 ± 0.32 mm at 10 years (n = 14). Only for three implants in two subjects the marginal bone loss was higher than 2 mm after 60 months. No implant was lost, and no prosthetic failure occurred after a mean follow‐up of 125 months (range 79–186 months), leading to 100% implant and prosthesis survival rates. The upper 95% confidence limit of the failure rate was 23% and 6% at patient and implant level, respectively. High level of satisfaction was reported at 5‐year follow‐up.Wider sample sizes will be required to determine whether the presented technique is a reliable treatment option for the immediate rehabilitation of the atrophic maxilla. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate clinical, clinician‐ and patient‐reported outcomes (PROs) of two adjacent single posterior implants immediately loaded with definitive single crowns up to 1 year. Ten patients in need of two adjacent posterior single implants were included. All implants were placed applying a fully digital workflow. Definitive screw‐retained single zirconia crowns were delivered within 72 h after implant placement. Clinical parameters, patient‐ and clinician‐reported outcomes were assessed up to 1 year of follow‐up. Clinical Considerations: Clinical outcomes remained stable, with no implant failures or technical and biological complications throughout the observation period. Patient satisfaction was very high at baseline (crown delivery) and remained consistently high at 6 and 12 months of follow‐up. Crown insertion 3 days after implant placement was rated as an easy procedure by clinicians. Conclusions: Two adjacent single implants with immediate definitive restorations (<72 h) in the posterior region appear to be a viable and easy treatment option to shorten the overall treatment time and potentially enhancing patient satisfaction. However, randomized controlled trials are needed to confirm the advantages of this treatment protocol over a delayed loading approach. Clinical Significance: In selected cases, immediate implant loading with definitive restorations in the posterior region appears a valuable and straightforward option to shorten the overall treatment time. [ABSTRACT FROM AUTHOR]

BACKGROUND: The threaded conical implant has a good ability to control micro movements and is conducive to immediate loading. However, the effects of double-threaded conical cylindrical implants and conical cylindrical implants on stress distribution and initial stability of implant-bone interface after immediate loading have not been reported. OBJECTIVE: To investigate the impact of double-threaded conical cylindrical implants and conical cylindrical implants on the biological distribution of the implant and the surrounding bone interface during immediate loading in the mandibular molar region. METHODS: (1) Three-dimensional finite element analysis: Conical beam CT scans of the mandible and first molar of a volunteer were used to develop a basal model of the mandible. The double-threaded conical cylindrical implants and conical cylindrical implants were assembled with the mandibular models, and an immediate-load (or delayed implantation) implant model (a total of four models) for the first mandibular molar was established. Loads in four directions (100 N): axial, lingual and buccal 45°, mesial and distal, and buccal and lingual, were applied to the central fossa of each model’s crown. Three-dimensional finite element method was used to analyze the implant displacement and the stress distribution at the implant-bone interface. (2) In vitro experiment: With the assistance of the oral implant robot, the double-threaded conical cylindrical implants and conical cylindrical implants were implanted on the same artificial bone pieces, separately, and the immediate load model of immediate implant implantation (or delayed implantation) was established in vitro (a total of four groups of models). Osstell resonance frequency analyzer and SmartPeg sensor were used to measure the implant stability coefficient in four vertical directions: front, rear, left, and right measurements, evaluate the initial stability, and verify the finite element analysis results. RESULTS AND CONCLUSION: (1) The displacement difference between double-threaded conical cylindrical implants and conical cylindrical implants was small when the immediate loading of delayed implantation was applied, but the maximum stress value of conical cylindrical implant-bone interface was greater than that of double-threaded conical cylindrical implant-bone interface. When the immediate loading of immediate implantation was applied, the maximum stress value and the maximum displacement of bone around the implant appeared when the load was applied in mesiodistal direction. The stress value of the conical cylindrical implant reached 298.84 MPa and the maximum displacement was 0.31 mm, both of which were larger than that of the double-threaded conical cylindrical implant. (2) The results of in vitro experiments showed that the stability coefficient of the double-threaded conical cylindrical implant was greater than that of the conical cylindrical implant. (3) Compared with the conical cylindrical implant, the double-threaded conical cylindrical implant has higher initial stability under immediate loading, suggesting that the use of double-threaded conical cylindrical implant should be given priority in clinical immediate loading. [ABSTRACT FROM AUTHOR]

This study aimed to compare implant stabilities between the immediate and early loaded, immediately placed bone‐level tapered dental implants in the maxilla and to evaluate marginal bone loss (MBL), oral health‐related quality of life (OHRQoL), and patient satisfaction at a 2‐year follow‐up. A pilot, prospective, randomized, controlled clinical trial was conducted on 24 maxillary failing dentition patients. The bone‐level tapered implants of 12 patients were immediately loaded with temporary restorations, while the other 12 patients did not receive any kind of temporization. Implant‐supported screw‐retained complete porcelain‐fused‐to‐metal prostheses were delivered to all patients in the seventh postoperative week. The insertion torque values of implants assigned to the immediate and early loading groups were 33.0 ± 4.87 and 29.26 ± 8.31 Ncm, respectively. The dynamics of implant stability changes from implant placement up to a 2‐year follow‐up were similar for both groups (Penguin®, p = 0.268; Ostell®, p = 0.552), while the MBL was at submillimeter level. The cumulative implant survival rate was 91.80% for immediately loaded implants and 97.22% for early loaded implants, without significant difference (p = 0.162). The total score on the Oral Health Impact Profile questionnaire significantly decreased over time in both groups, indicating improvement in OHRQoL (p < 0.001), and the high level of patient satisfaction remained after 2 years of function regardless of a loading protocol. Both loading protocols, immediate and early, of six immediately placed bone‐level tapered dental implants are an adequate treatment choice for fixed rehabilitation of the maxillary failing dentition. [ABSTRACT FROM AUTHOR]

Objectives: Evaluate the 5-year safety and efficacy of a narrow-diameter (3.0 mm) implant that was immediately provisionalized with a single crown in the maxillary lateral incisor or mandibular central or lateral incisor area. Materials and methods: An open, prospective, single-cohort, multicenter study was conducted, in which narrow-diameter implants were placed in fresh, healed extraction, or congenitally missing sites. All patients were required to meet strict criteria for immediate loading. The primary endpoints were marginal bone levels (MBL) and MBL changes (MBLC) from implant placement to 5-year follow-up. Secondary endpoints included cumulative 5-year survival and success rates, soft tissue health, and esthetic parameters. Results: A total of 91 implants were placed in 77 patients. The mean MBL remained stable from the 1-year (− 0.79 ± 0.73 mm, n = 75) to 5-year (− 0.74 ± 0.87 mm, n = 65) follow-up. A marginal bone gain of 0.11 ± 0.83 mm was observed from the 1-year to 5-year follow-up. The cumulative 5-year survival rate was 96.5%, and the cumulative 5-year success rate was 93%. The clinical parameters, including the modified plaque index, modified sulcus bleeding index, Jemt’s papilla index, and pink esthetic score improved throughout the 5-year study. Conclusions: The study demonstrated that narrow-diameter implants represent a safe and predictable treatment option for subjects suitable for immediate loading and with limited bone volume or limited inter-dental space. Clinical relevance: Narrow-diameter implants with immediate provisionalization can be considered for use to restore missing or damaged teeth with predictable functional and esthetic outcomes. This trial was registered with ClinicalTrials.gov (NCT02184845). [ABSTRACT FROM AUTHOR]

Purpose: To retrospectively evaluate peri-implant bone loss and health status associated with the long-term use of laser surface-treated implants. Methods: For control study, total of 23 titanium ASTM F136 grade 23 implants were placed in the edentulous molar area of the mandible. When the Implant Stability Quotient (ISQ) ≥ 70 and insertion torque value (ITV) ≥ 35–50 Ncm at the insertion site, an immediate provisional restoration was connected to the implant within a week after surgery. The definitive restorations were placed 2 months after surgery for all implants. 13 implants were immediately loaded, while 10 implants were conventionally loaded. For comparative study, Radiographs were taken from third years for and then annually for the subsequent eight years to monitor marginal bone loss. Results: After eight year of implant installation, the average change in vertical bone loss was 0.009 mm (P < 0.001), while the average change in horizontal bone loss 8 year after implant placement was 0.026 mm (P < 0.001). The mean marginal bone loss was < 0.2 mm on average. Conclusions: In this retrospective study, laser-treated implants exhibit a low rate of bone absorption around the implants. [ABSTRACT FROM AUTHOR]

This report describes a step-by-step staged digital protocol for the terminal dentition patient using a Provi-guide. This protocol will improve implant placement accuracy, shorten treatment time, and assure an implant-supported fixed complete denture immediately loaded after extraction of the remaining terminal dentition and complete edentulism. The novelty of the Provi-guide technique described is that it serves 2 objectives: (1) a nonlimiting surgical guide, and (2) a fixed interim prosthesis. Implants placed in the described digital stagged protocol can serve both the interim and the final prosthesis. [ABSTRACT FROM AUTHOR]

Background/Objectives: The insertion of dental implants using dynamic 3D navigated surgery while applying immediate function protocols for full-arch rehabilitations warrants further research. This study aimed to evaluate the outcomes of All-on-4® rehabilitations using 3D Dynamic navigated surgery (X-Guide™). Methods: This study included 10 patients (women: 7; men: 3; average age: 59.9 years) rehabilitated with full-arch prostheses through the All-on-4® concept, with 48 dental implants inserted using navigated surgery. The primary outcome evaluation was prosthetic/implant cumulative survival (CS), estimated using life tables. Secondary outcome evaluations were marginal bone resorption (MBR), biological complications, and mechanical complications. The evaluation parameters were measured between 1 and 3 years. Results: No patients were lost to follow-up. Two implants (4.2%) were lost in one patient (10%) with smoking habits, resulting in an implant CS rate of 95.8%. The average MBR was 0.51 mm ± 0.62 mm at the 1-year follow-up. The incidence rate of mechanical complications was 40% (n = 4 patients), all occurring in provisional prosthesis. No biological complications were registered. The patients maintained their prostheses in function throughout the follow-up of the study. Conclusions: Within the limitations of this study and based on the results, it can be concluded that the insertion of dental implants assisted by dynamic navigation for full-arch rehabilitation through the All-on-4® concept may be a valid treatment alternative in the short-term follow-up. However, more studies are necessary to validate this treatment modality. [ABSTRACT FROM AUTHOR]

Copyright of Implantologie is the property of Quintessenz Verlags GmbH and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Implantologie is the property of Quintessenz Verlags GmbH and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: To retrospectively evaluate the clinical outcomes of immediately loaded zygomatic implants combined with anterior regular implants (hybrid zygoma) for the fixed rehabilitation of atrophic maxillae. Materials and Methods: A total of 18 patients were enrolled in this study and treated with the hybrid zygoma concept by an experienced surgeon. Followup visits were planned after 1 week, 3 weeks, 4 months, 6 months, then annually. At the last follow-up appointment (mean: 36 months after surgery; range: 24 to 52 months), the prostheses were unscrewed and the implants and periimplant tissues were examined. The primary outcome evaluated was implant success. Following the criteria proposed by Aparicio et al, implant success was classified in five grades, with grade I representing the best condition and grade V representing a failure. At the annual check-up, patients were asked to fill out a questionnaire to evaluate their satisfaction with their oral rehabilitation. Results: A total of 80 implants (34 zygomatic and 46 regular) were inserted. One zygomatic implant was lost in one patient, and two regular implants failed in two other patients. Of the zygomatic implants, 24 (70.6%) presented a success grade I, 9 (26.5%) a success grade II, and 1 (2.9%) a grade V. Sinusitis was the most common biologic complication, occurring in two patients (5.6%). Two patients showed unilateral upper lip paresthesia that was persistent at the last follow-up appointment. According to the annual follow-up visit questionnaire data, 72%, 89%, and 94% of patients declared that they were satisfied with their phonetic ability, chewing ability, and esthetics, respectively. Conclusion: Although zygomatic implants combined with anterior regular implants present a higher risk of complications than traditional implantology, they allow for immediately loaded full-arch fixed rehabilitation of patients with advanced atrophy of the posterior maxilla, which provides satisfactory chewing ability, esthetics, and phonetics. [ABSTRACT FROM AUTHOR]

Purpose: To compare the matrix metalloproteinase-8 (MMP-8) levels in the peri-miniscrew implant crevicular fluid (PMCF) of immediate-loaded and delayed-loaded miniscrew implants at different time intervals. Materials and Methods: Titanium orthodontic miniscrews were placed bilaterally in the attached gingiva of 15 patients between the maxillary second premolar and maxillary first molar for en masse retraction. This split-mouth study was designed to have an immediate-loaded miniscrew on one side and a delayed-loaded miniscrew on the other side that was loaded 8 days after miniscrew placement. PMCF was collected from the mesiobuccal aspects of the immediate-loaded implants at 24 hours, 8 days, and 28 days after loading, and from the delayed-loaded miniscrew implants at 24 hours and 8 days before loading and 24 hours and 28 days after loading. An enzyme-linked immunosorbent assay kit was used to assess MMP-8 levels in the PMCF samples. Unpaired t test, ANOVA F-test, and Tukey post hoc test were used to evaluate data at the P < .05 level. Results: Although there were slight alterations in the MMP-8 levels in the PMCF over time, there was no statistically significant difference in the MMP-8 levels between groups. There was a statistically significant decrease in the levels of MMP-8 between 24 hours after miniscrew placement and 28 days after loading on the delayed-loaded side (P < .05). Conclusion: The MMP-8 levels did not vary much between immediate-loaded and delayed-loaded miniscrew implants as a result of the force application. However, there was no significant difference between immediate loading and delayed loading in terms of biologic response to mechanical stress. The increase in MMP-8 levels after 24 hours post-miniscrew insertion, as well as the subsequent gradual reduction over the course of the study period in both immediate and delayed groups after loading, is probably due to the bone adapting to stimuli. [ABSTRACT FROM AUTHOR]

Background: This pilot study aimed to evaluate the effectiveness of digitally crafted customized healing abutments in stabilizing peri-implant soft tissues following tooth extraction and assess the preservation of peri-implant soft tissue architecture over 5 years. Material and Methods: Forty patients (age ≥ 25 years) were divided into test (n = 20) and control (n = 20) groups. The test group received dental implants with immediate loading after tooth extraction, along with customized healing abutments fabricated using CAD/CAM technology. The control group received dental implants with immediate loading without customized healing abutments. The primary outcome was the change in distance between the peri-implant soft tissue margin and implant fixture surface from baseline to 5 years post implantation. Results: In the test group, there was a significant decrease in the distance between the peri-implant soft tissue margin and fixture surface from baseline to 5 years (p < 0.001), with pairwise comparisons showing significant differences between multiple time points (p < 0.05). The control group showed less pronounced changes over time. Conclusions: Within the limitations of this pilot study, digitally fabricated customized healing abutments appear effective in stabilizing peri-implant soft tissues and preserving soft tissue architecture around dental implants over 5 years following immediate implant placement. Randomized controlled trials are needed to confirm these findings.

Background: With the growing use of dental implants, there is an urgent need to determine a prosthetic placement protocol by assessing implant stability and monitoring healing. Implant Stability Quotient (ISQ) values are produced using dental non-invasive devices through resonance frequency analysis, considered as indicators for measuring primary stability (i.e., at implant placement), monitoring biological stability (osseointegration), and prosthetic loading. A systematic and detailed comparison of ISQ measurement devices, for a given patient population, is lacking in the literature. This aspect is the subject of the present work, with the devices being two that are widely used in clinical practice (Osstell® and Osseo®100). The aim of this study was to evaluate the reliability of ISQ measurement using two standard devices most commonly used in clinical practice and to highlight any differences when comparing measurements at undefined time intervals. Methods: We enrolled 50 patients (16 males and 34 females) with a mean age of 55.4 years, who indicated dental implant placement and met the inclusion criteria. The sample was divided into two equal groups based on bone density: A (D1–D2 bone density) and B (D3–D4 bone density); each had 25 patients with 40 implants. ISQ was measured using two devices: Osstell® and Osseo 100®, at different time points (A: three and B: four follow-ups). Results: All enrolled patients completed the study without adverse events; all implants placed were successful, with no implant failure. In each of the study groups, ISQ values increased gradually with increasing follow-up time, and there was no significant difference between Osstell and Osseo 100 values at follow-up times except for the T1 follow-up in group A. Temporal comparisons for the two devices revealed significant differences in T0 vs. T2 in group A, whereas significant differences existed in T0 vs. T1, T2, and T3 in group B. Our findings indicated that the overall effect significantly depended on bone density rather than on the device used to measure ISQ. Conclusion: Regardless of the devices used, the ISQ measurement effectively monitors healing after implant insertion and allows prosthetic load to be modulated according to the ISQ value, especially when prosthetizing implants placed in fine trabecular bone (D4 or regenerated bone).

Immediate loading protocol reduces patient discomfort because it reduces treatment time as fewer surgeries are performed and offers ample flexibility. The effect of immediate implant loading on peri-implant tissue has not been much discussed. Therefore, it is necessary to undertake a review of the immediate implant loading protocol and its relationship to the peri-implant tissue in the aesthetic zone, to review the most recent literature on the results of existing treatments and the criteria of the conditions that allow this type of treatment to be given. Moreover, an ideal soft tissue profile can be achieved with provisional restoration. Patients' satisfaction and adaptation can be achieved faster because provisional restoration can be placed immediately after surgery to preserve the patient's appearance. [ABSTRACT FROM AUTHOR]

Background: This pilot study aimed to evaluate the effectiveness of digitally crafted customized healing abutments in stabilizing peri-implant soft tissues following tooth extraction and assess the preservation of peri-implant soft tissue architecture over 5 years. Material and Methods: Forty patients (age ≥ 25 years) were divided into test (n = 20) and control (n = 20) groups. The test group received dental implants with immediate loading after tooth extraction, along with customized healing abutments fabricated using CAD/CAM technology. The control group received dental implants with immediate loading without customized healing abutments. The primary outcome was the change in distance between the peri-implant soft tissue margin and implant fixture surface from baseline to 5 years post implantation. Results: In the test group, there was a significant decrease in the distance between the peri-implant soft tissue margin and fixture surface from baseline to 5 years (p < 0.001), with pairwise comparisons showing significant differences between multiple time points (p < 0.05). The control group showed less pronounced changes over time. Conclusions: Within the limitations of this pilot study, digitally fabricated customized healing abutments appear effective in stabilizing peri-implant soft tissues and preserving soft tissue architecture around dental implants over 5 years following immediate implant placement. Randomized controlled trials are needed to confirm these findings. [ABSTRACT FROM AUTHOR]

Titanium implants undergo an aging process through surface hydrocarbon deposition, resulting in decreased wettability and bioactivity. Plasma treatment was shown to significantly reduce surface hydrocarbons, thus improving implant hydrophilicity and enhancing the osseointegration process. This study investigates the effect of plasma surface treatment on bone-to-implant contact (BIC) of implants presenting a nanostructured calcium-incorporated surface (XPEED®). Following a Randomized Controlled Trial (RCT) design, patients undergoing implant surgery in the posterior maxilla received additional plasma-treated (n = 7) or -untreated (n = 5) 3.5 × 8 mm implants that were retrieved after a 4-week healing period for histological examination. Histomorphometric analysis showed that plasma-treated implants exhibited a 38.7% BIC rate compared to 22.4% of untreated implants (p = 0.002), indicating enhanced osseointegration potential. Histological images also revealed increased bone formation and active osteoblastic activity around plasma-treated implants when compared to untreated specimens. The findings suggest that plasma treatment improves surface hydrophilicity and biological response, facilitating early bone formation around titanium implants. This study underscores the importance of surface modifications in optimizing implant integration and supports the use of plasma treatment to enhance osseointegration, thereby improving clinical outcomes in implant dentistry and offering benefits for immediate and early loading protocols, particularly in soft bone conditions. [ABSTRACT FROM AUTHOR]

Purpose: The objective of the present study was to ascertain the effect of immediate occlusal loading after implant placement on osseointegration and the micro/nanostructure of the surrounding bone. Methods: After extraction of a rat maxillary right second molar, an implant was placed immediately with initial fixation (2 N<). The implants were placed to avoid occlusal loading due to mastication, and in the loaded group, a superstructure was fabricated and subjected to occlusal loading. Bone morphometry, collagen fiber anisotropy, and biological apatite (BAp) crystallite alignment were quantitatively evaluated in both groups after extraction and fixation of the jaw bone at Days 7 and 21 after surgery. Results: Osseointegration was observed in both groups. Bone morphometry showed significant differences in bone volume, trabecular number, trabecular thickness and bone mineral density (BMD) at Days 21 postoperatively (P < 0.05). A significant difference was also found in the trabecular separation at Days 7 postoperatively (P < 0.05). In the evaluation of collagen fiber anisotropy, collagen fiber bundles running differently from the existing bone were observed in both groups. In terms of BAp crystallite alignment, a specific structure was observed in the reconstructed new bone after implantation, and preferential orientation of BAp crystallite alignment was observed in the longitudinal direction of the implants in the Day 21 postoperative loaded group. Conclusion: When sufficient initial fixation is achieved at the time of dental implant placement, then the applied masticatory load may contribute to rapidly achieving not only bone volume, but also adequate bone quality after implant placement. [ABSTRACT FROM AUTHOR]

The aim of the presented retrospective study was to evaluate the early crestal bone changes around an implant type designed for high primary stability. A total number of 111 implants placed clinically were evaluated regarding insertion torque, bone density, implant stability quotient (ISQ) and early crestal bone loss from standardized digital radiographs. The implants were allocated in two groups: the „regular torque " group contained all implants that achieved less than 50 Ncm as final insertion torque (n = 63) and the „high torque" group contained the implants that achieved 50–80 Ncm (n = 48). To avoid possible damage either to the implant´s inner connection or to the bone by application of excessive force, a limit of 80 Ncm was set for all surgeries. All implants underwent submerged healing for three months. ISQ measurements and standardized digital radiographs were taken at day of insertion and at day of second stage surgery. The bone loss was measured on the mesial and distal aspect of the implant. The data evaluation showed the following results: Mean bone loss was 0.27 ± 0.30 mm for the high torque group and 0.24 ± 0.27 mm for the regular torque group. The difference was not statistically significant (p = 0.552). In the two groups, no complications nor implant loss occurred. For the evaluated implant type, there was no significant difference in crestal bone changes and complication rate between high and regular insertion torque in the early healing period. [ABSTRACT FROM AUTHOR]

(1) Background: Recent digital workflows are being developed for full-arch rehabilitations supported by implants with immediate function. The purpose of this case series is to describe a new digital workflow for the All-on-4 concept. (2) Methods: The patients were rehabilitated using the All-on-4 concept with a digital workflow including computerized tomography scanning, intra-oral scanning, and CAD-CAM production of the temporary prosthesis, with the 3D printing of stackable guides (base guide, implant guide, and prosthetic guide). The passive fit of the prostheses and the time to perform the rehabilitations were evaluated. (3) Results: The digital workflow allowed for predictable bone reduction, the insertion of implants with immediate function, and the connection of an implant-supported prosthesis with immediate loading. The time registered to perform the full-arch rehabilitations (implant insertion, abutment connection, prosthesis connection) was below 2 hours and 30 min. No passive fit issues were noted. (4) Conclusions: within the limitation of this case series, the digital workflow applied to the All-on-4 concept using stackable base-, implant-, and prosthetic guides constitutes a potential alternative with decreased time for the procedure without prejudice of the outcome. [ABSTRACT FROM AUTHOR]

This case report documents the successful rehabilitation of a 78-year-old female patient who had been edentulous for 15 years. Despite residing in a remote area of Jammu and Kashmir (J&K), where access to dental care was limited, the patient's son, a bank employee, sought out specialized treatment for his mother's dental condition. After consultation and careful consideration, a treatment plan involving immediate loading of dental implants was implemented, providing the patient with fixed provisional teeth within 72 hours. This report highlights the importance of comprehensive assessment, interdisciplinary collaboration, and customized treatment planning in achieving successful outcomes, particularly in challenging cases. [ABSTRACT FROM AUTHOR]

Background: Patients with edentulism often have an impaired functional, phonetic, and esthetic status, resulting in poor quality of life; hence, the mandibular overdenture has been considered the standard implant treatment for such patients. Therefore, this study aimed to assess the effectiveness of mandibular overdentures retained using mini-implants on patient-reported satisfaction and their long-term survival. Methods: We searched patients' medical records for eligible subjects, screening and inviting patients who received a mandibular overdenture anchored on mini-implants over ten years ago. We used a numerical rating scale from 0 (the worst) to 10 (the best) to assess four aspects: comfort, retention, chewing ability, and speaking ability before and after having mini-implants. We carried out Kaplan–Meier analysis to assess their survival. Results: Forty-eight elderly patients who were medically compromised and had a mandibular overdenture anchored on four permucosal mini-implants were included. All patient-reported satisfaction (comfort, retention, chewing ability, and speaking ability) was significantly improved after supporting mandibular overdentures with mini-implants (p-values < 0.05), with retention and chewing ability being the most substantially improved. The 10- and 15-year mini-implant survival rates were both 97.9%. Conclusions: Mandibular overdentures with mini-implants can be considered a valid and practical alternative to conventional implant-supported overdentures in patients with atrophic ridges, medically compromised, and the elderly. [ABSTRACT FROM AUTHOR]

Background: With the growing use of dental implants, there is an urgent need to determine a prosthetic placement protocol by assessing implant stability and monitoring healing. Implant Stability Quotient (ISQ) values are produced using dental non-invasive devices through resonance frequency analysis, considered as indicators for measuring primary stability (i.e., at implant placement), monitoring biological stability (osseointegration), and prosthetic loading. A systematic and detailed comparison of ISQ measurement devices, for a given patient population, is lacking in the literature. This aspect is the subject of the present work, with the devices being two that are widely used in clinical practice (Osstell® and Osseo®100). The aim of this study was to evaluate the reliability of ISQ measurement using two standard devices most commonly used in clinical practice and to highlight any differences when comparing measurements at undefined time intervals. Methods: We enrolled 50 patients (16 males and 34 females) with a mean age of 55.4 years, who indicated dental implant placement and met the inclusion criteria. The sample was divided into two equal groups based on bone density: A (D1–D2 bone density) and B (D3–D4 bone density); each had 25 patients with 40 implants. ISQ was measured using two devices: Osstell® and Osseo 100®, at different time points (A: three and B: four follow-ups). Results: All enrolled patients completed the study without adverse events; all implants placed were successful, with no implant failure. In each of the study groups, ISQ values increased gradually with increasing follow-up time, and there was no significant difference between Osstell and Osseo 100 values at follow-up times except for the T1 follow-up in group A. Temporal comparisons for the two devices revealed significant differences in T0 vs. T2 in group A, whereas significant differences existed in T0 vs. T1, T2, and T3 in group B. Our findings indicated that the overall effect significantly depended on bone density rather than on the device used to measure ISQ. Conclusion: Regardless of the devices used, the ISQ measurement effectively monitors healing after implant insertion and allows prosthetic load to be modulated according to the ISQ value, especially when prosthetizing implants placed in fine trabecular bone (D4 or regenerated bone). [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the performance of fixed complete dental prostheses supported by axial and tilted implants after at least 3 years of follow-up. Materials and Methods: An electronic search plus a hand search up to April 2021 was undertaken. Clinical studies were selected using specific inclusion criteria, independent of the study design. The main outcomes were cumulative implant survival rate, marginal bone level changes, and complications, after ≥ 3 years of follow-up. The difference in outcomes between axial and tilted implants and between the maxilla and mandible was evaluated using meta-analysis and the Mantel-Cox test. Results: Out of 824 articles retrieved, 24 were included. In total, 2,637 patients were rehabilitated with 2,735 full prostheses (1,464 maxillary, 1,271 mandibular), supported by 5,594 and 5,611 tilted and axial implants, respectively. In a range between 3 and 18 years of follow-up, 274 implants failed. The cumulative implant survival rate was 93.91% and 99.31% for implants and prostheses, respectively. The mean marginal bone level change was moderate, exceeding 2 mm in only two studies. Marginal bone loss was significantly lower around axial compared with tilted implants (P < .0001), whereas it was not affected by arch (maxilla vs mandible; P = .17). Conclusion: Fixed complete dental prostheses supported by tilted and axially placed implants represent a predictable option for the rehabilitation of edentulous arches. Further randomized trials are needed to determine the efficacy of this surgical approach and the remodeling pattern of marginal bone in the long term. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was accuracy assessment of placed implants in full-arch cases using specific software and hardware to perform static computer-assisted implantology and immediately loaded prostheses. The degree of deviation existing between planned and achieved implants was carried out by a new noninvasive measurement procedure of the implant position performed on stone casts. Materials and Methods: Fourteen stone casts retrieved from 14 full-arch fully guided implant treatments were selected to perform the study. Each cast, manufactured for the surgical treatment by using a specific laboratory kit, was obtained from the respective surgical guide. A sleeve for each implant was embedded into the guide, which helped the examiners to manufacture a stone cast per guide containing the implant analogs, which was used to recover the final position of the planned implants. A total sample of 60 implants were assessed. The postoperative casts, poured to produce the immediate prostheses, were then processed by a contact (or tactile) scanner, and the generated standard tessellation language (STL) files were overlapped (best-fit alignment) using engineering software that revealed all the measured discrepancies. In terms of accuracy, differences relating to arch, assessed bone quality, implant length, and drill length (prolongation short or long) were reported. Results: The use of a noninvasive tactile scanner revealed mean entry point horizontal deviations of 0.30 mm (SD: 0.39 mm), mean entry point vertical deviations of 0.20 mm (SD: 0.25 mm), mean apical horizontal deviations of 0.50 mm (SD: 0.73 mm), and mean apical vertical deviations of 0.24 mm (SD: 0.28 mm). The frontal and lateral angular deviations were investigated, and corresponding mean values of 1.99 degrees (SD: 2.30 degrees) and 1.80 degrees (SD: 2.44 degrees) were detected. Conclusion: The reported results demonstrate that the contact tactile scan is a viable and biologic way to assess implant deviations. [ABSTRACT FROM AUTHOR]

Purpose: To observe whether the initial implant stability, evaluated by two different methods--the insertion torque value (ITV) and implant stability quotient (ISQ)--may be influenced by different clinical conditions as well as to understand whether it is possible to establish an overall positive correlation between both methods and whether the obtained correlation is maintained for each clinical variable under scope. Materials and Methods: The initial implant stability was evaluated by assessing and recording the ITV and the ISQ for each implant included in the study. The independent evolution of each method was observed considering clinical conditions grouped by gender (male or female), age (= 60 or > 60 years), arch (mandible or maxilla), location (incisors, canines and premolars, or molars), implant geometry (aggressive tapered or traditional parallel), diameter (3.5, 3.75, 4.3, or 5 mm), length (= 10 or < 10 mm), and immediate implantation (yes or no). The Mann-Whitney-Wilcoxon and Kruskal-Wallis localization tests were used to identify intragroup differences. To determine the level of correlation between both methods, the Spearman rank correlation was used. Results: The intragroup comparisons showed that the mandible (P = .03), short implants (P = .03), and delayed implantation (P= .07) subgroups exhibited higher ITVs. The other groups did not show significant differences. The higher ISQ measurements were obtained in the mandible (P = .0002), younger patients (P = .02), diameters of 3.75 mm and 4.3 mm (P = .04), and delayed implantation (P < .0001) subgroups. No differences were found for the other groups. A strong overall correlation (rho = 0.541; P = 8.023e-06) was found between both methods for ITVs up to 40 Ncm once they were accompanied by a linear increase in the ISQ to a value up to 78. From this value, the overall correlation decreased (rho = 0.237; P = .0055). Regarding the clinical conditions, different levels of significant correlations were found for both genders, older patients, maxilla, molar area, aggressive tapered implant geometries, diameters of 4.3 mm, diameters of 5 mm, lengths = 10 mm, and implants placed in healed bone. The other clinical conditions under scope did not exhibit an important correlation between both methods. Conclusion: When analyzed separately, clinical conditions such as the arch, implant length and diameter, patient age, and timing of implantation showed an influence on the ITV and the ISQ. An important overall correlation between both methods was found for ITVs of = 40 Ncm. This correlation was maintained for several of the clinical conditions studied. [ABSTRACT FROM AUTHOR]

Aim of the study The purpose of this study is to demonstrate the effectiveness of two primary stability measurement tools: insertion torque value and the stability coefficient using resonance frequency analysis with the ISQ (Implant Stability Quotient) in the therapeutic decision for the immediate loading of dental implants anchored in the golden quadrilateral of the maxillary bone. Material and methods 22 patients presenting with total edentation or advanced periodontal disease were consulted and operated in a private oral surgery clinic. A total of 110 conical- shaped implants were inserted. Results The average ISQ scale value for implant 1.1 was higher in the control group but it did not reach statistical significance between the two statistically analyzed groups. The average ISQ scale value for implant 1.4 was higher in the test group, compared to the control group, showing statistically significant significance. Patients in the control group associated a higher average value for the ISQ scale in the case of implant 2.4 , being a statistically significant parameter in our study group. The average insertion torque value for the implant was higher in the test group of patients at implant 1.1, implant 1.4 and implant 2.4 . Conclusions The insertion torque, along with the resonance frequency analysis, serve as tools for measuring primary stability. In our study, both groups exhibited adequate primary stability for immediate prosthetic loading, but the distal implants anchored in the golden quadrilateral of the maxilla showed a significant value.

Background: Patients with edentulism often have an impaired functional, phonetic, and esthetic status, resulting in poor quality of life; hence, the mandibular overdenture has been considered the standard implant treatment for such patients. Therefore, this study aimed to assess the effectiveness of mandibular overdentures retained using mini-implants on patient-reported satisfaction and their long-term survival. Methods: We searched patients’ medical records for eligible subjects, screening and inviting patients who received a mandibular overdenture anchored on mini-implants over ten years ago. We used a numerical rating scale from 0 (the worst) to 10 (the best) to assess four aspects: comfort, retention, chewing ability, and speaking ability before and after having mini-implants. We carried out Kaplan–Meier analysis to assess their survival. Results: Forty-eight elderly patients who were medically compromised and had a mandibular overdenture anchored on four permucosal mini-implants were included. All patient-reported satisfaction (comfort, retention, chewing ability, and speaking ability) was significantly improved after supporting mandibular overdentures with mini-implants (p-values < 0.05), with retention and chewing ability being the most substantially improved. The 10- and 15-year mini-implant survival rates were both 97.9%. Conclusions: Mandibular overdentures with mini-implants can be considered a valid and practical alternative to conventional implant-supported overdentures in patients with atrophic ridges, medically compromised, and the elderly.

The study aimed to assess the success and survival rates of post-extraction implants with immediate loading. A systematic search was performed in the Medline (PubMed), Cochrane Library (Wiley), and Scopus (Elsevier) databases to identify randomized and non-randomized studies of intervention (NRSI) on bone loss and success and survival rates in post-extraction implants with immediate, early, and delayed loading. Articles were selected based on predefined inclusion and exclusion criteria, and the risk of bias was assessed following Cochrane guidelines, and the Newcastle–Ottawa Scale was used to assess quality. A fixed-effect meta-analysis was conducted to evaluate bone loss using mean, median, and standard deviation, and to calculate odds ratios for success-survival rates. Of the 13 studies identified, three met the criteria for inclusion in the meta-analysis, involving a total of 178 patients and 296 post-extraction implants. Bone loss was the lowest in the delayed loading group (0.51 mm) compared to immediate (0.55 mm) and early loading (0.54 mm). Implant failures were similar in the immediate and early groups (one case each), while two failures were reported in the delayed group. Delayed loading reduced peri-implant bone loss, but immediate loading showed a slightly higher success-survival rate. Further high-quality studies are needed to strengthen the evidence on the long-term effects of the different implant loading protocols.

Background: The following case report presents the treatment of a patient with severe maxillary atrophy and failing residual dentition. The patient has been diagnosed with stage IV grade C periodontitis, making this case challenging from the very beginning. Methods: The treatment plan was based on collecting and merging digital data: CBCT, a face scan, and an intraoral scan. Due to the advancement of the periodontal disease, the treatment was divided into three stages. The entire process was conducted in a digital manner, based on the concept of prosthetically driven implantology. Additionally, all prosthetic temporaries were planned via digital smile design. Stage I included extracting the residual dentition, placing four implants in the mandible, and the delivery of a 3D-printed upper removable denture. Stage II included placing two zygomatic implants, two anchored piriform rims, and one midline implant. Both arches were immediately loaded with the intraoral welding of abutments screwed to multiunit abutments and 3D-printed shells. Subsequently, in stage III, two milled ceramic superstructures combined with a titanium milled bar were delivered as a final screw-retained restoration with the application of scan flags (horizontal scan bodies) for intraoral scanning. Results: The aforementioned technologies can all be implemented and merged into one complex treatment plan combining high predictability, successful esthetics, and a reliable and accurate end result. Even though the concept of scan flags is relatively new, this case shows its potential and merit. Conclusions: This case represents the power of the digital approach as a helpful tool in the recreation of functional and esthetic smiles in compromised conditions in periodontal patients.

Implant-supported immediate loading full-arch rehabilitation has been documented in the literature. More recently, computed surgical guides have frequently been used since they facilitate planning and performing surgical treatment without the need to raise a flap, thus reducing trauma and morbidity. This case report describes an immediate full-arch, fixed rehabilitation with full loading placed on four commercially available 3D-printed implants, with a 24-month follow-up. The implants were placed with the help of a digitally planned 3D-printed surgical guide. The provisional fixed prosthesis installed immediately was replaced after 3 months. At the time, the soft and hard tissue around the implants appeared stable, without signs of inflammation. The same situation was observed at the 24-month follow-up. Three-dimensional-printed implants seem to be a promising choice in this case. However, further clinical studies with longer follow-up periods are necessary to confirm their efficacy.

Purpose: The aim of this pilot exploratory cohort study was to assess the value of buccal augmentation in immediate implant placement and immediate restoration of anterior teeth in maxillae with missing buccal lamellar bone with regard to esthetic parameters, as well as soft and hard tissue level changes. Materials and Methods: This study compared three groups of 10 patients each with immediate implant placement and immediate restoration in the anterior maxilla: (1) patients with partially to totally missing buccal bone with simultaneous augmentation with bovine collagen (test group augmented [TGA]); (2) patients with partially to totally missing buccal bone without augmentation (test group nonaugmented [TNA]); and (3) patients with intact buccal lamellar bone (control group [CG]). The pink esthetic score (PES) and the course of the peri-implant bone level after 1, 3, and 12 months were used as assessment criteria. Results: Af ter 12 months, the PES in the TGA was assessed as being better than it was preoperatively (mean ± SD: 8 ± 3.09 vs 9.25 ± 3.01, respectively, P = .8243), while it remained almost identical in the other two groups (TNA = 8.75 ± 2.7 vs 8.6 ± 3.3, P = .4098; CG = 10.6 ± 2.41 vs 10.6 ± 2.22, P = .7085). A significant difference among the PES values of the three groups was not observed at any point in time (preoperative: P = .118, 12 months: P = .383). In total, the TNA and CG showed an improvement in 3 out of 7 parameters of the PES after 12 months, while this was the case in 5 out of 7 parameters in the TGA. No significant difference among the three groups could be seen at any time point regarding peri-implant bone level. In the CG and TGA patients, a nonsignificant improvement in peri-implant bone level was seen after 12 months (respectively: 1.6 mm to 0.99 mm; P = .08068; 1.89 mm to 1.73 mm; P = .5866). In contrast, TNA patients showed a nonsignificant deterioration vs the postoperative situation (1.16 mm to 1.45 mm; P = .08208). Conclusion: Within the limitations of this pilot study, it can be concluded that a missing buccal lamellar bone appears to be no contraindication for immediate implant placement and immediate restoration, provided the baseline esthetic situation is accepted. As compared to the nonaugmented defect group or the group with intact lamellar bone, neither the esthetic nor the radiologic results could be improved significantly by augmentation with bovine collagen. [ABSTRACT FROM AUTHOR]