Pregled bibliografske jedinice broj: 907841
Rehabilitation of Extremely Atrophic Mandible with Slim and Short Implants
Rehabilitation of Extremely Atrophic Mandible with Slim and Short Implants // Scientific Meeting of the Advanced Protocols in Oral Implantology, Proceeding Book
Beograd, Srbija, 2017. 2018, 1 (poster, podatak o recenziji nije dostupan, sažetak, znanstveni)
CROSBI ID: 907841 Za ispravke kontaktirajte CROSBI podršku putem web obrasca
Naslov
Rehabilitation of Extremely Atrophic Mandible with
Slim and Short Implants
Autori
Kovačić, Ines ; Divjak, Alan ; Modrić, Damir ; Peršić Kiršić, Sanja ; Kranjčić, Josip ; Čelebić, Asja
Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni
Izvornik
Scientific Meeting of the Advanced Protocols in Oral Implantology, Proceeding Book
/ - , 2017
Skup
Scientific Meeting of the Advanced Protocols in Oral Implantology
Mjesto i datum
Beograd, Srbija, 09.11.2017. - 12.11.2017
Vrsta sudjelovanja
Poster
Vrsta recenzije
Podatak o recenziji nije dostupan
Ključne riječi
mini dental implants ; oral rehabilitation ; atrophic mandible ; finite element analysis
Sažetak
Background and Aim Extreme alveolar ridge atrophy is a result of a long duration of edentulism. It is increased by poor bone quality, osteoporosis or inadequate removable denture (RD) wearing. Sometimes even the inferior alveolar nerve can be exposed under keratinized oral mucosa, the mandibular height between the two mental foramina can be less than 10 mm, accompanied with a reduced bucco-lingual width (class D or E according to Lecholm and Zarb, 1985 (1). It’s almost impossible to achieve stable and well-functioning mandibular RD in such cases and the patients are usually unsatisfied with their dentures and also have poor quality of life. Firstly we aimed to approve the protocol of four short and slim implants by means of finite element analysis (FEA), and than, for the first time to rehabilitate such patients with extremly atrophic mandible by means of both, slim (≤ 2.9 mm) and short (≤ 8 mm) mini dental implants (MDIs) and monitor them over time. Methods and Materials Finite element analysis For FEA the cone beam computed tomography (CBCT) scan of a single extremely atrophied human mandible of edentulous, 72-year-old female patient was selected. Six types of mini dental implants were designed, 6, 8 and 10 mm long, and 2 or 2.5 mm wide. FEA for the 10 mm long MDIs (minimum recomended lenght (2)) was included for comparison. On the model of the mandible FEA was made for six different MDI sizes (12 simulations altogether). Four implants intraforaminaly were inserted and loaded with two types of forces, axial and off-axial (45 degrees angulation) (Fig. 1) with the force of 50N per implant. Data for Von-Mises Stress and Elastic Equivalent (Von- Mises) Strain were generated. Clinical prospective study A total of 20 patients (12 females, 8 males) with mandibular ridge height < 10 mm and with reduced buccolingual diameter were included in the study. All patients were clinically examined and panoramic radiographs and CBCT-s were obtained. Each patient received four MDIs (Dentium, Seul, Korea – 2.0 or 2.5 mm wide, 6 or 8 mm long) in intraforaminal region without reflecting a flap (Fig 2, 3). After 3 months of osseointegration all new mandibular overdentures reinforced with CoCr metal framework were made. Patients completed the OHIP14-CRO questionnaire and the chewing function questionnaire at the baseline (before treatment and implant insertion), two weeks after overdentures had been delivered and all adjustments finished, at the one year stage of observation and only in 10 patients after 3 years follow-up. Results Finite element analysis All 6 sizes of MDIs and all 4 positions showed similar stress distribution in bone (Fig. 4). In all models under axial loading, the highest Von Mises stresses and elastic equivalent strain were observed around the apex of the implant, whereas under off-axial loading (45°), the maximum von- Mises stress and elastic equivalent strain were concentrated in the cervical regions of the implant (Fig. 5, 6). The maximum von-Mises stress values and maximum elastic equivalent strain values for each implant are shown on Fig. 7 and 8. Clinical prospective study All 20 patients were successfully provided with four slim and short MDIs and a new mandibular complete denture (MCD) reinforced with CoCr metal framework. At the baseline 70% of patients were not able to wear their old MCDs at all. However, after receiving new MCDs retained by MDIs, all of the patients were able to successfully wear their dentures. Results for patients’ centered outcomes (OHRQoL and self- reported chewing function) are presented in Fig. 9 and 10. Conclusions Preliminary clinical results are promising ; however more patients and a longer period of observation will be necessary to confirm the treatment success.
Izvorni jezik
Engleski
Znanstvena područja
Dentalna medicina
POVEZANOST RADA
Projekti:
HRZZ-DS-01.01/15 - Doktorski poslijediplomski studij biomedicina i zdravstvo
Ustanove:
Stomatološki fakultet, Zagreb,
Grafički fakultet, Zagreb
Profili:
Ines Kovačić
(autor)
Alan Divjak
(autor)
Asja Čelebić
(autor)
Josip Kranjčić
(autor)
Sanja Peršić Kiršić
(autor)
Damir Modrić
(autor)