Academy for Oral Implantology

Vienna, Austria

Academy for Oral Implantology

Vienna, Austria
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Pohl V.,Academy for Oral Implantology | Pohl S.,Medical University of Vienna | Sulzbacher I.,Medical University of Vienna | Fuerhauser R.,Academy for Oral Implantology | And 2 more authors.
International Journal of Oral and Maxillofacial Implants | Year: 2017

Purpose: To evaluate the use of chemically unchanged tooth material in lateral alveolar ridge augmentation or for the filling of jaw defects. Materials and Methods: A total of 20 patients underwent either lateral augmentation of the alveolar process (11 patients) or filling of jaw defects (6 patients) with autogenous unaltered tooth material in a longitudinal 2-year study. In three patients, the jaw defect was so marked that a bone block graft had to be used for augmentation in addition to particulate dental material. In four patients, an autogenous tooth block was exclusively used; in seven, crushed tooth material was exclusively used; and in the remaining six, dystopic teeth that had been extracted were removed, crushed, and reinserted into the defect in particulate form. Fully impacted teeth served as autogenous donor teeth. Results: After a healing time of 3 to 6 months, 28 implants could be placed (10 immediate implants, 18 delayed implants). At 6, 12, and 24 months postrestoration, peri-implant bone loss as assessed by x-ray was 0 mm, 0.4 mm, and 0.6 mm, respectively. Peri-implant probing depth was 1 mm after 1 year and 2 mm after 2 years. Bleeding on probing was not seen in any of the implants after 2 years. Conclusion: Autogenous tooth material appears to be suitable for the restoration of lateral and intraosseous defects of the alveolar ridge with both complete blocks and in particulate form. However, additional long-term studies with higher case numbers will be required for substantiating these results. © 2017 by Quintessence Publishing Co Inc.

PubMed | University of Vienna and Academy for Oral Implantology
Type: | Journal: Clinical implant dentistry and related research | Year: 2016

Implant esthetics may benefit from individualized zirconia abutments copying the emergence profile of the natural tooth and delivered within days after immediate implant insertion.To investigate the esthetic outcome of the Copy-Abutment technique using the Pink Esthetic Score (PES).A total of 77 patients with single-tooth implants in the anterior maxilla restored at the day of immediate implant placement using Copy-Abutments and provisional crowns were followed-up after 1 week, 1 month, 4 months, 6 months, 1, 2, 3, 4, and 5 years to assess implant esthetics.PES ranged between 7 and 14 (median: 13) and improved significantly between the 6 month and 1 year follow-up (p<.001), then remained stable up to the fifth year. Significant improvement was seen for the variables PES-6 soft tissue color (p=.002) and PES-7 soft tissue texture (p<.001) up to the 1 year follow-up, while PES-5 alveolar process deficiency deteriorated (p=.016). Mean mucosal recession was 0.260.86 mm (range: 0-1.6) after 5 years and not related to gingival biotype.Copy-Abutments for immediate restoration of implants in the esthetic zone show satisfactory long-term esthetic outcomes.

Furhauser R.,Academy for Oral Implantology | Mailath-Pokorny G.,Academy for Oral Implantology | Haas R.,Academy for Oral Implantology | Busenlechner D.,Academy for Oral Implantology | And 2 more authors.
International Journal of Oral and Maxillofacial Implants | Year: 2016

Failing residual dentition gives rise to patient concerns about the surgical and prosthodontic management of immediate implant rehabilitation. The purpose of this study was to assess subjective patient experiences of full-arch immediate implant loading. Materials and Methods: Patients made a transition from poor dentition in the maxilla (25 patients) or mandible (25 patients) to full-arch rehabilitation on the day of extraction using four interantral or interforaminal implants. Provisional restoration was performed, and postoperative pain, swelling, and patient-perceived impairment in the first week was recorded. Results: Absence of pain was reported by 40%, 52%, and 66% of patients, on the day of surgery, on the first day after surgery, and on the second day after surgery, respectively; pain levels decreased significantly (from 1.8 to 0.9, P <.001) and patient-reported swelling decreased from 1.5 to 1.3 (P =.058) on a 10-point scale. Postoperative impairment of everyday life and work (mean score = 1.1) was significantly less pronounced than impairment of food intake (mean score = 2.2; P =.004) or speech (mean score = 1.9; P =.002). Of these patients, 88% would again undergo the procedure without doubt. Conclusion: Although patient-perceived morbidity after immediate full-arch implant rehabilitation is low in general, minor masticatory and phonetic impairment should be taken into account. © 2016 by Quintessence Publishing Co Inc.

Pommer B.,Academy for Oral Implantology | Unger E.,Medical University of Vienna | Busenlechner D.,Academy for Oral Implantology | Haas R.,Academy for Oral Implantology | And 3 more authors.
Materials | Year: 2015

Bone grafting of the maxillary sinus is attempted to compensate for sinus pneumatization and permit reliable insertion of endosseous dental implants for prosthetic rehabilitation. The aim of the present clinical investigation was to study bone regeneration four months after transcrestal sinus floor elevation via the Gel-Pressure Technique (GPT) and application of pasteous nano-crystalline hydroxyapatite bone substitute. A total of 25 patients with deficient alveolar ridges in the posterior maxilla (mean residual bone height: 4.7 ± 1.8 mm) were subjected to 32 flapless transcrestal sinus floor augmentations and simultaneous insertion of 40 implants. Sinus membrane elevation height averaged 11.2 ± 2.7 mm and minimal vertical graft resorption of 0.1 mm was observed after four months. Radiographic bone density averaged 460 Hounsfield units in regions adjacent to the native jawbone (1 to 7 mm distance), while reduction of bone density by -7.2%, -11.3%, -14.8%, -19.6% and -22.7% was recorded in more apical regions of 8, 9, 10, 11, and ≥12 mm distance to the original sinus floor, respectively. The results suggest that graft remodeling is completed up to a distance of 7 mm within a healing period of four months after sinus augmentation using nano-crystalline hydroxyapatite bone substitute material. © 2015 by the authors.

Pohl V.,Academy for Oral Implantology | Schuh C.,Medical University of Vienna | Fischer M.B.,Medical University of Vienna | Fischer M.B.,Danube University Krems | Haas R.,Academy for Oral Implantology
International Journal of Oral and Maxillofacial Implants | Year: 2016

Purpose: This prospective longitudinal study reports on the results in patients given autologous tooth material for augmentation in a sinus elevation procedure. Materials and Methods: Six patients with inadequate bone supply for augmentation in the maxillary posterior tooth region and at least one impacted maxillary third molar underwent sinus elevation surgery with lateral access using the particulate tooth material. One of the patients received four implants during the same session, while the other patients had a total of 15 implants placed after a healing phase of an average 5.5 months. Drill cylinders collected from the implant bed during the procedure were subjected to histologic/immunohistochemical evaluation. Results: All six patients showed normal and unobtrusive postoperative healing, having undergone prosthetic restoration up to 5 years before. The average peri-implant probing pocket depth after a period of up to 5 years ranged between 1.86 mm (mesial and lingual) and 2.07 mm (distal and buccal). No bleeding could be triggered with any of the peri-implant probes. The average peri-implant bone resorption measured during the first year was up to 0.63 mm, with the lowest being 0 mm and the maximum 2.9 mm. Peri-implant bone remained stable for the follow-up time of up to 5 years. Histologically, six biopsy specimens collected from five patients showed osteoconductive osteogenesis with encapsulation of tooth enamel and dentin portions and partial resorption of the tooth components. Cementum shares were no longer discernible. Immunohistochemical assessment showed intense new vessel formation that could be observed in the area of loose stroma of reorganized tissue in the augmented area. Conclusion: Within the limits of these preliminary results and with adequate consideration of the small number of patients included, the use of autogenous crushed tooth material from impacted third molars may represent an alternative augmentation material for use in sinus elevation procedures. © 2016 by Quintessence Publishing Co Inc.

Schwarz L.,Medical University of Vienna | Schiebel V.,Medical University of Vienna | Hof M.,Medical University of Vienna | Ulm C.,Medical University of Vienna | And 3 more authors.
Journal of Oral and Maxillofacial Surgery | Year: 2015

Purpose To test patient- and sinus-related risk factors for an association with intraoperative membrane perforation and postoperative complications after sinus floor augmentation surgery. Materials and Methods Sinus floor elevation procedures using a lateral approach were retrospectively analyzed for patients' medical history and sinus anatomy on computed tomographic scans. Complications per sinus after membrane elevation and augmentation using a mixture of autologous bone and deproteinized bovine bone substitute (Bio-Oss) were recorded. Logic regression (adjusted using the generalized estimation equation approach) was performed to analyze the influence of patient age, gender, smoking habits, sinus septa, residual bone height, and mesiodistal elevation width. Results Of 407 sinus grafts in 300 patients (mean age, 56 yr), perforation of the Schneiderian membrane occurred in 35 sinuses (8.6%) and was significantly associated to the presence of sinus septa (odds ratio [OR] = 4.8; P =.002) and decreased residual bone height (OR = 0.01; P <.001). Smoking increased the risk of membrane perforation (OR = 4.8; P =.002), sinusitis (OR = 12.3; P <.001), and wound dehiscence (OR = 16.1; P = .005). Cases of sinus membrane perforation had higher odds for postoperative sinusitis (OR = 10.5; P <.001). The probability of wound dehiscence increased with the size of the elevated area (OR = 3; P <.001). Conclusion The results of the study suggest that the presence of sinus septa and residual bone height less than 3.5 mm are the main risk factors increasing sinus membrane perforation rates. There was a higher prevalence for sinusitis in cases of membrane perforation (31.4%) despite intraoperative closure with resorbable membranes (Bio-Guide). Smokers generally exhibited greater chances for complications. © 2015 American Association of Oral and Maxillofacial Surgeons.

PubMed | Academy for Oral Implantology
Type: Journal Article | Journal: Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery | Year: 2016

Minimally invasive implantology using reduced implant dimensions as well as virtual treatment planning and CAD/CAM stereolithographic templates has gained popularity in recent years. The aim of the present investigation was to analyze prevailing trends in clinical utilization of these graftless therapeutic options.A total of 12.865 dental implants were placed in 5.365 patients at the Academy for Oral Implantology in Vienna, of which 5.5% were short (length<10mm), 19.5% narrow (diameter<3.75mm) and 10.6% template-guided. Application trends were analyzed using linear regression and compared between jaw location and dentition subgroups.Use of short implants and guided surgery increased significantly in all subgroups. Narrow-diameter implants were most frequent in single-tooth gaps (24.1%), however, upward trends could only be observed in partially and completely edentulous patients. Short implants were predominantly used in the mandible (9.9% vs. 2.5%, P<0.001) while guided surgery was favored in the maxilla (14.2% vs. 5.4%, P<0.001).Short implants (most frequent in partial edentulism) and guided implant surgery (most frequent in complete edentulism) represent uprising and promising surgical approaches to avoid patient morbidity associated with bone graft surgery.

PubMed | Academy for Oral Implantology
Type: Journal Article | Journal: Journal of periodontal & implant science | Year: 2014

Rehabilitation of the incomplete dentition by means of osseointegrated dental implants represents a highly predictable and widespread therapy; however, little is known about potential risk factors that may impair long-term implant success.From 2004 to 2012, a total of 13,147 implants were placed in 4,316 patients at the Academy for Oral Implantology in Vienna. The survival rates after 8 years of follow-up were computed using the Kaplan-Meier method, and the impact of patient- and implant-related risk factors was assessed.Overall implant survival was 97% and was not associated with implant length (P=0.930), implant diameter (P=0.704), jaw location (P=0.545), implant position (P=0.450), local bone quality (P=0.398), previous bone augmentation surgery (P=0.617), or patient-related factors including osteoporosis (P=0.661), age (P=0.575), or diabetes mellitus (P=0.928). However, smoking increased the risk of implant failure by 3 folds (P<0.001) and a positive history of periodontal disease doubled the failure risk (P=0.001).Summing up the long-term results of well over 10,000 implants at the Academy for Oral Implantology in Vienna it can be concluded that there is only a limited number of patients that do not qualify for implant therapy and may thus not benefit from improved quality of life associated with fixed implant-retained prostheses.

PubMed | Academy for Oral Implantology and Medical University of Vienna
Type: Journal Article | Journal: Clinical implant dentistry and related research | Year: 2016

Discrimination between ongoing and solved research questions may help to distinguish established dogmas from evidence-based implant dentistry.The purpose of this study was to investigate topics of interest in the field of oral implant science and evolving thematic trends in clinical studies during the last decade.Electronic and manual searches of English literature were performed to identify clinical studies on oral implants. Out of 15,695 publications screened, 2,875 clinical investigations were included.Among the most prevalent topics were immediate loading (14.3%), bone substitutes (11.6%), lateral sinus grafting (10.7%), implant overdentures (10.5%), single-tooth implant crowns (8.8%), cross-arch implant bridges (8.0%), immediate implant placement (7.5%), implant surfaces (7.0%), simultaneous implant placement and augmentation (6.4%) as well as guided bone regeneration (5.3%). Significant increase of scientific interest was seen in immediate loading (+6.3%, p<.001), platform switching (+2.9%, p<0.001), lateral sinus grafting (+2.3%, p=.024), flapless implant surgery (+2.2%, p<0.001), and guided implant surgery (+1.9%, p=.011), while research on implant overdentures (-6.6%, p=.033) and tooth-to-implant connection (-2.5%, p=.010) was on the decline.Literature coverage, since the beginning of the 21st century, has seen greater focus on surgical topics compared to prosthodontic issues (p=.005) while only few topics experienced decrease of interest indicating scientific consensus.

PubMed | Academy for Oral Implantology
Type: | Journal: Clinical implant dentistry and related research | Year: 2015

Flapless implant placement using surgical templates may guarantee predictable and esthetic results provided that preplanned implant positions are transfered precisely into surgical reality.The study aims to investigate the effect of three-dimensional accuracy in guided implant surgery on the esthetic outcome of single-tooth implants in the anterior maxilla.Single-tooth implants for delayed replacement of upper incisors were inserted in 27 patients using stereolithographic templates. Superimposition of postoperative cone beam computed tomography (CBCT) scans allowed assessment of positional inaccuracy at the implant shoulder and apex, as well as angular deviation. Objective evaluation of implant esthetics was performed after a mean follow-up of 2.3 years using the Pink Esthetic Score (PES).Mean deviation between planned and actual implant position was 0.84mm at the implant shoulder and significantly correlated to average PES of 12 (p=.031). Inaccuracy toward the buccal side was most frequent (70%). Deviations 0.8 mm resulted in significantly worse implant esthetics (median PES: 9.5, interquartile range [IQR]: 8-11) compared with more accurate implant positions (median PES: 13, IQR: 12-13, p=.039).Positional inaccuracy is low in guided implant surgery, but may however significantly compromise implant esthetics in the anterior maxilla.

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