Immediate vs. Delayed Placement of Immediately Provisionalized Self-Tapping Implants: A Non-Randomized Controlled Clinical Trial with 1 Year of Follow-Up.

This study aimed to examine the clinical and esthetic outcomes of immediately provisionalized self-tapping implants placed in extraction sockets or healed edentulous ridges one year after treatment. Sixty patients in need of a single implant-supported restoration were treated with self-tapping implants (Straumann BLX) and immediate provisionalization. The implant stability quotient (ISQ) and insertion torque were recorded intraoperatively. After one year in function, the implant and prosthesis survival rate, pink esthetic score (PES), white esthetic score (WES), and marginal bone levels (MBL) were assessed. Sixty patients received 60 self-tapping implants. A total of 37 implants were placed in extraction sockets and 23 in edentulous ridges, and then all implants were immediately provisionalized. All implants achieved a high implant stability with a mean insertion torque and ISQ value of 58.1 ± 14.1 Ncm and 73.6 ± 8.1 Ncm, respectively. No significant differences were found between healed vs. post-extractive sockets (p = 0.716 and p = 0.875), or between flap vs. flapless approaches (p = 0.862 and p = 0.228) with regards to the insertion torque and ISQ value. Nonetheless, higher insertion torque values and ISQs were recorded for mandibular implants (maxilla vs. mandible, insertion torque: 55.30 + 11.25 Ncm vs. 62.41 + 17.01 Ncm, p = 0.057; ISQ: 72.05 + 8.27 vs. 76.08 + 7.37, p = 0.058). One implant did not osseointegrate, resulting in an implant survival rate of 98.3%. All implants achieved PES and WES scores higher than 12 at the 1-year follow-up. The clinical use of newly designed self-tapping implants with immediate temporization was safe and predictable. The implants achieved a good primary stability, high implant survival rate, and favorable radiographic and esthetic outcomes, regardless of the immediate or delayed placement protocols.

Accuracy of Computer-Assisted Flapless Implant Placement by Means of Mucosa-Supported Templates in Complete-Arch Restorations: A Systematic Review.

The aim of this study was to systematically review the current scientific literature regarding the accuracy of fully guided flapless implant positioning for complete-arch rehabilitations in edentulous patients and to assess if there was any statistically significant correlation between linear deviation at shoulder point, at apex point and angular deviation. The electronic and manual literature search of clinical studies was carried out using specified indexing terms. A total of 13 studies were eligible for qualitative analysis and 277 edentulous patients were rehabilitated with 1556 implants patients by means of fully guided mucosa-supported template-assisted flapless surgery. Angular deviation was 3.42° (95% CI 2.82-4.03), linear deviation at shoulder point 1.23 mm (95% CI 0.97-1.49) and linear deviation at apex point 1.46 mm (95% CI 1.17-1.74). No statistically significant correlations were found between the linear and angular deviations. A statistically significant correlation was found between the two linear deviations (correlation coefficient 0.91) that can be summarized by the regression equation y = 0.03080 + 0.8254x. Computer-assisted flapless implant placement by means of mucosa-supported templates in complete arch restorations can be considered a reliable and predictable treatment choice despite the potential effects that flapless approach could bring to the overall treatment.

Short Dental Implants (≤ 6 mm) to Rehabilitate Severe Mandibular Atrophy: A Systematic Review.

PURPOSE: This study aimed to assess the survival rate, marginal bone levels, and prosthetic success of short implants when placed in posterior areas of severely reabsorbed mandibles. MATERIALS AND METHODS: A systematic review was performed of all randomized controlled trials with at least 10 patients with a control group where bone augmentations were performed that were published between January 2015 and February 2020. From 77 pertinent studies, 14 full-text publications were studied, and 6 studies fulfilled the inclusion criteria. RESULTS: The implant survival rates of short dental implants ranged from 92% to 96.9% with a follow-up from 1 to 5 years, and the prosthetic success rate ranged from 90% to 100% during the same follow-up. The mean marginal bone level values of involved short implants ranged from -0.51 to -2.30 mm. CONCLUSION: The obtained data showed that short dental implants are a valid therapeutic choice to rehabilitate severe mandibular atrophy in the medium to long term.

Mechanical performance of Anatomic-Functional-Geometry dental treatments: A computational study.

In this paper the biomechanical response of a novel dental preparation technique, referred to as the Anatomic-Functional-Geometry treatment (AFG), is investigated through a 3D nonlinear finite-element modelling approach. A comparative investigation against a standard technique employed in dental clinical practice is carried out, by simulating typical experimental mechanical tests and physiological functional conditions. Failure mechanisms of treated tooth models are investigated through a progressive damage formulation implemented via a displacement-driven incremental approach. Computational results clearly show that AFG-treated teeth, as a consequence of a more conservative morphological preparation of the tooth, are characterized by more effective crown-dentin loading transfer mechanisms, higher fracture strength levels and more homogeneous stress patterns than the standard-treated ones, thereby opening towards widespread clinical application.