Isabella Rocchietta

Clinical outcomes of vertical bone augmentation to enable dental implant placement: a systematic review.

BACKGROUND This review addressed the focused question of what is the predictability of vertical ridge augmentation techniques for patients, who were diagnosed with insufficient alveolar bone volume for the placement of dental implants. MATERIAL AND METHODS A systematic online review of three main databases was performed between 1966 and 1 November 2007. Four groups of vertical bone augmentation techniques have been identified and evaluated: (1) guided bone regeneration, (2) distraction osteogenesis, (3) onlay bone grafting, and (4) an array of different techniques. Data extraction was based on the following outcomes: (a) success and failure rate of the procedure (vertical bone gain/loss), (b) complication rate of the procedure, and (c) implant survival, success and failure rate. RESULTS The initial search identified 189 papers from the electronic database. The review produced seven papers for GBR, 13 reporting distraction osteogenesis, five for onlay bone grafting and three describing different techniques. CONCLUSIONS For the concept of vertical ridge augmentation to enable dental implant placement, there are clinical and histological data supporting its potential use. Given the confined number of investigators using these techniques and the low number of patient treatments reported in the literature, the generalizability of this approach is limited at this time.

Surface‐modified zirconia implants: tissue response in rabbits

AIM To evaluate the bone tissue response to zirconia implants with three different surface modifications in comparison with the oxidized titanium surface with the goal to optimize osseointegration in terms of strength and speed. MATERIALS AND METHODS A total of 18 rabbits with 143 implants were used. One hundred and twenty-three were threaded zirconia ceramic implants with three different surface topographies and 20 modified titanium oxide implants were controls. Each rabbit received eight implants and sacrificed after 3 weeks. The removal torque test (RTQ) and histology were performed. RESULTS Sixteen out of 18 rabbits completed the study with a total of 110 implants. No statistical significance was observed between the chemical modification implants compared with the topographically modified zirconia implant in terms of interfacial shear strength proven by the RTQ applied. No statistical significance was also observed in the bone-to-implant contact between the zirconia implants and the control oxidized implants. CONCLUSIONS The findings suggest that additional specific chemical modifications of the topographically modified zirconia implants do not seem to enhance the bone-to-implant contact and appear not to increase the interfacial shear strength.

Effects of a calcium phosphate coating on the osseointegration of endosseous implants in a rabbit model

OBJECTIVES The aim of the present study was to evaluate a Ca-P coated implant surface in a rabbit model. The Ca-P surface (test) was compared to the titanium porous oxide surface (control) in terms of bone-to-implant contact (BIC) and removal torque value. MATERIALS AND METHODS Two hundred and sixteen dental implants were inserted in the tibia and in the femur of 36 rabbits. One hundred and eight were represented by Ca-P oxidized surface implant and other 108 were titanium porous oxide surface modified implants. Each rabbit received six implants. Animals were sacrificed after 2, 4 and 9 weeks of healing. Each group included 12 rabbits. The femoral implant and the proximal implant of the tibia of each animal were subjected to the histologic analysis and the distal implants of the tibia underwent removal torque test (RTQ). RESULTS Histological analysis in terms of BIC and RTQ did not revealed any significant difference between the Ca-P oxidized surface and the oxidized surface at 2 and 4 weeks. At 9 weeks, the oxidized surface demonstrated better results in terms of RTQ in the tibia. CONCLUSION In conclusion, findings from the present study suggested that the Ca-P coating had no beneficial effect in improving bonding strength at the bone-implant interface either at 2, 4 and 9 weeks.

A review assessing the quality of reporting of risk factor research in implant dentistry using smoking, diabetes and periodontitis and implant loss as an outcome: critical aspects in design and outcome assessment

AIM To assess, using a structured review, the quality of reporting (design and outcome assessment) of risk factor research using the STROBE statements. The outcome was implant loss, and the risk factors assessed were smoking, diabetes and periodontitis. MATERIALS AND METHODS Literature search was performed individually for each of the risk factors and the outcome using three sets of database: (a) MEDLINE, (b) references derived from relevant reviews and (c) references derived from identified manuscripts. Only case-control and cohort studies were included and assessed using the STROBE statements. RESULTS A total of 104 papers were retrieved, three of which were found to be cohort studies (one in the diabetes and two in the periodontitis review) and none was a case-control study. A total of 101 of 104 papers were case series or cross-sectional study. CONCLUSIONS Risk factor research in implant dentistry is mostly comprised of case series studies. These are used to generate hypotheses, but are the wrong tool to test these hypotheses. In the near future, well-designed observational studies are needed and should be reported according to the proposed checklist.

Equine-derived bone mineral matrix for maxillary sinus floor augmentation: a clinical, radiographic, histologic, and histomorphometric case series.

The objective of this proof-of-principle multicenter case series was to examine the bone regenerative potential of a newly introduced equine-derived bone mineral matrix (Equimatrix) to provide human sinus augmentation for the purpose of implant placement in the posterior maxilla. There were 10 patients requiring 12 maxillary sinus augmentations enrolled in this study. Histologic results at 6 months demonstrated abundant amounts of vital new bone in intimate contact with residual graft particles. Active bridging between residual graft particles with newly regenerated bone was routinely observed in intact core specimens. A mean value of 23.4% vital bone formation was observed at 6 months. This compared favorably with previous results using xenografts to produce bone in the maxillary sinus for the purpose of dental implant placement. Both the qualitative and quantitative results of this case series suggest comparable bone regenerative results at 6 months to bovine-derived xenografts.

Vertical ridge augmentation in the esthetic zone

The reconstruction of deficient alveolar ridges using vertical and/or horizontal guided bone regeneration techniques allows for ideal implant placement, which is crucial for function and also for esthetically successful outcomes. Unlike in the past, when meeting a patients functional demands was sufficient, many patients now have greater expectations from their implant restoration. Hence, it is no longer enough simply to restore the edentulous space with a functioning tooth or teeth. It has been suggested that patients now measure their final restoration using the contralateral natural tooth as the gold standard. Both subjective and objective levels of patient information on dental implants have increased significantly in the last decade. As a result of this demand, implant literature has inherited and developed specific esthetic parameters and patient-centered outcomes from studies in the restorative field. Unfortunately, studies reporting on guided bone regeneration in the esthetic zone entirely lack such parameters and outcomes. Currently, there is a strong need for a consensus on objective and well-defined parameters to assess the esthetics in bone regeneration and subsequently on implant dentistry.

Drugs and diseases: Summary and consensus statements of group 1. The 5thEAO Consensus Conference 2018

OBJECTIVES The task of this working group was to update the knowledge about the use of drugs and biologicals affecting healing of soft tissue and bone during implant treatment or procedures associated with it. Moreover, the impact of titanium particles and biocorrosion on complications and implant survival has been analysed. MATERIALS AND METHODS The literature in the areas of interest (platelet concentrates, antiresorptive drugs as well as implant-host interaction) was screened using systematic reviews for the former two areas, whereas a narrative critical review was performed for the latter topic. Two manuscripts on platelet concentrates, one manuscript on antiresorptive drugs and one manuscript on the effects of biocorrosion, were presented for group analysis with subsequent discussion in the plenum and final consensus approval. RESULTS Results and conclusions of the individual reviews of the three topics are presented in the respective papers. Conclusions of the group on strengths and weaknesses of available evidence as well as consensus statements and directions for further research are provided in this study. The following papers were subject to group discussions and formed the basis for the consensus statements: Stähli A, Strauss FJ, Gruber R. () The use of platelet-rich-plasma to enhance the outcomes of implant-related therapies: a systematic review Strauss FJ, Stähli A, Gruber R. (2018) The use of platelet-rich-fibrin to enhance the outcomes of implant-related therapies: a systematic review Mombelli A, Hashim D, Cionca N. () What is the impact of titanium particles and bio-corrosion on implant survival and complications? A critical review Stavropoulos A, Bertl K, Pietschmann P, Pandis N, Morten Schiødt, Klinge B. () The effect of antiresorptive drugs on implant therapy: a systematic review.