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Purpose: To evaluate the influence of immediate loading on the osseointegration and bone density of implants placed in a healed alveolar bone crest and supporting single crowns. Materials and Methods: Two solid titanium transmucosal mini-implants were placed in the distal regions of the mandible in 14 patients. One mini-implant was immediately functionally loaded, whereas the other was left unloaded. After 2 months of healing, biopsy samples were retrieved and the levels of new bone, old bone, and total bone (new + old) were assessed. Results: Histologic examination was performed on biopsies from 12 patients (n = 12). The new bone-to-implant contact percentage (BIC%) was 40.3% ± 16.8% and 55.1% ± 19.1% (P = .043) at the unloaded and loaded sites, respectively; in addition, the total BIC% was 44.9% ± 17.0% and 59.5% ± 18.8%, respectively (P = .034). The new bone density was 45.9% ± 11.6% for the unloaded implants and 45.9% ± 16.7% for the loaded implants (P = .622). Conclusions: Immediate loading had a positive effect on bone apposition at the implant surface, but no effect on bone density was observed after 2 months of healing. [ABSTRACT FROM AUTHOR]

Purpose: To assess the complications, satisfaction, and quality of life of patients rehabilitated with delayed and immediate loading of single crowns. Materials and Methods: An electronic search was conducted in PubMed/MEDLINE, Scopus, Web of Science, Cochrane Library, and Embase databases up to February 2023. Only prospective studies and randomized and nonrandomized clinical trials comparing immediate and delayed loading were included. For the quantitative analysis, dichotomous and consistent variables were evaluated with a 95% confidence interval. Results: A total of 20 studies were evaluated. No statistically significant difference was observed between protocols: satisfaction (I²: 0%; P = .42), quality of life (I²: 0 %; P = .05), biologic complications (I²: 9%; P = .17), mechanical complications (I²: 58%; P = .84), and survival rate (I²: 0%; P = .38). The subgroup analysis showed significant differences only for marginal bone loss (MBL) when immediate implants were placed in the mandible (I²: 15%; P = .01) and posterior zone (I²: 0%; P = .001). Conclusions: Complications and patient-centered outcomes for immediate single-implant crowns were comparable to delayed loading. Scientific evidence showed no significant difference between loading protocols for survival rates. Note that several factors could interfere with the complication events, implant failures, and MBL. The subgroup analysis showed that only immediate implants placed in the posterior mandible had a higher and statistically significant mean MBL. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the peri-implant parameters of immediately placed and loaded mandibular overdentures over a 5-year follow-up period. Materials and Methods: All subjects who had been advised and planned for two-implant mandibular overdenture treatment were included in this study. The peri-implant parameters –including plaque index (PI), bleeding index (BI) and peri-implant pocket depth (PIPD) as well as marginal bone loss (MBL) – were assessed. In addition, prosthodontic parameters including abutment-, implant- and denture-related complications were assessed. Patients were evaluated at follow-up visits, scheduled at 1, 12, 24, 36, 48, and 60 months. The data distribution was analysed with the Shapiro-Wilk test. Data within follow-up categories were compared using ANOVA and the Tukey-Kramer test. A p-value < 0.05 was considered statistically significant. Results: Among the 32 participants, 19 were males and 13 were females, with a mean age of 60.5 ± 7.33. The mean plaque index (PI), bleeding index (BI) and peri-implant pocket depth (PIPD) varied over time. However, no statistically significant difference was observed in the plaque index, bleeding index and peri-implant pocket depth over time (p > 0.05). The mean value at baseline was found to be -0.9 ± 0.3. The values increased over time, with the highest value observed at 60 months 2.6 ± 0.7, which was statistically significant (p < 0.001). Conclusion: Immediately placed and loaded mandibular implant overdentures using two un-splinted implants with locator attachments showed acceptable PI, BI and PIPD at the 5-year follow-up. Statistically significantly greater marginal bone loss was observed from baseline to follow-up, but it was within acceptable limits. A moderate number of restorative and abutment complications were observed during the follow-up of IODs. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Clinical Considerations Conclusions Clinical Significance Computer‐aided implant placement (CAIP) offers improved accuracy and reduced invasiveness. However, traditional static CAIP (sCAIP) protocols for complete‐arch restorations often involve multiple guides and clinical steps, increasing the risk of soft tissue trauma and procedural complexity. This article introduces the B‐guide technique, which integrates implant placement and interim prosthesis delivery into a single device to simplify the procedure and minimize tissue damage.The B‐guide combines the implant osteotomy and placement guide with an abutment placement and prosthesis pick‐up mechanism. The guide remains in place post‐implantation, allowing immediate prosthesis conversion. A 55‐year‐old female patient underwent complete‐arch rehabilitation using the B‐guide, enabling immediate implant placement and loading. The B‐guide minimized soft tissue trauma and eliminated the need for multiple guides, significantly reducing treatment complexity and time.The B‐guide simplifies procedures and improves predictability compared with traditional systems by integrating prosthetic adaptation and implant placement, reducing cumulative errors. However, its success is heavily reliant on the operator's expertise, especially in preoperative planning and design.By integrating implant and prosthesis placement into a single guide, the B‐guide reduces surgical complexity, minimizes trauma, and enhances prosthetic outcomes, improving clinical efficiency. [ABSTRACT FROM AUTHOR]

Purpose: To determine whether immediate implant placement and loading renders different outcomes from delayed loading with respect to midfacial mucosal level in the maxillary esthetic area. Materials and Methods: A literature search was conducted in four electronic databases (PubMed, Web of Science, Embase, and Cochrane), identifying eligible clinical studies published prior to December 2021. Only randomized controlled trials (RCTs) comparing immediate implant placement with or without immediate loading in the maxillary esthetic zone with a mean follow-up of at least 12 months were selected for qualitative analysis and meta-analysis. The Cochrane Risk of Bias tool was adopted to assess the quality of the evidence. The heterogeneity between the pooled literature was analyzed through the chi-square test (P < .05) and quantified by the I2 index. A mixed-effects model was applied if it appeared that there was noteworthy heterogeneity; otherwise, a random-effects model was chosen. For continuous outcomes, the estimate of relative effect was presented to display the standardized mean differences (SMDs) and 95% CIs. For dichotomous variables, the Mantel-Haenszel statistical method was applied with effect sizes expressed as risk ratios (RRs) and 95% CIs. This study is registered on PROSPERO with number CRD42017078611. Results: Out of 5,553 records, 8 RCTs were involved, providing data for 324 immediately placed implants (immediate implants subjected to immediate loading [IPIL]: 163; immediate implants subjected to delayed loading [IPDL]: 161) that had been in function within 12 to 60 months. Meta-analyses revealed significantly lower midfacial mucosal level changes for IPIL compared with IPDL, pointing to 0.48 mm (95% CI: -0.84 to -0.12; P = .01), as well as more significant papillary recession after IPDL (SMD -0.16; 95% CI: -0.31 to 0.00; P = .04). The differences regarding implant survival and marginal bone loss between the two loading groups showed no statistical significance. The result of metaanalyses revealed similar plaque score (SMD 0.03; 95% CI: -0.22 to 0.29; P = .79) and probing depth (SMD -0.09; 95% CI: -0.23 to 0.05; P = .21) for IPIL and IPDL. On the other hand, IPIL induced a trend toward more bleeding on probing (SMD 0.22; 95% CI: 0.01 to 0.42; P = .04) and less change in facial ridge dimension (SMD 0.94; 95% CI: -1.49 to --0.39; P < .01). Conclusion: After a follow-up ranging from 12 to 60 months, midfacial mucosa level change was 0.48 mm lower following IPIL compared with IPDL. Immediate implant placement and loading is conducive to the preservation of physiologic soft and hard tissue architecture, appearing to offer considerable benefits in the anterior zone. In summary, IPIL should be considered in the esthetic zone if the primary implant stability permits. [ABSTRACT FROM AUTHOR]

Purpose: Although immediate-loading implant (ILI) treatment is a general treatment strategy for fully edentulous maxillae, long-term evidence is required. The purpose of this study was to evaluate the long-term clinical results of, and risk factors for, ILI treatment in fully edentulous maxillae. Materials and Methods: ILI treatments of maxillae using 526 implants in 117 patients were reviewed retrospectively. The longest and mean observation periods were 15 years and 9.2 years, respectively. Kaplan-Meier survival curve analysis, log-rank tests, and multilevel mixed-effects parametric survival analysis were used for statistical analyses. Results: Overall, 38 of 526 implants failed in 23 patients, and the estimated 15-year cumulative implant-level and patient-level survival rates were 90.7% and 73.7%, respectively. The cumulative implant survival rate was significantly higher in female patients than in male patients. Sex, implant length, and implant diameter were significantly associated with implant survival. Conclusion: ILI treatment of completely edentulous maxillae demonstrated viable long-term clinical outcomes. Male sex, shorter implant length, and narrow implant diameter negatively affected implant survival. [ABSTRACT FROM AUTHOR]

Finite element analysis (FEA) has been used to analyze the behavior of dental materials, mainly in implantology. However, FEA is a mechanical analysis and few studies have tried to simulate the biological characteristics of the healing process of loaded implants. This study used the rule of mixtures to simulate the biological healing process of immediate implants in an alveolus socket and bone‐implant junction interface through FEA. Three‐dimensional geometric models of the structures were obtained, and material properties were derived from the literature. The rule of mixtures was used to simulate the healing periods—immediate and early loading, in which the concentration of each cell type, based on in vivo studies, influenced the final elastic moduli. A 100 N occlusal load was simulated in axial and oblique directions. The models were evaluated for maximum and minimum principal strains, and the bone overload was assessed through Frost's mechanostat. There was a higher strain concentration in the healing regions and cortical bone tissue near the cervical portion. The bone overload was higher in the immediate load condition. The method used in this study may help to simulate the biological healing process and could be useful to relate FEA results to clinical practice. [ABSTRACT FROM AUTHOR]

Background: The increase in soft tissue (ST) around implants can benefit peri-implant health and aesthetic results. The objective was to compare the gingival and esthetic health benefits of immediate implant placement (IIP) with simultaneous or delayed connective tissue graft (CTG) compared to IIP without CTG. Methods: A systematic review was carried out by two reviewers in Medline-Pubmed, Scopus, and Cochrane. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were considered. Randomized Clinical Trials (RCTs) that were published between April 2017 and February 2024 were used. Studies that analyzed the performance of a simultaneous or deferred CTG after the placement of an implant in the aesthetic zone, with or without immediate provisionalization, without previous regeneration, with a follow-up of 6 months, and that were performed in humans were included. Results: Quantitative analysis was performed using data provided by the RCTs. The five RCTs that were selected analyzed a total "n" of 245 subjects who met the inclusion criteria and focused on the subject of the study. In the quantitative analysis, four RCTs were included. The studies evaluated buccal gingiva levels when placing the IIP with and without CTG, obtaining a mean buccal gingiva level difference of 0.09 mm (95% CI: −0.54 to 0.72, p = 0.05), statistically not significant, but with a favorable trend. Conclusions: The use of CTG associated with the II can maintain the gum level but not increase the volume. CTG is favorable for achieving successful esthetic results when immediate placement of an implant with a provisional prosthesis is planned. [ABSTRACT FROM AUTHOR]

Purpose: This systematic review and meta-analysis aimed to evaluate the efficacy of two different loading methods in implant-supported removable prostheses (partial dentures and full-maxillary dentures). Methods: As of August 2023, three electronic databases and nine oral implant-related journals had been searched. Only randomised controlled trials (RCTs) that compare immediate loading with conventional loading in implant-supported removable prostheses were included. The primary outcome was the implant survival rate. At the same time, a meta-analysis of bone-level changes was performed. Cochrane risk-of-bias tool for randomised trials (RoB 2) was used to evaluate the risk of bias in the included trials. Results: A total of 16 RCTs were included, including 543 participants with 1595 implants. The included trials compared immediate loading and conventional loading in implant-supported removable prostheses. Regarding implants as the statistical unit, the immediate loading group had a statistically significant lower survival rate (RR = 0.950; 95% confidence interval [CI], (0.926, 0.974); P = 0.027; I² = 47%). When patients were regarded as statistical units, a statistically significant lower survival rate was also observed in the immediate loading group (RR = 0.929; 95% CI, (0.897, 0.961); P = 0.590; I² = 0%). When we analysed the bone level changes, a statistically significant decrease was observed in bone level in the immediate loading group compared with the conventional loading group (weighted mean difference [WMD] = −0.127; 95% CI, (−0.195, −0.059); P

Abstract Background The purpose of this study was to test how musical flow using baroque (BM) and classical era music (CM) as a non-pharmacological therapy can control anxiety and pain levels among patients undergoing IPI (Immediate post-extraction implants). Methods 78 patients who required an IPI were enrolled in this randomized clinical trial. Each patient was assigned to one of the three experimental groups with a simple randomization: Group I (n = 26) listened to BM; Group II (n = 27) listened to CM; and Group III (n = 25) did not listen to music and was the control group (C). The physiological dependent variables analyzed were systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR) and oxygen saturation (SpO2). The psychological dependent variable analyzed was modified dental anxiety scale (MDAS) and visual analogue scale (VAS), measured before and after surgery. In all cases, the level of statistical significance was set at p

Background: The purpose of this study was to test how musical flow using baroque (BM) and classical era music (CM) as a non-pharmacological therapy can control anxiety and pain levels among patients undergoing IPI (Immediate post-extraction implants). Methods: 78 patients who required an IPI were enrolled in this randomized clinical trial. Each patient was assigned to one of the three experimental groups with a simple randomization: Group I (n = 26) listened to BM; Group II (n = 27) listened to CM; and Group III (n = 25) did not listen to music and was the control group (C). The physiological dependent variables analyzed were systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR) and oxygen saturation (SpO2). The psychological dependent variable analyzed was modified dental anxiety scale (MDAS) and visual analogue scale (VAS), measured before and after surgery. In all cases, the level of statistical significance was set at p < 0.01. Results: Statistically significant differences were found in the SBP decrease in the CM group (p = 0.001, CI = 1.9716–6.5840) and the BM group (p = 0.003, CI = 1.4450–6.4396). Anxiety levels during the intervention decreased in both groups that listened to music: BM group (p = 0.002, CI = 0.645–2.662) and CM group (p = 0.000, CI = 1.523–3.884). Conclusions: Patients undergoing IPI placement surgery can register lower levels of SBP when listening to BM and CM than patients who were not exposed to the musical flow, improving their anxiety levels. [ABSTRACT FROM AUTHOR]

Background: Coaxial implants with an inclined neck might overcome some problems related to angulation of the implant axis when using tilted implants. Therefore, the aim of the present work was to conduct a narrative review of the current literature and to present a case series comparing traditional and coaxial external hex implants in full-arch immediate loading rehabilitations of the maxilla. Methods: A total of 13 external hex tapered implants (Southern Implants) was inserted in the upper jaw of 3 patients. Each patient received two tilted implants in distal sites. In one randomly selected quadrant, the tilted implant was a standard implant, while a Co-Axis® implant with a 24° inclination of the implant shoulder was inserted on the other hemi-arch. Straight conical abutments were screwed on coaxial implants while multiunit abutments of appropriate inclination were screwed as needed on the other implants to correct their axes. Peri-implant bone level was recorded radiographically at T0 (delivery of the immediate loading prosthesis), and at 3, 6, 12, and 24 months of healing and then annually. Plaque index, probing depth, and bleeding on probing were also evaluated. Cumulative implant survival rate (CSR) was calculated, and biological or technical complications were recorded as well as the operator satisfaction towards the use of coaxial implants. Results: The preliminary data collected did not show significant differences in peri-implant tissues health and maintenance over time between the two implant types. No implants failed, and both implant types proved to be favorable for full-arch rehabilitation using tilted implants. Coaxial implants facilitated the prosthodontic procedures. However, a learning curve is required in order to optimize their insertion. Conclusions: Both implants proved to be reliable and suitable for achieving clinical success in full-arch immediate loading rehabilitations, but further research with longer follow-up and larger sample size is needed to confirm these preliminary outcomes. [ABSTRACT FROM AUTHOR]

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Objectives: This cross-sectional study aimed to evaluate the factors that determine the choice of oral surgeons and periodontists to perform immediate dental implant placement. Material and Methods: An anonymous survey was carried out from January 6, 2024 to February 29, 2024. The questionnaire was distributed online to Lithuanian specialists - oral surgeons and periodontists, who perform implantation procedures. A total of 186 professionals were included in this survey. Chi-square test, its degrees of freedom was used for the analysis of variables. Results: The main reason for refusing immediate implant placement is a periapical lesion greater than 5 mm, reported by 91.7% of oral surgeons and 96.9% of periodontists. Good aesthetics and preservation of anatomical structures are identified as an advantage by 99.2% of oral surgeons and 92.3% of periodontists. In the aesthetic zone, for periodontists, the main criterion for choosing a method is the quantitative and qualitative indicators of the soft tissue of the extraction socket 96.9%, and for oral surgeons - the morphology of the bone walls of the socket 87.6%. Only 43.1% of periodontists and 33.9% of oral surgeons are familiar with and use extraction socket morphology assessment classifications for immediate dental implant placement. Conclusions: Taking into account study's results, it is recommended to adjust the teaching programs at Universities and to increase the knowledge of specialists performing dental implantation procedures, by carrying out continuous educational programs. [ABSTRACT FROM AUTHOR]

Objectives: This cross-sectional study aimed to evaluate the factors that determine the choice of oral surgeons and periodontists to perform immediate dental implant placement. Material and Methods: An anonymous survey was carried out from January 6, 2024 to February 29, 2024. The questionnaire was distributed online to Lithuanian specialists - oral surgeons and periodontists, who perform implantation procedures. A total of 186 professionals were included in this survey. Chi-square test, its degrees of freedom was used for the analysis of variables. Results: The main reason for refusing immediate implant placement is a periapical lesion greater than 5 mm, reported by 91.7% of oral surgeons and 96.9% of periodontists. Good aesthetics and preservation of anatomical structures are identified as an advantage by 99.2% of oral surgeons and 92.3% of periodontists. In the aesthetic zone, for periodontists, the main criterion for choosing a method is the quantitative and qualitative indicators of the soft tissue of the extraction socket 96.9%, and for oral surgeons - the morphology of the bone walls of the socket 87.6%. Only 43.1% of periodontists and 33.9% of oral surgeons are familiar with and use extraction socket morphology assessment classifications for immediate dental implant placement. Conclusions: Taking into account study’s results, it is recommended to adjust the teaching programs at Universities and to increase the knowledge of specialists performing dental implantation procedures, by carrying out continuous educational programs.

Rehabilitating thin jaws without reconstructive surgery entails using narrow implants. The proposed treatment adopted an innovative implant system, allowing the mini-screws to be parallel and immediately loaded. A mandible, wearing an overdenture, was functionalized contextually to the residual dental extraction and the placement of six 2.4-mm thick one-piece implants. Low-profile intermediate abutments, the LEMs, able to rotate over the spherical heads of the fixtures, were connected after suturing, oriented, and blocked in a mutual parallel position. The copings, engaging with a tapered juncture of the LEMs, resulted in their alignment to be intraorally wedged together. The provisional superstructure enclosed the copings and was immediately connected to the implants, and the definitive prosthesis was delivered after three months. No clinical signs of peri-implantitis or radiographically evident bone loss were recorded after a two-year follow-up without any prosthetic complication. No cases have been published regarding mini-implants bearing fixed prosthesis rehabilitation. [ABSTRACT FROM AUTHOR]

Introduction: Full arch reconstruction with dental implants is considered as a reference for dental rehabilitation. However, there are some limitations with patient affected by severe maxilla, mandible atrophy and dento-skeletal-disharmony. These defaults can be corrected with orthognathic surgery and several bone grafts. Observations: A partially edentulous 65-year-old female patient with a skeletal class II by mandibular retrognathia was treated with mandibular advancement osteotomy and simultaneous insertion of four fully guided implants with immediate screwed zirconia prostheses loading in just one session. Conclusion: Simultaneous bilateral sagittal split osteotomy with a full arch rehabilitation by implant with immediate loading by zirconia prosthesis seems to be a reliable and predictable approach to treat skeletal class II patient with a fixed solution. Virtual planning was compulsory to be able to perform this surgery with accuracy. [ABSTRACT FROM AUTHOR]

Purpose: The main objective of this study was to assess the influence of bone remodeling on late marginal bone loss in immediately loaded, implant-supported, complete-arch restorations and, secondarily, to determine its relationship to peri-implant disease occurrence using a multilevel analysis. Materials and Methods: A retrospective cohort study of patients treated consecutively in a private clinic with immediately loaded full-arch restorations with at least 12 months of follow-up was conducted. Bone remodeling and marginal bone loss were determined through measurements made on panoramic radiographs by two calibrated examiners. Peri-implant health status was diagnosed in a visit for peri-implant maintenance. Descriptive, bivariate, and multilevel analyses were performed with Stata/IC 15.1 software (StataCorp). Results: A total of 30 patients (11 men and 19 women, mean age: 63.3 ± 10.4 years), with a mean follow-up of 37.7 ± 19.6 months were included. Forty arches (20 maxillary and 20 mandibular) received 207 implants. Bone remodeling had an inversely proportional effect on marginal bone loss (P =.005) but was not related to peri-implantitis (P =.103; hazard rate [HR] = 2.1). Conclusion: Taking into account the limitations of this study, bone remodeling around immediately loaded dental implants supporting complete-arch restorations does not appear to increase marginal bone loss or peri-implantitis. [ABSTRACT FROM AUTHOR]

Purpose: This study was conducted to compare the radiographic, esthetic, and patient-reported outcome measures (PROMs) between immediate and delayed restorations of immediately placed single implants in the maxillary esthetic zone. Materials and Methods: Forty patients with immediate single dental implants in the anterior maxilla were included in this study. Afterward, they were allocated either for immediate restoration with a provisional restoration (IR: 20 patients) or for a delayed restoration (DR: 20 patients). The evaluations were performed after 1 year of follow-up. Results: No implant and prosthetic failures were observed during the 1-year follow-up. Two minor complications were found in two IR patients; however, no complication was reported in the DR group during the 1 year. Nevertheless, this difference was not statistically significant (P > .05). After 1 year, the mean marginal bone level changes (MBL) were 0.47 ± 0.29 mm and 0.54 ± 0.21 mm for IR and DR, respectively. There was no statistically significant difference between the two groups in terms of MBL (P = .3). Notably, the mean total pink esthetic score (PES) and white esthetic score (WES) after 1 year of follow-up were 11.2 ± 1.1 (PES) and 8 ± 1.02 (WES) for the immediate restoration, and 10.2 ± 0.97 (PES) and 7.65 ± 1.20 (WES) for the delayed restoration. Also, no statistically significant difference was found between IR and DR in terms of esthetic scores (P > .05). The patient satisfaction of these two groups had no statistically significant difference, except for the esthetic factor (P = .04). Conclusion: The immediate restoration and preferred esthetic satisfaction had similar outcomes compared with the delayed restoration. [ABSTRACT FROM AUTHOR]

Background: The increase in soft tissue (ST) around implants can benefit peri-implant health and aesthetic results. The objective was to compare the gingival and esthetic health benefits of immediate implant placement (IIP) with simultaneous or delayed connective tissue graft (CTG) compared to IIP without CTG. Methods: A systematic review was carried out by two reviewers in Medline-Pubmed, Scopus, and Cochrane. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were considered. Randomized Clinical Trials (RCTs) that were published between April 2017 and February 2024 were used. Studies that analyzed the performance of a simultaneous or deferred CTG after the placement of an implant in the aesthetic zone, with or without immediate provisionalization, without previous regeneration, with a follow-up of 6 months, and that were performed in humans were included. Results: Quantitative analysis was performed using data provided by the RCTs. The five RCTs that were selected analyzed a total “n” of 245 subjects who met the inclusion criteria and focused on the subject of the study. In the quantitative analysis, four RCTs were included. The studies evaluated buccal gingiva levels when placing the IIP with and without CTG, obtaining a mean buccal gingiva level difference of 0.09 mm (95% CI: −0.54 to 0.72, p = 0.05), statistically not significant, but with a favorable trend. Conclusions: The use of CTG associated with the II can maintain the gum level but not increase the volume. CTG is favorable for achieving successful esthetic results when immediate placement of an implant with a provisional prosthesis is planned.

Background: It is necessary to investigate the application of polymer materials in implant dentistry. The aim of this study was to examine the outcome of full-arch polyetheretherketone (PEEK)—acrylic resin implant-supported prostheses. Methods: Seventy-six patients were rehabilitated consecutively with 100 full-arch implant-supported prostheses of PEEK–acrylic resin (a development group (DG): 37 patients with 5 years of follow-up; a routine group (RG): 39 patients with 1 year of follow-up). The primary outcome measure was prosthetic survival. Secondary outcome measures were implant survival, marginal bone loss, biological complications, prosthetic complications, veneer adhesion, plaque levels, bleeding levels, and a patient subjective evaluation (including the Oral Health Impact Profile for the RG). Results: In both groups, prosthetic (DG: 93.6%; RG: 100%) and implant survival (DG: 98.9%; RG: 99.5%) were high, and marginal bone loss was low (DG: 0.54 mm; RG: 0.28 mm). The veneer adhesion rate was 28.6% of prostheses in DG (RG = 0%). Mechanical complications occurred in 49% and 11.8% of prostheses in DG and RG, respectively. Biological complications, plaque, and bleeding levels were low in both groups. The subjective patient evaluation was excellent in both groups (8.6 < DG < 8.8; 9.3 < RG < 9.5; OHIP = 1.38). Conclusions: Within the limitations of this study, PEEK can be considered a viable prosthetic alternative. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to review available evidence for Type 1A (immediate implant placement and immediate loading) of single tooth replacement in the maxillary esthetic zone. Materials and Methods: An electronic search was conducted utilizing the databases of MEDLINE, Embase, and Cochrane to identify publications reporting on the outcomes of Type 1A for single tooth replacement in the maxillary esthetic zone. The success and survival rates of the included articles were reported, which were further categorized according to the clinical criteria reported in Type 1A. Mean survival rates were univariately compared between risk groups and additionally between studies published before and since 2012 using bias‐corrected and study size‐weighed bootstrap tests. A study time‐correcting meta‐analysis was then performed to obtain an overall effect for the study pool. Results: A total of 3118 publications were identified in the search, with a total of 68 articles included. A mean number of implants per study were 37.2 and mean follow‐up was 2.8 years. All the included studies utilizing Type 1A report highly selective inclusion and exclusion criteria. Univariate risk group comparison determined that studies before 2012 report a significantly lower mean survival rate (difference of −1.9 percentage points [PP], 95% CI: [−0.3, −4.0], p =.02), facial gap dimension had an impact on survival rates (+3.1 PP [0.2, 5.3] for width >2 mm, p =.04), as well as presence of endodontic infection (+2.6 PP [0.9, 5.1], p =.004). Conclusions: Type 1A has a high survival rate in studies reporting strict patient and site selection criteria. Further research is required to assess esthetic and functional success with Type 1A treatments. [ABSTRACT FROM AUTHOR]

Abstract Aims The primary aim of the present study was to measure the discrepancy between the virtual and the actual position of the single-unit implants placed via a digitally-designed fully-guided surgical template using a flapless surgical technique. Prefabricated provisional restorations and periodontal factors were evaluated after the immediate loading of implants and 3 months after the surgery, respectively. Materials and methods Fourteen implants in nine patients were virtually planned after importing intraoral scans and cone-beam computed tomography (CBCT) records into 3D planning software. Accordingly, fully-guided surgical templates, customized abutments, and provisional restorations were designed and fabricated. The implant position after the surgery was compared with its virtual counterpart in terms of angular and apical linear deviations. Implants were immediately loaded after the surgery, and the occlusal level of the delivered provisional restorations was compared with their designed positions. Early implant failure, bleeding on probing, and peri-implant pockets were documented on the 3-month follow-up. Results A mean angular deviation of 5.07 ± 2.06° and a mean apical linear deviation of 1.74 ± 0.63 mm resulted. Two out of 14 implants failed within the first 3 months of the surgery, and the occlusal level difference was calculated for nine prefabricated provisional restorations. Conclusions DIONAVI protocol has been evaluated regarding its accuracy, and an estimation of the expected deviation is presented to the clinicians using this protocol. However, before widespread use, immediate-loading protocols and provisional restorations must be studied further. Trial registration IRCT, IRCT20211208053334N1. Registered 6 August 2022.

This study aimed to assess marginal bone loss and complication rates of mandibular overdentures retained on two implants with conventional and immediate loading protocols. Twenty edentulous patients were treated with mandibular two-implant-retained overdentures and new complete maxillary dentures. In one half of the sample, the implants were loaded immediately by VulkanLoc® abutments. In the counterpart group, these abutments were connected to the implants two months after implant placement (conventional protocol). Treatment outcomes were evaluated at 2, 6, and 12 months after implant placement. According to the pre- and post-insertion radiographs, there was a mean marginal bone loss of 0.25–0.59 mm (CI 95%) after 13.4 ± 2.1 months of follow-up. There were no significant differences between groups. The failure rate (percentage of implants failing per year) was slightly higher in the conventional loading group (14.0 ± 32.7%) than in the immediate loading group (8.3 ± 18.0%). The findings of the present study suggested that there were no differences in marginal bone loss observed at one year for immediately loaded implants (0.40–0.39 mm) versus conventionally loaded implants (0.44- 0.36 mm) placed for the retention of mandibular overdentures. There were no differences in primary and secondary stability of immediately loaded versus conventional implants; however, in the conventional loading group, stability increased significantly between implant placement compared at both 6 and 12 months post-placement.

Background: Coaxial implants with an inclined neck might overcome some problems related to angulation of the implant axis when using tilted implants. Therefore, the aim of the present work was to conduct a narrative review of the current literature and to present a case series comparing traditional and coaxial external hex implants in full-arch immediate loading rehabilitations of the maxilla. Methods: A total of 13 external hex tapered implants (Southern Implants) was inserted in the upper jaw of 3 patients. Each patient received two tilted implants in distal sites. In one randomly selected quadrant, the tilted implant was a standard implant, while a Co-Axis® implant with a 24° inclination of the implant shoulder was inserted on the other hemi-arch. Straight conical abutments were screwed on coaxial implants while multiunit abutments of appropriate inclination were screwed as needed on the other implants to correct their axes. Peri-implant bone level was recorded radiographically at T0 (delivery of the immediate loading prosthesis), and at 3, 6, 12, and 24 months of healing and then annually. Plaque index, probing depth, and bleeding on probing were also evaluated. Cumulative implant survival rate (CSR) was calculated, and biological or technical complications were recorded as well as the operator satisfaction towards the use of coaxial implants. Results: The preliminary data collected did not show significant differences in peri-implant tissues health and maintenance over time between the two implant types. No implants failed, and both implant types proved to be favorable for full-arch rehabilitation using tilted implants. Coaxial implants facilitated the prosthodontic procedures. However, a learning curve is required in order to optimize their insertion. Conclusions: Both implants proved to be reliable and suitable for achieving clinical success in full-arch immediate loading rehabilitations, but further research with longer follow-up and larger sample size is needed to confirm these preliminary outcomes.

This study proposes a simple, off-the-shelf ancillary method for application in the dental rehabilitation of severe maxillary atrophy with zygoma implants, allowing simultaneous improvement of lip support in cases with a moderate lack of premaxillary projection. Three consecutive patients with an atrophic maxilla were evaluated retrospectively. All were treated with a fixed rehabilitation over four zygomatic implants and the pillow technique. The study variables included radiological assessment of the premaxilla volume, upper lip and perinasal soft tissue changes, clinical complications, and subjective evaluation of functional and aesthetic patient satisfaction based on a visual analogue scale. All of the zygomatic implants showed osseointegration. The survival rate was 100%. The immediate postoperative course was uneventful, and no surgical complications were noted at the follow-up visits. Radiological assessment of the premaxilla volume enhancement showed a final mean skeletal projection improvement of +9.4 mm, while the nasolabial angle decreased an average of + 0.6 mm. On the other hand, only small changes in nasal width were detected. Patient satisfaction with the functional and aesthetic outcomes at the 1-year follow-up was excellent. The pillow graft is an easy-to-handle technique that can be included in the armamentarium for moderately incrementing the maxillary sagittal dimension and enhancing lip support in the context of zygoma implant rehabilitation. [ABSTRACT FROM AUTHOR]

The objective of this study was to report a clinical case of dental implant failure with significant bone loss that was treated using reconstructive surgical techniques. We present a 58-year-old man with a history of implant surgery and implant failure on the mandible. Data collected using cone beam computed tomography (CBCT) and intraoral scans were exported into Exoplan (exocad GmbH, Darmstadt, Germany), from which a standard tessellation file was obtained. To create a customized mandible mesh design, DentalCAD 3.0 Galway software (exocad GmbH, Darmstadt, Germany) was used. Based on guided bone regeneration, the method involved bone reconstruction and the application of a custom titanium mesh. The bone mix was obtained by combining a xenograft (Cerabone, Bottis biomaterials Gmbh, Zossen, Germany), an allograft (Max Graft, granules Bottis biomaterials Gmbh, Zossen, Germany), and an autograft. The titanium meshes were fixed to the bone using self-drilling screws and covered with a resorbable membrane. Immediately after surgery, an impression was recorded, and the next day, the patient received a milled polymethyl methacrylate interim denture. Based on our case study, the presented custom-made implant can be considered a temporary solution, during which guided bone regeneration is expected to take place. [ABSTRACT FROM AUTHOR]

Abstract Background Implants immediately loaded full-arch prosthesis in maxilla is always a challenge, especially when the zone 2 is extremely defected. To achieve a satisfying result, different therapeutic alternatives have been proposed, such as zygomatic implant, pterygoid implant; however, precise surgical skills limited its application. Case presentation This study reported a case that an edentulous patient was treated with a new technique, two axial implants and four tilted implants supporting an immediate fixed denture, extruding the cortical bone of the anterior wall of the maxillary sinus to establish the primary stability. Conclusions Two-year follow-up proves that it is a viable choice. Meanwhile, a reliable method for its saving time and money and low level of discomfort for patients is presented.

Aims: The primary aim of the present study was to measure the discrepancy between the virtual and the actual position of the single-unit implants placed via a digitally-designed fully-guided surgical template using a flapless surgical technique. Prefabricated provisional restorations and periodontal factors were evaluated after the immediate loading of implants and 3 months after the surgery, respectively. Materials and methods: Fourteen implants in nine patients were virtually planned after importing intraoral scans and cone-beam computed tomography (CBCT) records into 3D planning software. Accordingly, fully-guided surgical templates, customized abutments, and provisional restorations were designed and fabricated. The implant position after the surgery was compared with its virtual counterpart in terms of angular and apical linear deviations. Implants were immediately loaded after the surgery, and the occlusal level of the delivered provisional restorations was compared with their designed positions. Early implant failure, bleeding on probing, and peri-implant pockets were documented on the 3-month follow-up. Results: A mean angular deviation of 5.07 ± 2.06° and a mean apical linear deviation of 1.74 ± 0.63 mm resulted. Two out of 14 implants failed within the first 3 months of the surgery, and the occlusal level difference was calculated for nine prefabricated provisional restorations. Conclusions: DIONAVI protocol has been evaluated regarding its accuracy, and an estimation of the expected deviation is presented to the clinicians using this protocol. However, before widespread use, immediate-loading protocols and provisional restorations must be studied further. Trial registration: IRCT, IRCT20211208053334N1. Registered 6 August 2022. [ABSTRACT FROM AUTHOR]

Aim: To assess the esthetic and clinical performance of a novel self‐tapping implant system for single‐tooth restorations in the esthetic zone after immediate placement and provisionalization. Materials and Methods: This cross‐sectional study included 52 patients contributing a total of 52 immediately placed and restored implants with ≥12 months after functional loading, comparing two different implant systems: Straumann® BLX (Institut Straumann AG, Basel, Switzerland; 25 patients) and Ankylos® (Dentsply Sirona, Hanau, Germany; 27 patients). As the primary outcome measure, peri‐implant tissue esthetics were assessed by means of pink esthetics score (PES) rated by three independent clinicians. Moreover, as secondary outcome measures, the peri‐implant tissue health was assessed by means of bleeding on probing, probing depth, and suppuration. Apart from that, the modified plaque index, keratinized mucosa width, and the presence of mucosal recessions were also assessed. When clinical signs suggested the possibility of peri‐implantitis, radiographs were indicated to assess progressive bone loss. Results: The mean PES ratings were 12.10 ± 1.10 for Ankylos versus 11.2 ± 1.86 for BLX, both achieving good esthetic results without significant differences (p = 0.143). There were no differences among most clinical parameters (plaque, bleeding on probing, probing depth, peri‐implant mucosal recession), although peri‐implant mucositis was present in one‐third of the cases. The inter‐rater agreement on esthetics was not significant (p < 0.250). Conclusion: Within the limitations of the present study, it was concluded that the use of either BLX or Ankylos implant systems was associated to comparable peri‐implant health and good pink esthetic outcomes during immediate implantation and restoration protocols, for at least 12 months. [ABSTRACT FROM AUTHOR]

Objectives: Stability values of mini-implants (MIs) are ambiguous. Survival data for MIs as supplementary abutments in reduced dentitions are not available. The aim of this explorative research was to estimate the 3-year stability and survival of strategic MIs after immediate and delayed loading by existing removable partial dentures (RPDs). Material and methods: In a university and three dental practices, patients with unfavorable tooth distributions received supplementary MIs with diameters of 1.8, 2.1, and 2.4 mm. The participants were randomly allocated to group A (if the insertion torque ≥ 35 Ncm: immediate loading by housings; otherwise, immediate loading by RPD soft relining was performed) or delayed loading group B. Periotest values (PTVs) and resonance frequency analysis (RFA) values were longitudinally compared using mixed models. Results: A total of 112 maxillary and 120 mandibular MIs were placed under 79 RPDs (31 maxillae). The 1st and 3rd quartile of the PTVs ranged between 1.7 and 7.8, and the RFA values ranged between 30 and 46 with nonrelevant group differences. The 3-year survival rates were 92% in group A versus 95% in group B and 99% in the mandible (one failure) versus 87% in the maxilla (eleven failures among four participants). Conclusions: Within the limitations of explorative analyses, there were no relevant differences between immediate and delayed loading regarding survival or stability of strategic MIs. Clinical relevance: The stability values for MIs are lower than for conventional implants. The MI failure rate in the maxilla is higher than in the mandible with cluster failure participants. Clinical trial registration: German Clinical Trials Register (Deutsches Register Klinischer Studien, DRKS-ID: DRKS00007589, www.germanctr.de), January 15, 2015. [ABSTRACT FROM AUTHOR]

This study aimed to assess marginal bone loss and complication rates of mandibular overdentures retained on two implants with conventional and immediate loading protocols. Twenty edentulous patients were treated with mandibular two-implant-retained overdentures and new complete maxillary dentures. In one half of the sample, the implants were loaded immediately by VulkanLoc® abutments. In the counterpart group, these abutments were connected to the implants two months after implant placement (conventional protocol). Treatment outcomes were evaluated at 2, 6, and 12 months after implant placement. According to the pre- and post-insertion radiographs, there was a mean marginal bone loss of 0.25–0.59 mm (CI 95%) after 13.4 ± 2.1 months of follow-up. There were no significant differences between groups. The failure rate (percentage of implants failing per year) was slightly higher in the conventional loading group (14.0 ± 32.7%) than in the immediate loading group (8.3 ± 18.0%). The findings of the present study suggested that there were no differences in marginal bone loss observed at one year for immediately loaded implants (0.40–0.39 mm) versus conventionally loaded implants (0.44- 0.36 mm) placed for the retention of mandibular overdentures. There were no differences in primary and secondary stability of immediately loaded versus conventional implants; however, in the conventional loading group, stability increased significantly between implant placement compared at both 6 and 12 months post-placement. [ABSTRACT FROM AUTHOR]

Background: Implants immediately loaded full-arch prosthesis in maxilla is always a challenge, especially when the zone 2 is extremely defected. To achieve a satisfying result, different therapeutic alternatives have been proposed, such as zygomatic implant, pterygoid implant; however, precise surgical skills limited its application. Case presentation: This study reported a case that an edentulous patient was treated with a new technique, two axial implants and four tilted implants supporting an immediate fixed denture, extruding the cortical bone of the anterior wall of the maxillary sinus to establish the primary stability. Conclusions: Two-year follow-up proves that it is a viable choice. Meanwhile, a reliable method for its saving time and money and low level of discomfort for patients is presented. [ABSTRACT FROM AUTHOR]

Objectives The aim of this retrospective study was to assess the dimensions of the mandibular molar socket for immediate implant placement, using cone-beam computed tomography (CBCT) imaging. Methods The CBCT images of 81 patients were selected based on the inclusion and exclusion criteria. In the OnDemand software, measurements were assessed by virtually positioning a regular Straumann implant (4.8 mm) in the regions of the first and second mandibular molars. The socket morphology, the buccolingual width of cancellous bone, the gap between the implant and the socket wall, the length of the root, the cross-sectional morphology of the mandible, and the height and thickness of the interradicular septum were all determined. The variables were compared using either the Student’s t-test or the Mann-Whitney U test. Results Among the cross-sectional morphologies of the mandible, the undercut type (U) was found to be the most prevalent. The mean distance of the implant from the inferior alveolar nerve (IAN) was found to be 6.22 mm for the first molars and 5.17 mm for the second molars. Moreover, the mean horizontal distances from the implant to the mesial and distal socket walls were 2.01 and 2.30 mm for the first molars and 2.14 and 2.59 mm for the second molars, respectively. The width of the interradicular septum across various sections was found to have a significant correlation with the position of the tooth (P<0.05). Conclusion The majority of the samples exhibited the undercut (U type) morphology of the mandible. The interradicular septum in the second molar tooth was found to be insufficient. Overall, the assessment of pre-extraction CBCT scans and the virtual positioning of implants can be beneficial for surgical treatment planning. This approach can also aid in minimizing potential complications. [ABSTRACT FROM AUTHOR]

Background: It is necessary to investigate the application of polymer materials in implant dentistry. The aim of this study was to examine the outcome of full-arch polyetheretherketone (PEEK)—acrylic resin implant-supported prostheses. Methods: Seventy-six patients were rehabilitated consecutively with 100 full-arch implant-supported prostheses of PEEK–acrylic resin (a development group (DG): 37 patients with 5 years of follow-up; a routine group (RG): 39 patients with 1 year of follow-up). The primary outcome measure was prosthetic survival. Secondary outcome measures were implant survival, marginal bone loss, biological complications, prosthetic complications, veneer adhesion, plaque levels, bleeding levels, and a patient subjective evaluation (including the Oral Health Impact Profile for the RG). Results: In both groups, prosthetic (DG: 93.6%; RG: 100%) and implant survival (DG: 98.9%; RG: 99.5%) were high, and marginal bone loss was low (DG: 0.54 mm; RG: 0.28 mm). The veneer adhesion rate was 28.6% of prostheses in DG (RG = 0%). Mechanical complications occurred in 49% and 11.8% of prostheses in DG and RG, respectively. Biological complications, plaque, and bleeding levels were low in both groups. The subjective patient evaluation was excellent in both groups (8.6 < DG < 8.8; 9.3 < RG < 9.5; OHIP = 1.38). Conclusions: Within the limitations of this study, PEEK can be considered a viable prosthetic alternative.

Purpose: The purpose of this study was to retrospectively compare long-term outcomes for immediately loaded tilted and axial implants placed in the posterior region of the edentulous maxillary arch. Materials and Methods: Data obtained from a 5-year prospective study designed to assess clinical outcomes following immediate loading of implants with screw-retained fixed restorations in the edentulous maxillary arch were retrospectively reviewed. Where insufficient alveolar bone was available for axial placement of the posteriormost implant on each side of the arch, tilted placement was employed. Implant survival and marginal bone level changes for these tilted and axial posterior implants were compared. Results: Fifty-one subjects received 64 tilted and 38 axial posterior implants. Forty subjects with 53 tilted and 34 axial posterior implants returned for follow-up after 5 years. Five tilted and seven axial implants failed, representing an 89% and 86% survival proportion, respectively. The mean marginal bone loss was 0.79 (SD: 1.42) mm for tilted implants and 0.14 (SD: 0.34) mm for axial implants. The differences in survival proportions and marginal bone loss between axial and tilted implants were not statistically significant. Conclusion: Predictable long-term implant rehabilitation may be achieved in the edentulous maxillary arch using posterior tilted implants in combination with immediate loading. [ABSTRACT FROM AUTHOR]

Dental implant restoration is a predictable treatment option for replacing missing or damaged teeth. Conventional loading requires a prolonged treatment period and second surgical interventions. The aim of this study was to compare the clinical outcomes between immediate and non-immediate (early or conventional) loading in single-implant restorations. A literature search of the PubMed, Embase, Cochrane Library, Web of Science, and ClinicalTrials.gov databases was performed in January 2020. Only randomized clinical trials (RCTs) were included. The overall risk ratios (RRs), mean differences (MDs), and 95% confidence intervals (CIs) were used in the analyses. A total of 10 RCTs reporting on 423 patients were included. There was no significant difference in any of the outcomes of interest between the immediate and non-immediate loading cases: implant failure at the patient level (RR 1.29, 95% CI 0.35 to 4.78, P = 0.71), implant failure at the implant level (RR 1.19, 95% CI 0.40 to 3.51, P = 0.75), marginal bone loss (MD −0.04, 95% CI −0.16 to 0.08, P = 0.54). Subgroup analyses showed similar results. Immediate loading had predictable long-term clinical outcomes if the indicated patients were carefully selected. The influences of several technical factors need to be confirmed in additional clinical trials. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the influence of immediate loading on the osseointegration and bone density of implants placed in a healed alveolar bone crest and supporting single crowns., Materials and Methods: Two solid titanium transmucosal miniimplants were placed in the distal regions of the mandible in 14 patients. One mini-implant was immediately functionally loaded, whereas the other was left unloaded. After 2 months of healing, biopsy samples were retrieved and the levels of new bone, old bone, and total bone (new &#43; old) were assessed., Results: Histologic examination was performed on biopsies from 12 patients (n &#61; 12). The new bone-to-implant contact percentage (BIC%) was 40.3% ± 16.8% and 55.1% ± 19.1% (P &#61; .043) at the unloaded and loaded sites, respectively; in addition, the total BIC% was 44.9% ± 17.0% and 59.5% ± 18.8%, respectively (P &#61; .034). The new bone density was 45.9% ± 11.6% for the unloaded implants and 45.9% ± 16.7% for the loaded implants (P &#61; .622)., Conclusions: Immediate loading had a positive effect on bone apposition at the implant surface, but no effect on bone density was observed after 2 months of healing.

Aim: The objective of the present study was to determine the 3-year clinical and dimensional soft tissue change following implant placement in healed sites before and after loading with either customized or conventional healing abutments., Materials and Methods: Premolar/molar implants were immediately loaded with either provisional and customized abutments without finishing lines according to the principles of the biologically oriented preparation technique (BOPT; test group) or conventional healing abutments (control group). Three months later, the definitive crowns were fabricated. Primary outcomes (soft tissue changes) and secondary outcomes (adverse events) were registered., Results: A total of 50 of the 87 subjects who were originally included were finally selected for the present retrospective analysis: 23 in the test group and 27 in the control group. During the first days after surgery, two adverse events of mucositis occurred, one in each group. A few technical complications were recorded such as the unscrewing of four screw-retained crowns. A significant increase in the alveolar width was observed in both groups (test: &#43;2.5 ± 0.5 mm; control: &#43;1.0 ± 0.9 mm). The widths appeared unchanged from 3 months to 3 years in both groups. There were no significant differences regarding the width of the keratinized mucosa measured at baseline and after follow-up. The Jemt papilla index showed a higher increase in the test group compared with the control group., Conclusions: Within the 3-year follow-up period, the peri-implant soft tissue outcomes of single, immediately loaded implants with customized healing abutments showed better results in terms of thickness and width compared with those of the conventional group. The number of side effects (mucositis and dehiscence) appeared to be very similar for both groups. In addition, customized healing abutments led to significant augmentation of the alveolar width, which was more than twice of that registered in the conventional group.

Objectives: Single midline implants in the edentulous mandible can be used to support existing complete dentures to improve patients' satisfaction and masticatory efficiency. The impact on patients' dietary habits and the influence of the loading protocol of the implants was the subject of this study., Materials and Methods: In this prospective randomized clinical trial, edentulous patients with existing complete dentures in both jaws were treated with a single midline implant in the mandible. In group A, the implants were loaded immediately, in group B the loading was delayed after three months. Patients were asked to report on their nutritional intake before implant placement and 12, 24 and 60 months after loading using a standardized two-part questionnaire., Results: Nutritional intake regarding the frequency of consumption of the requested food items did not change significantly during the 60-months study period, regardless of the loading protocol. In contrast, the second part of the questionnaire revealed that after 60 months, there was a significant decrease in avoidance of food, that had a coarse and hard texture in both groups. This significant decrease was observable in the group A in the first 12 and 24 months and in the group B after 60 months., Conclusion: A change in the patients' dietary habits due to the insertion of a single midline implant in the mandible to support the existing complete denture cannot be observed, independently to the loading protocol., Clinical Relevance: Improving the chewing efficiency by single midline implants in the edentulous mandible does not lead to a change in dietary habits., (© 2024. The Author(s).)

This study aimed to identify the ideal interimplant distance for optimum outcome on immediately loaded implant supported prosthesis. Hence this study was taken up to analyze the effect of varying interimplant distance on fracture resistance of implant supported provisional fixed dental prosthesis (FDP). A total of 24 bis-acrylate composite resin samples were prepared. Interimplant distance was present in the metal die for placement of dummy implants at distances of 14 mm, 21 mm, and 30 mm respectively. Wax-up for 3-unit, 4-unit, and 5-unit implant-supported provisional restoration was made. Silicone molds were used for making multiple interim prostheses using bis-acrylate composite material. All samples were subjected to fracture test in the universal testing machine with a crosshead speed of 1 mm/min. All samples were loaded with gradual force starting from 100 N until it fractured. The load was applied at the center of prosthesis. Data was analyzed by one-way analysis of variance and Bonferroni post hoc test. Mean fracture resistance of 3-unit provisional FDP at 14 mm of interimplant distance showed 1342.61 ± 179.15 N. Mean fracture resistance of 4-unit provisional FDP at 21 mm of interimplant distance showed 1420.44 ± 170.37 N. Mean fracture resistance of 5-unit provisional FDP at 30 mm of interimplant distance showed 791.61 ± 203.59 N. Both 14 mm and 21 mm of interimplant distance are suitable span lengths to be considered for the optimum outcome during immediately loading with implant-supported provisional restorations. Limitations of the study were that force application was static in nature and not dynamic and the arch form was not "U" shaped but longitudinal using Bis-Acryl material only with no cantilever. Future studies can be done to evaluate the fracture resistance of bis-acrylate material considering biomechanics and arch form of natural dentition. Distal cantilever should be considered along with different material for fabricating provisional restoration.

Background: Clinicians are often faced with changes in socket anatomy after tooth extraction. Extraction socket management can be challenging, particularly in the aesthetic zone. Before an implant-based treatment can be proposed, a detailed diagnosis of the defect type must be made and a treatment plan developed accordingly to ensure the long-term stability of peri-implant tissues., Materials and Methods: The present authors developed a new extraction socket classification and associated recommendations for planning and execution of immediate dentoalveolar restoration., Results: The classification is based on six criteria: the bony anatomy of the 360-degree socket, socket health, facial gingival recession, periodontal biotype, bone density and apical height of the remaining bone. These criteria guide immediate dentoalveolar restoration planning so an optimal peri-implant tissue structure and aesthetic outcome can be achieved, and enabled long-term resolution in a complex clinical case., Conclusions: When planning post-extraction treatment that is effective and predictable in the long term, 360-degree anatomical classification of the extraction socket must be performed to ensure that the treatment is proportional to the socket and surrounding soft tissue damage., Conflict-Of-Interest Statement: The authors declare there are no conflicts of interest relating to this study.

Objectives: To assess the accuracy and effectiveness among operators with different levels of experience in a robot-assisted immediate implant surgery., Materials and Methods: The study included four participants who had received dental training at the same institution but have varying levels of clinical experience in implant dentistry, denoted as undergraduate student (UG), dental resident (DR), specialist with no robot experience (IS) and specialist with robot experience (RS). Following comprehensive theoretical training in robot-assisted implant operation, each operator participated in five robotic-assisted implant procedures at 21 sites, resulting in the implant surgery of a total of 20 implants. Subsequently, the accuracy of the implants was assessed by analyzing the preoperative planning and the postoperative CBCT scans, and the time required for each procedure was also recorded., Results: Angular deviation in UG, DR, IS and RS group was 0.82 ± 0.27°, 0.55 ± 0.27°, 0.83 ± 0.27°, and 0.56 ± 0.36°, respectively. The total deviation of the implant platform point was 0.28 ± 0.10 mm, 0.26 ± 0.16 mm, 0.34 ± 0.08 mm and 0.31 ± 0.06 mm, respectively. The total deviation of the apical point was 0.30 ± 0.08 mm, 0.25 ± 0.18 mm, 0.31 ± 0.09 mm, and 0.31 ± 0.05 mm, respectively. The time spent was 10.37 ± 0.57 min, 10.56 ± 1.77 min, 9.93 ± 0.78 min, and 11.76 ± 0.78 min for each operator. As the number of operations increased, the operation time decreased, but there was no significant difference in implant accuracy between the different groups., Conclusions: Within the scope of this study, robot-assisted implant surgery demonstrated high accuracy, with no significant differences in performance between operators with varying levels of clinical experience or implant robot-user experience. Furthermore, the learning curve for robotic implant surgery is steep and consistent., Clinical Relevance: Robot-assisted implant surgery demonstrates consistent high accuracy across operators of varying clinical and robotic experience levels, highlighting its potential to standardize procedures and enhance predictability in clinical outcomes., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Article Title and Bibliographic Information: Pitman J, Christiaens V, Callens J, Glibert M, Seyssens L, Blanco J, Cosyn J. Immediate implant placement with flap or flapless surgery: A systematic review and meta-analysis. J Clin Periodontol. 2023 Jun;50(6):755-764. doi: 10.1111/jcpe.13795. Epub 2023 Mar 5. PMID: 36843361., Source of Funding: The study was funded by the authors and their affiliated institutions., Type of Study/design: Systematic review with meta-analysis., (Copyright © 2023. Published by Elsevier Inc.)

Background: Factors like medical and periodontal conditions, implant location and smoking can affect marginal bone loss (MBL) of basal implants. Objectives: The purpose of this study is to explore the association of MBL with multiple variables including gender, age, smoking status, diabetes, implant placement protocol, location of implant, and type of prosthesis. Material and Methods: A total of 156 single-piece basal implants (Dr. Ihde Dental AG in Gommiswald, Switzerland) were placed in 44 patients. Dental panoramic tomographs were obtained postoperatively and following a one-year of service to determine MBL on mesial and distal sides. The association of MBL with the multiple variables was analysed using the multivariate and the random forest analysis. Results: The mean mesial and distal MBL was 0.64 millimetres. None of the implants presented MBL exceeding 1 millimetre. All implants were retained without complications during the first year of service. The MBL was remarkably associated with the smoking status, diabetes, location of implant and implant placement protocol. Diabetes mellitus is the most vital parameter in predicting MBL. Conclusion: The mean MBL of all implants did not exceed the threshold of 1 millimetre during the first year of service. When placing implants in patients who smoke and have diabetes, care should be taken.

Abstract Background Immediate loading of implant-supported full-arch rehabilitations has become routine practice when treating edentulous patients. The combination of static computer-aided implant surgery (s-CAIS) and digital prosthetic workflow could eliminate several treatment steps and facilitate prostheses delivery. The aim of this study is to evaluate the 1-year results of digitally prefabricated polymethyl methacrylate (PMMA) provisional prostheses without a cast for full-arch computer-assisted immediate loading. Materials and methods A digital pre-operative treatment planning was realized for all patients: dental implants and screw-retained abutments were selected in the planning software and two surgical templates were fabricated for each patient. The first template was mucosa or teeth-supported to drill the holes for fixating pins, while the second template was placed after raising a full-thickness flap and was supported by pins as well as soft or hard tissue distal support. Furthermore, based on the surgical planning, interim prostheses were digitally designed and milled of PMMA resin blocks with subsequent pink resin veneering. Osteotomies and implant placement were performed through the surgical guides and all implants were immediately loaded with prefabricated full-arch interim prostheses directly connected to titanium copings with a flowable resin. Results A total of 55 dental implants were placed in ten patients. In all cases, interim prostheses allowed the insertion of titanium copings without the need of access hole enlargement or adaptation. All the prostheses had 1 year of functional loading to simulate the long provisional phase. No screw loosening occurred at the first removal of the prostheses after implant osseointegration. No fracture occurred during the whole period. After 1 year, the mean marginal bone loss level was 0.37 ± 0.06 mm, while the implant survival rate was 98.18% (n=54/55), with just one implant failing but not affecting final prosthesis delivery to the patient. Conclusions Within the limitations of the present study, the authors concluded that digitally prefabricated provisional prostheses for full-arch immediate loading with s-CAIS could be a valid alternative treatment modality. Milled PMMA restorations proved to be durable enough during the long provisional phase, without prosthetic complications.

Background: There is concern regarding immediate implantation in the molar region because of discrepancy between socket size and inserted implant diameter. The purpose of this study was to assess the local anatomy of the posterior mandibular region in relation to immediate implant placement using cone-beam computed tomography (CBCT).Materials and Methods: Using CBCT imaging data, 204 mandibular first molars and 201 mandibular second molars were assessed for the interradicular and alveolar bone dimensions, tooth sizes and proximity to vital structures. The cross-sectional mandibular shape and root configuration of these molars were determined.Results: Distances to the inferior alveolar canal (IAC) from the root apices of the first molar were significantly greater than the second molar. Up to 14.5% of second molars had less than 10 mm of vertical bone height between the IAC and furcation bone crest. Interradicular bone width of < 3 mm was found in 57% of second molars. All first molars in this study had two to three roots while 16% of second molars presented with a single root. The prevalent mandible shape at the first and second molars was the parallel and undercut ridges, respectively.Conclusions: The mandibular second molars from samples of a Southeast Asian population presented with greater anatomical difficulties for immediate implant placement which include absent or inadequate interradicular bone thickness, higher incidence of unfavourable mandible shape and increased proximity to vital structures. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to evaluate implant survival rate and to measure peri-implant bone changes in fullarch rehabilitations with immediate placement and immediate loading implants with platform switching and Morse taper connection, in addition to platelet-rich fibrin (PRF) and buccal bone augmentation, after 4 years of follow-up. Method and Materials: In this retrospective controlled study, patients who had been fully rehabilitated with immediate placement and immediate loading implants were evaluated 4 years post-loading. Implants with platform switching and Morse taper connections were used (In-Kone Universal System, Global D) and PRF and buccal bone augmentation were applied. The radiographic bone loss was calculated by subtracting the bone level at baseline (BLT0) from that at the 4-year follow-up (BLT4) in immediate and delayed implants. Measurements were made at the distal, mesial, vestibular, and oral sites of the implants and the deepest value was recorded. Implants placed in extraction sites and implants placed in healed sites were considered. A comparison between the groups was performed using the Mann-Whitney test. The implant survival rate was calculated using the KaplanMeier analysis. Results: In total, 42 patients (28 females and 14 males; average age 55.8 years old, age range 45 to 77) were recruited to this study. A total of 334 implants were put in place (226 in the maxilla, 108 in the mandible). The implant survival rate was 97.8% for the maxilla and 98.1% for the mandible, 98.3% for immediate implants and 96.9% for delayed implants. No statistically significant differences (P > .05) in the mean radiographic bone loss (mBL) were observed when comparing the immediate and delayed implants and the anterior and posterior implants. Statistically significant differences were found in the mBL between the mandibular and maxilla implants in the vestibular (P = .01) and mesial (P = .001) sites. Conclusion: Within their limits, the present results suggest that rehabilitation with platform switching and taper connection implants, in addition to buccal bone augmentation and the use of PRF, can lead to predictable results. [ABSTRACT FROM AUTHOR]

The objective of this study was to report a clinical case of dental implant failure with significant bone loss that was treated using reconstructive surgical techniques. We present a 58-year-old man with a history of implant surgery and implant failure on the mandible. Data collected using cone beam computed tomography (CBCT) and intraoral scans were exported into Exoplan (exocad GmbH, Darmstadt, Germany), from which a standard tessellation file was obtained. To create a customized mandible mesh design, DentalCAD 3.0 Galway software (exocad GmbH, Darmstadt, Germany) was used. Based on guided bone regeneration, the method involved bone reconstruction and the application of a custom titanium mesh. The bone mix was obtained by combining a xenograft (Cerabone, Bottis biomaterials Gmbh, Zossen, Germany), an allograft (Max Graft, granules Bottis biomaterials Gmbh, Zossen, Germany), and an autograft. The titanium meshes were fixed to the bone using self-drilling screws and covered with a resorbable membrane. Immediately after surgery, an impression was recorded, and the next day, the patient received a milled polymethyl methacrylate interim denture. Based on our case study, the presented custom-made implant can be considered a temporary solution, during which guided bone regeneration is expected to take place.

Introduction: This paper presents a case report of immediate implant placement (IIP) with a provisionalization technique to restore function and esthetics with follow‐up after 4 years. Case Presentation: Minimally traumatic extraction was performed with IIP, soft‐tissue grafting, and immediate provisional crown. Six months after optimal healing, the patient was submitted to an esthetic restorative work through veneers in lithium disilicate. Fourteen‐month and 4‐year follow‐up visits revealed stability of the peri‐implant soft‐tissues with peri‐implant health status, with the evaluation of the pink and white esthetic score, yielding to mean scores, respectively, in 14 months of 11.62 ± 2.07 (pink esthetic score [PES]) and 18.25 ± 1.46 (PES/white esthetic score [WES]) and in 4 years of 11.0 ± 1.32 (PES) and 17.62 ± 0.65 (PES/WES). Intraoral digital radiographs showed minimal crestal bone level changes throughout the follow‐up period. Thus, IIP is a sensitive technique procedure, and a 3D implant position is crucial for success. Conclusion: Immediate implant with grafting to fill the gap and soft tissue augmentation led to less horizontal changes and stable mucosal margin, and immediate provisionalization helped to maintain soft tissue architecture, and proper case selection is key for clinical success. [ABSTRACT FROM AUTHOR]