Volume 4, Issue 2, December 2018, Page: 35-41
Restoration of the Atrophic Maxilla with Four Narrow and Ultrashort Implants
Rolf Ewers, University Hospital for Cranio-Maxillofacial and Oral Surgery Medical University of Vienna, Vienna, Austria
Mauro Marincola, Implant Dentistry Center, University of Cartagena, Cartagena, Colombia
Vincent Morgan, Bicon Implant Institute, Boston, USA
Paolo Perpetuini, Dental Laboratory, Cisterna di Latina, Italy
Florian Wagner, University Hospital for Cranio-Maxillofacial and Oral Surgery Medical University of Vienna, Vienna, Austria
Rudolf Seemann, University Hospital for Cranio-Maxillofacial and Oral Surgery Medical University of Vienna, Vienna, Austria
Received: Sep. 6, 2018;       Accepted: Oct. 9, 2018;       Published: Oct. 27, 2018
DOI: 10.11648/j.ijcoms.20180402.11      View  170      Downloads  5
Presented is a prospective cohort study of 72 calcium phosphate coated Bicon Integra-CP implants for 18 patients with pronounced class V and VI maxillary atrophy according to the classification of Cawood and Howell (1988) and treated with four ultrashort 4.0 x 5.0 mm locking taper implants. The patients were divided into three groups. For the first group, four 4.0 x 5.0 mm implants were placed. For the second group, two narrow 3.0 x 8.0 mm implants were placed in very thin anterior alveolar bone. For the third group, the alveolar bone in the premolar and molar region was too narrow and too shallow; therefore, 4.0 x 5.0 mm implants were placed in the maxillary tuberosities. All implants were restored with TRINIA, a metal-free fiber-reinforced hybrid resin CAD/CAM material. Two patients lost one implant each during the observation period, which were subsequently replaced successfully. The cumulative one-year patient-based implant survival rate (CSR) was 88.8%. The cumulative one-year implant-based survival rate was 97.2%. Since the patients with a failed implant were able to wear their prosthesis with only three implants while the replacement implants were being osseointegrated, this resulted in 100% prosthetic success. The good result allows the conclusion that the long-term use of four ultrashort and narrow locking taper implants reveal a comparable outcome to standard size implants with complex bone augmentations.
Ultrashort Implants, Locking Taper or Conical Implants, Maxillary Atrophy, Maxillary Tuberosity Implants, Avoiding Sinus Lift Procedures, Avoiding Augmentation Procedures, Metal-Free Fiber-Reinforced Hybrid Resin Prosthesis, CAD/CAM Prostheses Fabrication
To cite this article
Rolf Ewers, Mauro Marincola, Vincent Morgan, Paolo Perpetuini, Florian Wagner, Rudolf Seemann, Restoration of the Atrophic Maxilla with Four Narrow and Ultrashort Implants, International Journal of Clinical Oral and Maxillofacial Surgery. Vol. 4, No. 2, 2018, pp. 35-41. doi: 10.11648/j.ijcoms.20180402.11
Copyright © 2018 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Wagner, F., Dvorak, G., Nemec, S., Pietschmann, P., Figl, M. & Seemann, R. A principal components analysis: How pneumatization and edentulism contribute to maxillary atrophy. Oral Diseases 2017 23: 55-61.
Tatum OH. Lecture presented to the Alabama Implant Congress. Alabama Implant Congress. 1976. doi:10.1111/cid.12136/full.
Boyne PJ, James RA. Grafting of the maxillary sinus floor with autogenous marrow and bone. J Oral Surg. 1980; 38(8):613-616.
Mellonig JT, Bowers GM, Bailey RC. Comparison of bone graft materials. Part I. New bone formation with autografts and allografts determined by Strontium-85. J Periodontol. 1981;52(6):291-296. doi:10.1902/jop.1981.52.6.291.
Tatum H. Maxillary and sinus implant reconstructions. Dent Clin North Am. 1986;30(2):207-229.
Ewers R. Maxilla sinus grafting with marine algae derived bone forming material: a clinical report of long-term results. J Oral Maxillofac Surg. 2005; 63(12):1712-1723. doi:10.1016/j.joms.2005.08.020.
Summers RB. A new concept in maxillary implant surgery: the osteotome technique. Compendium. 1994;15(2):152–154–6–158passim–quiz162.
Summers RB. The osteotome technique: Part 3--Less invasive methods of elevating the sinus floor. Compendium. 1994;15(6):698–700–702–4passim–quiz710.
Ali SA, Karthigeyan S, Deivanai M, Kumar A. Implant Rehabilitation For Atrophic Maxilla: A Review. The Journal of Indian Prosthodontic Society. 2014;14(3):196-207. doi:10.1007/s13191-014-0360-4.
Pérez-Martínez S, Martorell-Calatayud L, Peñarrocha-Oltra D, García-Mira B, Peñarrocha-Diago M.: Indirect sinus lift without bone graft material: Systematic review and meta-analysis. J Clin Exp Dent. 2015 Apr 1;7(2):e316-9.
Cawood JI, Howell RA. A classification of the edentulous jaws. Int J Oral Maxillofac Surg. 1988 Aug;17(4):232–6.
Ewers R, Perpetuini P, Morgan V, Marincola M, Wu R, Seemann R. TRINIA™— Metal-free restorations. Implants 2017, 1:2-7.
Wagner F, Seemann R, Marincola M, Ewers R. Fixed, fiber-reinforced resin fixed prostheses on four short implants in severely atrophic maxillas: 1-year results of a prospective cohort study. J Oral Maxillofac Surg. 2018 Jun; 76(6):1194-1199. doi: 10.1016/j.joms.2018.02.001. Epub 2018 Feb 19.
Lopes LF, da Silva VF, Santiago JF Jr, Panzarini SR, Pellizzer EP. Placement of dental implants in the maxillary tuberosity: a systematic review. Int J Oral Maxillofac Surg. 2015 Feb;44(2):229-38.
Härle F, Ewers R. Die Hufeisenosteotomie mit Knocheninterposition zur Erhöhung des Knochenkammes: eine im Experiment steckengebliebene Operationsmethode. Dtsch. Zahnärztl Z 1980;35:105-107.
Yerit K, Posch M, Hainich S, Turhani D, Klug C, Wanschitz F, Wagner A, Watzinger F, Ewers R. Long-term implant survival in the grafted maxilla: results of a 12-year retrospective study. Clin Oral Impl Res 15:693-699, 2004.
Ewers R. Standard clinical Situations - 4.7 Edentulous Maxilla In: Oral Implants – Bioactivating concepts Editors: Ewers R, Lambrecht JT, Quintessenz Publ. Co. Chicago 2012:329-356
Lehrberg J, Coelho P. Biologic Response to Dental Implants In: The Bicon Short Implant: A Thirty-Year Perspective Editor Morgan VJ, Quintessenz Publ. Co. Chicago 2017:37-47.
Daher S, Ewers R, Cicconetti A. Ridge Splitting and the Split-Thickness Flap In: The Bicon Short Implant: A Thirty-Year Perspective Editor Morgan VJ, Quintessenz Publ. Co. Chicago 2017:81-198.
Aparicio C, Ouazzani W, Aparicio A, Fortes V, Muela R, Pascual A, Codesal M, Barluenga N, Franch M. Immediate/Early loading of zygomatic implants: clinical experiences after 2 to 5 years of follow-up. Clin Implant Dent Relat Res. 2010 May;12 Suppl 1:e77-82.
Blanco J, Suárez J, Novio S, Villaverde G, Ramos I, Segade LA. Histomorphometric assessment in human cadavers of the peri-implant bone density in maxillary tuberosity following implant placement using osteotome and conventional techniques: Clin Oral Implants Res. 2008 May;19(5):505-10.
Ewers R, Seemann R, De Witt T, Sarvan I, Coetzer M, Pisarik K. Atrophic Maxillary Ridges In: The Bicon Short Implant: A Thirty-Year Perspective Editor Morgan VJ, Quintessenz Publ. Co. Chicago 2017:199-213.
Ewers R, Marincola M, Perpetuini P, Seemann R, Morgan V, Wu R. Leichtgewicht im Praxistest-Restaurationen bei schwierigen Situationen und atrophen Kiefern: Z Oral Implant. 13: 1/17; 28-36.
Seemann, R., Jirku, A., Wagner, F. & Wutzl, A. (2017) What do sales data tell us about implant survival? PloS One 12: e0171128.
Neugebauer J, Vizethum F, Berger C, Bolz W, Bowen A, Deporter D, Ewers R, Fairbairn P, Felino A, Fortin T, Gowd V, Kern M, Kobler P, Konstantinovic V, Marincola M, Nickenig HJ, Özyuvaci H, Schmedtmann N, Zöller JE. Update: Kurze, angulierte und durchmesserreduzierte Implantate - Praxisleitfaden: 11. Europäische Konsensuskonferenz (EuCC). BDIZ/EDI Konkret 2016; 20: 88-90.
Felice P, Checchi L, Barausse C, Pistilli R, Sammartino G, Masi I, Ippolito DR, Esposito M. Posterior jaws rehabilitated with partial prostheses supported by 4.0 x 4.0 mm or by longer implants: One-year post-loading results from a multicenter randomised controlled trial. Eur J Oral Implantol. 2016 Spring; 9(1):35-45.
Pohl, V., Thoma, D. S., Sporniak-Tutak, K., Garcia-Garcia, A., Taylor, T. D., Haas, R. & Hammerle, C. H. (2017) Short dental implants (6 mm) versus long dental implants (11-15 mm) in combination with sinus floor elevation procedures: 3-year results from a multicenter, randomized, controlled clinical trial. Journal of Clinical Periodontology 44: 438-445.
Browse journals by subject