Dental implants in medically complex patients—a retrospective study

Clinical Oral Investigations - Dental implant insertion for oral rehabilitation is a worldwide procedure for healthy and medically compromised patients. The impact of systemic disease risks on the...     

Dental implants in frail elderly adults: a benefit or a liability?

If an implant-borne fixed prosthesis cannot be maintained by effective home oral health care, it could be modified to a removable prosthesis/overdenture.     

Dental implants in patients with Sjögren’s syndrome: a case series and a systematic review

The purpose of this study was to assess the clinical outcomes of dental implants in patients with Sjögren’s syndrome (SS). The study consisted of two parts: report of a case series and a systematic review of the literature. The results of the clinical series revealed that 19 patients received 107 implants and were followed for a mean of 125 months. Two patients lost three implants (failure rate 2.8%, 3/107). At the last follow-up, there was a mean marginal bone loss (MBL) of ?2.190 ± 1.384 mm; estimated MBL after 30 years was 4.39 mm. The review identified 18 studies, resulting in 19 studies for analysis including the present clinical series. A total of 712 implants were placed in 186 patients; 705 implants were followed up for a mean of 72.5 months (failure rate 4.1%, 29/705; failed at a mean time of 12.9 ± 31.7 months). The probability of failure was 2.8% (95% confidence interval 1.6–4.1%). Primary SS patients had a lower implant failure rate (2.5%, 3/118) than secondary SS patients (6.5%, 12/184). In conclusion, dental implants should be considered by dentists as a viable treatment option for patients with SS, as the failure rate is fairly low. SS patients may, however, present a higher MBL around implants than patients from the general population.     

Dental implants: one or two stages?

Dental implants can be inserted in one or two stages. The promoters of the two stages implant systems believe that submersion is essential for osseointegration. Animal and human studies, however, have shown that implants can also be successful when the one stage procedure is used. In this article the principles and the (dis)advantages of both procedures are discussed.     

Dental dilemmas: Endodontics or dental implants?

This narrative review explores treatment planning options in restorative dentistry. The growth of dental implants, as an accessible and predictable treatment option, gives practitioners a useful tool for managing the missing tooth or teeth with a hopeless prognosis. Traditionally, endodontics and fixed prosthodontics have been used to restore teeth and spaces where the outlook for such treatment appears reasonable. Practitioners may, however, question the predictability and cost effectiveness of such an approach where, at times, it might appear that replacement of a compromised tooth with a dental implant could be a more predictable option. The evidence base for these treatment options is explored and discussed, and suggestions are made for future management strategies. CLINICAL RELEVANCE: A clear knowledge and understanding of the scientific literature for implants and endodontic treatment is necessary if practitioners are to make an evidence-based approach when treatment planning these modalities for their patients. This is particularly true in cases where there may appear to be a reasonable choice between the two of these.     

Immediate loading of Brånemark system implants following placement in edentulous patients: a clinical report

The purpose of this study was to evaluate the immediate loading of Br?nemark System implants following placement with a screw-retained provisional prosthesis in edentulous patients. Twelve mandibular and 5 maxillary arches were treated from December 1997, including 3 bimaxillary patients. The provisional prosthesis, made of heat-polymerizing resin, had an inner casting of cobalt-chromium alloy to provide rigidity. The implants whose placement torque was more than 40 Ncm were immediately loaded. Implants that were placed with placement torque of less than 40 Ncm or that were associated with bone grafting were submerged. Following abutment connection, temporary cylinders were incorporated into the provisional prosthesis intraorally with autopolymerizing resin. After the provisional prosthesis was completed extraorally, it was screw-retained. After a 4- to 6-month healing period, a definitive prosthesis was fabricated and placed. Of the 140 immediately loaded implants, 136 osseointegrated during an 8- to 24-month follow-up period (97.2%). All 17 submerged implants osseointegrated. The results suggest that immediate loading of Br?nemark System implants at the time of placement in edentulous patients can be a valuable adjunct to therapy and as predictable as delayed loading, in both mandibular and maxillary arches.     

Do longer implants improve clinical outcome in immediate loading?

It is generally believed that longer implants (length >13 mm) have higher success rates than standard implants (length=13 mm). Few reports focus on long implants and none specifically address the clinical outcome of immediate loading (IL) of longer implants. This retrospective study was performed to compare the clinical outcomes of long and standard length implants. A total of 244 standard and 536 long implants were inserted and immediately loaded. The mean follow-up was 3 years. Only 4 of 780 implants (99.5%) were lost, and these 4 were all 13 mm long. No or reduced marginal bone loss was taken as an additional indicator of success to evaluate the effect of several factors on clinical outcome. Only 4 of the 244 13-mm-long implants were lost (98%), but this was statistically different from the survival rate of longer implants. Poor quality bone was related to increased marginal bone loss and thus a worse outcome in both groups. IL standard length implants have a high survival rate, but it is statistically worse than that of IL longer implants. Standard or longer implants are reliable devices for insertion in poor quality bone, although slightly higher bone resorption is to be expected.     

Early implant failures in patients treated with Brånemark System titanium dental implants: a retrospective study

Implant failure has been associated with factors such as poor bone quality, insufficient bone volume, implant instability, unfavorable implant loading, and smoking habits. Infections and host responses may also be important factors in dental implant failure. The objectives of the present study were to identify various explanatory factors associated with titanium implant failure. Forty subjects with stage 1 non-osseointegrated titanium dental implants (NOTI) ad modum Br?nemark and 40 age- and gender-matched control subjects with successfully osseointegrated titanium implants (SOTI) were studied. Clinical data and gamma G immunoglobulin (IgG) antibody titers were studied. An independent t test revealed that significantly longer implants were placed in subjects with SOTI (P < .05). Statistically significant differences in bone shape and resorption (BSR) scores were found between SOTI and NOTI (P < .05). Logistic regression analysis identified 3 significant explanatory outcome variables: serum antibody avidity scores for Bacteroides forsythus (P < .0001), serum antibody titers to Staphylococcus aureus (P < .001), and the BSR scores (P < .05). Antibody avidity to B forsythus and antibody titer to S aureus were therefore the 2 most important factors associated with early implant failures and with a significant predictive ability. This indicates that immunologic factors are involved in osseointegration.     

Brushing associated with oral irrigation in maintaining implants and overdentures hygiene – a randomized clinical trial

Odontology - Evaluate, through a randomized clinical trial, the efficacy of brushing associated with oral irrigation in maintaining implant and overdenture hygiene. Thirty-eight participants, who...     

Dental patients’ awareness and knowledge in using dental implants as an option in replacing missing teeth: A survey in Riyadh,Saudi Arabia

Aim

The purpose of this survey was to assess the level, sources, and need for information about dental implants among a selected sample of dental patients in Riyadh, Saudi Arabia.

Materials and methods

Patients’ knowledge and awareness in using dental implants as an option in replacing missing teeth were evaluated through a standardized self- explanatory questionnaire distributed in two places in Riyadh: Military Hospital and College of Dentistry, King Saud University (Darraiyah campus). The questionnaires were handed to the patients during their regular dental visits. A total of 379 subjects were included in this survey.

Results

The results of this study indicate that 66.4% of the subjects knew about dental implants. The subjects’ friends and their relatives were the main source of information about dental implants for 31.5% of the subjects, and dentists were the secondary source for 28.3% of the sample. About 82.4% of the subjects need more information about dental implants and 85.2% of them chose the dentist to be the desired source for such information, followed by the internet in 28.5% of the cases. Almost 74.4% of those surveyed did not know if their regular dentists use dental implants. High cost was the major factor in preventing patients from choosing implants in 86.5% of the cases while the long treatment time and fear of surgery was the factor in 71% and 68.6% of the subjects, respectively.

Conclusion

The results of this survey showed an acceptable level of awareness about dental implants among a selected sample of dental patients in Riyadh. It also showed the need for providing more general and accurate information to the patients about this treatment modality.     

Do dental implants facilitate bone invasion in patients with oral squamous cell carcinoma? A case series

Osseointegrated dental implants in the vicinity of oral squamous cell carcinoma (OSCC) will become more common given the increasing popularity of dental implants. Reports and studies of OSCC around dental implants are rare, as is the topic of how to handle OSCC surgically when implants are in contact with the tumour. In view of this uncertainty, a histological study was performed to assess tumour behaviour around implants. The aim was to determine whether an implant facilitates inward growth of the tumour and how this should be taken into account during staging and treatment planning. A total of 20 specimens were collected. The implants were macroscopically in contact with OSCC in 13 of the 20 specimens. Histologically, tumour tissue near the implant was indeed confirmed in nine of these cases. In seven cases, tumour invasion had led to resorption of the underlying jaw bone; tumour between the bone–implant interface was identified in only two of these cases, but without downward growth along the implant. In conclusion, no proof was found to confirm that the bone–implant interface is a preferred route for invasion. Therefore, dental implants in the vicinity of OSCC should not influence staging and treatment planning in this regard.