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This technical note aims to present a recently developed computer-guided protocol characterized by titanium-reinforced stackable surgical guides during post-extractive implant placement and subsequent immediate loading. A full maxillary edentulism was rehabilitated with one-piece implants, starting from a pre-existing removable denture. 3D digital scans of the removable denture and upper and lower arches were performed. On this basis, a prototype with ideal esthetic and functional outcomes was realized and replicated into a custom-made radiological stent with markers. The superimposition of STL and DICOM files allowed virtual planning of one-piece implants in the ideal prosthetically driven position. The stackable guides, composed of a fixed base template and additional removable components, were then realized. The fixed template, initially secured with anchor pins to the bone, was no longer removed. The removable components, which were screwed to the base template, were used to perform implant surgery and immediate prosthetic loading. No surgical complications occurred, the implants achieved a minimum insertion torque of 35 Ncm, and immediate prosthetic loading was performed. The base template allowed for the maintenance of a fixed reference during the entire workflow, improving the transition between the digital project, the surgical procedure, and the prosthetic rehabilitation.

To ensure single dental implant stability, there are some approaches. The stabilization of a single-piece implant by welding it to a titanium needle allows immediate loading and promotes the final osseointegration. The aim of this case report study was an evaluation of long-term clinical outcomes of immediate loading in cases with bone atrophy in the canine region by welding single implant to a titanium needle. In two cases with maxillary atrophic anterior bone, single-piece titanium implants were used. As support structure, a Scialom-type stabilization titanium needle was used (diameter 1.2 mm and suitable length to obtain a bicortical positioning). These two elements were joined together using a Mondani intraoral welder. The implants immediately loaded by temporary restorations. The cases were followed for 24 years, and clinical outcomes were assessed. The use of this method, in the cases with maxillary atrophic anterior bone, allows immediate loading with a fixed acrylic prosthesis at the end of the surgical session. Clinical outcome was successful for 24 years. This approach is a successful method that allows immediate loading in atrophic bone.

Purpose: This study was conducted to investigate one-piece narrow-diameter implants installed in maxillary lateral and mandibular incisor sites using immediate nonfunctional loading. Materials and Methods: In this 10-year clinical trial study, 42 narrow-diameter (3.0-mm) one-piece implants for 35 patients were inserted. Clinical and radiographic measurements were recorded in 10 years and analyzed statistically using t test. Results: A total of 26 patients (20 females and 6 males) with 30 implants were available for the 10-year follow-up. The 10-year implant survival rate was 100%. A statistically significant mean marginal bone loss was observed between 12 months and 10 years (0.18 ± 0.29 mm). The mean pocket depth increase was statistically significant (0.68 ± 0.83 mm). No bleeding on probing was observed around 90% of the implants. Full-mouth plaque index was registered at 20% of the implants. Conclusion: The results obtained in this analysis suggest that modest marginal bone loss was observed around the implants. One-piece narrow-diameter implants (Maximus 3.0; BioHorizons) can predictably restore missing maxillary lateral incisors and mandibular incisors in cases of careful patient selection. [ABSTRACT FROM AUTHOR]

Dental implants are supposed to be clean, when delivered in a sterile packaging. Implant surface pollution with organic particles and/or major inorganic residues originating from the production process are suspected to cause insufficient or missing osseointegration of dental implants. Unintended micrometer-scale particles may induce a foreign body reaction with a loss of bone in the early stages of osseointegration. In cooperation with the University of Cologne and the Charité University Medicine Berlin the Medical Materials Research Institute Berlin analyzed the quality of dental implants in three consecutive studies since 2008 [1, 2]. In 2015 extensive material contrast images were obtained and qualitative and quantitative elemental analyses were performed on 135 dental implants using the same study protocol. Results of the recent study and comparison with previous analyses showed an increasing spread of quality in the market. Dental implants are an integral part of the therapeutic armamentarium of contemporary dental practices. With their excellent success rates, they have become the globally established treatment alternative to purely prosthetic solutions for tooth loss. And with the variety of implant systems offered, it has become ever more difficult for the dentist to choose just the right system for his or her practice and patients. Specific surface topographies, material properties that promote osseointegration or surface treatments are often emphasized in advertising as significant advantages to distinguish a given system from its many competitors

Background: One-piece implants (OPIs) incorporate the trans-mucosal abutment facing the soft tissues as an integral part of the implant. OPIs are usually welded together and loaded immediately. Since no report focuses specifically on OPIs inserted in cuspid sites, a retrospective study is performed. Materials and Methods: Nineteen patients (10 females and 9 males) with a median age of 62 years (range, 43-80) were admitted at the Dental Clinic, University of Chieti (Italy), for evaluation and implant treatment, by one surgeon between January and December 2010. Results: In our series, the survival rate (SVR) and success rate (SCR) were 96.8% and 100%, respectively. Statistical analysis demonstrated that no studied variable had an impact on the survival (i.e., lost implants) and clinical success (i.e., crestal bone resorption). Conclusion: OPIs are reliable devices for oral rehabilitation in the cuspid sites.

Background : One-piece implants (OPIs) incorporate the trans-mucosal abutment facing the soft tissues as an integral part of the implant. Since OPIs become more and more popular and no report specifically focuses on OPIs inserted in incisors′ area, a retrospective study is performed. Materials and Methods: Fifty-five OPIs were inserted in incisors′ area in a series of patients admitted at the Dental Clinic, University of Chieti (Italy), for evaluation and implant treatment between January and December 2010. Results: In our study, the survival rate and success rate were 96.2% and 96.1%, respectively. Statistical analysis demonstrated that no studied variable had an impact on the survival (i.e., lost implants) and clinical success (i.e., crestal bone resorption). Conclusions: OPIs are reliable devices for oral rehabilitation in the incisors′ area.

It is understood that one-piece implant design is a stronger concept as there is no connection between implant and abutment. The absence of a microgap can lead to minimal peri-implant bone loss. Furthermore, there is a reduction of mechanical complications such as screw loosening and abutment fractures. These implants can be immediately placed and can be put through instant function because of their high cortical stabilization. This immediate function protocol has advantages over two-stage surgical placement. Other benefits are fewer surgical appointments, reduced treatment time, and minimal trauma. It is suggested that one-piece implant can be an alternative to conventional implants for edentulous arches where there is a resorbed bone in width and height. Initially, one-piece implants were used as transitional or provisional implants. However, because of biological osseointegration, their removal often became difficult. Several manufacturers obtained approval for its use in defined situations. Proper treatment planning avoided comorbidity associated with augmentation procedures and acceptable esthetic result was achieved., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 National Journal of Maxillofacial Surgery.)

Dental implant treatment and immediate loading protocol in the front maxillae provides severe esthetical difficulties, for example in cases where the transition zone of the patients' teeth and the gums is visible during habitual movements of the upper lip or when the patient presents excessive gingival display. In this case report, it is shown in detail how to overcome the esthetic problems in a straightforward manner in such clinical situations. The article also discusses in which financial environments treatments on teeth are endlessly continued and under which conditions patients manage to get (and prefer) an early switch to implant borne teeth., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Annals of Maxillofacial Surgery.)

Purpose: To analyze the impact of microthreads on the stresses generated in peri-implant bone surrounding reduced-diameter zirconia and titanium implants under loading., Materials and Methods: Two custom-made zirconia implants, microthreaded or smooth neck, and two titanium replicas were made. Strains were recorded in the peri-implant region under 200-N vertical load. Two three-dimensional finite element models were created. Zirconia and titanium implants were tested under 200-N vertical load and 150-N oblique load at 30, 45, and 60 degrees., Results: The lowest peri-implant strain (40 ± 6 με) under vertical load was related to the microthreaded zirconia implant. Oblique load showed higher von Mises stress on bone in comparison with vertical load. The von Mises stress increased by increasing the load angle by approximately 2 MPa per degree. Under oblique load, implants showed more stress in peri-implant bone and the implant itself. On the other hand, total strains were within physiologic limits in all tested cases., Conclusion: Stresses within the peri-implant cortical bone around the reduced-diameter implant with microthreads appeared to be superior compared with the smooth-neck one. Reduced-diameter zirconia implants induced less stress on bone in comparison with the titanium implants, suggesting that zirconia is a feasible alternative for titanium.

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The popularity of one-piece implants has increased considerably between patients and dentists. The advantages of one-piece immediate loading for rehabilitation of edentulous mandibles are to reduce the number of interventions and timing of prosthetic. These parameters can be better controlled with a one-piece implant. Twenty-one patients with one-piece implants inserted in totally edentulous mandibles were considered for this retrospective study. Inclusion criteria were: Good oral hygiene, absence of lesions of the oral mucosa, no smoking or smoking less than 20 cigarettes a day, drinking less than 2 glasses of wine a day, good general health no pregnancy. Twenty-one (12 female 9 males) patients were enrolled in this retrospective study. The mean follow-up was 1 year. A total 84 one-piece implants (Biohorizon, Italy) were inserted in edentulous mandible. Implants diameter was 3,0 mm in all fixtures. Implant's length was equal and longer than 12 mm in 44 and 40 fixtures respectively. 48 were inserted in females 36 in males (range 33-67; mean age 58,3). One-piece immediate loading implants has non-difference in survival rate respect to two-piece implant and delayed loading for rehabilitation of totally edentulous mandibles. In conclusion one-piece immediate loading implant is a reliable device for mandible rehabilitation., (Copyright 2019 Biolife Sas. www.biolifesas.org.)

Novel one-piece implants with concave smooth neck have been introduced to promote the formation of a thick mucosal layer and preserve marginal bone. A retrospective study on 70 patients with 1- to 6-year follow-up was carried out. Cumulative survival rates were assessed. Variations of marginal bone level were measured on periapical radiographs as distance of the implant-abutment junction from the bone crest. Influence of different variables on treatment outcome was evaluated. Cumulative success rate after 6 years was 99.4 % at implant level and 98.6 % at patient level. Marginal bone level changed in a significant way over time. After 4 months, an increase of radiographic bone level of 0.173 ± 1.088 mm at implant level and 0.18 ± 1.019 mm at patient level was recorded. Mean marginal bone loss after 5 years was 0.573 ± 0.966 mm at implant level and 0.783 ± 1.213 mm at patient level. Age, sex, smoking habits, implant sites, implant lengths and diameters, prosthetic retentions, and timing of loading did not influence marginal bone remodeling in a statistically significant way. At 4-year follow-up partial restorations lost a mean of 0.96 mm of more marginal bone compared with single restorations. This difference was statistically significant. [ABSTRACT FROM AUTHOR]

To ensure single dental implant stability, there are some approaches. The stabilization of a single-piece implant by welding it to a titanium needle allows immediate loading and promotes the final osseointegration. The aim of this case report study was an evaluation of long-term clinical outcomes of immediate loading in cases with bone atrophy in the canine region by welding single implant to a titanium needle. In two cases with maxillary atrophic anterior bone, single-piece titanium implants were used. As support structure, a Scialom-type stabilization titanium needle was used (diameter 1.2 mm and suitable length to obtain a bicortical positioning). These two elements were joined together using a Mondani intraoral welder. The implants immediately loaded by temporary restorations. The cases were followed for 24 years, and clinical outcomes were assessed. The use of this method, in the cases with maxillary atrophic anterior bone, allows immediate loading with a fixed acrylic prosthesis at the end of the surgical session. Clinical outcome was successful for 24 years. This approach is a successful method that allows immediate loading in atrophic bone., Competing Interests: The authors of this manuscript declare that they have no conflicts of interest, real or perceived, financial or nonfinancial in this article.

Today, clinicians have a variety of treatment modalities available to address the increasing number of implant procedures performed each year. Single-stage implant surgery is now commonly used in implant dentistry. With patients' demands for immediate restoration, the utilization of 1-piece implants is gaining acceptance. This article reports the results of tapered 1-piece implants (Zimmer Biomet) placed in a single practice over a 10-year period. A total of 33 1-piece dental implants were placed in 24 patients and provisionally restored out of occlusion at the time of surgery. All 33 implants were definitively restored with ceramometal crowns after 3 months of provisionalization. Implant survival and success rates were 100% after 2.6-10 years of follow-up. Only 1 minor complication of crestal bone remodeling occurred among the 33 implants placed. Adequately stabilized tapered 1-piece implants can be successfully restored out of occlusion at the time of implant placement and definitively loaded in occlusion 3 months without adversely affecting function or esthetics. Additional long-term controlled studies are recommended to further understand these findings.

Objective: To assess clinical survival and success rates of one-piece implants placed at the time of tooth extraction with immediate provisionalization and to evaluate radiographic peri-implant bone loss around one-piece implants 1 year after functional loading. Method and Materials: Forty-six patients (20 men and 26 women) with a mean age of 45.5 years (range, 24 to 74 years) were recruited from four centers for this case series report. Immediately following the extraction of untreatable teeth, all patients received one-piece implants. The implants were immediately restored and placed into function with no occlusal contact. Outcome assessments included clinical and radiographic evaluations. Results: Of the one-piece implants placed after extraction in the maxilla and mandible, 95.7% integrated successfully. The mean marginal bone loss after 1 year was 0.80 mm (SD, 0.53 mm). Overall peri-implant bone loss at maxillary sites was compared with overall bone loss at mandibular sites. At the 1-year follow-up, no statistically significant difference was found. The deeper the implants were placed below the crest, the more marginal bone loss was observed. However, no difference in marginal bone loss was observed as a consequence of the following three variables: implant length (10, 11.5, or 13 mm), implant diameter (3, 3.7, or 4.7 mm); and 3- and 6-month time periods after implant prosthesis placement. Conclusion: Based on data obtained from this sample size study, it can be concluded that one-piece implants can be successfully placed immediately after extraction with minimal peri-implant bone loss. [ABSTRACT FROM AUTHOR]