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The Use of Narrow Diameter Implants in the Molar Area

Identifieur interne : 000416 ( Pmc/Checkpoint ); précédent : 000415; suivant : 000417

The Use of Narrow Diameter Implants in the Molar Area

Auteurs : M. Saad [Liban] ; A. Assaf [Liban] ; E. Gerges [Liban]

Source :

RBID : PMC:4879234

Abstract

Implant rehabilitations in the posterior jaw are influenced by many factors such as the condition of the remaining teeth, the force factors related to the patient, the quality of the bone, the maintenance of the hygiene, the limited bone height, the type and extent of edentulism, and the nature of the opposing arch. The gold standard is to place a regular diameter implant (>3.7 mm) or a wide one to replace every missing molar. Unfortunately, due to horizontal bone resorption, this option is not possible without lateral bone augmentation. In this situation, narrow diameter implant (NDI < 3.5 mm) could be the alternative to lateral bone augmentation procedures. This paper presents a clinical study where NDIs were used for the replacement of missing molars. They were followed up to 11 years. Special considerations were observed and many parameters were evaluated. NDI could be used to replace missing molar in case of moderate horizontal bone resorption if strict guidelines are respected. Yet, future controlled prospective clinical trials are required to admit their use as scientific evidence.


Url:
DOI: 10.1155/2016/8253090
PubMed: 27293436
PubMed Central: 4879234


Affiliations:


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PMC:4879234

Le document en format XML

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<pmc article-type="research-article">
<pmc-dir>properties open_access</pmc-dir>
<front>
<journal-meta>
<journal-id journal-id-type="nlm-ta">Int J Dent</journal-id>
<journal-id journal-id-type="iso-abbrev">Int J Dent</journal-id>
<journal-id journal-id-type="publisher-id">IJD</journal-id>
<journal-title-group>
<journal-title>International Journal of Dentistry</journal-title>
</journal-title-group>
<issn pub-type="ppub">1687-8728</issn>
<issn pub-type="epub">1687-8736</issn>
<publisher>
<publisher-name>Hindawi Publishing Corporation</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="pmid">27293436</article-id>
<article-id pub-id-type="pmc">4879234</article-id>
<article-id pub-id-type="doi">10.1155/2016/8253090</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Clinical Study</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>The Use of Narrow Diameter Implants in the Molar Area</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Saad</surname>
<given-names>M.</given-names>
</name>
<xref ref-type="aff" rid="I1">
<sup>1</sup>
</xref>
<xref ref-type="corresp" rid="cor1">
<sup>*</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Assaf</surname>
<given-names>A.</given-names>
</name>
<xref ref-type="aff" rid="I2">
<sup>2</sup>
</xref>
<xref ref-type="aff" rid="I3">
<sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Gerges</surname>
<given-names>E.</given-names>
</name>
<xref ref-type="aff" rid="I4">
<sup>4</sup>
</xref>
</contrib>
</contrib-group>
<aff id="I1">
<sup>1</sup>
Private Practice Limited to Periodontology and Implantology, Tyre 00961, Lebanon</aff>
<aff id="I2">
<sup>2</sup>
Unit of Biomaterials and Technology, School of Dentistry, Lebanese University, Beirut 00961, Lebanon</aff>
<aff id="I3">
<sup>3</sup>
School of Dentistry, Beirut Arab University, Beirut 00961, Lebanon</aff>
<aff id="I4">
<sup>4</sup>
Department of Prosthodontics, School of Dentistry, Lebanese University, Beirut 00961, Lebanon</aff>
<author-notes>
<corresp id="cor1">*M. Saad:
<email>dr.moustafasaad@yahoo.com</email>
</corresp>
<fn fn-type="other">
<p>Academic Editor: Li Wu Zheng</p>
</fn>
</author-notes>
<pub-date pub-type="ppub">
<year>2016</year>
</pub-date>
<pub-date pub-type="epub">
<day>11</day>
<month>5</month>
<year>2016</year>
</pub-date>
<volume>2016</volume>
<elocation-id>8253090</elocation-id>
<history>
<date date-type="received">
<day>23</day>
<month>2</month>
<year>2016</year>
</date>
<date date-type="rev-recd">
<day>6</day>
<month>4</month>
<year>2016</year>
</date>
<date date-type="accepted">
<day>6</day>
<month>4</month>
<year>2016</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright © 2016 M. Saad et al.</copyright-statement>
<copyright-year>2016</copyright-year>
<license xlink:href="https://creativecommons.org/licenses/by/4.0/">
<license-p>This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
</license>
</permissions>
<abstract>
<p>Implant rehabilitations in the posterior jaw are influenced by many factors such as the condition of the remaining teeth, the force factors related to the patient, the quality of the bone, the maintenance of the hygiene, the limited bone height, the type and extent of edentulism, and the nature of the opposing arch. The gold standard is to place a regular diameter implant (>3.7 mm) or a wide one to replace every missing molar. Unfortunately, due to horizontal bone resorption, this option is not possible without lateral bone augmentation. In this situation, narrow diameter implant (NDI < 3.5 mm) could be the alternative to lateral bone augmentation procedures. This paper presents a clinical study where NDIs were used for the replacement of missing molars. They were followed up to 11 years. Special considerations were observed and many parameters were evaluated. NDI could be used to replace missing molar in case of moderate horizontal bone resorption if strict guidelines are respected. Yet, future controlled prospective clinical trials are required to admit their use as scientific evidence.</p>
</abstract>
</article-meta>
</front>
<floats-group>
<fig id="fig1" orientation="portrait" position="float">
<label>Figure 1</label>
<caption>
<p>Panoramic X-ray showing teeth loss on the lower 1st molar area.</p>
</caption>
<graphic xlink:href="IJD2016-8253090.001"></graphic>
</fig>
<fig id="fig2" orientation="portrait" position="float">
<label>Figure 2</label>
<caption>
<p>Narrow diameter implant (3,3 × 12 mm) placed on the lower left 1st molar area.</p>
</caption>
<graphic xlink:href="IJD2016-8253090.002"></graphic>
</fig>
<fig id="fig3" orientation="portrait" position="float">
<label>Figure 3</label>
<caption>
<p>Xenograft to cover the exposed threads.</p>
</caption>
<graphic xlink:href="IJD2016-8253090.003"></graphic>
</fig>
<fig id="fig4" orientation="portrait" position="float">
<label>Figure 4</label>
<caption>
<p>Panoramic X-ray after implant placement.</p>
</caption>
<graphic xlink:href="IJD2016-8253090.004"></graphic>
</fig>
<fig id="fig5" orientation="portrait" position="float">
<label>Figure 5</label>
<caption>
<p>Periapical X-ray immediately after loading.</p>
</caption>
<graphic xlink:href="IJD2016-8253090.005"></graphic>
</fig>
<fig id="fig6" orientation="portrait" position="float">
<label>Figure 6</label>
<caption>
<p>Periapical X-ray 1 year after loading.</p>
</caption>
<graphic xlink:href="IJD2016-8253090.006"></graphic>
</fig>
<fig id="fig7" orientation="portrait" position="float">
<label>Figure 7</label>
<caption>
<p>Cbct. 2 years after loading.</p>
</caption>
<graphic xlink:href="IJD2016-8253090.007"></graphic>
</fig>
<fig id="fig8" orientation="portrait" position="float">
<label>Figure 8</label>
<caption>
<p>Patient's distribution according to gender, parafunction, and implant's distribution according to the type of edentulism. Nine females and 1 male. Nine patients without parafunction and 1 with parafunction. Seven out of 11 implants were in bounded saddle and 4 in free end saddle.</p>
</caption>
<graphic xlink:href="IJD2016-8253090.008"></graphic>
</fig>
<fig id="fig9" orientation="portrait" position="float">
<label>Figure 9</label>
<caption>
<p>Periapical X-ray showing teeth loss on the lower left second premolar, first and second molar.</p>
</caption>
<graphic xlink:href="IJD2016-8253090.009"></graphic>
</fig>
<fig id="fig10" orientation="portrait" position="float">
<label>Figure 10</label>
<caption>
<p>Three implants to replace the missing teeth, the implants placed on the second premolar and first molar are narrow diameter implant (3,5 mm).</p>
</caption>
<graphic xlink:href="IJD2016-8253090.010"></graphic>
</fig>
<fig id="fig11" orientation="portrait" position="float">
<label>Figure 11</label>
<caption>
<p>Periapical X-ray 6 months after crown cementation.</p>
</caption>
<graphic xlink:href="IJD2016-8253090.011"></graphic>
</fig>
<fig id="fig12" orientation="portrait" position="float">
<label>Figure 12</label>
<caption>
<p>Clinical situation 7 years after loading.</p>
</caption>
<graphic xlink:href="IJD2016-8253090.012"></graphic>
</fig>
<fig id="fig13" orientation="portrait" position="float">
<label>Figure 13</label>
<caption>
<p>Centric occlusion.</p>
</caption>
<graphic xlink:href="IJD2016-8253090.013"></graphic>
</fig>
<fig id="fig14" orientation="portrait" position="float">
<label>Figure 14</label>
<caption>
<p>Clinical situation 11 years after loading.</p>
</caption>
<graphic xlink:href="IJD2016-8253090.014"></graphic>
</fig>
<fig id="fig15" orientation="portrait" position="float">
<label>Figure 15</label>
<caption>
<p>Panoramic X-ray 11 years after.</p>
</caption>
<graphic xlink:href="IJD2016-8253090.015"></graphic>
</fig>
<table-wrap id="tab1" orientation="portrait" position="float">
<label>Table 1</label>
<caption>
<p>The different parameters evaluated in our case series. Patient gender (F, female; M, male ), NDI position in the arch, bone management, type of prosthesis (fixed partial denture = FPD or single crown (SC)), loading protocol, type of edentulism (F = free end saddle, B = bounded saddle), splinted to wider diameter implant, nature of opposing arch, presence of a cantilever, follow-up period, and median probing depth.</p>
</caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th align="left" rowspan="1" colspan="1">Patient name, gender, age</th>
<th align="center" rowspan="1" colspan="1">NDI position</th>
<th align="center" rowspan="1" colspan="1">NDI diameter length
<break></break>
micro- and macrogeometry</th>
<th align="center" rowspan="1" colspan="1">Parafunction</th>
<th align="center" rowspan="1" colspan="1">Bone management</th>
<th align="center" rowspan="1" colspan="1">Type of prosthesis</th>
<th align="center" rowspan="1" colspan="1">Loading protocol</th>
<th align="center" rowspan="1" colspan="1">Free end (F) or bounded (B) saddle</th>
<th align="center" rowspan="1" colspan="1">Splinted to wider diameter implant</th>
<th align="center" rowspan="1" colspan="1">Nature of opposing arch</th>
<th align="center" rowspan="1" colspan="1">Presence of a cantilever</th>
<th align="center" rowspan="1" colspan="1">Follow-up period</th>
<th align="center" rowspan="1" colspan="1">Mean probing depth</th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" rowspan="1" colspan="1">Patient 1: F, 55 years</td>
<td align="center" rowspan="1" colspan="1">46</td>
<td align="center" rowspan="1" colspan="1">3,3 × 10 Straumann SP
<break></break>
cylindrical shape, monothread, SLA surface</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">FPD</td>
<td align="center" rowspan="1" colspan="1">3 months</td>
<td align="center" rowspan="1" colspan="1">F</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">Fixed
<italic>metal</italic>
-ceramic</td>
<td align="center" rowspan="1" colspan="1">Yes (median)</td>
<td align="center" rowspan="1" colspan="1">4 years</td>
<td align="center" rowspan="1" colspan="1">3 mm</td>
</tr>
<tr>
<td align="center" colspan="13" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Patient 2: F, 49 years</td>
<td align="center" rowspan="1" colspan="1">36, 47</td>
<td align="center" rowspan="1" colspan="1">Nucleoss (2) 3,4 × 10
<break></break>
conical shapes, Maxicell surface (SLA)</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">FPD</td>
<td align="center" rowspan="1" colspan="1">4 months</td>
<td align="center" rowspan="1" colspan="1">36: B. 47: F</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
<td align="center" rowspan="1" colspan="1">Fixed
<italic>metal</italic>
-ceramic</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">3 years</td>
<td align="center" rowspan="1" colspan="1">4 mm</td>
</tr>
<tr>
<td align="center" colspan="13" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Patient 3: F, 44 years</td>
<td align="center" rowspan="1" colspan="1">36</td>
<td align="center" rowspan="1" colspan="1">3,4 × 12 Nucleoss
<break></break>
conical shapes, Maxicell surface (SLA)</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">FPD</td>
<td align="center" rowspan="1" colspan="1">3 months</td>
<td align="center" rowspan="1" colspan="1">F</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
<td align="center" rowspan="1" colspan="1">Fixed
<italic>metal</italic>
-ceramic</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">4 years</td>
<td align="center" rowspan="1" colspan="1">3 mm</td>
</tr>
<tr>
<td align="center" colspan="13" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Patient 4: F, 53 years</td>
<td align="center" rowspan="1" colspan="1">46</td>
<td align="center" rowspan="1" colspan="1">3,5 × 11,5 Astra Tech
<break></break>
OsseoSpeed, TiO
<sub>2</sub>
blasted surface</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">FPD</td>
<td align="center" rowspan="1" colspan="1">4 months</td>
<td align="center" rowspan="1" colspan="1">F</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
<td align="center" rowspan="1" colspan="1">Fixed
<italic>metal</italic>
-ceramic</td>
<td align="center" rowspan="1" colspan="1">Yes (median and distal)</td>
<td align="center" rowspan="1" colspan="1">9 years</td>
<td align="center" rowspan="1" colspan="1">5 mm</td>
</tr>
<tr>
<td align="center" colspan="13" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Patient 5: F, 64 years</td>
<td align="center" rowspan="1" colspan="1">46</td>
<td align="center" rowspan="1" colspan="1">3,4 × 10 Nucleoss
<break></break>
conical shapes, Maxicell surface (SLA)</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">Full-arch fixed</td>
<td align="center" rowspan="1" colspan="1">2 months</td>
<td align="center" rowspan="1" colspan="1">B</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
<td align="center" rowspan="1" colspan="1">Removable denture</td>
<td align="center" rowspan="1" colspan="1">Yes (median)</td>
<td align="center" rowspan="1" colspan="1">2 years</td>
<td align="center" rowspan="1" colspan="1">3 mm</td>
</tr>
<tr>
<td align="center" colspan="13" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Patient 6: F, 39 years</td>
<td align="center" rowspan="1" colspan="1">36</td>
<td align="center" rowspan="1" colspan="1">3,4 × 10 Nucleoss
<break></break>
conical shapes, Maxicell surface (SLA)</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">FPD</td>
<td align="center" rowspan="1" colspan="1">3 months</td>
<td align="center" rowspan="1" colspan="1">B</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
<td align="center" rowspan="1" colspan="1">Fixed
<italic>metal</italic>
-ceramic</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">5 years</td>
<td align="center" rowspan="1" colspan="1">3 mm</td>
</tr>
<tr>
<td align="center" colspan="13" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Patient 7: M, 57 years</td>
<td align="center" rowspan="1" colspan="1">46</td>
<td align="center" rowspan="1" colspan="1">3,3 × 12 Straumann SP
<break></break>
cylindrical shape, monothread, SLA surface</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">FPD</td>
<td align="center" rowspan="1" colspan="1">3 months</td>
<td align="center" rowspan="1" colspan="1">B</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">Fixed
<italic>metal</italic>
-ceramic</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">2 years</td>
<td align="center" rowspan="1" colspan="1">3 mm</td>
</tr>
<tr>
<td align="center" colspan="13" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Patient 8: F, 51 years</td>
<td align="center" rowspan="1" colspan="1">36</td>
<td align="center" rowspan="1" colspan="1">3,5 × 11,5 replace select conical shape, TiUnite surface</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">FPD</td>
<td align="center" rowspan="1" colspan="1">4 months</td>
<td align="center" rowspan="1" colspan="1">B</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">Natural teeth</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">11 years</td>
<td align="center" rowspan="1" colspan="1">3 mm</td>
</tr>
<tr>
<td align="center" colspan="13" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Patient 9: F, 49 years</td>
<td align="center" rowspan="1" colspan="1">36</td>
<td align="center" rowspan="1" colspan="1">3,3 × 12 Straumann BL
<break></break>
cylindrical shape, monothread, SLA surface</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">Yes (xenograft)</td>
<td align="center" rowspan="1" colspan="1">SC</td>
<td align="center" rowspan="1" colspan="1">6 months</td>
<td align="center" rowspan="1" colspan="1">B</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">Fixed
<italic>metal</italic>
-ceramic</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">1 year</td>
<td align="center" rowspan="1" colspan="1">3 mm</td>
</tr>
<tr>
<td align="center" colspan="13" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Patient 10: F, 62 years</td>
<td align="center" rowspan="1" colspan="1">46</td>
<td align="center" rowspan="1" colspan="1">3,5 × 12 Biohorizon
<break></break>
cylindrical shape, Laser-Lok surface</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">Yes (allograft)</td>
<td align="center" rowspan="1" colspan="1">SC</td>
<td align="center" rowspan="1" colspan="1">4 months</td>
<td align="center" rowspan="1" colspan="1">B</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">Fixed
<italic>metal</italic>
-ceramic</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">1 year</td>
<td align="center" rowspan="1" colspan="1">3 mm</td>
</tr>
</tbody>
</table>
</table-wrap>
</floats-group>
</pmc>
<affiliations>
<list>
<country>
<li>Liban</li>
</country>
</list>
<tree>
<country name="Liban">
<noRegion>
<name sortKey="Saad, M" sort="Saad, M" uniqKey="Saad M" first="M." last="Saad">M. Saad</name>
</noRegion>
<name sortKey="Assaf, A" sort="Assaf, A" uniqKey="Assaf A" first="A." last="Assaf">A. Assaf</name>
<name sortKey="Assaf, A" sort="Assaf, A" uniqKey="Assaf A" first="A." last="Assaf">A. Assaf</name>
<name sortKey="Gerges, E" sort="Gerges, E" uniqKey="Gerges E" first="E." last="Gerges">E. Gerges</name>
</country>
</tree>
</affiliations>
</record>

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