Additively Manufactured Subperiosteal Implants for the Rehabilitations of Lateral Incisors Agenesis - a case series.

IF 2.2 3区医学 Q2 Dentistry

Journal of Stomatology Oral and Maxillofacial Surgery Pub Date : 2025-01-25 DOI:10.1016/j.jormas.2025.102263

Marco Roy, Mauro Cerea, Wieslaw Hedzelek, Luigi Angelo Vaira, Barbara Dorocka-Bobkowska

{"title":"Additively Manufactured Subperiosteal Implants for the Rehabilitations of Lateral Incisors Agenesis - a case series.","authors":"Marco Roy, Mauro Cerea, Wieslaw Hedzelek, Luigi Angelo Vaira, Barbara Dorocka-Bobkowska","doi":"10.1016/j.jormas.2025.102263","DOIUrl":null,"url":null,"abstract":"Background: Tooth agenesis, particularly the absence of upper lateral incisors, presents substantial challenges for clinicians due to the associated bone atrophy, which limits the use of traditional implant solutions. Current options, such as endosseous implants combined with guided bone regeneration (GBR), often fail due to insufficient osseointegration in atrophic bone. This study aims to evaluate the effectiveness of custom-made, additively manufactured subperiosteal implants in addressing these challenges METHODS: This retrospective study assessed 16 custom-made subperiosteal implants used in 12 patients (10 females, 2 males; mean age 25 ± 2.3 years) with lateral incisor agenesis who had previously experienced early implant failure with conventional endosseous implants. The protocol included subperiosteal implants combined with bovine bone grafts and PRF membranes, allowing for immediate loading and correct prosthetic alignment. Clinical evaluations focused on implant stability, peri-implant tissue health and esthetic (including probing depths and bleeding on probing), and prosthetic success over time.Results: During a follow-up period of 18 to 64 months (mean 48 ± 6.7 months), all patients maintained stable implants, with no implant failures reported. Biological outcomes demonstrated stable peri-implant health, with probing depths averaging 3 mm and minimal signs of inflammation. The mean pink esthetic score was 12.3 ± 1.1 (range: 10 to 14). Prosthetic complications were limited to minor adjustments, with two cases requiring recementing of crowns after three years.Conclusions: The results indicate that this new protocol provides a reliable, single-procedure solution for the rehabilitation of lateral incisor agenesis in patients with significant bone atrophy, achieving a 100% success rate in this study. Despite promising outcomes, the study is limited by a small sample size and the need for longer follow-up to assess durability. This approach offers a viable alternative for patients where traditional implants are not feasible due to bone deficiencies.","PeriodicalId":56038,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":" ","pages":"102263"},"PeriodicalIF":2.2000,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Stomatology Oral and Maxillofacial Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jormas.2025.102263","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Dentistry","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Tooth agenesis, particularly the absence of upper lateral incisors, presents substantial challenges for clinicians due to the associated bone atrophy, which limits the use of traditional implant solutions. Current options, such as endosseous implants combined with guided bone regeneration (GBR), often fail due to insufficient osseointegration in atrophic bone. This study aims to evaluate the effectiveness of custom-made, additively manufactured subperiosteal implants in addressing these challenges METHODS: This retrospective study assessed 16 custom-made subperiosteal implants used in 12 patients (10 females, 2 males; mean age 25 ± 2.3 years) with lateral incisor agenesis who had previously experienced early implant failure with conventional endosseous implants. The protocol included subperiosteal implants combined with bovine bone grafts and PRF membranes, allowing for immediate loading and correct prosthetic alignment. Clinical evaluations focused on implant stability, peri-implant tissue health and esthetic (including probing depths and bleeding on probing), and prosthetic success over time.

Results: During a follow-up period of 18 to 64 months (mean 48 ± 6.7 months), all patients maintained stable implants, with no implant failures reported. Biological outcomes demonstrated stable peri-implant health, with probing depths averaging 3 mm and minimal signs of inflammation. The mean pink esthetic score was 12.3 ± 1.1 (range: 10 to 14). Prosthetic complications were limited to minor adjustments, with two cases requiring recementing of crowns after three years.

Conclusions: The results indicate that this new protocol provides a reliable, single-procedure solution for the rehabilitation of lateral incisor agenesis in patients with significant bone atrophy, achieving a 100% success rate in this study. Despite promising outcomes, the study is limited by a small sample size and the need for longer follow-up to assess durability. This approach offers a viable alternative for patients where traditional implants are not feasible due to bone deficiencies.

查看原文本刊更多论文

背景：牙齿缺失，尤其是上侧切牙缺失，给临床医生带来了巨大的挑战，因为相关的骨质萎缩限制了传统种植解决方案的使用。目前的方案，如结合引导骨再生（GBR）的骨内种植体，往往因萎缩骨的骨结合不足而失败。本研究旨在评估定制的、添加剂制造的骨膜下种植体在应对这些挑战方面的有效性方法：本回顾性研究评估了 16 个定制的骨膜下种植体，这些种植体用于 12 名侧切牙缺失患者（10 名女性，2 名男性；平均年龄为 25 ± 2.3 岁），这些患者之前曾因使用传统的骨内种植体而经历过早期种植失败。该方案包括将骨膜下种植体与牛骨移植和 PRF 膜结合在一起，从而实现即时加载和正确的修复对齐。临床评估的重点是种植体的稳定性、种植体周围组织的健康和美观（包括探诊深度和探诊出血），以及随着时间的推移修复体的成功率：结果：在 18 到 64 个月的随访期间（平均 48 ± 6.7 个月），所有患者的种植体都保持稳定，没有种植失败的报告。生物学结果显示种植体周围健康状况稳定，探查深度平均为 3 毫米，炎症迹象极少。平均粉色美学评分为 12.3 ± 1.1（范围：10 至 14）。修复并发症仅限于轻微的调整，有两个病例在三年后需要更换牙冠：研究结果表明，这一新方案为骨质严重萎缩患者的侧切牙缺失修复提供了可靠的单次手术解决方案，成功率达到 100%。尽管研究结果令人鼓舞，但由于样本量较小，且需要更长时间的随访来评估耐久性，因此研究受到了限制。这种方法为因骨缺损而无法使用传统种植体的患者提供了一种可行的替代方案。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Stomatology Oral and Maxillofacial Surgery Dentistry-Oral Surgery

CiteScore

2.20

自引率

9.10%

发文量

305

期刊介绍： J Stomatol Oral Maxillofac Surg publishes research papers and techniques - (guest) editorials, original articles, reviews, technical notes, case reports, images, letters to the editor, guidelines - dedicated to enhancing surgical expertise in all fields relevant to oral and maxillofacial surgery: from plastic and reconstructive surgery of the face, oral surgery and medicine, … to dentofacial and maxillofacial orthopedics. Original articles include clinical or laboratory investigations and clinical or equipment reports. Reviews include narrative reviews, systematic reviews and meta-analyses. All manuscripts submitted to the journal are subjected to peer review by international experts, and must: Be written in excellent English, clear and easy to understand, precise and concise; Bring new, interesting, valid information - and improve clinical care or guide future research; Be solely the work of the author(s) stated; Not have been previously published elsewhere and not be under consideration by another journal; Be in accordance with the journal''s Guide for Authors'' instructions: manuscripts that fail to comply with these rules may be returned to the authors without being reviewed. Under no circumstances does the journal guarantee publication before the editorial board makes its final decision. The journal is indexed in the main international databases and is accessible worldwide through the ScienceDirect and ClinicalKey Platforms.