Customized Subperiosteal Implants for the Rehabilitation of Atrophic Jaws: A Consensus Report and Literature Review.

(1) Background: The aim was to perform a literature review on customized subperiosteal implants (CSIs) and provide clinical guidelines based on the results of an expert consensus meeting held in 2023. (2) Methods: A literature search was performed in Pubmed (MEDLINE) in July 2023, including case series and cohort studies with a minimum follow-up of 6 months that analyzed totally or partially edentulous patients treated with CSIs. Previously, an expert consensus meeting had been held in May 2023 to establish the most relevant clinical guidelines. (3) Results: Six papers (four case series and two retrospective cohort studies) were finally included in the review. Biological and mechanical complication rates ranged from 5.7% to 43.8% and from 6.3% to 20%, respectively. Thorough digital planning to ensure the passive fit of the CSI is mandatory to avoid implant failure. (4) Conclusions: CSIs are a promising treatment option for rehabilitating edentulous patients with atrophic jaws; they seem to have an excellent short-term survival rate, a low incidence of major complications, and less morbidity in comparison with complex bone grafting procedures. As the available data on the use of CSIs are very scarce, it is not possible to establish clinical recommendations based on scientific evidence.

Assessment of Dental Implants with Modified Calcium-Phosphate Surface in a Multicenter, Prospective, Non-Interventional Study: Results up to 50 Months of Follow-Up.

Prescription of implant treatments is very widespread at present, mainly due to the low rate of annual loss and, to date, few studies have assessed their survival in the routine clinical practice of dentistry. The purpose of this observational study was to evaluate the effectiveness of dental implants with a calcium-phosphate surface in the daily practice of dental clinics. A multicenter, prospective, non-interventional, observational study was performed, in which three experienced practitioners (one maxillofacial and two oral surgeons) inserted implants using standard external and internal hexagon connections in adult patients requiring ≥1 osseointegrated implants to replace missing teeth. Follow-up was performed for 24 months after implant loading. Two hundred and twelve subjects were included (51.5% men), with a mean age of 51.2 ± 11.90 years, in whom 544 implants were inserted. 87.2% of the patients received 1⁻4 implants. The preferred connection system was internal hexagon (73.5%). There were nine failures, with an interval survival rate (ISR) at 24 months of 100% and a cumulative survival rate (CSR) of 98.3%. In conclusion, implants with a modified calcium-phosphate surface are associated with a high rate of survival and may be considered a method of choice in clinical practice.

Biomechanical repercussions of bone resorption related to biologic width: a finite element analysis of three implant-abutment configurations.

Most biomechanical studies of implant-supported restorations have not taken into account the biologic changes that occur following exposure of the implants to the oral environment. Therefore, the present finite element analysis study was designed to compare the biomechanical response of three types of implant-abutment configurations both before and after establishment of a new biologic width. The three functional units studied were: a 5-mm implant platform connected with an external hexagon to a 5-mm-diameter abutment (type 1), a 5-mm implant platform connected with an external hexagon to a 4.1-mm-diameter abutment (type 2), and a 4.8-mm implant platform connected with an internal hexagon to a 4.1-mm-diameter abutment (type 3). The type 3 design, which combined platform switching with an internal connection, exhibited the smallest distortions in stress distribution after bone modeling, and the stress was distributed over the entire contact surface most smoothly and uniformly. Bone resorption following creation of the biologic width changes the biomechanical behavior of a restoration. In this study, the two implant-abutment designs featuring a smaller-diameter abutment on a larger-diameter implant platform achieved better results than the implant featuring the same-diameter implant platform and abutment, even though their initial bio?mechanical load potential was lower. (Int J Periodontics Restorative Dent 2009;29:479-487.).

Benefits of an implant platform modification technique to reduce crestal bone resorption.

PURPOSE: The alveolar bone resorption that occurs around a 2-piece implant following abutment attachment is a well-documented observation. Several investigators propose that crestal bone loss is a response to the invasion of the biologic width by secondary bacterial colonization and micromovements at the implant-abutment interface. This study proposes the creation of a difference between the diameter of the implant platform and diameter of the abutment (implant platform modification), shifting the implant-abutment interface medially to minimize invasion of the biologic width. MATERIAL AND METHODS: We present a series of 30 control cases and 30 study cases using the platform-modification technique. Interproximal bone resorption on the medial and distal of each implant was assessed using digital radiography at 1, 4, and 6 months after abutment attachment. RESULTS: The mean value of bone resorption observed in the mesial measurement for the control group was 2.53 mm, whereas for those patients included in the study group, it was 0.76 mm. The mean value of bone resorption observed in the distal measurement for patients in the control group was 2.56 mm, whereas for those included in the study group, it was 0.77 mm. CONCLUSIONS: All patients in the study group had a significant reduction of bone loss in comparison to the control group (P < 0.0005).