Immediate implants following tooth extraction. A systematic review.
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OBJECTIVES: The aim of this article is to review the current state of immediate implants, with their pros and contras, and the clinical indications and contraindications. MATERIAL AND METHODS: An exhaustive literature search has been carried out in the COCHRANE library and MEDLINE electronic databases from 2004 to November 2009. Randomized clinical trials and clinical trials focused on single implants placed in fresh extraction sockets were included and compared. A meta-analysis could not be performed due to heterogeneity of the data. RESULTS: Twenty studies out of 135 articles from the initial search were finally included, which summed up a total of 1139 immediate implants with at least a 12-month follow-up. Our results have been compared with other current available papers in the literature reviewed that obtained similar outcomes. DISCUSSION: Immediate implants have predictable results with several advantages over delayed implant placement. However, technical complications have been described regarding this technique. Also, biomaterials may be needed when the jumping distance is greater than 1mm or any bone defect is present. CONCLUSIONS: Few studies report on success rates rather than survival rates in the literature reviewed. Short-term clinical results were described and results were comparable to those obtained with delayed implant placement. Further long-term, randomized clinical trials are needed to give scientific evidence on the benefits of immediate implants over delayed implant placement. (+info)
Meta-analytic study of implant survival following sinus augmentation.
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OBJECTIVES: To evaluate graft types used for maxillary sinus augmentation and review success rates of dental implants inserted in these areas, analyzing the graft materials used, implant surface types and the moment of implant placement. STUDY DESIGN: A meta-analytic study reviewing articles on sinus augmentation published during the last ten years. RESULTS: 3,975 implants placed in sinus augmentations (with bony windows) were registered, of which 3,749 implants survived, a survival rate of 94.3%. CONCLUSIONS: When performing sinus augmentation, bone substitute materials are just as effective as autologous bone, whether used alone or in combination with autologous bone. Implant surface treatments can have an important effect on implant survival and it would appear that roughened surfaces are the best option. When implants are inserted simultaneously to grafting, a higher failure rate can be expected. (+info)
Transcrestal sinus lift and implant placement using the sinus balloon technique.
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OBJECTIVE: A description is made of transcrestal sinus lift using the sinus balloon technique, evaluating the bone height achieved and implant success one year after prosthetic loading. MATERIAL AND METHOD: Between January and July 2007, transcrestal sinus lift using the sinus balloon technique for dental implant placement was carried out in 6 patients. A panoramic X-ray study and maxillary computed tomography scan were carried out before the operation, in order to discard possible sinus pathology. During the intervention, the integrity of the sinus membrane was evaluated using a Medi Pack Pal endoscope (Farol Store and Co., Tuttlingen, Germany), and the intraoperative complications were analyzed. The dental implants were placed in the same surgical step in the presence of 3 mm or more of residual bone. Following the operation, panoramic X-rays were used to assess the bone height gained. One year after prosthetic loading, the implant success rate was determined based on the criteria of Buser. RESULTS: One patient was excluded due to Schneider's membrane perforation as confirmed by endoscopy. Transcrestal sinus lift was carried out in 5 males with a mean age of 41.6 years (range 27-51), without antecedents of sinus disease. There were no intraoperative complications. In four patients the implants were placed simultaneous to sinus lift, while in another case implant placement was postponed due to insufficient remaining bone height. The mean gain in height after the operation was 8.7 mm. One year after prosthetic loading, the implant success rate was 100%. CONCLUSIONS: Transcrestal sinus lift using the sinus balloon technique is a minimally invasive procedure. In 5 patients the bone height gained proved sufficient to allow implant placement even in the presence of 3 mm of residual bone. (+info)
YouTube, dentistry, and dental education.
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The objective of this study was to systematically assess the informational value, intention, source, and bias of videos related to dentistry available on the video-sharing Internet platform YouTube. YouTube (www.youtube.com) was searched for videos related to dentistry, using the system-generated sorts "by relevance" and "most viewed" and two categories (All and Education). Each of the first thirty results was rated by two assessors filling out a questionnaire for each (total: 120). The data were subjected to statistical analysis using Cohen's kappa, Pearson's correlation coefficient tau, Mann-Whitney U-tests, and a nonparametric three-way ANOVA, including an analysis of the interaction between the sorting and category effect, with an alpha-level of 5 percent. The scan produced 279,000 results in the category All and 5,050 in the category Education. The analysis revealed a wide variety of information about dentistry available on YouTube. The purpose of these videos includes entertainment, advertising, and education. The videos classified under Education have a higher degree of usefulness and informational value for laypersons, dental students, and dental professionals than those found in a broader search category. YouTube and similar social media websites offer new educational possibilities that are currently both underdeveloped and underestimated in terms of their potential value. Dentists and dental educators should also recognize the importance of these websites in shaping public opinion about their profession. (+info)
Oral rehabilitation with tilted dental implants: a metaanalysis.
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OBJECTIVE: To compare the course of patients treated with tilted implants versus those treated conventionally with axial implants, analyzing the success rate and marginal bone loss. MATERIAL AND METHODS: A PubMed search was made using the key words "tilted implants ", "angled implants ", "angulated implants ", "inclined implants " and "maxillary atrophy. " A review was made of the articles published between 1999-2010. The inclusion criteria were the use of tilted implants, clinical series involving at least 10 patients, and a minimum follow-up of 12 months after prosthetic loading. The exclusion criteria were isolated clinical cases, studies with missing data, and publications in languages other than English or Spanish. The metaanalysis finally included 13 articles: 7 retrospective studies and 6 prospective studies. RESULTS: On analyzing the success rate in the retrospective studies, two reported a higher success rate with tilted implants; one a higher success rate with axial implants; and two reported similar success rates with both implants. On analyzing the success rate in the prospective studies, two reported a higher success rate with tilted implants; two a higher success rate with axial implants; and two reported similar success rates with both implants. On examining marginal bone loss, three studies reported greater bone loss with axial implants and one with tilted implants. CONCLUSIONS: There was no evidence of differences in success rate between tilted and axial implants in either the prospective or retrospective studies subjected to review. The marginal bone loss observed with the tilted and axial implants likewise proved very similar. It thus can be deduced that tilted implants exhibit the same evolutive behavior as axial implants. (+info)
Resonance frequency analysis-reliability in third generation instruments: Osstell mentor(R).
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Few studies assess repeatability and reproducibility in registers of resonance frequency analysis (a value of dental implant stability). OBJECTIVE: Few studies assess repeatability and reproducibility in resonance frequency analyses (implant stability evaluation). This study is aimed at assessing reliability (repeatabilty and reproducibility) in the Osstell Mentor(R) system using the intraclass correlation coefficient (ICC) as the statistical method. STUDY DESIGN: ISQ measurements of RFA were carried out by means of the Osstell Mentor(R) instrument in 58 implants in 19 patients. Six measurements were performed on each implant by means of two different Smart-Pegs (I and II). Three consecutive measurements were registered with each transducer. RESULTS: Average ISQ varied from 72.43 to 72.60 and 73.26 in the first, second and third measurements, respectively with the SamrtPeg I and from 72.98 to 73.26 and 73.74 in the first, second and third measurements, respectively with the SamrtPeg II . Exactly equal values were observed in 10.43 and 12.1% of the cases with Smart-Pegs I and II, respectively. The intraclass correlation coefficient was 0.96 and 0.96 for Smart Pegs I and II, respectively. Repeatability and reproducibility was 0.97 for both Smart-Pegs I and II. CONCLUSIONS: The RFA system contributed by Osstell Mentor(R) renders almost perfect reproducibility and repeatability, as proven by statistical analysis carried out by means of ICC with 95% confidence level. This instrument contributes highly reliable RFA measurements in dental implants. (+info)
Predoctoral fixed implant patient satisfaction outcome and challenges of a clinical implant competency.
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Treatment with fixed and removable partial dentures has been the traditional method of addressing the replacement of teeth competencies in dental education. However, by 2013 the Commission on Dental Accreditation (CODA) standards will mandate a competency in "replacement of teeth including fixed, removable, and dental implants." In 2005, New York University College of Dentistry implemented a comprehensive implant program for predoctoral dental students. One of the outcome assessments of this program was to determine the level of patient satisfaction. Therefore, a patient satisfaction survey (n=103) assessed the use of implant treatment for the restoration of partially edentulous patients, measuring such dimensions of satisfaction as function, comfort, and esthetics. The results revealed that 96 percent of the patients surveyed were satisfied with their ability to chew, 91 percent were satisfied with the comfort of their restoration, and 86 percent were satisfied with the appearance of their restoration. Additionally, 90 percent of the surveyed patients who received implant-retained crowns as part of their routine care were satisfied with the overall treatment experience, and 97 percent of them would recommend this treatment to a friend. The survey results validate implant-supported crown treatment in predoctoral education. Although implant-supported restorations are a valid treatment option that must be presented to patients during treatment planning, creating a clinical competency in implant therapy requires greater consideration. Therefore, the benefits and challenges of such a clinical competency are discussed. (+info)
Survival of implants placed with the osteotome technique: an update.
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A literature review is made to analyze the survival of implants placed with the osteotome technique. A PubMed search was made based on the key words "osteotome AND dental implants", corresponding to publications between 1998-2008. The inclusion criteria were: a) a minimum of 10 patients; b) a minimum follow-up of 6 months; c) implants placed using the osteotome technique with or without indirect sinus lift; and d) specification of the implant number and survival rate. Sixty-four articles were identified, of which 20 met the inclusion criteria. A total of 2006 implants were placed in 1312 patients using the osteotome technique. The duration of follow-up after prosthetic loading ranged from 6-144 months. Indirect sinus lift was carried out in all but one of the studies. The residual crest height ranged from 2.8-12 mm, with a mean gain in bone after sinus lift of 2.5-5.1 mm. The time from implant placement to prosthetic loading varied from 1.5-9 months. The percentage implant survival rate was 85.1-100%. The survival rate of implants placed with the osteotome technique is high and does not differ with respect to implant placement with the conventional technique. (+info)