Rachele Censi

Evaluation of the success criteria for zirconia dental implants: a four-year clinical and radiological study.

Objectives. The aim was to evaluate survival and success rates, soft tissue health, and radiographic marginal bone loss (MBL) of zirconia implants placed in the esthetic and posterior areas of the jaws and in association with multiple or single implant restorations after at least 6 months of definitive restoration. Material and Methods. 35 one-piece zirconium implants were utilized for single or partially edentulous ridges rehabilitation. All implants received immediate temporary restorations and six months after surgery were definitively restored. Every 6 months after implant placement, a clinical-radiographic evaluation was performed. For each radiograph, the measurements of MBL were calculated. Results. The results showed that the mean MBL at 48-month followup was 1.631 mm. The mean MBL during the first year of loading was not more significant for implants placed in the first molar regions than for those positioned in other areas. Moreover, no differences in marginal bone level changes were revealed for multiple and single implants, whereas MBL in the first year was observed to be slightly greater for implants placed in the maxilla than for those placed in the mandible. Conclusion. Zirconia showed a good marginal bone preservation that could be correlated with one-piece morphology and characteristics of zirconia implants.

Multiple teeth replacement with endosseous one-piece yttrium-stabilized zirconia dental implants.

Objectives: The purpose of this study is to clinically and radiographically evaluate survival and success rate of multiple zirconia dental implants positioned in each patient during a follow-up period of at least 12 months up to 48 months. Study Design: Eight patients were treated for multiple edentulism with 29 zirconia dental implants. All implants received immediate temporary restorations and 6 months after surgery were definitively restored. 6 months to 4 years after implant insertion, a clinical-radiographic evaluation was performed in order to estimate peri-implant tissues health and peri-implant marginal bone loss. Results: Survival rate within follow-up period was therefore 100%. The average marginal bone loss (MBL) from baseline to 6 months was +1.375±0.388 mm; from 6 months to 1 year was +0.22±0.598 mm; from 1 year to 2 years was -0.368±0.387 mm; from 2 years to 3 years was -0.0669±0.425 mm; from 3 years to 4 years +0.048±0.262 mm. The mean marginal bone loss at 4 years from the implants insertion was +1.208 mm. Conclusions: According to several studies, when using a radiographic criterion for implant success, marginal bone loss below 0.9-1.6 mm during the first year in function can be considered acceptable. In our work, radiographic measurements of MBL showed values not exceeding 1.6 mm during the first year of loading and also 1 year up to 4 years after surgery further marginal bone loss was minimal and not significant. This peri-implant bone preservation may be associated to the absence of micro-gap between fixture and abutment since zirconia dental implants are one-piece implant. Moreover, zirconia is characterized by high biocompatibility and it accumulates significantly fewer bacteria than titanium. Key words:Zirconia dental implants, multiple implants, radiographic evaluation, marginal bone loss (MBL).

Zirconia implants in esthetic areas: 4-year follow-up evaluation study

Objectives. The aim is to evaluate the survival and success rates, as well as the marginal bone loss (MBL) and periodontal indexes of zirconia implants positioned in the esthetic jaw areas. Materials and Method. 13 patients were selected and 20 one-piece zirconia implants were used for the rehabilitation of single tooth or partially edentulous ridge in the esthetic jaw areas. Six months after surgery and then once a year, a clinical-radiographic evaluation was performed in order to estimate peri-implant tissue health and marginal bone loss. Results. The survival and success rates were 100%. The average marginal bone loss from baseline to 48 months after surgery was +2.1 mm. Four years after surgery, the median and the mode for visible Plaque Index and Bleeding On Probing resulted 1 whereas Probing Pocket Depth amounted to 3 mm (SD = ±0.49 mm). Conclusion. One-piece zirconia dental implants are characterized by high biocompatibility, low plaque adhesion, and absence of microgap that can be related to the clinical success of these implants even in the esthetic areas.

Esthetic Rehabilitation of a Severely Compromised Anterior Area: Combined Periodontal and Restorative Approach

The complete oral rehabilitation of patients demanding a beautiful and attractive smile involves a multidisciplinary approach that includes the change of both the morphological aspect of the teeth and the architecture of gum tissues. This clinical report describes a successful interdisciplinary approach for the treatment of an esthetically compromised dentition. In a first phase, the periodontal plastic surgery was performed for root coverage and, in particular, it was decided for the execution of a coronally advanced flap for the treatment of multiple recession defects. Once complete healing of soft tissues was obtained, six lithium disilicate veneers were placed over the anterior maxillary teeth. Lithium disilicate is a glass-based ceramic which presents excellent aesthetics and allows the passage of light without creating unnatural reflections. This feature has made it possible to recreate a natural aspect of teeth that in combination with the harmonic architecture of soft tissue has permitted obtaining a beautiful and pleasant smile.

Treatment of the atrophic upper jaw: rehabilitation of two complex cases.

In reconstructive surgery, the fresh frozen homologous bone (FFB) represents a valid alternative to the autologous bone, because FFB allows bone regeneration thanks to its osteoinductive and osteoconductive properties. The purpose of this work is to describe the surgical-implant-prosthetic treatment of two complex cases using FFB. In particular, fresh frozen homologous bone grafts were used to correct the severe atrophy of the maxilla, and, then, once the graft integration was obtained, implant therapy was performed and implants placed in native bone were immediately loaded.

Infection Related Inferior Alveolar Nerve Paresthesia in the Lower Premolar Teeth

Introduction. The aim of this paper was to describe two cases of IAN infection-induced paresthesia and to discuss the most appropriate treatment solutions. Methods. For two patients, periapical lesions that induced IAN paresthesia were revealed. In the first case, the tooth was previously endodontically treated, whereas in the second case the lesion was due to pulp necrosis. Results. For the first patient, a progressive healing was observed only after the tooth extraction. In the second patient, the paresthesia had resolved after endodontic treatment. Conclusions. The endodontic-related paresthesia is a rare complication that can be the result of a combination of etiopathogenic mechanisms such as mechanical pressure on the nerve fibers due to the expanding infectious process and the production of microbial toxins. Paresthesia resulting from periapical lesions usually subsides through elimination of infection by root canal treatment. However, if there are no signs of enhancement, the immediate extraction of the tooth is the treatment of choice in order to prevent irreversible paresthesia because it was demonstrated that there is a correlation between the duration of mechanical or chemical irritation and the risk of permanent paresthesia.

Dislocazione di un impianto dentale nel seno mascellare: caso clinico e revisione della letteratura

Riassunto Obiettivi La dislocazione degli impianti dentali a livello del seno mascellare e una seria complicanza che spesso segue un’inadeguata riabilitazione del mascellare superiore. Scopo dello studio e descrivere un caso di migrazione implantare nel seno mascellare. Materiali e metodi Il paziente e stato sottoposto a una riabilitazione del mascellare superiore attraverso metodiche di rigenerazione ossea, tra cui un rialzo di seno bilaterale. Dopo 6 mesi di attesa per la guarigione degli innesti ossei e stata eseguita la chirurgia implantare. Ai successivi 6 mesi dall’inserimento delle fixture e emersa la presenza di una fistola suppurante a livello dell’impianto 1.6: una radiografia endorale di controllo ha confermato la dislocazione dello stesso. A distanza di 7 giorni si e proceduto al recupero chirurgico della fixture implantare in anestesia locale attraverso l’antrostomia precedentemente eseguita per il rialzo di seno. Risultati e conclusioni Una volta ottenuta la guarigione del sito chirurgico, confermata sia clinicamente sia radiograficamente, si e proceduto alla protesizzazione degli impianti restanti. La migrazione implantare e stata causata, in questo caso, dalla scarsa stabilita primaria dell’impianto associata a una qualita non ottimale dell’osso innestato.

Sinus Lift and Transantral Approach to Root Fragment Removal

The aim of this case report is to present a case of root fragment removal during planned sinus lift procedure. After failed molar tooth extraction, we chose to retrieve the residual root apex with transantral approach not to damage excessively bone volume. Without changing primary implant rehabilitation purpose, the fragment removal procedure was performed prior to implant placement during necessary sinus lift surgery. Higher visibility of surgical field was achieved. The root fragment residual was removed without an additional surgery appointment avoiding postoperative discomfort. The goal is to underline the importance of being able to change planning during intrasurgical complications. It is most appropriate to operate with safe and simple procedures to reduce surgical discomfort for the patient.