The International Journal of Prosthodontics, 3/2023
DOI: 10.11607/ijp.7827, PubMed ID (PMID): 35234748Pages 282-292, Language: EnglishEnkling, Norbert / Thanendrarajah, Thanuja / Mathey, Ayse / Janner, Simone / Schimmel, Martin / Abou-Ayash, SamirPurpose: To evaluate 1-year survival and success rates of 6-mm short implants placed in mandibular molar sites with two different abutments (dome/ball) retaining existing removable partial dentures (RPDs).
Materials and Methods: In 19 patients, 38 implants of 6-mm length were placed bilaterally. After 4 months, each participant received the dome abutment, which 2 months later was exchanged with the ball abutment. Clinical data were recorded at abutment connection (4 months postsurgery) and at 6 and 12 months postsurgery, including probing depth, bleeding on probing, presence of plaque, and standardized radiographs. Implant success was assessed using the following criteria: presence of pain, mobility, radiographic bone loss, probing depth, and the presence of exudate. For descriptive analyses, mean and SD values were calculated. Paired sample t tests and linear regressions with a significance level of α < .05 were applied to analyze the evolution of peri-implant parameters and the influence of implant placement depth.
Results: The overall mean marginal bone level alteration (DMBL) was 1.05 ± 0.69 mm. A statistically significant marginal bone loss over time was observed at the mesial and distal aspects of all implants (P < .05). The implant survival rate was 100%. No implants showed pain, exudate, mobility, or probing depth > 7 mm. Three implants were classified as having satisfactory survival due to a DMBL > 2 mm (resulting success rate: 92.1%). No influence of implant placement depth was found.
Conclusion: These short-term results suggest that short implants can be used in mandibular molar sites for additional posterior support of free-end RPDs. However, in individual cases, DMBL > 2 mm may occur.
The International Journal of Prosthodontics, 1/2023
DOI: 10.11607/ijp.7055, PubMed ID (PMID): 33625384Pages 59-62, Language: EnglishAbou-Ayashmed, Samir / Schimmel, Martin / Worni, Andreas / Enkling, NorbertPurpose: To analyze the influence of pristine matrix and O-ring dimensions on retention force and its reproducibility in single one-piece mini dental implants (MDIs) with ball patrices under in vitro conditions.
Materials and Methods: Three different matrix/O-ring combinations (MH1, MH2, and MH3) were evaluated (n = 50 measurements each) on 1.8-mm–diameter implants. The matrices were manually mounted on the implants and subsequently removed in a vertical linear manner using a metal pin with two strain gauges, which recorded the maximum force during disconnection. The O-rings were exchanged after five disconnections, and the mean retention force was calculated, resulting in a total of 50 values for each matrix/O-ring combination. Mean and SD retention forces with 95% CI were calculated. ANOVA was used to test the global difference, and post hoc pairwise comparisons were subsequently applied. The level of significance was set at P < .05.
Results: ANOVA (global P < .0001) and pairwise comparisons (all P < .001) demonstrated statistically significant differences between the three different matrix/O-ring combinations with mean values of 5.18 N (MH 1), 6.73 (MH 2), and 9.08 (MH 3). Within each combination, retention force variations of > 1 N could not be demonstrated; ie, by exchanging O-rings, a similar retention force can be reestablished.
Conclusion: Matrix and O-ring dimensions have a significant influence on retention forces in one-piece MDIs. Pristine O-rings demonstrated highly reproducible initial retention forces in all matrices.
DZZ International, 1/2022
Open Access Online OnlyClinical SnapshotsDOI: 10.53180/dzz-int.2022.0001Pages 3, Language: EnglishEnkling, NorbertToday, missing teeth can be replaced with alloplastic implants with a high probability of survival. Such restorations come close to a "restitutio ad integrum". However, the question regarding the extent to which dental implants are integrated into the existing stomatognathic control circuit remains unanswered: does the "implant as a foreign body" need to be protected in a special way, or can it be considered a "fully fledged replacement tooth" with its own sensory perception?
Keywords: dental implants, osseoperception, tactile sensibility
Deutsche Zahnärztliche Zeitschrift, 1/2022
PraxisDOI: 10.53180/dzz.2022.0002Pages 12, Language: GermanEnkling, NorbertOsseoperception: tactile sensibility of dental implants?Zu physiologischen Grundlagen des Tastempfindens von osseointegrierten Implantaten und ihre klinische Relevanz
Keywords: Osseoperzeption, Tastempfinden, dentale Implantate
Quintessence International, 4/2021
DOI: 10.3290/j.qi.a45603, PubMed ID (PMID): 33491392Pages 360-373, Language: EnglishBürklein, Sebastian / Brodowski, Christoph / Fliegel, Eva / Jöhren, Hans Peter / Enkling, NorbertObjectives: The prevalence of “dental anxiety” (DA) is often underestimated and numerous diagnostic methods are available for dental practitioners. It is difficult to differentiate between a dental phobia requiring an interdisciplinary approach and DA, which can be managed by dental practitioners alone. The appropriate use of diagnostic tools is key for the successful management of highly anxious and/or phobic patients. The aim was to provide a guideline to recognize dental fear and to differentiate DA from patients who are highly anxious or even have a phobia. Data sources: In total, 8,929 articles that were selected for the development of the German guidelines for “Dental anxiety in adults” in PubMed, Web of Science, Embase, and MedPilot were filtered for diagnosis of DA disorder. The focus for this review was on the use of scales to measure DA levels. The methods and tools used in the 51 reviewed articles to assess DA levels were evaluated in terms of their practicability and suitability in daily practice to differentiate between phobia (ie, DA disorder) and nonpathologic anxiety. In addition, the internal consistency (Cronbach alpha) of the questionnaires/tools was determined.
Conclusion: All identified DA questionnaires validated in the German language had an acceptable to excellent internal consistency (0.7 to 0.986). The only validated questionnaire-free method was galvanic skin reaction measurement. For the assessment of DA and diagnosis of a DA disorder in adults, the survey by means of any suitable questionnaire or even several questionnaires in combination with a behavioral observation of the patient is currently the method of choice.
Keywords: dental anxiety, dental phobia, diagnosis, probability, scale
Deutsche Zahnärztliche Zeitschrift, 3/2021
PraxisDOI: 10.3238/dzz.2021.0013Pages 142, Language: GermanEnkling, NorbertImmediate dental implant placement, immediate restorative treatment and immediate loading: treatment options in dental practice?Hintergrund
Sofort-Therapie-Konzepte in der zahnärztlichen Implantologie werden immer populärer, da von den Patienten die Verkürzung der Behandlungszeit sehr geschätzt wird und unbequeme provisorische Versorgungen vermieden werden können. Bei der richtigen Indikationsstellung sind die Prognosen für die Implantate und die Prothetik vergleichbar mit den konventionellen, verzögerten Therapiekonzepten. Sofortbehandlungskonzepte sollten daher in der täglichen Praxis als Therapieoption Berücksichtigung finden.
DZZ International, 3/2021
Open Access Online OnlyClinical SnapshotsDOI: 10.3238/dzz-int.2021.0011Pages 91, Language: EnglishEnkling, NorbertImmediate treatment concepts in dental implantology are becoming increasingly popular because the reduction in treatment time is highly appreciated by patients and uncomfortable provisional restorations can be avoided. Given the correct indication, the prognoses of immediately placed implants and their prosthetic restoration are comparable to conventional, delayed treatment concepts. Thus, immediate treatment concepts should be considered as therapeutic options in routine dental practice.
DZZ International, 5/2020
Open Access Online OnlyClinical SnapshotsDOI: 10.3238/dzz-int.2020.0155-0159Pages 155, Language: EnglishEnkling, NorbertDental implants are an indispensable part of the dental treatment spectrum and represent an integral component of contemporary prosthodontic treatment concepts. The use of implants for both removable and fixed prosthodontics offers clinically relevant advantages, which have been recorded for patients in the form of an improvement in the oral health-related quality of life and masticatory function, as well as, better long-term restorative treatment prognosis.
Deutsche Zahnärztliche Zeitschrift, 5/2020
PraxisDOI: 10.3238/dzz.2020.0270-0274Pages 270, Language: GermanEnkling, NorbertDentale Implantate sind aus dem zahnmedizinischen Behandlungsspektrum nicht mehr wegzudenken und sind fester Bestandteil aktueller prothetischer Behandlungskonzepte.
Sowohl bei der herausnehmbaren als auch bei der festsitzenden Prothetik zeigen sich klinisch relevante Vorteile durch den Einsatz von Implantaten, die sich für die Patientinnen und Patienten über eine Verbesserung der mundgesundheitsbezogenen Lebensqualität, über eine verbesserte Kau¬funktion und über bessere Langzeitprognosen des Zahnersatzes dokumentieren.
Quintessence International, 4/2018
DOI: 10.3290/j.qi.a39947, PubMed ID (PMID): 29484310Pages 267-276, Language: EnglishWorni, Andreas / Hicklin, Stefan Paul / Mericske-Stern, Regina / Enkling, NorbertObjective: The aim of the present prospective clinical study was to assess the survival rate and the radiologic crestal bone level alteration around four interforaminal immediately loaded narrow-diameter implants (NDIs) in the edentulous mandible.
Method and Materials: A total of 20 participants received each 4 NDIs (MDI, 3M Espe; diameter 1.8 mm, length 13 or 15 mm) in the edentulous mandible. Immediate loading was performed if insertion torque was 35 Ncm or higher. The implants were loaded the same day by converting the existing full denture into an implant overdenture. Follow-up visits were performed five times (baseline to 52 weeks). Standardized radiographs were taken at baseline and 12, 26, and 52 weeks post-loading. Clinical parameters (Plaque Index, probing depth, bleeding on probing) were assessed. The nonparametric ANOVA test was used to assess crestal bone level changes.
Results: In all 20 patients the healing of the total 80 implants was uneventful and no implant was lost. Sixty-eight (85%) implants were loaded immediately. All clinical parameters showed healthy, stable, and well-maintained peri-implant soft tissue conditions. The mean (± standard deviation) radiographic bone loss after 1 year was 0.78 (± 0.64) mm.
Conclusion: According to the 1-year results of this prospective clinical study, NDIs seem to be a reliable alternative to support prostheses in edentulous patients with a reduced horizontal mandibular bone volume.
Keywords: bone loss, edentulism, immediate loading, mandibular overdenture, narrow-diameter implants