Tag: nevin manimala

Int J Oral Maxillofac Implants. 2023 Jul-Aug;38(4):697-708. doi: 10.11607/jomi.10055.

ABSTRACT

Purpose: To evaluate the survival rate and marginal bone level (MBL) of calcium phosphate-blasted acid-etched titanium implants placed in a cohort of patients with different ridges after a follow-up period of at least 10 years. Materials and Methods: A total of 61 patients with a minimum implant follow-up of 10 years were selected for this historical prospective, best clinical practice cohort study. Between 2009 and 2012, 121 titanium implants were placed using a flap, flapless, or postextractive technique. The implant placement timing was performed according to pre-extractive diagnosis and divided into immediate (immediately after tooth extraction with an absence of infection), early (within 2 to 3 months with an acute periapical lesion), delayed (6 to 12 months from extraction with a large periapical infection), or late (> 12 months from extraction with healed edentulous ridges). All implants were loaded after 3 months with provisional and definitive cemented restorations. Periapical radiographs were taken before implant insertion and at 3, 6, 12, 24, 36, 48, 96, and 120 months (T3, T6, T12, T24, T36, T48, T96, and T120, respectively). The MBL was calculated in single blind by an additional examiner. Linear logistic regression was performed to analyze statistically significant differences in relation to different operative variables at all evaluation times. Multilevel mixed logistic regression was made to evaluate the factors associated to MBL at 10 years (T120). Results: After 10 years, 47 patients and 92 implant restorations were analyzed, showing that 88 implants (95.6%) survived and 4 implants (4.4%) failed. The cumulative drop-out rate was 22.1%. Loosening and/or mobility was observed in a total of 9 abutments (9.7%) during the observational time. No other complications were reported. Implants placed with a flapless technique revealed a similar MBL to those placed with a flap technique. No significant differences were observed between the surgical techniques at T96 and T120. Immediate and early implants revealed a more stable MBL than both delayed and late implants up to T48. At longer evaluation times (T96 and T120), the MBL values were not statistically significant (P > .05). Narrower diameter implants (3.5 mm) revealed a higher bone loss when compared to the 4.1-mm- and 5.0-mm-diameters, especially in the first year from implant insertion (from T3 to T12) and at longer follow-up (T36 and T48). After that, the difference was reduced. Multilevel analysis showed that none of these variables appear to significantly influence MBL at 120 months. Conclusions: MBL was not influenced by surgical technique or implant placement timing after 10 years. Maintaining a strict occlusal and hygiene control created the conditions to preserve bone integrity and achieve a high implant survival rate.

PMID:37669529 | DOI:10.11607/jomi.10055

Int J Oral Maxillofac Implants. 2023 Jul-Aug;38(4):643-650. doi: 10.11607/jomi.10478.

ABSTRACT

One of the most important parts of any research project is the statistical analysis through which results are described and deemed significant or otherwise. Given this role of statistical analyses, it is imperative to understand what statistical tests are available and, most importantly, when they are appropriate. This is because choosing an improper statistical test can lead to inaccurate results and meaningless conclusions. We have written this data analysis guide to assist dental researchers with carrying out a proper analysis plan in consultation with a statistician. In this first part, we detail common types of outcome and predictor variables and include some common tests that can be used for each scenario. Using different simulated datasets, we also provide examples of common data visualization techniques and how a proper statistical test can be applied. We hope this guide provides some general background knowledge on common statistical techniques and allows for easier and more effective conversations with your statistician.

PMID:37669527 | DOI:10.11607/jomi.10478

Int J Oral Maxillofac Implants. 2023 Jul-Aug;38(4):784-788. doi: 10.11607/jomi.10119.

ABSTRACT

Purpose: To evaluate differences in the temperature rise at the cervical area of one-piece vs two-piece implants during the setting of relined provisional crowns. Materials and Methods: A K-type thermocouple was fixed to the coronal thread of 15 one-piece implants and 15 two-piece implants that were mounted on a plexiglass apparatus. Baseline temperature (Bl Temp) was recorded before starting the curing process. The maximum temperature (Max Temp) reached during the process in both implant groups was also recorded. Total heat flux (THF) was calculated as well as the thermal amplitude (Temp-Amp) at the implant surface. Finally, the differences between the implant types were compared using unpaired t test. Results: The increase in temperature from baseline was statistically significantly greater in the one-piece implants than in the two-piece implants (P < .01). Similarly, the THF and Temp-Amp were significantly greater in the one-piece implants compared to two-piece implants (P < .01). Conclusions: The polymerization of PMMA-based resin temporary crowns produces a significant temperature rise in both one-piece and two-piece implants. It is advisable to use two-piece implants to restore immediately loaded implants to reduce the risk to implant surroundings that may occur due to the temperature rise at the implant neck.

PMID:37669526 | DOI:10.11607/jomi.10119

Int J Oral Maxillofac Implants. 2023 Jul-Aug;38(4):727-732. doi: 10.11607/jomi.10134.

ABSTRACT

Objective: To verify the effect of fiducial marker number and configuration on target registration error (TRE) for dynamic computer-aided zygomatic implant surgery. Material and Methods: All patients who underwent zygomatic implant surgery with navigation from January 2018 to December 2021 were enrolled. For each patient, 6 to 8 miniscrews were placed intraorally as fiducial markers before the surgery. After the registration procedure, the TRE, which represents the distance between the target of the image space and the real position of the fiducial markers, was calculated. SPSS (22.0) was used for statistical analysis. Results: A total of 325 titanium miniscrews were placed in 47 patients who underwent zygomatic implant placement by navigation. The lowest TRE was 0.2 mm, compared to the highest TRE of 1.9 mm. There was no significant difference in the mean TRE value among the different titanium miniscrew groups (P = .07). A total of 8 miniscrews in 7 patients were lost in the maxillary tuberosity area prior to and during navigation surgery, which resulted in an irregular polygonal distribution of fiducial markers. However, there was no statistically significant difference in TRE between a polygonal distribution (0.62 ± 0.35 mm) and an irregular polygonal distribution (0.68 ± 0.33 mm) (P = .35). Conclusion: A scattered, polygonal distribution with of a minimum of five fiducial markers in an edentulous maxilla could achieve acceptable TRE values in registration. It seems that the registration error was not influenced by the absence of one corner in a polygon distribution.

PMID:37669525 | DOI:10.11607/jomi.10134

Int J Oral Maxillofac Implants. 2023 Jul-Aug;38(4):667-680. doi: 10.11607/jomi.10142.

ABSTRACT

Purpose: To assess the literature comparing histologic levels of osseointegration for titanium vs zirconia dental implants. Materials and Methods: This systematic review was conducted following the PRISMA guidelines and was registered in PROSPERO (CRD42021236781). Electronic and manual searches were carried out through the PubMed/MEDLINE, PubMed Central, and Embase databases with a platform-specific search strategy combining controlled terms (MeSH and Emtree) and text words. The articles were selected by two independent investigators who evaluated the articles based on the criteria for eligibility. Results: A total of 17 articles were included. All were preclinical studies. The populations included dogs (27.55%), minipigs (14.28%), rats (14.28%), and rabbits (43.89%); and the implantation site varied among the mandible (36.82%), maxilla (9.04%), tibia (17.64%), skull (10.70%), and femur (25.80%). A total of 370 titanium (Ti) implants and 537 zirconia (Zr) implants were evaluated. The average osseointegration (% bone-to-implant contact) for Zr was 55.51% (17.6% to 89.09%), and for Ti was 58.50% (23.2% to 87.85%). There was no statistical difference between studies at the 2-month follow-up (P = .672), but this difference was significant at 1 and 3 months (P < .001). Conclusions: Within the limitations of this review, Zr implants had a similar level of osseointegration compared to Ti implants. Nonetheless, because these findings are based on preclinical research, all data must be carefully examined.

PMID:37669522 | DOI:10.11607/jomi.10142

Int J Oral Maxillofac Implants. 2023 Jul-Aug;38(4):733-738. doi: 10.11607/jomi.10096.

ABSTRACT

Purpose: To compare the stability of short vs standard (ie, regular-length) implants in the edentulous mandible. Materials and Methods: In this prospective clinical study, 20 patients with edentulous mandibles received four implants each-two short implants (4 mm) in the region of the first molar and two standard implants (≥ 10 mm) in the interforaminal region. Implant stability was assessed using resonance frequency analysis immediately after implant placement and at the day of the abutment connection after 3 months of healing in order to provide an implant stability quotient (ISQ). Results: Implant stability in the two implant groups at placement (ISQ: short 66.2; standard 68.2) and at abutment connection (ISQ: short 74.9; standard 75.7) did not differ substantially or statistically significantly (both P > .05). Findings did not change after statistically controlling for potential confounders such as bone quality and bone crest width. At abutment connection, 95% of the short and 97.5% of the standard implants demonstrated sufficient stability for conventional loading (P > .05). Conclusions: Short dental implants demonstrate similar primary and secondary stability compared to standard implants and seem to be a promising treatment option for rehabilitation of patients with edentulous mandibles.

PMID:37669521 | DOI:10.11607/jomi.10096

Int J Oral Maxillofac Implants. 2023 Jul-Aug;38(4):801-810. doi: 10.11607/jomi.9820.

ABSTRACT

Purpose: To compare glycated multilayered membranes (OV) to a commercially available thin-layer membrane (OP) in a lateral ridge augmentation model in dogs. Materials and Methods: This was designed as a three-arm study, where one negative control (empty defect) was compared to two test arms: alveolar bone defects grafted with a mixture of 90% deproteinized bovine bone mineral and 10% porcine collagen, then covered with either a thick- (OV) or thin-layered (OP) membrane. Animals were randomly divided into three groups corresponding to the final sacrifice times of 4 weeks, 12 weeks, and 24 weeks. Sections underwent microCT, histology, histopathology, and histomorphometry. Results: No statistical differences were observed for OV compared to OP regarding the percentage of mineral volume and mean mineral density, amount of bone maturation, percentage of bone graft and membrane remaining in the grafted area, alveolar ridge width measurements, membrane mineralization, or ossification. Test groups presented significantly higher values compared to the empty control for all the endpoints. Conclusions: Within its limitations, this in vivo study highlighted that multilayered thick glycated membranes can serve as effective occlusive barriers for up to 6 months.

PMID:37669520 | DOI:10.11607/jomi.9820

Int J Oral Maxillofac Implants. 2023 Jul-Aug;38(4):709-716. doi: 10.11607/jomi.9766.

ABSTRACT

Purpose: To evaluate the gain in peri-implant keratinized mucosa (KM) using a combination of a free gingival graft (FGG) strip with a xenogeneic collagen matrix (XCM) and compare it to that of an FGG alone. Materials and Methods: This randomized controlled clinical study included a total of 30 patients with a minimal amount of peri-implant KM (≤ 1 mm) in the maxillary and mandibular anterior regions (including the premolars). The study population was divided into two groups using a randomization protocol; group A (n = 15) received a combination of FGG strip and XCM, and group B (n = 15) received FGG only to augment the KM. Clinical parameters included width of KM (WKM) measured at baseline, 1 month, and 6 months; a customized pink esthetic score (PES) measured at baseline and 6 months; and patient morbidity using visual analog scale (VAS) at days 1, 7, and 14 postoperatively. Results: After 1 month, both groups showed statistically significant gain in KM that reduced slightly by the 6-month follow-up but remained statistically significant when compared to baseline. When the gain was compared between the two groups, the difference was not statistically significant. Better esthetic outcomes and lower morbidity were reported in group A compared to group B, and this difference was statistically significant. Conclusions: Within the limitations of the study, it can be concluded that the combination of FGG strip with XCM is a viable alternative to the use of FGG in augmenting peri-implant KM.

PMID:37669514 | DOI:10.11607/jomi.9766

Int J Oral Maxillofac Implants. 2023 Jul-Aug;38(4):775-783. doi: 10.11607/jomi.10100.

ABSTRACT

Objective: To assess the effect of topically applied hyaluronic acid (HA) on the stability of immediately loaded implants in the posterior maxilla. Materials and Methods: For the clinical study, a total of 20 implants were placed in 14 patients seeking the replacement of missing single or multiple posterior maxillary teeth. The patients were randomly divided into two groups. In the clinical control group (CC group), 10 implants were placed and immediately loaded, while in the clinical study group (CS group), 10 implants were coated with HA immediately before placement and immediately loaded. All patients had implant stability clinically evaluated at implant placement time (T₀) and 1 (T₁), 3 (T₃), and 6 (T₆) months after loading. Peri-implant pocket depth and modified sulcus bleeding index were evaluated clinically at 6 months in all patients. Bone density was evaluated radiographically after 3 months. All the clinical and radiographic data were subjected to statistical analysis. For the animal study, a total of 12 implants were placed in the tibiae of six rabbits. For each rabbit, 1 implant without any applied HA was placed in the left tibia (AC group), and 1 implant coated with HA was placed in the right tibia (AS group). The rabbits were euthanized at 21 and 45 days after implant insertion. Results: There were no significant statistical differences between the two groups regarding implant stability, peri-implant pocket depth, modified sulcus bleeding index, or bone density from the palatal and apical aspects. However, there was a significant statistical difference in the bone density from the buccal aspect in favor of the study group. The animal study showed that the newly formed bone in the right tibiae showed improved quantity and quality of bone, as it had denser bone trabeculae and smaller marrow spaces compared to the left tibiae. Conclusion: In the clinical study, the application of hyaluronic acid had a superior effect on the buccal bone density around immediately loaded implants. In the animal study, hyaluronic acid had a synergistic effect on the quality and quantity of bone formation around dental implants.

PMID:37669513 | DOI:10.11607/jomi.10100

Int J Oral Maxillofac Implants. 2023 Jul-Aug;38(4):768-774. doi: 10.11607/jomi.10092.

ABSTRACT

Purpose: To evaluate the incorporation of liquid platelet-rich fibrin in different collagen matrices in vitro. Materials and Methods: Collagen matrices with liquid platelet-rich fibrin were used and divided into the following test groups (n = 5): Mucoderm (MD), Mucograft (MG), and Fibro-Gide (FG). After incubating the collagen matrices in liquid platelet-rich fibrin, histologicl and fluid absorption capacity analysis were performed. Intergroup comparisons of cell count, blood plasma penetration area, and fluid absorption capacity were performed using one-way ANOVA and Tukey tests. Intragroup comparisons of fluid absorption capacity were made using the independent t test with a 5% significance level. Results: Descriptive qualitative analysis showed total incorporation of liquid platelet-rich fibrin in the FG group, while the MG and MD groups showed only partial and shallow incorporation, respectively. There was a statistically significant difference among the three groups regarding inflammatory cell infiltration (P = .000), with the FG group presenting the highest number of cells in the matrices (577.15 ± 54.88). The FG group showed an area of total blood plasma penetration into the matrix, followed by the MG group with partial penetration, and the MD group with minor penetration area (P = .000). Considering the fluid absorption capacity analysis, only groups FG and MG were statistically different when comparing the liquid platelet-rich fibrin absorption coefficient (P = .017), with higher absorption in group FG (14.30 ± 3.35). Conclusions: The FG collagen matrix showed a good capacity for liquid platelet-rich fibrin incorporation in vitro.

PMID:37669512 | DOI:10.11607/jomi.10092