Sebastian Berthold Maximilian Patzelt

Clinical and Patient-reported Outcomes of a Zirconia Oral Implant: Three-year Results of a Prospective Cohort Investigation

The objective of this study was to determine the clinical, radiographic, and patient-reported outcomes of a 1-piece alumina-toughened zirconia implant restored with single crowns (SCs) or 3-unit fixed dental prostheses (FDPs) after 3 y of observation. Forty patients received 53 implants, placed in a 1-stage operation with immediate temporization. Finally, 50 implants were restored with 24 SCs and 13 FDPs. To evaluate peri-implant bone loss, standardized radiographs were taken at implant insertion, at final restoration delivery, and after 1 and 3 y. Additionally, several soft tissue parameters and patient-reported outcome measures were evaluated. Linear mixed models with random intercept for each patient and patients as clusters were used to compare subgroups. Three patients did not receive a SC due to early implant loss, and 1 patient died. As a result, 36 patients with 49 implants were followed-up for 3 y, giving a cumulative survival rate of 94.2%. The average marginal bone loss amounted to 0.79 mm (SCs, 0.47 mm; FDPs, 1.07 mm; P < 0.001). After the delivery of the final prosthetic restoration, further bone loss was not statistically significant (0.09 mm; P = 0.700). Probing depth, clinical attachment level, and modified bleeding index increased significantly at the implant sites, whereas gingival recession decreased significantly. Compared with the pretreatment questionnaires, the patient-reported outcome measures showed a permanently improved perception of function, aesthetics, sense, speech and self-esteem. The survival rate of the investigated ceramic implant system seems to be comparable to reported survival rates of titanium implants when immediately restored. The recorded parameters suggest its potential for clinical utilization.

CAD/CAM-fabricated implant-supported restorations: a systematic review

OBJECTIVES The aim of this systematic review was to identify and summarize the available literature related to CAD/CAM-fabricated implant-supported restorations. MATERIALS AND METHODS A systematic review of the literature was conducted using the Cochrane Library and the US Library of Medicine, National Institute of Health databases (Pubmed). Several search runs with specific search terms were performed and combined. All published papers available on the databases up to January 15, 2015 were considered with primarily no restrictions. RESULTS About 12 of 3484 identified papers met the inclusion criteria and were analyzed in the present review. One paper reported results on implant-supported single crowns (SCs), one on partial fixed dental prostheses (FDPs), and 10 papers reported results on full-arch screw-retained FDPs. Publications on SCs and FDPs were very limited but it was possible to identify 10 papers reporting adequate results on full-arch screw-retained FDPs. Survival rates ranged between 92% and 100% with observation times of 1-10 years. CONCLUSION The available data provided promising results for CAD/CAM-fabricated implant-supported restorations; nonetheless, current evidence is limited due to the quality of available studies and the paucity of data on long-term clinical outcomes of 5 years or more. In the sense of an evidence-based dentistry, the authors recommend further studies designed as randomized controlled clinical trials and reported according to the CONSORT statement.

Digital technologies to support planning, treatment, and fabrication processes and outcome assessments in implant dentistry: summary and consensus statements: the 4th EAO consensus conference 2015

OBJECTIVE The task of this working group was to assess the existing knowledge in computer-assisted implant planning and placement, fabrication of reconstructions applying computers compared to traditional fabrication, and assessments of treatment outcomes using novel imaging techniques. MATERIAL AND METHODS Three reviews were available for assessing the current literature and provided the basis for the discussions and the consensus report. One review dealt with the use of computers to plan implant therapy and to place implants in partially and fully edentulous patients. A second one focused on novel techniques and methods to assess treatment outcomes and the third compared CAD/CAM-fabricated reconstructions to conventionally fabricated ones. RESULTS The consensus statements, the clinical recommendations, and the implications for research, all of them after approval by the plenum of the consensus conference, are described in this article. The three articles by Vercruyssen et al., Patzelt & Kohal, and Benic et al. are presented separately as part of the supplement of this consensus conference.

Effect of two different healing times on the mineralization of newly formed bone using a bovine bone substitute in sinus floor augmentation: a randomized, controlled, clinical and histological investigation

PURPOSE To investigate the amount of the mineralization of a bovine bone substitute material in sinus floor augmentation after healing times of 3 and 6 months. MATERIALS AND METHODS Fifty-one patients were randomized into two healing time groups and received sinus floor augmentations with a bovine bone material. After 3 or 6 months of healing, trephine bone biopsies were retrieved. The biopsies were processed for histological and histomorphometric evaluations to primarily investigate the amount of mineralized bone in the augmented area and secondarily compare the amount of mineralized bone in the augmented area and in the pristine bone. Statistical tests were performed to analyse the fraction of the mineralized bone (p < 0.05). RESULTS The biopsies of both groups showed remnants of the well-integrated bone substitute material. The histology revealed osteoblasts, osteocytes with osteoid, and osteoclasts. The mean percentage of mineralized bone in the augmented area was 23.8% (3 months group) and 23.6% (6 months group; p = 0.9246); the amount of remaining bone substitute material was 35% (3 months group) and 33.9% (6 months group; p = 0.6325). CONCLUSION It can be concluded that the bone maturation in the augmented sinus using the bovine bone material is similar after 3 and 6 months. Thus, implant installation after 3 months following a lateral window sinus floor augmentation approach using a bovine bone material seems to be clinically acceptable.

Evaluation of Guided Bone Regeneration around Oral Implants over Different Healing Times Using Two Different Bovine Bone Materials: A Randomized, Controlled Clinical and Histological Investigation

PURPOSE To evaluate the potential of two bone substitute materials and the influence of different healing periods in guided bone regeneration therapy of osseous defects around implants. MATERIALS AND METHODS Twenty-four edentulous patients received implants in the region of the lost lower incisors. Around two standardized osseous defects were created, treated either with a 50:50 mixture of PepGen P-15® and OsteoGraf®/N-700 (test group) or with BioOss® (control group), and covered with titanium membranes. After healing periods of 2, 4, 6, or 9 months, the implants were removed together with the surrounding bone and subsequently prepared for histological evaluations. RESULTS Defect depths in both groups showed a clinical reduction after intervention. The histologically measured distance from the implant shoulder to the first point of bone-implant contact (BIC) after treatment did not differ between the two groups. The healing time influenced the level of the first point of BIC, with a longer healing period producing a more coronal first point of BIC. A greater percentage BIC and a higher fraction of mineralized bone were found in the pristine bone area compared with the augmented defect area. CONCLUSION It can be concluded that in the treatment of osseous defects around oral implants, both materials were equally effective bone substitute materials when used in combination with guided bone regeneration.