vendex and Mouth--Edentulous

In immediately loaded implants within 72 h after the implant placement in the unilaterally and partially edentulous ridge, primary stability is considered critical, which can be influenced by the design of the implant fixture.. To determine the outcomes at 1 year after the immediate loading of multiunit fixed partial prostheses over either tapered implants (TIs) or straight implants (SIs) in the posterior region.. Forty-eight patients (24 patients, 52 implants in TI group; 24 patients, 50 implants in SI group) were included for the study. Except for the one SI group patient whose two implants showed the insertion torque less than 30 Ncm, provisional prostheses designed and fabricated from intraoral scan data obtained immediately after implant surgery were delivered to rest of the 47 subjects at 3-7 days. After a year, the survival rate was estimated by intention-to-treat (ITT) and per-protocol (PP) analyses, and marginal bone loss (MBL) and implant stability were also analyzed statistically (p < 0.05).. Survival rate at implant level in TI group was 96.2%, and that of SI group in the ITT analysis was 86.0%. Intergroup difference, however, was not statistically significant (p > 0.05). Insertion torque was significantly higher in TI group than SI group (47.12 ± 6.37 Ncm vs. 41.60 ± 9.77 Ncm; p < 0.05). MBLs of both groups were less than 0.1 mm at 1-year follow-up and was similar between two groups (p > 0.05).. Immediate loading of fixed partial prostheses after TI and SI placement showed reliable outcomes in the partially edentulous posterior ridge. In terms of the initial mechanical stability, the performance was superior for TIs than for SIs.

Topics: Dental Implantation, Endosseous; Dental Implants; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Follow-Up Studies; Humans; Immediate Dental Implant Loading; Mouth, Edentulous; Torque; Treatment Outcome

To evaluate the outcome of three (fixed-on-3 = Fo3) vs four (fixed-on-4 = Fo4) implants immediately restored with metal-resin screw-retained cross-arch prostheses in fully edentulous jaws.. Forty-eight edentulous or to be rendered edentulous patients were randomised in six centres (eight patients per centre) to the Fo3 group (24 patients: 12 maxillae and 12 mandibles) and to the Fo4 group (24 patients: 12 maxillae and 12 mandibles) according to a parallel group design. To be immediately loaded, implants had to be inserted with a minimum torque of 40 Ncm. Outcome measures were prosthesis and implant failures, complications and peri-implant marginal bone level changes evaluated up to 1 year post-loading.. One maxillary prosthesis per group was delayed loaded because implants could not be placed with a torque of at least 40 Ncm. Ten patients in the Fo3 group and four in the Fo4 group had implants placed flapless. One year after loading no drop out occurred. One patient of the Fo3 group lost three implants vs three patients of the Fo4 group who lost four implants, the difference being no statistically significant (risk difference = -0.08; 95% CI: -0.27 to 0.10; Fisher's exact test P = 0.609). One mandibular Fo3 and one maxillary Fo4 prosthesis failed. Six Fo3 patients were affected by complications vs three Fo4 patients (risk difference = 0.12; 95% CI: -0.10 to 0.34; Fisher's exact test; P = 0.461). Both groups lost marginal bone in a statistically significant way (0.22 ± 0.20 mm for Fo3 patients and 0.40 ± 0.21 mm for Fo4 patients), with Fo3 group showing less marginal peri-implant bone loss than Fo4 group (estimate of the difference = -0.18 (standard error: 0.06) mm; 95% CI: -0.30 to -0.06; P = 0.005). There were no differences in clinical outcomes between the six operators.. These preliminary results suggest that immediately loaded cross-arch prostheses of both jaws can be supported by only three dental implants at least up to 1 year post-loading, though longer follow-ups are definitively needed.

Topics: Dental Implantation, Endosseous; Dental Implants; Dental Prosthesis, Implant-Supported; Humans; Immediate Dental Implant Loading; Jaw, Edentulous; Mandible; Maxilla; Mouth, Edentulous; Torque

To compare planning and patient rehabilitation using a 3D dental planning software and dedicated surgical guides with conventional rehabilitation of partially or fully edentulous patients using flapless or mini-flap procedures and immediate loading.. Fifty-one fully or partially edentulous patients requiring at least 2 implants to be restored with a single prosthesis, having at least 7 mm of bone height and 4 mm in bone width, had their implant rehabilitation planned on three-dimensional (3D) cone beam computed tomography (CBCT) scans using a dedicated software. Afterwards they were randomised according to a parallel group study design into two arms: computer-guided implant placement aided with templates (computer-guided group) versus conventional implant placement without templates (conventional group) in three different centres. Implants were to be placed flapless and loaded immediately; if inserted with a torque over 35 Ncm with reinforced provisional prostheses, then replaced, after 4 months, by definitive prostheses. Outcome measures, assessed by masked assessors were: prosthesis and implant failures, complications, peri-implant bone level changes, number of treatment sessions, duration of treatment, post-surgical pain and swelling, consumption of pain killers, treatment time, time required to solve complications, additional treatment cost, patient satisfaction. Patients were followed up to 1 year after loading.. Twenty-six patients were randomised to the conventional treatment and 25 to computerguided rehabilitation. No patient dropped out. One provisional prosthesis failed, since one of the two supporting implants failed 11 days after implantation in the conventional group (P = 1.0). Four patients of the conventionally loaded groups experienced one complication each, versus five patients (6 complications) in the computer-guided group (P = 0.726). There were no statistically significant differences between the two groups for any of the tested outcomes with the exception of more postoperative surgical pain (P = 0.002) and swelling (P = 0.024) at conventionally treated patients.. When treatment planning was made on 3D CBTC scan using a dedicated software, no statistically significant differences were observed between computer-guided and a free-hand rehabilitations, with the exception of more postoperative pain and swelling at sites treated freehand because more frequently flaps were elevated.

Topics: Adult; Aged; Aged, 80 and over; Analgesics; Cone-Beam Computed Tomography; Dental Implantation, Endosseous; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Edema; Female; Follow-Up Studies; Humans; Imaging, Three-Dimensional; Immediate Dental Implant Loading; Jaw, Edentulous, Partially; Male; Middle Aged; Mouth, Edentulous; Operative Time; Pain, Postoperative; Patient Care Planning; Patient Satisfaction; Postoperative Complications; Surgery, Computer-Assisted; Surgical Flaps; Torque; Treatment Outcome

To evaluate the clinical outcome of fully edentulous patients rehabilitated with immediately loaded bimaxillary screw-retained metal-resin prostheses supported by five implants placed flapless: two in the mandible and three in the maxillae.. Twenty-five consecutively treated patients were recruited. To be immediately loaded, implants had to be inserted with a minimum torque of 80 Ncm. Outcome measures were prosthesis and implant failures, and complications.. Six months after loading no patients dropped out and no prosthesis or implant failed. Two maxillary prostheses were loaded early at 8 weeks because implants were inserted with a torque inferior to 45 Ncm. Three complications occurred in two patients but they were all successfully treated.. Six months after loading, immediately loaded bimaxillary cross-arch prostheses can be supported by only two mandibular and three maxillary flapless-placed dental implants. Longer follow-ups of approximately 10 years are needed to understand the prognosis of this treatment modality.

Topics: Adult; Aged; Bone Density; Cohort Studies; Dental Implantation, Endosseous; Dental Implants; Dental Prosthesis Design; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Denture Design; Denture Retention; Denture, Complete, Immediate; Female; Follow-Up Studies; Humans; Immediate Dental Implant Loading; Intraoperative Complications; Male; Middle Aged; Mouth, Edentulous; Postoperative Complications; Prospective Studies; Surface Properties; Torque; Treatment Outcome