Search

Purpose: The present study evaluated implant and peri-implant outcomes as well as prosthodontic maintenance efforts for implant/bar-supported mandibular prostheses with different prosthesis anchorage systems. Materials and Methods: Seventy-six patients who received two or four interforaminal implants were assigned to one of three different bar designs and subsequently to different prosthesis supporting systems. Forty-nine patients received implants and a mucosa-supported implant-retained overdenture (OD) with an ovoid bar (two implants; design 1) or multiple ovoid bars (four implants; design 2). Twenty-seven patients received four implants and a rigid implant-supported prosthesis (ISP) with a milled bar (design 3). Implant survival, peri-implant parameters (marginal bone resorption, pocket depth, and plaque, bleeding, gingival, and calculus indices), and postinsertion prosthodontic maintenance were followed over a 5-year period and compared among the different retention modalities. At the most recent follow-up examination, subjective patient satisfaction was additionally evaluated using a simplified scoring system (ranging from 1 = not satisfactory to 5 = excellent). Results: Implant survival rates (100%) and all peri-implant parameters evaluated showed no differences among the three designs used for implant prosthesis anchorage. Prosthodontic maintenance did not differ between the different ODs (OD design 1: average of 1.04 maintenance visits/year/patient; OD design 2: 1.2 maintenance visits/year/patient), but it was significantly lower for the dentures that were rigidly stabilized with milled bars (ISP: 0.37 maintenance visits/year/patient). A high subjective satisfaction rate (range: 4.5 to 5.0) was registered at the final examination, without any differences among the designs used. Conclusions: Rigid anchorage with milled bars on four-implant prostheses combined with a metal-reinforced framework showed a lower extent of prosthodontic maintenance issues than round bars on two- or four-implant overdentures with resilient denture stabilization. Nevertheless, implants and peri-implant structures were not negatively affected by either resilient or rigid anchorage mechanisms. Int J Oral Maxillofac Implants 2010;25:589-597. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this retrospective study was to evaluate the long-term survival and success rates of screw-type root-shaped (Camlog) implants of various diameters and their implant-prosthodontic reconstructions for more than 5 years of clinical use. Materials and Methods: A retrospective study of patients receiving root-shaped screw-type dental implants placed between May 2001 and July 2003 was conducted. The cumulative implant survival and success rates and peri-implant conditions (marginal bone loss, pocket depth, Plaque Index, Gingival Index, Bleeding Index) as well as the prosthodontic maintenance requirements were evaluated. Results: In all, 541 implants (3.8 mm: 237 implants; 4.3 mm: 211 implants, 5/6 mm: 93 implants) were placed and restored for implant prosthodontic rehabilitation in 216 patients (134 women, 82 men; mean age 54.3 +/- 9.1 years). Of the original 216 patients enrolled, 198 (91.6%; 510/541 implants [94.2%]) were available for a follow-up evaluation after 5 to 7 years (mean follow-up, 68.8 +/- 7.4 months). The overall cumulative 5-year survival and success rates were 98.3% and 97.3%, respectively. A failure rate of 3.7% (9/237) was seen for 3.8-mm-diameter implants; the corresponding figures for the 4.3-mm and wide-diameter (5.0/6.0-mm) implants were 1.4% (3/211) and 1.0% (1/93), respectively. For implants classified as successful, the average peri-implant marginal bone resorption value was 1.8 +/- 0.4 mm, with no differences among the different implant diameters evaluated. Peri-implant soft tissue conditions such as plaque, bleeding, and pocket depth were also satisfactory. All prostheses were functional throughout the observation period, with no fractures of implants, abutments, or screws. Abutment screw (4.5%) or isolated crown loosening (9.8%) for single-tooth restorations requiring recementation, retightening of screws, and adaptation of removable prostheses were the most frequent prosthodontic maintenance needs. Conclusion: The root-shaped implants and the associated prosthetic constructions used in this study showed excellent survival and success rates. Int J Oral Maxillofac Implants 2010;25:357-366. [ABSTRACT FROM AUTHOR]

PURPOSE: This retrospective study assessed implant and prosthodontic treatment outcomes of patients suffering from rheumatic disorders such as rheumatoid arthritis (RA) and connective tissue diseases (CTDs). MATERIALS AND METHODS: This study included 22 patients (all women) suffering from autoimmune rheumatic disorders such as isolated RA (n = 16), RA with concomitant CTDs (n = 5), or isolated CTDs (n = 1). Overall, 89 implants were placed for rehabilitations such as single-tooth replacement (n = 8), fixed partial dentures (n = 14), complete dentures (n = 5), and overdentures (n = 2), and were evaluated after a mean of 42.6 +/- 25.2 months. The cumulative implant survival and success rates and peri-implant conditions (marginal bone loss, pocket depth, Plaque Index, Gingival Index, Bleeding Index, and Calculus Index) were evaluated with a special focus on RA and CTDs. In addition, incidence and type of prosthodontic maintenance were evaluated. RESULTS: A high implant survival rate was noted during follow-up with a cumulative 3-year implant success rate of 96.1%. Patients with RA demonstrated acceptable marginal bone resorption (mean: 2.1 +/- 0.5 mm) and good soft tissue conditions, while CTD patients showed increased bone resorption (mean: 3.1 +/- 0.7 mm). This was especially noted in scleroderma patients, as were major peri-implant soft tissue alterations (Bleeding Index) in patients suffering from Sjogren syndrome. CONCLUSIONS: A high implant and prothodontic success rate can be anticipated even for patients suffering from autoimmune rheumatic disorders such as RA and CTDs. A scrupulous maintenance program that includes optimal oral hygiene could assist in ensuring stable long-term results for CTD patients with more vulnerable soft tissue conditions. Int J Prosthodont 2010;23:22-28. [ABSTRACT FROM AUTHOR]

Purpose: The aim of the present study was to evaluate the prosthodontic maintenance required for mandibular overdentures supported by 4 implants and splinted with either a round bar and resilient overdenture anchorage or a milled bar with rigid anchorage over a 5-year period. Materials and Methods: In a randomized prospective trial, 51 edentulous patients received 4 mandibular interforaminal implants to support an overdenture and maxillary complete dentures. For the implant-supported overdentures (IODs), bar architecture and denture stabilization were chosen randomly; 25 patients received round bars (group 1) and resilient anchorage and 26 patients received milled bars (group 2) and rigid anchorage. The prosthodontic maintenance required for the IODs and opposing dentures were evaluated during a 5-year follow-up period and compared between the 2 retention modalities used for IODs. Results: Forty-six patients (22 in group 1, 24 in group 2) were available for a 5-year follow-up (dropout rate: 9.8%). Prosthodontic maintenance efforts were significantly greater (P < .01) with the round bar design (group 1) than with the overdentures stabilized with milled bars (group 2). In group 1, prosthodontic maintenance efforts were more frequent in the early phase of use (1 to 2 years), as compared with an evenly distributed incidence over the 5-year period with the rigid milled bar system. Major prosthetic complications (IOD remaking, bar fracture) were only seen in cases without metal-reinforced frameworks (group 1). Conclusion: When 4 interforaminal implants are used to anchor mandibular overdentures, the design of the anchorage system will significantly affect prosthodontic maintenance efforts and complication rates. Rigid anchorage using milled bars and a metal-reinforced denture framework required less prosthodontic maintenance, ie, for clip activation/fracture, than resilient denture stabilization using multiple round bars without a rigid denture framework. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to evaluate the use of provisional implants, which can provide patients with provisional fixed partial dentures during the healing time of augmentation procedures and/or during the osseointegration period of definitive implants until delivery of the definitive prosthesis. Materials and Methods: Thirty-one patients were consecutively included in the study. Eighteen patients (group A, primary simultaneous group) were initially treated simultaneously with provisional and definitive implants and provided with 18 interim fixed partial dentures. Thirteen patients (group B) received provisional implants in a staggered procedure. In the first stage of group B patients (augmentation phase), provisional implants were placed to bridge the augmentation phase and for anchoring 13 interim fixed partial dentures. In the second stage (secondary simultaneous group), patients of group B received provisional implants to bridge the osseointegration phase for simultaneously placed definitive implants by further use of 13 interim fixed partial dentures. All patients were followed from provisional implant and definitive implant placement to delivery of the definitive prosthesis. Loss of provisional implants and interim fixed partial dentures was noted, and stability of provisional implants was evaluated using the Periotest device. The procedures of immediate rehabilitation with fixed partial dentures using provisional implants were subjectively rated by patients with regard to satisfaction, treatment period, and acceptance. Results: In 31 patients, 44 provisional fixed partial dentures were supported by 98 provisional implants. No provisional implant loss in group A or group B-second stage was observed. Only 3 (3%) provisional implants were lost in group B-first stage during the augmentation phase. Incidence (90.8% versus 9.2%) and stability (Periotest values: 8.6 +/- 3.9 versus 4.8 +/- 2.7) of provisional implants differed significantly between maxilla and mandible (P < .01). All interim fixed partial dentures (n = 44) remained in place for the intended time period but in 3 cases with provisional implant loss they were shortened. No definitive implant loss (n = 94, survival: 100%) and especially no implant loss in cases of maxillary sinus augmentation was seen. The items rated showed high satisfaction and good acceptance of the intensive surgical and prosthodontic program. Conclusion: This clinical review showed that (1) provisional implants can successfully provide patients with a fixed partial denture for immediate rehabilitation to bridge the osseointegration or augmentation phase, even in cases with an initially compromised bone situation and (2) although treatment is elaborate, the selected patients decided on a fixed interim rehabilitation with provisional implants rather than on a removable solution. [ABSTRACT FROM AUTHOR]

PURPOSE: The aim of the present retrospective investigation was to evaluate implant-supported maxillary overdentures using either anterior (group 1) or posterior (group 2) maxillary implant placement. MATERIAL AND METHODS: Maxillary overdentures were planned with support by either 4 implants placed in the maxillary anterior region (group 1) or 6 to 8 implants placed in augmented maxillary posterior regions (group 2, bilateral sinus augmentation) and anchored either on an anterior or on 2 bilaterally placed milled bars. Cumulative implant survival rate, peri-implant conditions (marginal bone loss, pocket depth, Plaque Index, Gingival Index, Bleeding Index, and Calculus Index) and the incidence and type of prosthodontic maintenance were assessed and compared for the 2 groups. In addition, the cumulative survival rate for implants placed in grafted regions was compared with that of implants placed in nongrafted regions. RESULTS: Thirty-four patients (16 for group 1 and 18 for group 2) with 179 implants were available for follow-up examination after a mean period of 42.1 +/- 20.1 months. Four initially placed implants failed to osseointegrate and were replaced, but no further losses were seen during the loading period, for a 5-year cumulative implant survival rate of 978%. No differences in implant survival rates were seen between either the group-1 (98.4%) and group-2 (97.4%) concepts or nongrafted (98.0%) and grafted (97.5%) implants. The peri-implant parameters showed a healthy soft tissue, good oral hygiene, and an acceptable degree of peri-implant marginal bone loss. The rigid fixation of all overdentures was associated with a low incidence of prosthodontic maintenance, without any significant differences between the 2 groups. CONCLUSIONS: In well-planned overdenture treatment programs, a high survival rate and excellent peri-implant conditions can be achieved for implants placed in the anterior or posterior maxilla. Rigid anchorage of maxillary overdentures either on an extended anterior milled bar or on 2 bilateral posterior milled bars provides for a low incidence of prosthodontic maintenance. [ABSTRACT FROM AUTHOR]

PURPOSE: The aim of this retrospective study was to present the results of implants and natural teeth used as combined abutments to support maxillary telescopic prostheses. MATERIALS AND METHODS: Between 1997 and 2004, 22 patients with residual maxillary teeth underwent prosthodontic rehabilitation with supplementary implant placement of implant-tooth-supported telescopic prostheses. A total of 60 supplementary implants (mean: 2.9 implants; SD: 1.6; range: 1 to 5 per patient) were placed in strategic position and connected with 48 natural abutment teeth (mean: 2.2 teeth; SD: 0.9; range: 1 to 4 per patient) using telescopic crowns. The follow-up registration included implant and natural tooth survival rates and peri-implant and periodontal parameters, along with prosthodontic maintenance. Natural tooth abutments were additionally followed to compare their periodontal parameters at baseline to the follow-up examination. RESULTS: After a mean of 38 months (12 to 108 months) no implants or natural tooth abutments were lost (survival rate: 100%). There was no fracture, endodontic treatment, loss, or intrusion of natural teeth used for telescopic abutments. Implant abutments showed high stability and excellent periimplant soft tissue conditions. Natural tooth abutments used for double crowns also showed uneventful progress. A low rate of prosthodontic maintenance was seen, with implant screw abutment loosening as the most severe complication (3 of 60 implants; 5%). CONCLUSIONS: On the basis of this retrospective clinical review, the following conclusions were drawn: (1) successful function over a prolonged period and a minor complication rate of implant-tooth-supported telescopic maxillary dentures may be anticipated, and (2) the great variety of treatment modalities offered by tooth-implant support for telescopic prostheses appears to be useful as a treatment option for the maxilla in elderly patients. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this retrospective study was to evaluate implant survival rate, peri-implant conditions, and prosthodontic maintenance for implant-supported mandibular overdentures rigidly retained with a milled bar. Materials and Methods: Patients with 4 interforaminal implants (cylindric or screw-type) supporting an overdenture on a milled bar treated between 1996 and 2004 were asked to participate in a retrospective study. The cumulative implant survival rate and peri-implant conditions (marginal bone loss, pocket depth, Plaque Index, Gingival Index, Bleeding Index, and calculus presence) were evaluated and compared between cylindric and screw-type implants. The incidence and type of prosthodontic maintenance and subjective patient satisfaction rating were also evaluated. Results: Fifty-eight of 67 patients (87.3%) and 232 implants (76 cylindric, 156 screw-type) were available for follow-up examination after a mean period of 59.2 ± 26.9 months. The cumulative implant survival rate was 99%, and no differences in peri-implant soft tissue conditions were noted between the different implant types used. The cylindric implants showed more pronounced marginal bone resorption than the screw-type implants (1.9 ± 0.6 mm vs 2.2 ± 0.6 mm; P = .02) but the difference was not clinically significant. A low incidence of prosthodontic maintenance evenly distributed throughout the overall follow-up period and a high subjective satisfaction rating by the patients were noted. Conclusion: Interforaminal screw-type and cylindric implants supporting a milled bar for rigid overdenture anchorage were associated with a high survival rate and excellent peri-implant conditions. The incidence of prosthodontic maintenance was low and evenly distributed throughout the follow-up period as a result of rigid denture stabilization by the milled bar. Rigid anchorage of a mandibular overdenture with a milled bar unites the prosthodontic advantages of removable and fixed prostheses. [ABSTRACT FROM AUTHOR]

PURPOSE: The aim of this study was to evaluate single-tooth implant-supported restorations placed in conjunction with several methods of maxillary sinus augmentation. MATERIALS AND METHODS: A retrospective review was conducted of all consecutively treated patients who received single-implant tooth rehabilitation in combination with sinus augmentation. Implant survival rate and peri-implant conditions, such as marginal bone resorption (mm), pocket depth (mm), Plaque and Bleeding Indices, and Periotest values, were compared for the different augmentation procedures. RESULTS: Fifty-one patients were treated with 54 screw-type single implant-supported restorations in the posterior maxilla in combination with isolated sinus floor augmentation. Depending on the residual ridge height and the intended augmentation height, sinus lift elevation was performed either in a 1-stage lateral approach (25 patients, 28 implants), in a 2-stage lateral approach (12 patients, 12 implants), or with the osteotome technique (14 patients, 14 implants). The predominant use of long implants provided for a favorable implant-crown ratio (> 1.0) and produced an overall clinical survival rate of 100% over the observation period (44.5 +/- 22.7 months), with no differences between the augmentation procedures and implant types used. The most frequent site for single-tooth replacement in combination with sinus floor augmentation was the first molar region (61%). Implants with wider diameters (94% 2 4.3 mm) were used in this region. The most frequent intraoperative complication was tearing of the sinus membrane (58%) as a result of the restricted access for the lateral 1- or 2-stage approach, and the most frequent prosthetic complication was crown loosening. CONCLUSION: On the basis of this retrospective review, the following was observed: (1) Successful function and excellent peri-implant parameters may be anticipated for single implant-supported restorations placed in conjunction with sinus elevation procedures. (2) Clinical and radiographic examinations demonstrated similar conditions for single-tooth restorations despite the use of different surgical approaches to sinus augmentation. (More than 50 references). [ABSTRACT FROM AUTHOR]

PURPOSE: The aim of the present study was to evaluate implant survival, peri-implant conditions, and prosthodontic maintenance requirements for implant-supported mandibular overdentures in atrophic mandibles retained with ball or resilient telescopic crown attachments during a 3-year period. MATERIALS AND METHODS: Twenty-five patients with edentulous mandibles each received 2 Camlog root-form dental implants in the mandibular interforaminal (canine) region. The denture attachment system was chosen randomly; 13 patients received ball attachments and 12 patients received resilient telescopic crowns. Implant survival, implant mobility (Periotest values), and peri-implant conditions such as bone resorption, pocket depth, Plaque Index, Gingiva Index, Bleeding Index, and Calculus Index values were assessed for each implant. In addition, detailed prosthodontic maintenance was evaluated during the follow-up period and the 2 retention modalities were compared. RESULTS: There were no differences in implant survival, implant mobility (Periotest values), and peri-implant conditions between the 2 retention modalities. During the 3-year period significantly more complications/interventions for maintenance purposes were registered in the ball group (62 interventions) than in the telescopic crown group (26 interventions; P < .01). CONCLUSION: The results indicate that both ball attachments and resilient telescopic crowns used on isolated implants in the edentulous mandible are viable treatment options. Implant success and peri-implant conditions did not differ between ball attachments and telescopic crowns used as retention modalities for implant overdentures, but the frequency of technical complications was significantly higher with ball attachments than with resilient telescopic crowns. [ABSTRACT FROM AUTHOR]

PURPOSE: This study evaluated the status of teeth adjacent to single-tooth implants in the anterior and posterior jaw during a follow-up of more than 3 years. MATERIALS AND METHODS: Seventy-eight single-tooth implants and 148 adjacent teeth were followed for a mean of 58 months. Implant survival rate, peri-implant structures, and prosthetic complication rates were evaluated. Crowns and periodontal status of adjacent teeth were compared at crown placement and at the last examination. Horizontal distance from the implant edge to adjacent teeth was calculated and compared for anterior and posterior regions. The influence of approximal crestal bone resorption of the adjacent teeth was calculated using multivariate regression analysis. RESULTS: The clinical findings for implants (one loss), peri-implant structures, and prosthetic complication rates (three crown fractures) were excellent. There was a high proportion of intact adjacent teeth in both anterior and posterior regions at crown placement and at the follow-up examination. No adjacent teeth required extraction or endodontic treatment, and only four required restoration. Comparison of the periodontal status at crown placement and at follow-up revealed no differences for plaque and bleeding indices or for pocket depth of adjacent teeth. There was a significant influence of the horizontal distance on approximal bone loss in the closer distance of the anterior region, but not in the posterior region. CONCLUSION: The crown and periodontal status of teeth adjacent to single-implant restorations was excellent. The approximal bone crest reduction of the adjacent teeth was significantly influenced by the horizontal distance between the implant edge and neighboring tooth. [ABSTRACT FROM AUTHOR]

PURPOSE: This study was intended to provide a report of experience and results with Frialit-2 implants used for single-tooth replacement. MATERIALS AND METHODS: Over a 7-year period (1994-2000), 146 single-tooth implants (84 maxilla, 62 mandible) were placed in 112 patients (67 females, 45 males; 31.2 +/- 16.4 years). The sites included maxillary anterior teeth (n = 38) as well as the mandibular premolars and molars (n = 57). Ninety-three crowns were cemented and 53 crowns were screw mounted (22 with vertical, 31 with horizontal screws) on standard abutments. The follow-up time varied between 3 and 80 months (35.8 +/- 16.5 months). RESULTS: Two implants (1.4%) were lost, 1 during early loading and the other after 6 years. The most frequent prosthetic complication was isolated crown loosening of cemented crowns requiring recementation of 9 crowns (9.9%). Crowns with vertical screws showed no crown and/or screw loosening. Four crowns (2.8%) were replaced because of ceramic fracture. DISCUSSION: Peri-implant soft tissue condition, bone resorption, and Periotest values indicated satisfactory results. The cumulative implant survival rate during the follow-up period was 97.3%, and that of the crowns 96.4% (total cumulative survival rate 93.7%). CONCLUSIONS: With the low number of abutment screw loosenings (3.5%), the deep internal hexagonal retention compared favorably to external retention methods. The predominant use of long implants (98.4% > or = 13 mm) allowed a favorable implant/crown ratio with the potential for problem-free, long-term results. [ABSTRACT FROM AUTHOR]

A variable number of septa, also referred to as Underwood's septa, divide the floor of the maxillary sinus into several recesses and may thus cause various complications during sinus-lift procedures. The incidence of Underwood's septa was evaluated by examining 41 edentulous maxillas. In 13 of these maxillas (31.7% of the cases), sinus floors with at least one septum were observed. Most of the septa were located in the region between the second premolar and the first molar. A possible cause of septal formation could be the variable phases of maxillary sinus pneumatization of the empty alveolar process following tooth extraction. [ABSTRACT FROM AUTHOR]

Removable maxillary prostheses (n = 31) rigidly retained on either a one-piece anteriorly located milled bar fixed on four implants located in the anterior maxillary region (group 1, n = 15) or on two bilaterally placed milled bars fixed on six to eight implants located in the posterior maxillary region (group 2, n = 16) were evaluated for prosthodontic maintenance and the calculated bar-generated supporting area. Comparisons of the incidence of prosthodontic maintenance and the supporting area generated by the bars did not differ between groups. Evident advantages were noted for the anterior concept (group 1) with regards to surgical, technical, and prosthodontic aspects, suggesting a preference for this approach versus the more intricate and complex posterior concept (group 2) under particular circumstances and on appropriate indication. Int J Prosthodont 2009;22:576-578. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate 4 veneer composites-Signum+EM, Gradia Enamel E3, Sinfony E3, and SR Adoro S1-in a standardized test at 2 different conditions. For each composite, 2 groups of specimens (added to cultures immediately after preparation [ie, fresh] or after 7 days of incubation in cell culture medium) were added to L-929 fibroblast cultures for 72 hours. All composites showed reduced cell numbers compared to glass controls. Fresh specimens of Signum+EM exhibited the least cytotoxicity, followed by Gradia Enamel E3 and Sinfony E3 and then SR Adoro S1. For specimens with 7-day incubation, 3 of the composites (Signum+EM, Sinfony E3, and Gradia Enamel E3) showed similarly low cytotoxicity, while cytotoxic results with SR Adoro S1 were significantly higher. With low in vitro toxicity values in conjunction with good mechanical properties, veneer composites appear to offer an interesting alternative for prosthetic rehabilitation. [ABSTRACT FROM AUTHOR]

Copyright of International Journal of Computerized Dentistry is the property of Quintessence Publishing Company Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BACKGROUND: Surgical treatment of mandibular neck fractures is frequently associated with postoperative complications. This study aims at an in-depth analysis of complication rates of surgically treated mandibular neck fractures. METHODS: All treated patients (264 male, 103 female patients, with 429 mandibular neck fractures) of the Vienna University Clinic of Maxillofacial Surgery in the period of 1995 to 2005 with at least 1 mandibular neck fracture were included. RESULTS: Of surgically treated fractures, 94.8% healed successfully after 1 open reduction, 4.4% had 2, and 0.8% had 3 open reductions. Osteosynthesis failure was 11.3% for 1 miniplate, 6.7% for 2 miniplates, and 8.5% for 1 lag screw. Of the surgically treated, 53 (21.3%) had 1 complication, 12 (4.8%) had 2, and 4 (1.6%) had 3 complications. Comparing isolated and mandibular neck fractures combined with other mandibular fractures the risk of suffering osteosynthesis failure is 3.59 in case of isolated (P = .004). CONCLUSIONS: Predominant causes of revision surgery are osteosynthesis failure, pseudarthrosis, and malposition. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the performance and clinical outcome of vertical and horizontal bone augmentation (VHBA) in posterior maxillary regions combining lateral window sinus floor elevation (LWSFE) with a horizontal bone shell technique applying the maxillary facial sinus wall as a bone plate., Materials and Methods: In 18 patients, LWSFE was combined with a horizontal bone shield augmentation procedure utilizing the maxillary facial sinus bone wall as a lateral bone plate. Both the sinus cavity and the lateral bone box created were grafted with a mixture of autogenous bone/venous blood and bovine bone mineral. The primary aim was to assess the performance of combined techniques enabling subsequent implant placement. Using radiographic measurements (preoperative, after VHBA, at implant placement, and at follow-up), bone gain/reduction of augmented horizontal ridge width (HRW) and vertical bone height (VBH) were evaluated. Additionally, clinical outcome assessing implant survival/success rate, marginal bone loss (MBL), and implant health (mucositis/peri-implantitis) was evaluated., Results: For the combined VHBA techniques, HRW and VBH increased significantly (p < 0.001) from preoperative 3.5 ± 1.4 mm/3.6 ± 2.1 mm to 9.7 ± 1.9 mm/18.0 ± 1.6 mm post-augmentation. However, HRW and VBH dimensions decreased up to 8.9 ± 1.8 mm/17.1 ± 1.4 mm at implant placement and 8.6 ± 1.7 mm/16.7 ± 1.3 mm at follow-up evaluation (3.8 ± 1.8 years; p < 0.001, respectively). Augmented bone reduction was significantly higher (-7.7%) between the augmentation procedure and implant placement than in the post-implant-placement period (-2.5%). All implants survived (100%) representing peri-implant MBL of -0.9 ± 0.7 mm, pocket depth of 3.4 + 1.8 mm, and prevalences of 5%/0% for peri-implant mucositis/peri-implantitis., Conclusion: The combination of horizontal bone augmentation using local bone shield transfer from the maxillary facial sinus wall with LWSFE enables sufficient reconstruction of maxillary posterior ridge., (© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Purpose: The aim of the present study was to compare the histomorphometrically evaluated new bone formation (NB), the radiographically measured graft stability, and the clinical implant outcome for maxillary sinus augmentation grafted with deproteinized bovine bone mineral (DBBM) with either small (Bio-Oss-S, Geistlich) or large (Bio-Oss-L, Geistlich) particles., Materials and Methods: Using a split-mouth study design, bilateral maxillary sinus augmentation was performed in 13 patients either with Bio-Oss-S particles (0.25 to 1 mm) or Bio-Oss-L particles (1 to 2 mm). After a healing period of 6 months, bone biopsies were axially retrieved in the molar region for histologic/histomorphometric analysis of NB, including subsequent staged implant placement. To determine graft stability, the maxillary sinus augmentation vertical graft heights were radiographically measured immediately after sinus augmentation, at implant placement, and at the 2- and 4-year post-augmentation follow-ups. In addition, the clinical implant-prosthodontic outcome (survival/ success/marginal bone loss) was assessed at 1 and 3 years post-loading., Results: A total of 22 sinuses from 11 patients with split-mouth evaluation were ultimately available for data and statistical analysis. Histomorphometric analysis of the axially retrieved bone biopsies revealed the presence of NB (S: 25.5% ± 7.0% vs L: 23.6% ± 11.9%; P = .640), residual graft particles (S: 19.6% ± 9.2% vs L: 17.5% ± 6.3%; P = .365) as well as connective tissue (S: 54.9% ± 9.2% vs L: 58.9% ± 12.5%; P = .283), without significant differences between the use of small (Bio-Oss-S) and large (Bio-Oss-L) particles. However, there was significantly (P = .021) higher bone-to-graft contact (BGC) for the small-particle graft sites (27.9% ± 14.8%) compared to the large-particle graft sites (19.9% ± 12.9%), representing a significantly higher osteoconductivity. Both particle sizes showed significant (P < .01) vertical graft height reduction over time (4 years) of about 10%, with predominant graft reduction in the time period between sinus augmentation and implant placement compared to any follow-up periods after implant placement. At the 3-year post-loading implant evaluation, all implants and prostheses survived (100%), and the peri-implant marginal bone loss (S: 0.52 ± 0.19 mm; L: 0.48 ± 0.15 mm) as well as the peri-implant health conditions (S: 87.5%, L:81.2%) did not differ between implants inserted with the two different xenograft particles used., Conclusions: The use of small and large bovine xenograft particles for maxillary sinus augmentation provides for comparable bone formation, ensuring stable graft dimensions combined with high implant success and healthy peri-implant conditions. However, small particle size resulted in a higher BGC, providing for higher osteoconductivity than with the larger particle size.

Objective: The present study aimed to compare histomorphometrically evaluated new bone formation, radiographically measured graft stability, and clinical implant outcome between maxillary sinus grafting with either deproteinized porcine bone mineral (DPBM) or deproteinized bovine bone mineral (DBBM)., Materials and Methods: Thirty maxillary sinuses were initially included and randomly assigned to the test group (TG; DPBM, n = 15) or control group (CG; DBBM, n = 15). After a healing period (6 months), axially retrieved bone biopsies of the molar region were used for histological/histomorphometric analysis of new bone formations. Additionally, radiographically measured graft stability and clinical implant outcome were assessed., Results: Twenty-three sinus sites with 10 sinuses of the TG and 13 of the CG were ultimately available for data and statistical analysis. In the TG, a slightly, but yet significantly (p = .040) higher proportion of new bone formation (TG: 27.7 ± 5.6% vs. CG: 22.9 ± 5.1%) and a lesser (p = .019) amount of connective (non-mineralized) tissue (TG: 47.5 ± 9.5% vs. CG: 56.1 ± 9.5%) was found than in the CG. However, both xenografts showed comparable (n.s.) residual bone graft (TG: 23.7 ± 7.2% vs. CG: 21.1 ± 9.85.6%), bone-to-graft contacts (TG: 26.2 ± 9.8% vs. CG: 30.8 ± 13.8%), similar graft height reduction over time (TG: 12.9 ± 6.7% CG: 12.4 ± 5.8%) and implant survival/success rate (100%). At the 3-year post-loading evaluation, the peri-implant marginal bone loss (TG: 0.52 ± 0.19 mm; CG: 0.48 ± 0.15 mm) and the peri-implant health conditions (TG: 87.5%/CG: 81.2%) did not differ between implants inserted in both xenografts used., Conclusions: The use of DPBM or DBBM for maxillary sinus augmentation is associated with comparable bone formation providing stable graft dimension combined with healthy peri-implant conditions., (© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objective: Several extrusion techniques have been described to restore teeth with insufficient coronal tooth structure and to avoid their extraction. Still, there is little evidence for a treatment concept combining surgical extrusion using an atraumatic axial extraction system., Materials and Methods: A total of nine patients, each with an iso- or subgingival fractured tooth, were retrospectively examined. Treatment of the damaged tooth comprised an atraumatic forced surgical extrusion performed with an axial tooth extraction system and a more coronal positioning within the socket. The teeth were initially splinted and subsequently restored. The follow-up period was up to 57.1 months and averaged 36.5 (SD: ±13.5) months., Results: All nine teeth were still in situ, without signs of inflammation. During the period of the provisional restoration, six prosthetic complications occurred, which were resolved with little effort, whereas, success rate for the definitive restoration was 100%. No biological complications were observed concerning the root apex or soft tissue. The radiographically measured mean extrusion distance was 3.4 (SD: ±1.0) mm, so that a sufficient prosthetic ferrule could be reestablished., Conclusions: Surgical extrusions using an axial tooth extraction system demonstrate low biological and prosthetic complications rates over observation time., Clinical Significance: The presented extrusion approach preserves soft and hard tissue and is an efficient treatment option for severely destroyed teeth. Saving hopeless teeth by this relatively predictable and feasible procedure has hardly any disadvantages for patients, and in case of failure, an implant or fixed partial denture are still an option., (© 2023 The Authors. Journal of Esthetic and Restorative Dentistry published by Wiley Periodicals LLC.)

Objectives: To evaluate the clinical outcome for implants placed with transsinusoidal-lateral nasal cavity augmentation (NA) compared to implants placed in maxillary sinus augmentation (SA)., Materials and Methods: In 28 atrophic edentulous maxillary regions (14 patients bi-maxillary), a lateral window approach was used to perform transsinusoidal-lateral NA (TSLNA) combined with maxillary SA. After healing period of about 6 months, each patient received bimaxillary one anterior implant located in the pre-maxilla having lateral NA and 2-3 implants in the maxillary posterior region with SA. In a prospective follow-up evaluation, clinical implant outcome (survival/success rates) and peri-implant health (mucositis/peri-implantitis) were assessed and compared between implants placed in TSLNA (n = 28) and SA (n = 58)., Results: At the year-1, year-3, and year-5 evaluation, neither patient-based nor implant-based comparisons revealed differences for marginal bone level reduction between implants placed in TSLNA (5-year overall: 1.11 ± 0.26 mm) and SA (5-year overall: 1.07 ± 0.30 mm), although with a significant (p < .001) continuous reduction over the observation time. At the year-5 evaluation, all implants (n = 86) and restorations (n = 14) were still in situ (survival 100%) and showed an implant-based incidence of peri-implant mucositis/peri-implantitis of 14.3%/0% in TSLNA and 6.9%/3.4% in SA corresponding to 21.4%/0% and 28.6%/7.1% for implant-based evaluation. In addition, the implant success rate did not differ between NA and SA at implant- (100%/ 98.8%) and patient-based (100%/97.6%) evaluation., Conclusion: The findings obtained show TSLNA as an effective method for implant placement of adequate length and direction in the atrophic premaxilla providing for success rates comparable to those of implants placed in SA., (© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Purpose: To evaluate the efficacy of split-thickness labial eversion periosteoplasty (EPP) for soft tissue closure in horizontal ridge augmentation of posterior mandibular regions using a bone shell onlay grafting technique. Materials and Methods: Sixteen patients (12 female and 4 male; mean age: 46.2 ± 8.7 years) with 18 horizontal bone defects in posterior mandibular regions were included for lateral onlay bone grafting using the bone shell technique. After lateral bone augmentation, the EPP was used for soft tissue closure and was prospectively followed up for wound healing efficacy using a modified scoring index. The scoring index included dichotomous (yes: 0 / no: 1) evaluation of the following items: (1) bleeding on palpation or spontaneously, (2) tissue color difference, (3) presence of hematoma, (4) presence of granulation tissue, (5) incomplete incision margin closure, (6) dehiscence with visible augmentation material, (7) presence of exudation, and (8) presence of suppuration. In addition, a visual analog scale (VAS) was used to quantify and record the amount of pain and swelling (0 = no pain/swelling and 5 = severe pain/swelling); VAS scores of 0, 1, and 2 were rated as 1 in the dichotomous scoring index, and VAS scores of 3, 4, and 5 were rated as 0. A summarized wound healing score consisting of all 10 items was assessed at days 2, 7, and 14 and at months 1 and 4 postoperatively, including a comparison of the follow-up evaluations. Results: The summarized healing score increased significantly ( P < .01) between day 2 (score: 6.6 ± 1.1) and day 7 (score: 8.9 ± 1.0) but showed little difference between day 14 (score: 9.6 ± 0.6) and the 1- and 4-month follow-ups (score: 10.0 ± 0). There was no wound dehiscence and no incomplete incision margin adaptation. For the individual parameters evaluated, bleeding on palpation, hematoma, and exudation were the most frequent side effects at day 2 at 50%, 100%, and 22.2%, respectively, and at day 7 at 16.7%, 55.6%, and 22.2%, respectively. The average pain score and the swelling/edema score were initially 4.0 ± 0 and 3.0 ± 0.77 on day 2, with a significant decrease ( P < .001) by day 7 (pain: 2.0 ± 0; edema/swelling: 2.0 ± 0.59) and day 14 (pain: 1.0 ± 0.42; edema/swelling: 2.0 ± 0.79) and complete absence (score: 0) at months 1 and 4. Conclusions: Labial split-thickness EPP facilitates flap advancement and enables tight soft tissue coverage in large horizontal posterior mandibular bone augmentations as a result of offset double-layer wound closure. Although this procedure is shown to be surgically demanding, the postoperative complication rate may be reduced significantly.

Objectives: The primary aim was to evaluate the success of the defect closure (tight or open) of oroantral communications (OAC) after treatment with platelet-rich fibrin (PRF) clots or a buccal advancement flap (BAF). Secondary outcome measurements were the evaluation of the wound healing, the displacement of the mucogingival border (MGB), and the pain level., Material and Methods: Fifty eligible patients with an OAC defect larger than 3 mm were randomly assigned to either PRF (test group, n = 25) or BAF (control group, n = 25) for defect closure. In a prospective follow-up program of 21 days, the defect closure healing process, the wound healing course using Landry's wound healing index (score: 0-5), the displacement of the MGB, and the postoperative pain score were evaluated., Results: Five patients in each group were lost to follow-up resulting in 40 patients (20 in each group) for continuous evaluation. On postoperative day 21 (study endpoint), no difference regarding success rate (defined as closure of OAC) was noticed between the test (90%; 18/20) and control group (90%; 18/20). A univariate analysis showed significant differences for age and defect size/height for the use of PRF between successful-tight and open-failed defect healing. At the final evaluation, a significantly (p = 0.005) better wound healing score, a lower displacement of the MGB as well as lower pain-score were seen for the use of PRF., Conclusions: Based on the findings of the current study, the use of platelet-rich fibrin represents a reliable and successful method for closure of oroantral communications. The use of PRF clots for defect filling is associated with lowered pain levels and less displacement of the mucogingival border., Clinical Relevance: The defect size should be taken into account when choosing the number and size of PRF plugs., (© 2023. The Author(s).)

Objectives: To evaluate the peri-implant marginal bone level for immediately loaded implants placed simultaneously in both fresh extraction sites (FES) and healed sites (HS) supporting a 4-implant supported mandibular fixed prosthesis (4-ISFMP) using the all-on-4 concept., Material and Methods: A 5-year prospective study was conducted in 24 patients (96 implants) treated with 4-ISFMP including 55 implants inserted in FES and 41 implants in HS. At implant placement (baseline) and at the 1 st -, 3 rd - and 5 th -year follow-up examinations, peri-implant marginal bone level was evaluated radiographically and compared between placement in FES and HS. Marginal bone loss was calculated as the difference in the marginal bone level evaluated at the follow-up periods. Additionally, implant and prosthesis survival rates as well as the presence of peri-implant mucositis (bleeding on probing+[BOP]) and peri-implantitis (BOP+ >2 mm MBL) were evaluated., Results: 22/24 patients with 88/96 implants (dropout rate: 8.3%) were continually followed for 5 years (survival rate: 100%). Radiographically measured marginal bone level differed significantly between FES and HS at implant placement (1.46 ± 0.80 mm vs. 0.60 ± 0.70 mm; p < .001), at the 1-year (-0.04 ± 0.14 mm vs. -0.18 ± 0.20 mm; p = .002) and 3-year (-0.26 ± 0.49 mm vs. -0.58 ± 0.48 mm, p = .049), but not at the 5-year evaluation (-0.90 ± 0.66 mm vs. -1.00 ± 0.59 mm, p = .361). The marginal bone loss differed significantly (p < .001) between FES and HS between implant placement and the 1-year evaluation but not for the 1- to 3-year (p > .99) and the 3- to 5-year period (p = .082). At the 5-year follow-up evaluation, no implant/prosthesis failed (100% survival) and peri-implant mucositis and peri-implantitis were noted in 41.2% and 11.7% at patient level and in 17.6% and 4.5% at implant level respectively., Conclusion: Implants placed in FES showed a prolonged peri-implant remodelling process but provided for similar peri-implant marginal bone levels as implants placed in HS at the 5-year evaluation for immediately loaded 4-ISFMP., (© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Maxillary sinus membrane perforation (SMP) during lateral window sinus floor elevation (SFE) might be associated with postoperative complications (PC)., Objectives: To evaluate the prevalence of PC and clinical implant outcome for different forms of SMP with lateral window SFE., Material and Methods: The prevalence of PC such as maxillary sinusitis, graft necrosis and wound infection was retrospectively evaluated for 434 lateral window SFE (334 patients) with 331 SFE (241 patients) without and 103 SFE (93 patients) with SMP. SMP was additionally classified into four subgroups regarding to membrane perforation size (small-moderate [<10 mm] vs. large [>10 mm]) and membrane biotype ([BT] thin vs. thick). Additionally, patient- and surgery-related risk factors affecting PC and the 1-year implant survival rate were evaluated for SFE without and with SMP and subgroups., Results: A significantly higher prevalence including significant odds ratios of PC such as maxillary sinusitis (10/103 [9.7%] vs. 4/331 [1.2%]; p < 0.021; OR: 8.85; p < 0.021) and graft necrosis (7/103[6.8%] vs. 1/103[0.3%]; p < 0.017; OR:7.43; p < 0.017) was found for SFE with than without SMP. The SMP subgroup with large size and thin BT involved significantly (p < 0.005) more PC (15/20[75%]) than all other SMP subgroups (5/20[25%]). For the risk factors evaluated the univariate analysis demonstrated differences of PC for the presence versus absence of SMP (p < 0.001) and for thin versus thick sinus mucosa (p < 0.038; p < 0.006) but not for sex, smoking, sinus septa and surgical stage. In the multivariate risk factors analysis, PC were significantly related to risk factors such as large size with thin BT (OR:18.049; p < 0.007). The 1-year implant survival rate did not differ between SFE without (99.5%) and with SMP (99.1%), regardless of successfully repaired subtype of SMP., Conclusion: The synopsis of perforation size and membrane biotype is crucial in differentiating different forms of SMP assessing and anticipating different prevalences of PC in lateral window SFE., (© 2021 Wiley Periodicals LLC.)

Objectives: To evaluate prevalences, affecting risk factors and efforts for repair mechanism for different forms of sinus membrane perforations (SMP) during sinus floor elevation (SFE) using the lateral window technique (LWT)., Material and Methods: For 334/434 patients, SFE undergoing LWT prevalence of SMP was retrospectively evaluated including a subselection based on membrane perforation size (<10 mm: small-moderate/≥10 mm: large) and biotype (BT; thick BT/thin BT) into four subgroups (SMP1: thick BT/small-moderate; SMP2: thin BT/small-moderate; SMP3: thick BT/large; SMP4: thin BT/large). For the various subgroups, patient- and surgery-related/anatomic risk factors affecting SMP were evaluated and the scope of sinus membrane repair (SSMR) mechanisms rated with 1 (easy) to 5 (complex) was compared., Results: For 103/434 SMP (27.6%) in 93/334 patients (30.8%) the prevalence of various forms of SMP differed significantly (p < 0.001) among the four subgroups. SMP4 with a prevalence of 45.6% (n = 47) was the most frequent type, while SMP3 had low prevalence with 4.85% (n = 5). Small/moderate SMPs with thick (SMP1: n = 26) or thin BT (SMP2: n = 23) were seen in 26.2% and 23.3%, respectively. Univariate analysis showed significant differences between subgroups with large perforations (SMP3/SMP4) and those with small/moderate perforations (SMP1/SMP2) regarding anatomic risk factors such as residual ridge height (p = 0.023) and history of previous oral surgical interventions (OSI; p = 0.026). Most evidently, multivariate analysis showed that induction of large SMP with thin biotype (SMP4) was significantly affected by the presence of sinus septa (p < 0.022, OR: 2.415), reduced residual ridge height (p < 0.001, OR: 1.842), and previous OSI (p < 0.001, OR: 4.545). SSMR differed significantly (p < 0.001) between SMP4 (4.62 ± 0.49) and the subgroups SMP1 (1.11 ± 0.32), SMP2 (1.08 ± 028), and SMP3 (2.2 ± 0.55)., Conclusion: The most frequently found type of SMP had characteristics of thin biotype and large size associated with risk factors such as sinus septa, reduced residual ridge, and previous surgical interventions and required challenging repair mechanisms assessing clinical impact., (© 2021 Wiley Periodicals LLC.)

Purpose The aim of this study was to evaluate the stability of single crowns and 3-unit bridges in relation to the implant-abutment complex with and without tube in tube connection.Methods 60 specimens with a total of 90 implants (diameter 3.8 mm) were fabricated and distributed into 4 groups: CST (Crown with short tube), CLT (crown with long tube), BNT (Bridge without tube) and BLT (bridge with long tube). All superstructures consisted of one-piece hybrid abutment restorations out of monolithic zirconia, bonded on prefabricated titanium bases and were directly screwed into the implants. Specimen underwent artificial aging (2.000.000 cycles, 120 N, 30° off axis) and were subsequently loaded in an universal testing machine at an angle of 30° until failure. The specimens were examined for damage during and after artificial aging.Results During artificial aging, one test specimen of group CLT and two test specimens of group BNT failed. The average failure load was 498.8 (± 34.4) N for CLT, 418.8 (± 41.5) N for CST, 933.1 (± 26.2) N for BLT and 634.4 (± 29.0) N for BNT, with a statistical differences (p ˂ 0.001) between the crown and bridge groups. All tested samples exhibited macroscopic deformations at the implant shoulder, which were more pronounced in the specimens without a tube in tube connection.Conclusions Single crowns and 3-unit bridges with a long tube in tube connection showed significantly higher fatigue fracture strength compared to restorations with short or without tube in tube connection.

Objective: To evaluate the clinical, functional and aesthetic outcomes for radial forearm free flap (RFFF) donor sites covered with amniotic membrane (AM)., Material and Methods: The healing process of patients with RFFF donor sites covered with AM was prospectively followed for 1 year. Additionally at the 12-month evaluation, objective scoring systems were used to assess the aesthetic (Vancouver scar scale, VSS: range 1-13) and functional outcome (skin sensibility, hand/wrist functionality [goniometer], grip strength [score 1 = excellent, 5 = poor]). By using a subjective rating system (score 1 = excellent, 5 = poor), the patient-reported aesthetic and functionality outcome was correlated with objective data analysis., Results: Twenty-one out of 23 patients were followed for 12 months (dropout: 2 patients at 3 months). In 17/23 (73.9%) patients RFFF defect covered with AM showed an uneventful healing period (< 3 months). Prolonged healing periods (> 3 months < 6) for 6 patients (26.1%) were attributed to wound infections (4×), seroma (1×) and inflammation (1×). At the 1-year evaluation, there was a significant (p < 0.01) correlation between subjective (2.0 ± 0.71) and objective aesthetic scores (VVS 3.74 ± 2.18), and a successful grip strength (score 1.67 ± 0.86); however, thumb hyposensibility in 76.2% was seen. A high body mass index (BMI) was in conjunction with a negative (p = 0.012) and the use of antihypertensive medications provided positive effects (p = 0.041) on the aesthetic outcome., Conclusion: RFFF donor site defects covered using AM show excellent clinical, aesthetic and functional outcome representing patient comorbidities (BMI, antihypertensive drugs) might affect the aesthetic outcome., Clinical Relevance: In relation to the excellent outcomes found, the use of AM offers an alternative treatment procedure for RFFF defect covering.

Purpose: To analyze risk factors affecting sinus membrane perforation (SMP) during sinus floor elevation (SFE) procedures using the lateral window technique (LWT)., Materials and Methods: For patients with SFEs using the LWT, patient-related risk factors (age/sex/smoking/diabetes) and surgical-anatomical-related risk factors (stage approach/sinus side/residual ridge height/sinus membrane thickness/previous surgical interventions) were compared between perforated and nonperforated sites and were evaluated for their influence affecting SMP. Additionally, SMPs were further subdivided into small/moderate (< 10 mm) or large (≥ 10 mm) in dimension, which were also analyzed for risk factors and consecutively for their influence on perforation., Results: The study sample comprised 434 SFE procedures in 355 patients; 94/355 patients (26.5%) presented SMP in 103 of 434 SFE procedures (23.8%). SFE procedures with (n = 103) and without (n = 331) SMP did not differ for patient-related risk factors but differed significantly (P = .001) for surgical-anatomical factors as follows: residual ridge height (3.05 ± 1.35 mm vs 4.15 ± 1.46 mm), sinus membrane thickness (1.2 ± 0.5 mm vs 2.6 ± 1.1 mm), prevalence of staged procedures (78.6% vs 57.7%), presence of maxillary sinus septa (75.7% vs 14.2%), presence of thin (< 1.5 mm) mucosa biotype (62.1% vs 29%), and previous oral surgical interventions (37.9% vs 16.3%). In the multivariate analysis, significant associations of SMP were found with the presence of sinus septa (odds ratio [OR] = 31.992; P = .001), residual ridge height (OR = 1.563; P = .007), sinus membrane thickness (OR = 1.057; P = .001), presence of thin (< 1.5 mm) sinus biotype (OR = 8.883; P = .001), previous surgical interventions (OR = 4.689; P = .002), and smoking habits (OR = 2.238; P = .030). For inducing a large (≥ 10 mm) SMP, the presence of thin sinus membrane thickness/thin sinus membrane biotype (OR = 5.319; P = .006; OR = 22.222; P = .001) and reduced alveolar ridge height (OR = 0.629; P = .026) were assessed as being significant risk factors., Conclusion: In general, the presence of sinus septa, thin sinus mucosa, staged procedures, and previous surgical interventions are the main risk factors inducing SMP for SFE using the LWT. In particular, the presence of thin sinus membrane in conjunction with a staged procedure significantly increases the risk for a large SMP.

Objectives: To measure the abutment rotation and fracture load of two-piece zirconia implants screwed with three different abutment screw materials., Material and Methods: Thirty-six zirconia implants with 36 zirconia abutments were distributed into 3 test groups: group G connected with gold screws, group T with titanium screws, and group P with peek screws. In the first part of the study, the rotation angle of the abutments was measured. The second part of the study measured the maximum fracture force of adhesively bonded lithium disilicate crowns after artificial aging and fracture modes were reported., Results: In group G, the median rotation angle was 8.0°, in group T 11.6°, and in group P 9.5°. After artificial aging, no screw loosening, crown, abutment, or implant fracture occurred. The median fracture force in group G was 250 N, in group T 263 N, and in group P 196 N., Conclusions: Rotation angles and fracture loads of two-piece zirconia implants with gold, titanium, or peek screws showed no significant differences; however, fracture loads showed inferior results for group P., Clinical Relevance: The indication for the material peek as an abutment screw is still questionable and should be considered carefully.