scholarly journals Accuracy and Feasibility of a Zero-Setup Implant Guide System Made of a Light-Cured Composite Resin with Simultaneous Flapless Sinus Augmentation: A Pilot Study

2021 ◽  
Vol 11 (17) ◽  
pp. 8085
Author(s):  
Jin-Young Park ◽  
Joo-Yeon Lee ◽  
Joo-Nyeon Kim ◽  
Jeong-Won Paik ◽  
Jung-Seok Lee ◽  
...  

The aim of this study was to evaluate the accuracy and feasibility of flapless implant placement using a light-cured surgical template made of composite resin comprising dimethacrylate and diurethane, performed simultaneously with crestal sinus augmentation. This pilot study was a prospective, single-armed, controlled clinical trial. Four patients having an edentulous region in the posterior maxilla with 4 to 8 mm of residual ridge height were enrolled. Flapless fully-guided implant placement was performed using a zero-setup surgical template with simultaneous crestal sinus graft. Horizontal, vertical, and angular deviations of the placed implants from the planned positions were measured. Clinical observations were made, and implant stability was measured up to 3 months postoperatively. All four implants were placed and maintained successfully without complication. The mean deviations of the four implants were 1.27 and 1.85 mm horizontally at platform and apex, respectively, 0.84 mm vertically at apex, and 4.76° in angle. Satisfactory implant stability was obtained in all implants at placement and 3 months. Fully-guided implant placement and crestal sinus graft using a zero-setup surgical template can be a safe and feasible method with acceptable accuracy. A randomized controlled trial should be performed in the future to validate its clinical performance in terms of surgical time, accuracy, and patient-reported outcomes.

2021 ◽  
Vol 23 (05) ◽  
pp. 392-411
Author(s):  
Dr. Ali Nahi Hamdi ◽  
◽  
Dr. Shehab Ahmed Hemd ◽  

Dental implants are considered the first choice to replace lost or non-restorable teeth. However, the posterior maxilla remains a challenge in its management because of the quality of bone in the posterior maxilla. Osseo densification (OD) concept has been proposed in the literature to improve primary implant stability, which is an important aspect of osseointegration. Densah bur is novel drills specially designed to enhance a bone density by Osseo densification, which in turn increases primary stability. This present study was conducted to assess crestal sinus floor elevation by osteotome in comparison to Densah bur in the posterior atrophic maxilla. This was a randomized controlled clinical trial conducted on 20 patients to evaluate available crestal bone height loss, implant stability after implant placement in healed posterior maxillary alveolar ridge, whole bone height, Schneiderian membrane trauma, and post-operative complication.


2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Antonio Scarano

Background. One of the most problematic regions for endosseous implants is the posterior maxilla, not only having poor bone density, but also lacking adequate vertical height as a result of sinus pneumatization. The purpose of the present study was a radiologic, histological, and histomorphometrical evaluation, in humans, of specimens retrieved from sinuses augmented with decellularized bovine compact particles, after a healing period of 6 months. Methods. Four patients, with atrophic resorbed maxillas, underwent a sinus lift augmentation with decellularized bovine compact bone from bovine femur. The size of the particles used was 0.25–1 mm. A total of four grafts and 5 biopsies were retrieved and processed to obtain thin ground sections with the Precise 1 Automated System. Results. The mean volume after graft elevation calculated for each of the 4 patients was 2106 mm3 in the immediate postoperative period (5–7 days), ranging from 1408.8 to 2946.4 mm3. In the late postoperative period (6 months) it was 2053 mm3, ranging from 1339.9 to 2808.9 mm3. Histomorphometry showed that newly formed bone was 36±1.6% and marrow spaces were 34±1.6%, while the residual graft material was 35±1.4%. Conclusion. In conclusion, based on the outcome of the present study, Re-Bone® can be used with success in sinus augmentation procedures and 6 months are considered an adequate time for maturation before implant placement.


2017 ◽  
Vol 43 (1) ◽  
pp. 33-38 ◽  
Author(s):  
Vladimir S. Todorovic ◽  
Miroslav Vasovic ◽  
Mia-Michaela Beetge ◽  
Andre W. van Zyl ◽  
Vladimir Kokovic

The objective of the present study was to elucidate stability development of immediately loaded hybrid self-tapping implants inserted in the posterior maxilla. Forty-eight hybrid self-tapping implants with a chemically modified surface (∅︀4.1; length: 8 mm) were inserted bilaterally in the maxillary first and second premolar and first molar sites of 8 patients. In each patient, both sides of the maxilla were assigned randomly to either immediate (IL) or early (EL) loading group. Implant stability was evaluated by means of resonance frequency analysis immediately after implant placement and after 1, 2, 3, 4, 5, 6, 12, 26, and 52 weeks. High values of primary stability were found in both groups (71.91 ± 6.52 implant stability quotient [ISQ] in IL group; 73.87 ± 6.5 ISQ in EL group), with significant differences between the groups at the different time points. Initial decrease in stability was observed between the first and fifth weeks in the IL group and between the first and third weeks for the EL group. In the IL group 1 implant was removed after 3 weeks due to lack of stability. Early results of this study showed the ability of hybrid self-tapping dental implants with a chemically modified surface to achieve sufficient primary stability and to maintain high values of secondary implant stability in bone type 3 and 4, even when loaded immediately. Minimal alterations in stability were observed for both investigated groups, but the EL group showed faster recovery after an initial drop in stability.


2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Susanna Annibali ◽  
Giovanna Iezzi ◽  
Gian Luca Sfasciotti ◽  
Maria Paola Cristalli ◽  
Iole Vozza ◽  
...  

Objective. The aim of this investigation was to examine the bone regenerative potential of newly biphasic calcium phosphate ceramics (HA-β-TCP 30/70), by assessing histological and histomorphometric results of human specimens retrieved from sinuses augmented with HA-β-TCP 30/70, and comparing them to anorganic bovine bone (ABB), mineralized solvent-dehydrated bone allograft (MSDBA), and equine bone (EB), after a healing period of 6 months.Materials and Methods. Four consecutive patients with edentulous atrophic posterior maxilla were included in this report. A two-stage procedure was carried out for sinus augmentation with HA-β-TCP 30/70, ABB, MSDBA, and EB. After 6 months, specimens were retrieved at the time of implant placement and processed for histological and histomorphometric analyses.Results. At histological examination, all biomaterials were in close contact with the newly formed bone and showed the same pattern of bone formation; the grafted granules were surrounded by a bridge-like network of newly formed bone. A limited number of ABB particles were partially covered by connective tissue. The histomorphometric analysis revealed 30.2% newly formed bone for Ha-β-TCP 30/70, 20.1% for ABB, 16.4% for MSDBA, and 21.9% for EB.Conclusions. Within the limitations of the present investigation, these results support the successful use of HA-β-TCP 30/70 for sinus augmentation.


2018 ◽  
Vol 12 (1) ◽  
pp. 801-810
Author(s):  
Mohammed Jasim AL Juboori ◽  
Mohammed Ahmed AL Attas ◽  
Raquel Zita Gomes ◽  
Basma Fathi Alanbari

Objective: Implants placed in the posterior region of the maxilla have a high incidence of implant failure due to poor bone quality, especially when immediate implant loading is needed. Immediate Progressive Loading (IPL) can enhance bone quality and may offer an alternative solution when Immediate Implant loading is needed. Methods: Six patients (one male and five females; 34-62 years old) were included in this study. Twelve implants were inserted in the posterior region of the maxilla. Resonance Frequency Analysis (RFA) was performed at the time of implant placement and after 1, 2, 3 and 6 months. ISQ (Implant Stability Quotient) values were compared between the Delayed Loading (DL) group after 2 months and the Progressive Loading (PL) group and between different time points for each group. Results: At implant placement, the mean ISQ values for PL and DL implants were 63 and 57, respectively. One month after implant placement, the mean ISQ value for PL implants was 73. Two months after implant placement, the mean ISQ value for PL implants was 75. Three months after implant placement, the mean ISQ values for PL and DL implants were 76 and 69, respectively. Six months after implant placement, the mean ISQ values for PL and DL implants were 79 and 76, respectively. Conclusion: Despite its limitations, this pilot study indicated that compared to DL, PL can enhance bone density and implant stability, resulting in greater early functionality and fewer surgery sessions.


Author(s):  
Ghazwan Almahrous ◽  
Sandra David-Tchouda ◽  
Aboubacar Sissoko ◽  
Nathalie Rancon ◽  
Jean-Luc Bosson ◽  
...  

Purpose: To assess patient-reported outcomes measures (PROMs) for two implant placement techniques in cases of sinus bone atrophy (bone graft surgery (BGS) versus computer-aided implant surgery (CAIS)), after surgery and one year later, and to evaluate the clinical success of both treatments. Methods: Sixty patients with bone atrophy in the posterior maxilla and in need of implant placement were randomly assigned to two groups, and in accordance with the case report form (CRF), 30 were treated with BGS and 30 with CAIS. Immediately after treatment and one year later, PROMs were assessed, and the clinical success of both treatments was evaluated. Results: No significant differences were found between BGS and CAIS with regard to the following: loss of implants (p = 492); patient recommendation (p = 210); duration of surgery (p = 987); pain on the intervention day (p = 512); pain in the week after intervention (p = 299); and complications in the stage of surgery (p = 1.00). Similarly, at one year, no differences were found with regard to the following: pain around implant (p = 481); infection of implants (p = 491); abnormal radiographic imaging (p = 226); occurrence of undesirable events (p = 1.00); loss of one of the implants (p = 1.00); plaque detection (p = 1.00); bleeding on probing (p = 236); and presence of keratinized mucosa (p = 226). However, a significant difference was found among BGS and CAIS with regard to the number of consultations (p = 0001); number of implants placed (p = 033); and treatment difficulty (p = 0369). Significant differences were found for peri-implantitis (p = 0481) and radiology of craterization (p = 020) in clinical examination at the first year. Conclusion: Treatment difficulty and number of consultations were higher for BGS than for CAIS, as well as peri-implantitis and bone craterization at one year, indicating significant differences between the two treatments. However, there were no statistically significant differences between BGS and CAIS regarding the other PROMs, at placement and after one year.


Author(s):  
María Piedad Ramírez Fernández ◽  
Sergio Alexander Gehrke ◽  
Patricia Mazón ◽  
Jose Luis Calvo-Guirado ◽  
Piedad N. De Aza

The aim of the present study was to monitor implant stability after sinus floor elevation with two biomaterials during the first 6 months of healing by a resonance frequency analysis (RFA), and how physico-chemical properties affect the implant stability quotient (ISQ) at the placement and healing sites. Bilateral maxillary sinus augmentation was performed in 10 patients in a split-mouth design using a bobine HA (BBM) as a control and porcine HA (PBM). Six months after sinus lifting, 60 implants were placed in the posterior maxilla. The ISQ was recorded on the day of surgery from RFA at T1 (baseline), T2 (3 months), and T3 (6 months). Statistically significant differences were found in the ISQ values during the evaluation period. The ISQ (baseline) was 63.8±2.97 for BBM and 62.6±2.11 for PBM. The ISQ (T2) was ~ 73.5±4.21 and 67±4.99, respectively. The ISQ (T3) was ~ 74.65±2.93 and 72.9±2.63, respectively. All the used HAs provide osseointegration and statistical increases in the ISQ at baseline, T2 and T3 (follow-up), respectively. The BBM, sintered at high temperature with high crystallinity and low porosity, presented higher stability, which demonstrates that variations in the physico-chemical properties of a bone substitute material clearly influence implant stability.


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