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Bibliografía de implantes personalizados

1. Osteointegración de implantes subperiósticos empleando sustituto óseo bovino y membranas.

Cómo citar este artículo científico:

Aaboe M, Schou S, Hjørting-Hansen E, Helbo M, Vikjaer D. Osseointegration of subperiosteal implants using bovine bone substitute and various membranes. Clin Oral Implants Res. 2000 Feb;11(1):51-8.

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An earlier study revealed incomplete osseointegration of individually made titanium subperiosteal implants covered by ePTFE membranes and fixated to the rabbit tibial bone surface. In addition, the newly-formed bone was dominated by large marrow spaces. In this subsequent study, subperiosteal implants were alsofixated on the bone surface of both tibia of 9 Copenhagen White rabbits. Bio-Oss particles were packed densely covering the entire implant surface. One of 3 different membranes covered the implant and the particles. The membranes used were the degradable Polyglactin 910 mesh, a degradable bilayer collagen membrane and the non-degradable ePTFE membrane. Undecalcified sections were prepared for histologic evaluation after a 12 weeks’ observation period. All 18 subperiosteal implants were completely osseointegrated. In addition, the marrow spaces were reduced compared to our previous study. The Bio-Oss particles proved to be biocompatible and osteoconductive. The ePTFE membranes revealed neither signs of collapse nor adjacent infiltration of inflammatory cells. The Polyglactin 910 mesh and the bilayer collagen membranes collapsed slightly. There were signs of resorption of the surface of the newly-formed bone under the degradable membranes. The cause of resorption can not be documented.
DOI: 10.1034/j.1600-0501.2000.011001051.x
PMID: 11168194 [Indexed for MEDLINE]

2. Papel de los implantes subperiósticos personalizados en la rehabilitación de los maxilares atróficos: informe de caso.

Cómo citar este artículo científico:

Ângelo DF, Vieira Ferreira JR. The role of custom-made subperiosteal implants for rehabilitation of atrophic jaws – A case report. Ann Maxillofac Surg 2020;10:507-11.

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Rehabilitation of atrophic jaws with conventional endosseous implant-supported overdentures and immediate loading protocols still presents a challenge nowadays. Custom-made implants with immediate loading overdenture are emerging as a solution for atrophic jaws rehabilitation. The authors describe the case of a 44-year-old male with a history of congenital dental agenesis. A previous oral rehabilitation with an all-on-6 type, implant-fixed mandibular overdenture, had failed due to peri-implantitis. The patient was successfully treated with bimaxillary custom-made subperiosteal implants with an innovative design, combining subperiosteal and endosseous support. The authors consider custom-made subperiosteal implants, in selected patients, present several advantages over classic bone-grafting plus endosseous implant-placement techniques such as (1) possibility of a single-stage procedure with immediate loading in atrophic jaws; (2) possible primary option to approach atrophic jaws as a simpler and less time-consuming technique; and (3) a valid rescue option for failed endosseous implants. More long-term studies with large samples of patients will be necessary to confirm previous assumptions.

3. Implantes subperiósticos a medida de titanio de sinterización por láser: estudio clínico retrospectivo en 70 pacientes. 2018.

Cómo citar este artículo científico:

Cerea M, Dolcini GA. Custom-Made Direct Metal Laser Sintering Titanium Subperiosteal Implants: A Retrospective Clinical Study on 70 Patients. Biomed Res Int. 2018 May 28;2018:5420391.

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PURPOSE: To present a digital technique for the fabrication of custom-made subperiosteal implants and to report on the survival and complication rates encountered when using these fixtures.
METHODS: The data used for this retrospective clinical study were derived from the medical records of five different private dental practices. Inclusion criteria were patients over the age of 60, treated with custom-made direct metal laser sintering (DMLS) titanium subperiosteal implants (Eagle-Grid®, BTK, Dueville, Vicenza) during a two-year period (2014-2015) and estored with fixed restorations; all enrolled patients needed to have complete pre- and postoperative clinical and radiographic documentation, with at least 2 years of follow-up. Exclusion criteria were smoking and bruxism. The main outcomes looked at were implant survival and complications.
RESULTS: Seventy patients (39 males and 31 females, aged 62-79 years) who had been treated with custom-made DMLS titanium subperiosteal implants were enrolled in this study. After 2 years of follow-up, three implants were lost due to recurrent, untreatable infections; the survival rate was therefore 95.8% (67/70 implants). Four patients reported pain/discomfort/swelling after mplant placement; the incidence of immediate postoperative complications was therefore 5.7% (4/70 implants). During the follow-up period, one patient suffered from recurrent infections classified as a biologic complication; the incidence ofbiologic complications was therefore 1.4% (1/67 surviving implants). Finally, four patients experienced prosthetic problems with their implant-supported restorations during the provisional phase (fracture of the acrylic restoration) and two patients had ceramic chipping of the definitive restoration; the incidence of prosthetic complications was therefore 8.9% (6/67 surviving implants).
CONCLUSIONS: Within the limits of the present study (limited follow-up time and low number of patients treated, retrospective design), the application of custom-made DMLS titanium subperiosteal implants showed satisfactory implant survival (95.8%) and low complication rates. Further studies are needed to confirm the positive outcomes found in this research.
DOI: 10.1155/2018/5420391
PMCID: PMC5994585
PMID: 29998133 [Indexed for MEDLINE]

4. Evaluación de la osteointegración y nueva formación ósea alrededor de implantes subperiósticos de titanio mediante histomorfometría y nanoindentación. 2015

Cómo citar este artículo científico:

Claffey N, Bashara H, O’Reilly P, Polyzois I. Evaluation of New Bone Formation and Osseointegration Around Subperiosteal Titanium Implants with Histometry and Nanoindentation. Int J Oral Maxillofac Implants. 2015 Sep-Oct;30(5):1004-10

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PURPOSE: To assess the quality and quantity of newly formed bone around rough-surfaced titanium subperiosteal implants stabilized with two different fixation techniques and to investigate nanoindentation as a method for measuring the elastic properties of the bone around these implants.
MATERIALS AND METHODS: Ten 6-month-old white rabbits were used in this study. 
One femur received a subperiosteal implant fixed to the bone with screws. The other femur received a subperiosteal implant stabilized with a trough (bed) in the bone area, plus fixation screws. After a 3-month healing period, the animals were sacrificed and each titanium plate was resected along with the surrounding bone. Histometric measurements of osseointegration were performed on 16 titanium plates, and 16 titanium plates were evaluated qualitatively (hardness and modulus of elasticity) with nanoindentation. A regression model was used to analyze the data.
RESULTS: Subperiosteal implants placed into a trough performed significantly better than those placed on top of the cortical bone in terms of percentage of bone in direct contact with the titanium plate, length of new bone, and percentage of area of new bone. The mechanical properties (modulus of elasticity, hardness) of the newly formed bone above the plate measured at the microstructural level were significantly inferior to those of the mature cortical bone below the plate.
CONCLUSION: Subperiosteal implants placed into a trough performed better than those placed on top of the cortical bone, but it seems that 3 months of healing is not enough to achieve optimal integration and bone maturation around them. 
Nanoindentation can offer valuable insight into the elastic properties of the microstructural component of the bone.
DOI: 10.11607/jomi.3647
PMID: 26394334 [Indexed for MEDLINE]

5. Nuevo dispositivo osteogénico de Ti-6Al-4V para la rehabilitación de la función dental en pacientes con grandes reabsorciones óseas: diseño, desarrollo e implementación. 2016.

Cómo citar este artículo científico:

Cohen DJ, Cheng A, Kahn A, Aviram M, Whitehead AJ, Hyzy SL, Clohessy RM, Boyan BD, Schwartz Z. Novel Osteogenic Ti-6Al-4V Device For Restoration Of Dental Function In Patients With Large Bone Deficiencies: Design, Development And Implementation. Sci Rep. 2016 Feb 8;6:20493..

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Custom devices supporting bone regeneration and implant placement are needed for edentulous patients with large mandibular deficiencies where endosteal implantation is not possible. We developed a novel subperiosteal titanium-aluminum-vanadium bone onlay device produced by additive manufacturing (AM) and post-fabrication osteogenic micro-/nano-scale surface texture modification. Human osteoblasts produced osteogenic and angiogenic factors when grown on laser-sintered nano-/micro-textured surfaces compared to smooth surfaces. Surface-processed constructs caused higher bone-to-implant contact,vertical bone growth into disk pores (microCT and histomorphometry), and mechanical pull-out force at 5 and 10 w on rat calvaria compared to non surface-modified constructs, even when pre-treating the bone to stimulate osteogenesis. Surface-modified wrap-implants placed around rabbit tibias osseointegrated by 6 w. Finally, patient-specific constructs designed to support dental implants produced via AM and surface-processing were implanted on edentulous mandibular bone. 3 and 8 month post-operative images showed new bone formation and osseointegration of the device and indicated stability of the dental implants.
DOI: 10.1038/srep20493
PMCID: PMC4745084
PMID: 26854193 [Indexed for MEDLINE]
Conflict of interest statement: ZS is a consultant for AB Dental.

6. Un nuevo concepto de rehabilitación dental implantosoportada; ¿Cómo superar los puntos débiles de los implantes dentales convencionales?. 2017

Cómo citar este artículo científico:

Gellrich NC, Rahlf B, Zimmerer R, Pott PC, Rana M. A new concept for implant-borne dental rehabilitation; how to overcome the biological weak-spot of conventional dental implants? Head Face Med. 2017 Sep 29;13(1):17.

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BACKGROUND: Every endosseous dental implant is dependent on an adequate amount and quality of peri-implant hard and soft tissues and their fully functional interaction. The dental implant could fail in cases of insufficient bone and soft tissues or due to a violation of the soft to hard tissues to implant shoulder interface with arising of a secondary bone loss.
METHOD: To overcome this biological weak-spot, we designed a new implant that allows for multi vector endosseous anchorage around the individual underlying bone, which has to be scanned by computed tomography (CT) or Cone beam CT (CBCT) technique to allow for planning the implant. We developed a workflow to digitally engineer this customized implant made up of two planning steps. First, the implant posts are designed by prosthodontic-driven backward planning, and a wireframe-style framework is designed on the individual bony surface of the recipient site. Next, the two pieces are digitally fused and manufactured as a single piece implant using the SLM technique (selective laser melting) and titanium-alloy-powder.
RESULTS: Preoperative FEM-stress-test of the individual implant is possible before it is inserted sterile in an out-patient procedure.
CONCLUSION: Unlike any other historical or current dental implant protocol, our newly developed “individual patient solutions dental” follows the principle of a fully functional and rigid osteosynthesis technology and offers a quick solution for an implant-borne dental rehabilitation in difficult conditions of soft and hard tissues.
DOI: 10.1186/s13005-017-0151-3
PMCID: PMC5622522
PMID: 28962664 [Indexed for MEDLINE]
Conflict of interest statement: ETHICS APPROVAL AND CONSENT TO PARTICIPATE: Not applicable. CONSENT FOR PUBLICATION: Not applicable. COMPETING INTERESTS: The authors declare that they have no competing interests. PUBLISHER’S NOTE: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

7. Osteointegración del implante subperióstico empleando regeneración tisular guiada. Estudio piloto. 1995.

Cómo citar este artículo científico:

Hjørting-Hansen E, Helbo M, Aaboe M, Gotfredsen K, Pinholt EM. Osseointegration of subperiosteal implant via guided tissue regeneration. A pilot study. Clin Oral Implants Res. 1995 Sep;6(3):149-54.

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The principle of guided tissue regeneration was applied in an attempt to generate bone to cover a subperiosteal implant. Titanium frame works, casted on individual impressions of the anterior surface of the tibia of 4 Copenhagen White rabbits, were stabilized to the tibia by microscrews, and half of them were covered by an expanded polytetrafluoroethylene augmentation membrane.
The  observation period was 12 weeks. Guided bone regeneration partly covering the implants was seen at all experimental sides; on the control sides the implants were mainly embedded in fibrous tissue. Studies are in progress with the aim of reducing marked marrow space formation observed in all the regenerated areas.
DOI: 10.1034/j.1600-0501.1995.060303.x
PMID: 7578790 [Indexed for MEDLINE]

8. Calidad de vida relacionada con la salud bucal en pacientes oncológicos tratados con implantes dentales personalizados. 2020

Cómo citar este artículo científico:

Jehn P, Spalthoff S, Korn P, Stoetzer M, Gercken M, Gellrich NC, Rahlf B. Oral health-related quality of life in tumour patients treated with patient-specific dental implants. Int J Oral Maxillofac Surg. 2020 Aug;49(8):1067-1072.

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Dental rehabilitation after surgically acquired bone deficiency related to tumour treatment remains a challenge. The insertion of patient-specific implants geared to the contour of the remaining bone is a feasible method of supporting fixed or removable dentures. As oral health-related quality of life (OHRQoL) is of great interest in these cases, 12 individuals treated with patient-specific implants for severe bone deficiency were surveyed and their Oral Health Impact Profile (OHIP) scores after dental rehabilitation were evaluated. The OHIP-G53 questionnaire was used to measure overall treatment outcomes. The distribution of OHIP sum-scores for participants treated with patient-specific implants was almost homogeneous when compared to those cited in the literature for patients treated with conventional dental implants. OHIP items related to functional impairment and physical pain showed the highest scores (occurring occasionally), and financial loss related to treatment was frequently stated. Moreover, higher scores were detected in almost all OHIP dimensions for participants with patient-specific implant-supported removable dentures. Conversely, those treated with patient-specific dental implants and fixed dentures showed lower psychosocial impact scores and equal or superior OHRQoL. Hence, patient-specific dental implants, especially combined with fixed dentures, can lead to a positive OHRQoL in patients with severe bone deficiencies related to tumour therapy.
Copyright © 2020 International Association of Oral and Maxillofacial Surgeons. 
Published by Elsevier Ltd. All rights reserved.
DOI: 10.1016/j.ijom.2020.01.011
PMID: 31992467 [Indexed for MEDLINE]

9. Atrofia mandibular severa tratada con implante subperióstico e injerto simultáneo con rhBMP-2 y aloinjerto mineralizado: reporte de un caso. 2014

Cómo citar este artículo científico:

Loperfido C, Mesquida J, Lozada JL. Severe mandibular atrophy treated with a subperiosteal implant and simultaneous graft with rhBMP-2 and mineralized allograft: a case report. J Oral Implantol. 2014 Dec;40(6):707-13

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A 71-year-old patient was successfully rehabilitated by means of a 3D model-derived, hydroxyapatite-coated titanium subperiosteal mandibular implant. 
The implant was specifically designed to allow bone augmentation. The deficient 
bone was simultaneously grafted with mineralized bone allograft and recombinant 
bone morphogenetic protein -2 (rhBMP-2). The 32-month postoperative cone beam computerized tomography follow-up showed vertical bone augmentation beneath the implant frame.
DOI: 10.1563/AAID-JOI-D-12-00132
PMID: 23574428 [Indexed for MEDLINE]

10. Carga funcional inmediata de sobredentaduras en implantes mandibulares: fundamentos quirúrgicos y prostodónticos de 2 modalidades de implantes. 2004

Cómo citar este artículo científico:

Lozada JL, Ardah AJ, Rungcharassaeng K, Kan JY, Kleinman A. Immediate functional load of mandibular implant overdentures: a surgical and prosthodontic rationale of 2 implant modalities. J Oral Implantol. 2004;30(5):297-306..

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Classic guidelines in osseointegration for root-form dental implants include a 
long healing period, during which functional load should be avoided. However, 
the long healing period might impose an intolerable situation on some patients, 
especially in the completely edentulous situation. Subperiosteal dental implant 
guidelines demonstrate that the implant upon insertion can be put into immediate 
function and be restored with the final prosthesis soon after surgery. Studies 
on immediately functional loaded implant-supported prostheses in patients who 
are completely edentulous have been reported, exhibiting high success rates 
comparable with conventionally loaded implants. This article describes the 
surgical and prosthodontic procedure for the immediately functional loaded 
mandibular implant overdentures in 2 different dentalimplant modalities, as well 
as its clinical rationale.
DOI: 10.1563/0686.1
PMID: 15587020 [Indexed for MEDLINE]

11. Precisión de rehabilitaciones mandibulares asistidas por ordenador utilizando implantes personalizados en combinación con llaves de transferencia fabricadas por CAD/CAM. 2017

Cómo citar este artículo científico:

Mascha F, Winter K, Pietzka S, Heufelder M, Schramm A, Wilde F. Accuracy of computer-assisted mandibular reconstructions using patient-specific implants in combination with CAD/CAM fabricated transfer keys. J Craniomaxillofac Surg. 2017 Nov;45(11):1884-1897.

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BACKGROUND: A new method in mandible reconstruction has recently been developed using patient-specific mandible reconstruction plates (PSMP) after preoperative computer planning using CAD/CAM procedures. To transfer the virtual planned position of the PSMP into the intraoperative situs resection margins and plate position is determined by using surgical guides made by CAD/CAM procedures as well (PSMP-method).
METHODS: Mandibular reconstruction with the PSMP-method was performed on 18 patients. The study included sole alloplastic reconstruction cases (AP, n = 10) and microvascular osseous reconstruction cases (MV, n = 8). Pre- and 
postoperative CT-scans were evaluated by measuring distances between 
corresponding landmarks on the mandibular rami. The difference was used to 
evaluate reconstruction accuracy.
RESULTS: The median deviation of all distances was 1.13 mm for PSMP-method 
including all cases. For AP-group, the median deviation was 0,80 mm, for 
MV-group it was 2,47 mm. There was a high significant difference between both groups (AP and MV). Larger mandibular resections in combination with the need of positioning the surgical guides in the region of the upper condyle seemed to reduce reconstruction-accuracy. This was found more often in MV-group as in the AP-group.
CONCLUSIONS: PSMP-method seems to be an effective and satisfying method for accurate mandibular reconstruction. Microvascular reconstruction seems less accurate than sole alloplastic reconstruction. Larger resections of the mandible and technical more challenging approaches up to the mandibular condyle might explain this result.
Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. 
Published by Elsevier Ltd. All rights reserved.
DOI: 10.1016/j.jcms.2017.08.028
PMID: 28965991 [Indexed for MEDLINE]

12. Análisis de implantes subperiósticos recubiertos de HA. 2003

Cómo citar este artículo científico:

Minichetti JC. Analysis of HA-coated subperiosteal implants. J Oral Implantol. 2003;29(3):111-6; discussion 117-9.

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Bone atrophy is often encountered in the endentulous patient. With many 
clinicians performing bone grafting and augmentation techniques, there appears 
to be a decreased use of the subperiosteal implant modality for prosthetic 
stabilization. In recent years, there seems to be a decreasing number of 
literature reports and fewer academic presentations about the subperiosteal 
implant technique. Additionally, the American Academy of Implant Dentistry 
deleted this requirement for fellowship in its bylaws at its 1999 annual 
meeting. The purpose of this paper is to present the success and complication 
rates of 22 hydroxyapatite-coated subperiosteal implants placed over a 10-year 
period. Correlations between arch type and full vs unilateral subperiosteal 
implant cases are analyzed.
DOI: 10.1563/1548-1336(2003)029<0111:AOHCSI>2.3.CO;2
PMID: 12837050 [Indexed for MEDLINE]

13. Implantes subperiósticos mandibulares fabricados por tecnología aditiva. 2017

Cómo citar este artículo científico:

Mommaerts MY. Additively manufactured sub-periosteal jaw implants. Int J Oral Maxillofac Surg. 2017 Jul;46(7):938-940.

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Severe bone atrophy jeopardizes the success of endosseous implants. This 
technical note aims to present the innovative concept of additively manufactured 
sub-periosteal jaw implants (AMSJIs). Digital datasets of the patient’s jaws and 
wax trial in occlusion are used to segment the bone and dental arches, for the 
design of a sub-periosteal frame and abutments in the optimal location related 
to the dental arch and for the design of the suprastructure. The implants and 
suprastructure are three-dimensionally (3D) printed in titanium alloy. The 
provisional denture is 3D-printed in polymer. AMSJIs offer an alternative 
approach for patients with extreme jaw bone atrophy. This report refers to the 
use of this technique for full maxillary rehabilitation, but partial defects in 
either jaw and extended post-resection defects may also be approached using the same technique. This customized, prosthesis-driven reverse-engineering approach avoids bone grafting and provides immediate functional restoration with one surgical session.
Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. 
Published by Elsevier Ltd. All rights reserved.
DOI: 10.1016/j.ijom.2017.02.002
PMID: 28258795 [Indexed for MEDLINE]

14. Pasos evolutivos en el diseño y biofuncionalidad de implantes subperiósticos mandibulares fabricados por tecnología aditiva ‘AMSJI’. 2019

Cómo citar este artículo científico:

Mommaerts MY. Evolutionary steps in the design and biofunctionalization of the additively manufactured sub-periosteal jaw implant ‘AMSJI’ for the maxilla. Int J Oral Maxillofac Surg. 2019 Jan;48(1):108-114.

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The purpose of this prospective registry case-series study was to determine the biological, mechanical, and aesthetic improvements made to the additively 
manufactured sub-periosteal jaw implant (AMSJI) after timed installation. A 
total of nine patients received maxillary AMSJIs in three sessions over a 2-year 
period. Architectural changes, topological optimization, and amendments to 
biofunctionalization were performed after each phase through the use of 
computer-aided design, finite element analysis, and growing clinical experience. 
Biological improvements included sandblasting (large grit alumina) and 
acid-etching; increased hydrophilicity by plasma surface activation; deletion of 
the crestal connecting struts; relocation of the anterior post in front of the 
anterior part of the basal loop; protection of the Schneiderian membrane from 
fixation screw penetration; high polishing of the posts; major platform switch 
with equigingival connections; the use of removable posts that require local 
anaesthesia and do not inflict major biological damage; scaffolding for 
secondary stability; and the provision of an incision guide. Mechanical 
improvements included the creation of a generic design based on finite element analysis and the resulting topological optimization, a shortening of the wings, and a reduction in the number of fixation screws. Aesthetic improvements included relocation of the anterior post, as described above, and pink anodization of the posts.
Copyright © 2018 International Association of Oral and Maxillofacial Surgeons. 
Published by Elsevier Ltd. All rights reserved.
DOI: 10.1016/j.ijom.2018.08.001
PMID: 30131272 [Indexed for MEDLINE]

15. Revisión retrospectiva descriptiva tras 18 años de implantes subperiósticos en pacientes con mandíbulas edéntulas severamente atrofiadas. 2004

Cómo citar este artículo científico:

Moore DJ, Hansen PA. A descriptive 18-year retrospective review of subperiosteal implants for patients with severely atrophied edentulous mandibles. J Prosthet Dent. 2004 Aug;92(2):145-50.

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STATEMENT OF PROBLEM: Fabricating dentures for the patient with severe 
mandibular atrophy can be a challenge for both the dentist and patient. 
Subperiosteal implants with a mandibular overdenture may be a solution for the atrophic mandible.
PURPOSE: The purpose of this retrospective study was to review the survival of mandibular subperiosteal implants placed at the University of Missouri Kansas City (UMKC) School of Dentistry Graduate Prosthodontics program between 1982 and 2000.
MATERIAL AND METHODS: Forty subperiosteal implants were placed in atrophic mandibles of 40 patients (33 women, 7 men) between 1982 and 2000. The age range of the patients was 47 to 80 years of age at time of placement (mean=62 years). 
Each patient was reviewed clinically by an author (DJM). Manual depression and lifting of the framework were used to evaluate the stability of the implant. 
Additionally, the implants were observed for any movement. Each patient was 
questioned for pain or discomfort. Each patient was examined for observable 
inflammation and intraoral exposure of the framework and questioned as to 
whether the implant had satisfied the patient and met the patient’s 
expectations.
RESULTS: Thirty-nine of the 40 original patients were recalled in 2000. One 
patient had died. Fourteen patients had implants for over 10 years, 12 patients 
had implants between 5 and 10 years, and 12 patients had implants for less than 5 years (mean time of implant service=8 years). Thirty-eight patients had the implant in place with no sign of inflammation or mobility, 1 patient with 
diabetes had inflammation around one of the struts. All patients were wearing 
their prostheses, and there was no sign of exposed implant framework for any 
patient. All patients reported a high level of satisfaction with the implant.
CONCLUSIONS: Within the limitations of this study, the mandibular implants 
placed at UMKC were still functioning, and all patients denied any discomfort or pain from the prostheses. Patients reported they were comfortable and able to function with the implant-supported prosthesis.
DOI: 10.1016/j.prosdent.2004.05.018
PMID: 15295323 [Indexed for MEDLINE]

16. Microestructura y comportamiento mecánico del Ti-6Al-4V producido por fabricación de capa rápida para aplicaciones biomédicas. 2009

Cómo citar este artículo científico:

Murr LE, Quinones SA, Gaytan SM, Lopez MI, Rodela A, Martinez EY, Hernandez DH, Martinez E, Medina F, Wicker RB. Microstructure and mechanical behavior of Ti-6Al-4V produced by rapid-layer manufacturing, for biomedical applications. J Mech Behav Biomed Mater. 2009 Jan;2(1):20-32.

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The microstructure and mechanical behavior of simple product geometries produced by layered manufacturing using the electron beam melting (EBM) process and the selective laser melting (SLM) process are compared with those characteristic of conventional wrought and cast products of Ti-6Al-4V. Microstructures are characterized utilizing optical metallography (OM), scanning electron microscopy (SEM) and transmission electron microscopy (TEM), and included alpha (hcp), beta (bcc) and alpha(‘) (hcp) martensite phase regimes which give rise to hardness variations ranging from HRC 37 to 57 and tensile strengths ranging from 0.9 to 1.45 GPa. The advantages and disadvantages of layered manufacturing utilizing initial powders in custom building of biomedical components by EBM and SLM in contrast to conventional manufacturing from Ti-6Al-4V wrought bar stock are discussed.
DOI: 10.1016/j.jmbbm.2008.05.004
PMID: 19627804 [Indexed for MEDLINE]

17. Histología del implante endoóseo personalizado e informe de caso de un implante personalizado maxilar integrado, retirado tras nueve años en servicio. 2014

Cómo citar este artículo científico:

Nordquist WD, Krutchkoff DJ. The Custom Endosteal Implant histology and case report of a retrieved maxillary custom osseous-integrated implant nine years in service. J Oral Implantol. 2014 Apr;40(2)195-201.

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The Custom Endosteal Implant (CEI) is a custom-cast osseo-integrated implant 
that has evolved to replace the “old” fibro-integrated subperiosteal variant. 
This newly developed implant achieves osseous integration by utilizing a 
hydroxyapatite (HA) coating, and a specialized grafting technique that produces 
much improved success rates relative to its fibro-integrated subperiosteal 
predecessor. This case reported here represents a maxillary CEI implant that was 
placed and in functional service for 9 years before being retrieved and 
processed for histologic examination subsequent to the patient’s demise. In 
addition, due to infection that occurred shortly after placement, an early 
provisional procedure with fluoridated HA was also performed. Histologic 
analysis of the postmortem specimen revealed a fully integrated new bone 
formation intimately surrounding the previously dehisced implant strut. The 
latter had previously been decontaminated and grafted with a thin layer of 
fluorapatite (FA) material. Results including histologic analysis confirmed 
complete osseo-integration of the implant following successful FA graft 
revision.
DOI: 10.1563/AAID-JOI-D-11-00218
PMID: 24779953 [Indexed for MEDLINE]

18. Modelado 3D, implantes personalizados y sus perspectivas de futuro en cirugía craneofacial. 2014

Cómo citar este artículo científico:

Parthasarathy J. 3D modeling, custom implants and its future perspectives in craniofacial surgery. Ann Maxillofac Surg. 2014;4(1)9-18.

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Custom implants for the reconstruction of craniofacial defects have gained 
importance due to better performance over their generic counterparts. This is 
due to the precise adaptation to the region of implantation, reduced surgical 
times and better cosmesis. Application of 3D modeling in craniofacial surgery is 
changing the way surgeons are planning surgeries and graphic designers are 
designing custom implants. Advances in manufacturing processes and ushering of 
additive manufacturing for direct production of implants has eliminated the 
constraints of shape, size and internal structure and mechanical properties 
making it possible for the fabrication of implants that conform to the physical 
and mechanical requirements of the region of implantation. This article will 
review recent trends in 3D modeling and custom implants in craniofacial 
reconstruction.
DOI: 10.4103/2231-0746.133065
PMCID: PMC4073471
PMID: 24987592
Conflict of interest statement: Conflict of Interest: None declared.

19. 41 años de historia de implantes subperiósticos mandibulares. 2000

Cómo citar este artículo científico:

Schou S, Pallesen L, Hjørting-Hansen E, Pedersen CS, Fibaek B. A 41-year history of a mandibular subperiosteal implant. Clin Oral Implants Res. 2000 Apr;11(2):171-8.

Ver resumen
The subperiosteal implant was originally described in the 1940s. The inadequate long-term results of subperiosteal implants are in contrast to the excellent results documented for endosseous osseointegrated oral implants. Consequently, subperiosteal implants and other soft-tissue-anchored implants should not be used presently. Furthermore, these implants are seldom seen today, because they generally were removed rather shortly after placement. The present report documents a full 41-year history of a mandibular subperiosteal implant inserted in 1957 by focusing upon the consequences of not removing an implant in spite of continuous periods of complications during 4 decades. Implant exposure, inflammation, infection, and fistula formation occurred persistently. Total implant removal was refused by the patient in 1973. After 25 years without control, tremendous resorption of the mandible was observed in 1998. 
Consequently, the entire implant was then removed. Placement of osseointegrated oral implants was impossible without extensive autogenous bone grafting. The present report has demonstrated that regular control of patients with subperiosteal implants is mandatory. Furthermore, subperiosteal implants should definitely be removed, if continuous periods of complications occur.
PMID: 11168208 [Indexed for MEDLINE]

20. Alternativas de rehabilitación con implantes para el maxilar edéntulo atrófico. 2018

Cómo citar este artículo científico:

Spencer KR. Implant based rehabilitation options for the atrophic edentulous jaw. Aust Dent J. 2018 Mar;63 Suppl 1:S100-S107.

Ver resumen
The atrophic and edentulous jaw can pose a number of challenges for the implant 
clinician. In simple terms, the amount of bone that remains is insufficient for the conventional placement of a dental implant. A variety of treatment strategies can be employed to enable implants to be placed despite the paucity of bone stock in either the mandible or the maxilla. Conceptually these strategies follow one of two pathways: either augmentation of the bone, or the novel utilization of the remaining bone. This article will discuss patient assessment, treatment planning, and the range of contemporary options available to enable fixed implant based rehabilitation of each jaw. “The edentulous patient is an amputee, an oral invalid, to whom we should pay total respect and rehabilitation ambitions” (P-I Branemark, September 2005).
© 2018 Australian Dental Association.
DOI: 10.1111/adj.12595
PMID: 29574819 [Indexed for MEDLINE]

Bibliografía sobre alternativas para rehabilitación en atrofia severa:

1. Tratamiento de maxilar atrófico con implantes cigomáticos: una serie de casos. 2017

Cómo citar este artículo científico:

Balan I, DI Girolamo M, Lauritano D, Carinci F. Treatment of severe atrophic maxilla with zygomatic implants: a case series. Oral Implantol (Rome). 2017 Nov 30;10(3):317-324.

Ver resumen
Treatment of severe maxillary atrophy with implants has achieved important successes in recent years. The limit of implant insertion is related to inadequate bone quantity (i.e. height and width). Alveolar bone grafting, sinus lifting and major grafting via Le Fort I osteotomy have used in the past to restore bone volume prior of implant insertion. However successes do not always occur and a second stage surgery is necessary in most cases. Immediate loading cannot be performed in all grafted bone. In recent years a new treatment approach has been proposed by using zygomatic implants. This new technique can provide a better stability to the prosthesis and less morbidity for patient. 
Here a cases series of eighteen patients rehabilitated with zygomatic together 
with standard implants and immediate loading is reported.
DOI: 10.11138/orl/2017.10.3.317
PMCID: PMC5735395
PMID: 29285335

2. Fracturas mandibulares asociadas a implantes endóseos. 2009

Cómo citar este artículo científico:

Chrcanovic BR, Custódio AL. Mandibular fractures associated with endosteal implants. Oral Maxillofac Surg. 2009 Dec;13(4):231-8.

Ver resumen
PURPOSE: The purpose of this study is to report four cases of mandibular fractures associated with endosteal implants and to discuss prevention and treatment of these types of fractures.
DISCUSSION: To evaluate whether the patient’s anatomy allows insertion of implants, radiological exams that demonstrate the height and the labial-lingual width are needed. To reduce the potential fracture problem, the mandible can be restrengthened with bone grafting techniques. The treatment of a fracture in an atrophic mandible is always a challenge because of the diminished central blood supply, the depressed vitality of the bone, and the dependence on the eriosteal blood supply. The basic principles in fracture treatment are reduction and immobilization of the fractured site for restoration of form and function.
CONCLUSIONS: If implants are placed in severe atrophic mandible, iatrogenic 
fracture of the mandible may occur during or after implant surgery because 
implant placement weakens the already-compromised mandible. A few millimeters of cortical bone should remain on both the labial and the lingual sites after the hole for insertion of an implant has been drilled. A 3-D surgical planning 
should be recommended at least in severe atrophic mandibles in order to prevent 
a severe reduction of bone tissue.
DOI: 10.1007/s10006-009-0171-7
PMID: 19789898 [Indexed for MEDLINE]

3. Tratamiento del maxilar atrófico con implantes cigomáticos en 29 pacientes. 2014

Cómo citar este artículo científico:

Rodríguez-Chessa JG, Olate S, Netto HD, Shibli J, de Moraes M, Mazzonetto R. Treatment of atrophic maxilla with zygomatic implants in 29 consecutives patients. Int J Clin Exp Med. 2014 Feb 15;7(2):426-30.

Ver resumen
Atrophic maxilla is a common condition in older population; some treatments are proposed with bone reconstruction or zygomatic implant. Long-term follow up show the efficiencies of zygomatic implant but limited data are associated to consecutive patient. The aim of this study was to evaluate retrospectively the zygomatic implants performed consecutively in 29 patients. Data from clinical records of 29 patients treated with zygomatic implants were analyzed; were include patient with at least 10 month of prosthetic function. Four surgeons realized all surgeries using local anesthesia with a slot technique on local anesthesia; the variables analyzed were implant survival, complications, prosthetic load and satisfaction of patient; data collection was analyzed by descriptive statistic and chi-square test with p<0.05 for significance statistical. 67 zygomatic implants and 84 conventional implants were installed in patients between 35 and 69 year old being 18 (62%) female and 11 (38%) male.The main indication was the case of severe alveolar resorption in 21 cases (72.41%), followed by failures in maxillary reconstruction with bone graft in 4 (13.79%). The implant success was 79.1% and the immediate or delayed load was not associated to statistical difference (p=0.104). The main complication was the loss of osseointegration and mucositis. Analogue Visual Scale (AVS) for satisfaction show acceptable esthetic and function. Finally we conclude that zygomatic implant present adequate survivor and a good response of patient; important complication can be present in a learn curve for this surgery.
PMCID: PMC3931599
PMID: 24600500

4. Complicaciones de los implantes cigomáticos: nuestra experiencia clínica en 4 casos. 2016

Cómo citar este artículo científico:

Tzerbos F, Bountaniotis F, Theologie-Lygidakis N, Fakitsas D, Fakitsas I. Complications of Zygomatic Implants: Our Clinical Experience with 4 Cases. Acta Stomatol Croat. 2016 Sep;50(3):251-257.

Ver resumen
Zygomatic implants have been used for rehabilitation of the edentulous atrophic maxilla as an alternative to bone grafting for almost two decades resulting in satisfactory clinical outcomes. However, the patients with edentulous atrophic maxilla treated using this technique may present serious complications that could put the prosthetic restoration at risk. Four cases are reported in this paper, one case with a cutaneous fistula in the left zygomatic-orbital area caused by aseptic necrosis at the apical part of the implant, which was treated with the surgical removal of this part, a second case with loss of the right zygomatic implant due to failure of osseointegration and two cases of periimplantitis that resulted in partial and complete removal of the implant, respectively. All patients who had complications were treated without compromising the restoration which remained functional after appropriately modified treatment.
DOI: 10.15644/asc50/3/8
PMCID: PMC5108285
PMID: 27847399
Conflict of interest statement: The authors report no conflicts of interest related to this study.

5. Complicaciones de la cirugía de implantes: etiología y tratamiento. 2008

Cómo citar este artículo científico:

Misch K, Wang HL. Implant surgery complications: etiology and treatment. Implant Dent. 2008 Jun;17(2):159-68.

Ver resumen

Implant surgery complications are frequent occurrences in dental practice and
knowledge in the management of these cases is essential. The aim of this review
was to highlight the challenges of treatment plan-related, anatomy-related, and
procedure-related surgical complications as well as to discuss the etiology,
management and treatment options to achieve a satisfactory treatment outcome.

DOI: 10.1097/ID.0b013e3181752f61
PMID: 18545047 [Indexed for MEDLINE]