Background: Immediate implants are frequently employed in the anterior maxillary area. However, the installation of dental implants simultaneously with tooth extraction can also provide with benefits in the posterior areas with a reduction in time prior the recovery of the masticatory function. Results previously reported in the literature show high-survival and success rates for implants placed in extraction sockets in molar areas; however, this topic has received limited systematic analysis. Material and methods: Electronic and manual literature searches were performed by two independent reviewers in several data-bases, including MEDLINE, EMBASE, and Cochrane Oral Health Group Trials Register, for articles up to January 2019 reporting outcomes of immediate implants placed in molar areas. Primary outcomes included survival and success rates, as well as marginal bone loss. Secondary outcomes included the influence of implant position, type of implant connection, grafting protocol, flap or flapless approach, implant diameter, surgical phase, presence of buccal plate, and loading protocol. Results: Twenty studies provided information on the survival rate, with a total sample of 1.106 implants. The weighted mean survival rate of immediate implants after 1 year of follow-up was 96.6%, and the success rate was 93.3%. On the other hand, marginal bone loss was 1.29 ± 0.24 mm. Secondary outcomes demonstrated that grafting the gap and the loading protocol have an effect on survival and success rates. Similarly, the presence or absence of the buccal bone affect crestal bone levels. Meta-analysis of 4 investigations showed a weighted mean difference of 0.31 mm ± 0.8 IC 95% (0.15–0.46) more marginal bone loss at immediate implant placement versus implants in healed sites (p < 0.001) I2 = 15.2%. Conclusion: In selected scenarios, immediate implant placement in molar extraction socket might be considered a predictable technique as demonstrated by a high survival and success rates, with minimal marginal bone loss.
Statement of the problem: Most of the clinical documentation of implant success and survival published in the literature have been issued by either experienced teams from university settings involving strict patient selection criteria or from seasoned private practitioners. By contrast, studies focusing on implants placed and rehabilitated by inexperienced post-graduate students are scarce. Purpose: To record failure rates and identify the contributing factors to implant failure and marginal bone loss (MBL) of implants placed and rehabilitated by inexperienced post-graduate students at the one-year follow-up. Material and Methods: A prospective cohort study was conducted on study participants scheduled for implant therapy at the International University of Catalonia. An experienced mentor determined the treatment plan in accordance with the need of each participant who signed an informed consent. All surgeries and prosthetic rehabilitation were performed by the post-graduate students. Implant failure rate, contributors to implant failure, and MBL were investigated among 24 variables related to patient health, local site, and implant and prosthetic characteristics. The risk of implant failure was analyzed with a simple binary logistic regression model with generalized equation equations (GEE) models, obtaining unadjusted odds ratios (OR). The relationship between MBL and the other independent variables was studied by simple linear regression estimated with GEE models and the Wald chi2 test. Results: One hundred and thirty dental implants have been placed and rehabilitated by post-graduate students. Five implants failed before loading and none after restoration delivery; survival and success rates were 96.15% and 94.62%, respectively. None of the investigated variables significantly affected the implant survival rate. At the one-year follow-up, the mean (SD) MBL was 0.53 (0.39) mm. The following independent variables significantly affected the MBL: Diabetes, implant depth placement. The width of keratinized tissue (KT) and probing depth (PD) above 3 mm were found to be good indicators of MBL, with each additional mm of probing depth resulting in 0.11 mm more MBL. Conclusion: The survival and success rates of dental implants placed and rehabilitated by inexperienced post-graduate students at the one-year follow-up were high. No contributing factor was identified regarding implant failure. However, several factors significantly affected MBL: Diabetes, implant depth placement, PD, and width of KT. Clinical Implications: Survival and success rates of dental implants placed and rehabilitated by inexperienced post-graduate students were high at the one-year follow-up, similar to experienced practitioners. No contributing factors were identified regarding implant failure; however, several factors significantly affected MBL: Diabetes, implant depth placement, PD, and KM.
(1) Background: Most of the clinical literature dealing with dental implants has been issued by experienced teams working either in university settings or in private practice. The purpose of this study was to identify contributing covariates to implant failure and marginal bone loss (MBL) at the 1-year follow-up of a novel triangular-neck implant design when placed by inexperienced post-graduate students. (2) Methods: A prospective cohort study was conducted on study participants eligible for implant placement at the UIC (International University of Catalonia), Barcelona, Spain. Implant failure rate and contributors to implant failure and MBL were investigated among 24 implant and patient variables. (3) Results: One hundred and twenty implants (V3, MIS) were placed and rehabilitated by the students. The mean insertion torque was 37.1 Ncm. Survival and success rates were 97.5% and 96.7%, respectively. Implants placed in patients with smoking habits displayed a tendency of higher failure risk (OR = 5.31, p = 0.17) when compared to non-smokers. The mean (SD) MBL was 0.51 (0.44) mm. Gender significantly affected the MBL (p = 0.020). Bleeding on probing (BoP) on the buccal sites proved to be a good predictor of proximal MBL (p = 0.030). (4) Conclusions: The survival and success rates of the V3 triangular-neck implant placed by inexperienced post-graduate students at the 1-year follow-up were high and similar to the ones published in the literature by experienced teams on other implants.
27 February 2024 in The International Journal of Oral and Maxillofacial Implants
Purpose: The present study describes a new presurgical soft tissue technique in oral/maxillary bone reconstructive surgery for reducing the risk of soft tissue dehiscence and its related complications. Materials and Methods: Ten consecutive patients with Cawood and Howell type V atrophy were ...