Ignacio Sanz-Martín

Effectiveness of Lateral Bone Augmentation on the Alveolar Crest Dimension A Systematic Review and Meta-analysis

Lateral ridge augmentation procedures are aimed to reconstruct deficient alveolar ridges or to build up peri-implant dehiscence and fenestrations. The objective of this systematic review was to assess the efficacy of these interventions by analyzing data from 40 clinical studies evaluating bone augmentation through either the staged or the simultaneous approach. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guideline for systematic reviews was used. The primary outcomes were the changes at reentry, in the ridge width, and in the vertical and horizontal dimensions of the peri-implant defect, measured in millimeters, in the staged and simultaneous approaches, respectively. The results of the meta-analysis showed, for the simultaneous approach, a statistically significant defect height reduction when all treatments were analyzed together (weighted mean difference [WMD] = −4.28 mm; 95% confidence interval: [CI] –4.88, –3.69; P < 0.01). The intervention combining bone replacement grafts with barrier membranes was associated with superior outcomes The most frequently used intervention was the combination of xenograft and bioabsorbable membrane. Similarly, for the staged approach, there was a statistically significant horizontal gain when all treatment groups were combined (WMD = 3.90 mm; 95% CI: 3.52, 4.28; P < 0.001). The most frequently used intervention was the use of autogenous bone blocks. Both treatment strategies led to high survival and success rates (>95%) for the implants placed on the regenerated sites. Nonexposed sites gained significantly more in the simultaneous and staged approaches (WMD = 1.1 and 3.1 mm).

Loading protocols and implant supported restorations proposed for the rehabilitation of partially and fully edentulous jaws. Camlog Foundation Consensus Report

Abstract Objectives The aim of this consensus meeting was to assess whether immediate loading protocols achieve comparable clinical outcomes when compared to conventional loading protocols depending on the type of prosthetic restoration. In addition post‐loading implant loss for implant supported prostheses in edentulous jaws was analyzed regarding a potential impact of implant location (maxilla vs. mandible), implant number per patient, type of prosthesis (removable vs. fixed), and type of attachment system (screw‐retained, ball vs. bar vs. telescopic crown). Material and methods Two comprehensive systematic reviews were prepared in advance of the meeting. Consensus statements, practical recommendations, and implications for future research were based on within group as well as plenary scrutinization and discussions of these systematic reviews. Results The survival rates are high for immediate loaded and conventional loaded implants, but immediate loading may impose a greater risk for implant failure. The estimated implant loss rate is influenced by the implant location, type of restoration, and implant number. Conclusions Consistent reporting of clinical studies is necessary and high‐quality studies are needed to confirm the present results.

Effects of modified abutment characteristics on peri-implant soft tissue health: A systematic review and meta-analysis

Abstract Objectives The purpose of this systematic review was to evaluate the impact of the abutment characteristics on peri‐implant tissue health and to identify the most suitable material and surface characteristics. Methods A protocol was developed aimed to answer the following focused question: “Which is the effect of the modification of the abutment design in regard to the maintenance of the peri‐implant soft tissue health?” Further subanalysis aimed to investigate the impact of the abutment material, macroscopic design, surface topography and surface manipulation. Randomised controlled trials (RCTs) with a follow‐up of at least 6 months after implant loading were considered as inclusion criteria. Meta‐analyses were performed whenever possible. Results Nineteen final publications from thirteen investigations were included. The results from the meta‐analysis indicated that zirconia abutments (Zi) experienced less increase in BOP values over time [n = 3; WMD = −26.96; 95% CI (−45.00; −8.92); p = .003] and less plaque accumulation [n = 1; MD = −20.00; 95% CI (−41.47; 1.47); p = .068] when compared with titanium abutments (Ti). Bone loss was influenced by the method of abutment decontamination [n = 1; MD = −0.44; 95% CI (−0.65; −0.23); p < .001]. The rest of the studied outcomes did not show statistically significant differences. Conclusions The macroscopic design, the surface topography and the manipulation of the implant abutment did not have a significant influence on peri‐implant inflammation. In contrast, the abutment material demonstrated increased BOP values over time for Ti when compared to Zi abutments.

Randomized controlled clinical trial comparing two dental implants with different neck configurations: Sanz-Martín et al.

BACKGROUND Peri-implant bone levels can vary according to the implant neck macro-design and the implant-abutment interface. PURPOSE To compare the changes in soft and hard tissues when using a one-piece implant with a machined collar (TG) versus a two-piece implant with a progressive platform widening and a platform switching connection (SP). MATERIAL AND METHODS Partially edentulous patients willing to receive one or two implants in the posterior maxilla or mandible were randomized to the control (TG) or to the test group (SP). Final prostheses were delivered after 12 months. Radiographic measurements of interproximal bone levels (primary outcome) were assessed at implant loading and 1-year postloading. Clinical, patient related outcomes and adverse events were assessed at loading and after 6 and 12 months. RESULTS Sixty-one implants were placed in 47 patients, 37 patients (18 in the TG group and 19 in the SP group), and 47 implants (23 TG and 24 SP) completed the 24-months follow up. At the patient level, a significantly greater bone resorption from baseline to implant loading was observed in the SP group (-0.42 ± 0.45 vs -0.07 ± 0.45; P = .001*), while from loading to the final visit, the TG group had significantly greater bone loss than the SP group (-0.26 ± 0.22 vs -0.11 ± 0.2; P = .020*). At 24 months after surgery, there were no significant differences between both groups (control: 0.33 ± 0.49 vs test: 0.53 ± 0.53; P = .230). Similarly, no significant differences were observed for the secondary outcomes. CONCLUSIONS Both types of implant reported high survival rates and similar bone level changes, clinical parameters, and patient related outcomes after 12 months of loading.