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Short implant prognostic factors
Dental Implants Short implant prognostic factors Background.—Short implants, variously defined as % 10 mm in length, offer an alternative to advanced bone augmentation surgeries and may be as effective. Implant systems have been developed to alter the micro-topography of the implant surface, roughening it and increasing the available surface area. This, in turn, has increased the survival of short implants in some studies. The clinical outcomes of short implants (<10 mm) in partially edentulous patients were investigated.
Discussion.—Short implants can be placed successfully in partially edentulous patients, but the survival is better for the longer implants. Mandibular implants fare better than maxillary ones. Higher implant survival rates result when smokers are excluded from studies. Neither surface topography nor bone augmentation procedure affects the failure rate with shorter implants.
Methods.—A systematic search of the MEDLINE and EMBASE databases identified 29 acceptable studies. The analysis covered a total of 2611 short implants, ranging in length from 5 to 9.5 mm.
Clinical Significance.—The shortest short implants tend to fail more often than longer short implants in partially edentulous patients. However, these implants can be used successfully, particularly in mandibular sites. Smoking has a negative effect on implant survival. These are all concerns that must be taken into account when determining a treatment plan for partially edentulous patients.
Results.—Longer implant length was associated with increased implant survival, increasing it from 93.1% to 98.6%. Subgroup analyses were conducted to identify heterogeneity between the various studies. The subgroups included implant surface topography (rough vs. machined), location (mandible vs. maxilla), smoking status (smokers excluded or included), and augmentation procedure (performed simultaneously with implant placement or not). The various surface topographies showed similar estimated failure rates. Maxillary implants had a significantly higher estimated failure rate than those in the mandible. Excluding smokers gave estimated failure rates twice as low as including them. No difference in estimated failure rate was related to bone augmentation procedure.
Telleman G, Raghoebar GM, Vissink A, et al: A systematic review of the prognosis of short (<10 mm) dental implants placed in the partially edentulous patient. J Clin Periodontol 38:667-676, 2011 Reprints available from G Telleman, Dept of Oral and Maxillofacial Surgery, Univ Medical Ctr Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands; e-mail: [email protected]
Esthetic Dentistry Comparing esthetic properties of composites Background.—The demand for esthetic results is growing as patients retain more of their natural teeth. Dentists can fulfill many of these demands because of the enamel/ dentin adhesive systems currently available and the improved direct composite resins. Restorations can be fabricated that are esthetically, biologically, and functionally acceptable for anterior and posterior teeth. To achieve the goal of providing restorations reflecting the patient’s natural form, function, and appearance requires manipulation of the form, surface texture, translucency, and color of the restorative materials. Composite layering techniques permit the development of restorations that meet esthetic
206
Dental Abstracts
and functional goals. However, multitudes of commercial brands and shades are available in the direct composite systems, making it difficult for experienced practitioners, and even more so for undergraduate students, to choose the best, most complete system. Therefore, indirect or semidirect restorations using composite resin or porcelain are more often chosen for esthetic dentistry. Even so, the wide variety of shades makes the choice time consuming and increases the risk of choosing an inferior combination. It is suggested that ideally the composite material should have dentin shades with a single hue, a single opacity, and a large chroma scale beyond the four chroma levels and
Discussion.—Short implants can be placed successfully in partially edentulous patients, but the survival is better for the longer implants. Mandibular implants fare better than maxillary ones. Higher implant survival rates result when smokers are excluded from studies. Neither surface topography nor bone augmentation procedure affects the failure rate with shorter implants.
Methods.—A systematic search of the MEDLINE and EMBASE databases identified 29 acceptable studies. The analysis covered a total of 2611 short implants, ranging in length from 5 to 9.5 mm.
Clinical Significance.—The shortest short implants tend to fail more often than longer short implants in partially edentulous patients. However, these implants can be used successfully, particularly in mandibular sites. Smoking has a negative effect on implant survival. These are all concerns that must be taken into account when determining a treatment plan for partially edentulous patients.
Results.—Longer implant length was associated with increased implant survival, increasing it from 93.1% to 98.6%. Subgroup analyses were conducted to identify heterogeneity between the various studies. The subgroups included implant surface topography (rough vs. machined), location (mandible vs. maxilla), smoking status (smokers excluded or included), and augmentation procedure (performed simultaneously with implant placement or not). The various surface topographies showed similar estimated failure rates. Maxillary implants had a significantly higher estimated failure rate than those in the mandible. Excluding smokers gave estimated failure rates twice as low as including them. No difference in estimated failure rate was related to bone augmentation procedure.
Telleman G, Raghoebar GM, Vissink A, et al: A systematic review of the prognosis of short (<10 mm) dental implants placed in the partially edentulous patient. J Clin Periodontol 38:667-676, 2011 Reprints available from G Telleman, Dept of Oral and Maxillofacial Surgery, Univ Medical Ctr Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands; e-mail: [email protected]
Esthetic Dentistry Comparing esthetic properties of composites Background.—The demand for esthetic results is growing as patients retain more of their natural teeth. Dentists can fulfill many of these demands because of the enamel/ dentin adhesive systems currently available and the improved direct composite resins. Restorations can be fabricated that are esthetically, biologically, and functionally acceptable for anterior and posterior teeth. To achieve the goal of providing restorations reflecting the patient’s natural form, function, and appearance requires manipulation of the form, surface texture, translucency, and color of the restorative materials. Composite layering techniques permit the development of restorations that meet esthetic
206
Dental Abstracts
and functional goals. However, multitudes of commercial brands and shades are available in the direct composite systems, making it difficult for experienced practitioners, and even more so for undergraduate students, to choose the best, most complete system. Therefore, indirect or semidirect restorations using composite resin or porcelain are more often chosen for esthetic dentistry. Even so, the wide variety of shades makes the choice time consuming and increases the risk of choosing an inferior combination. It is suggested that ideally the composite material should have dentin shades with a single hue, a single opacity, and a large chroma scale beyond the four chroma levels and