Searched for: person:it16
A Proposal of New Classification for Dental Implant Complications
Turkyilmaz, Ilser
AIM/OBJECTIVE:The aims of this study are to review the available literature related to implant complications and propose a new classification method for dental implant complications. MATERIALS AND METHODS/METHODS:Dental literature was reviewed via PubMed focusing on articles published in English, which included data regarding dental implants, complications, and classification from January 2000 to January 2018. The author, who has experience with implant placement and restorations for 15 years, and ten of his colleagues, formed a list of implant complications that they have encountered in their practices. RESULTS:After 3,736 articles were found in the initial search, a total of 613 potentially relevant review articles were identified in the database. After the full-text analysis of 25 articles, only 6 review articles with complication classifications were utilized in this study. In addition, a clinically based classification named "Turkyilmaz's Classification of Implant Complications" including three categories was created. Types of complications in these three groups (Mild, Moderate, and Severe) were listed, and some of them were illustrated. Also, recommendations for clinicians were made on how to avoid these problems and/or overcome them. CONCLUSION/CONCLUSIONS:It has been suggested that categorical data regarding complications of dental implants are limited, and the new complication classification presented in this article may help clinicians identify and overcome commonly encountered implant complications. CLINICAL SIGNIFICANCE/CONCLUSIONS:For clinicians, it is important to know possible complications regarding dental implants. In this article, a group of dentists created and suggested a new classification for implant complications, which may help clinicians identify commonly encountered complications and how to handle them in the clinic.
PMID: 30150507
ISSN: 1526-3711
CID: 3255832
Evaluation of the Sealing Capability of the Internal Conical Connections of Implants with Titanium and Zirconia Abutments
Black, Damian L; Turkyilmaz, Ilser; Lien, Wen; Chong, Chol H
AIM: The purpose of this in vitro investigation was to evaluate the sealing capability of the conical implant-abutment interfaces under different abutment screw torque values using titanium and zirconia abutments with Morse taper designs. MATERIALS AND METHODS: A total of 42 dental implants (n = 21 for titanium abutments and n = 21 for zirconia abutments) were inoculated internally with three bacteria. These assemblies were divided into four test groups (n = 10) based on screw fixation torques of 35 or 20 Ncm and placed in sterile broth; the remaining abutments were used as positive controls and torqued to 10 Ncm. Microleakage was quantified by enumerating the bacteria from the colony-forming units. An analysis of variance for the estimates of bacteria enumerated and microgaps was used with a post hoc analysis as indicated. A p-value of 0.05 was used as the level of significance. RESULTS: There was no statistically significant difference in microleakage among the four test groups; there were no significant effects of screw torque or abutment type on the bacteria enumerated. There was a significantly smaller mean microgap with the zirconia abutments. CONCLUSION: The results of this study indicated no statistically significant difference in the sealing capabilities between titanium and zirconia abutments, having internal conical connections, after increasing the abutment screw torque. CLINICAL SIGNIFICANCE: It is important for clinicians to follow the guidelines suggested by the implant companies to avoid biomechanical complications over time.
PMID: 28989130
ISSN: 1526-3711
CID: 2731522
Eighteen-Month Outcomes of Titanium Frameworks Using Computer-Aided Design and Computer-Aided Manufacturing Method
Turkyilmaz, Ilser; Asar, Neset Volkan
PURPOSE: The aim of the report is to introduce a new software and a new scanner with a noncontact laser probe and to present outcomes of computer-aided design and computer-aided manufacturing titanium frameworks using this new software and scanner with a laser probe. MATERIALS AND METHODS: Seven patients received 40 implants placed using a 1-stage protocol. After all implants were planned using an implant planning software (NobelClinician), either 5 or 6 implants were placed in each edentulous arch. Each edentulous arch was treated with a fixed dental prosthesis using implant-supported complete-arch milled-titanium framework using the software (NobelProcera) and the scanner. All patients were followed up for 18 +/- 3 months. Implant survival, prosthesis survival, framework fit, marginal bone levels, and maintenance requirements were evaluated. RESULTS: One implant was lost during the follow-up period, giving the implant survival rate of 97.5%; 0.4 +/- 0.2 mm marginal bone loss was noted for all implants after 18 +/- 3 months. None of the prostheses needed a replacement, indicating the prosthesis success rate of 100%. CONCLUSION: The results of this clinical study suggest that titanium frameworks fabricated using the software and scanner presented in this study fit accurately and may be a viable option to restore edentulous arches.
PMID: 28368878
ISSN: 1538-2982
CID: 2521772
Rehabilitation of a Severely Atrophic Mandible Using Soft Tissue Matrix Expansion (Tent-Pole)
Leland, Jeremy; Turkyilmaz, Ilser; Arguello, Conception Barboza; Perez, Daniel
PMID: 25546095
ISSN: 1548-1336
CID: 2426332
30-Year Outcomes of Dental Implants Supporting Mandibular Fixed Dental Prostheses: A Retrospective Review of 4 Cases
Turkyilmaz, Ilser; Tozum, Tolga F
PURPOSE: The aim of this study was to present the 30-year outcomes of 28 implants supporting mandibular screw-retained fixed dental prostheses (FDPs). MATERIALS AND METHODS: Dental charts of the 4 patients were carefully reviewed, and it was noticed that they received 28 implants and 5 screw-retained FDPs in 1983 and 1984. The chief concerns raised by these patients were poor retention of their complete dentures and decreased masticatory function at the time of treatment planning. Each dental care they received was recorded in the last 30 years. Implant survival, radiographic, and prosthodontic examinations were performed. RESULTS: No implants were lost after 30 years, giving the implant a survival rate of 100%. The average marginal bone level was 2.6 +/- 0.5 mm at the last recall appointment. Of the 5 FDPs delivered, 1 needed replacement, indicating a prosthesis survival rate of 80%. The patients needed 21 repairs such as replacement of denture teeth/gold screws and hard relining, and 19 adjustments such as occlusal adjustments and acrylic resin contouring, over 30 years. CONCLUSION: This clinical report shows that machined-surface dental implants can successfully support screw-retained fixed dental prostheses for over 30 years, making dental implants an important dental treatment alternative compared to the traditional prosthetic treatment methods.
PMID: 26288163
ISSN: 1538-2982
CID: 2426312
Accuracy of surgical guides made from conventional and a combination of digital scanning and rapid prototyping techniques
Reyes, Ashley; Turkyilmaz, Ilser; Prihoda, Thomas J
STATEMENT OF PROBLEM: Surgical guides aid in accurately placing dental implants to achieve a predictable restorative outcome. Which surgical guide fabrication technique results in the most accurately fitting surgical guide is unknown. PURPOSE: The purpose of this investigation was to determine the internal fit of dental implant surgical guides on dentate and edentulous ridges by using implant surgical guides fabricated from conventional and computer-aided design/computer-aided manufacturing (CAD/CAM) techniques. MATERIAL AND METHODS: Eighty surgical guides were fabricated from conventional and CAD/CAM techniques; half were designed from Kennedy Class 2 (K2) casts, and half were designed from Kennedy Class 3 (K3) casts. Conventional surgical guides were fabricated from acrylic resin. The CAD/CAM surgical guides were scanned by using cone beam computed tomography (CBCT) or an optical scan (OS). The guides were printed with stereolithography (SL) or 3-dimensional digital printing (3DP). All surgical guides were cemented to their respective design casts, sectioned, and measured at standardized locations. A 2-way ANOVA and the post hoc Fisher least square difference t test was performed (alpha=.05). RESULTS: The 2-way ANOVA indicated that the difference between surgical guide groups and Kennedy class was statistically significant (P<.05) and the interaction between groups and Kennedy class was statistically significant (P<.05). The OS/3DP CAD/CAM guide was the best-fitting cast for the K2 cast group, and the conventional guide was the best-fitting guide for the K3 group. CONCLUSIONS: Conventionally fabricated and OS surgical guides have greater accuracy of fit than CBCT scanned surgical guides.
PMID: 25681352
ISSN: 1097-6841
CID: 2426322
An investigation of heat transfer to the implant-bone interface when drilling through a zirconia crown attached to a titanium or zirconia abutment
Mason, Amy G; Sutton, Alan; Turkyilmaz, Ilser
STATEMENT OF PROBLEM: Thermal injury to the implant-bone interface may lead to bone necrosis and loss of osseointegration. This is a concern during manipulation of the implant throughout the restorative phase of treatment. The risk of heat transfer to the implant-bone interface during abutment preparation or prosthesis removal should be considered. PURPOSE: The purpose of the study was to examine the amount of heat transferred to the implant-bone interface when a zirconia crown is drilled to access the screw channel or section a crown with a high-speed dental handpiece. MATERIAL AND METHODS: Of the 64 ceramic-veneered zirconia crowns fabricated, 32 had a coping thickness of 0.5 mm and 32 had a coping thickness of 1.0 mm. The crowns were cemented on either titanium stock abutments or zirconia stock abutments. Each group was further subdivided to evaluate heat transfer when the screw channel was accessed or the crown was sectioned with a high-speed handpiece with or without irrigation. Temperature change was recorded for each specimen at the cervical and apical aspect of the implant with thermocouples and a logging thermometer. ANOVA was used to assess the statistical significance in temperature change between the test combinations, and nonparametric Mann-Whitney U tests were used to evaluate the findings. RESULTS: The use of irrigation during both crown removal processes yielded an average temperature increase of 3.59 +/-0.35 degrees C. Crown removal in the absence of irrigation yielded an average temperature increase of 18.76 +/-3.09 degrees C. When all parameter combinations in the presence of irrigation were evaluated, the maximum temperature change was below the threshold of thermal injury to bone. The maximum temperature change was above the threshold for thermal injury at the coronal aspect of the implant and below the threshold at the apical aspect in the absence of irrigation. CONCLUSIONS: Within the limitations of this investigation, the use of irrigation with a high-speed dental handpiece to remove a ceramic-veneered zirconia crown results in a temperature increase at the implant-bone interface insufficient to cause irreversible damage. Conversely, a lack of irrigation may yield a temperature increase capable of producing irreversible damage at the coronal aspect of the implant.
PMID: 24951389
ISSN: 1097-6841
CID: 2426352
An investigation of the effect of scaling-induced surface roughness on bacterial adhesion in common fixed dental restorative materials
Checketts, Matthew R; Turkyilmaz, Ilser; Asar, Neset Volkan
STATEMENT OF PROBLEM: Bacterial plaque must be routinely removed from teeth, adjacent structures, and prostheses. However, the removal of this plaque can inadvertently increase the risk of future bacterial adhesion. PURPOSE: The purpose of this investigation was to assess the change in the surface roughness of 3 different surfaces after dental prophylactic instrumentation and how this influenced bacterial adhesion. MATERIAL AND METHODS: Forty specimens each of Type III gold alloy, lithium disilicate, and zirconia were fabricated in the same dimensions. The specimens were divided into 4 groups: ultrasonic scaler, stainless steel curette, prophylaxis cup, and control. Pretreatment surface roughness measurements were made with a profilometer. Surface treatments in each group were performed with a custom mechanical scaler. Posttreatment surface roughness values were measured. In turn, the specimens were inoculated with Streptococcus mutans, Lactobacillus acidophilus, and Actinomyces viscosus. Bacterial adhesion was assessed by rinsing the specimens with sterile saline to remove unattached cells. The specimens were then placed in sterile tubes with 1 mL of sterile saline. The solution was plated and quantified. Scanning electron microscopy was performed. The statistical analysis of surface roughness was completed by using repeated-measures single-factor ANOVA with a Bonferroni correction. RESULTS: The surface roughness values for gold alloy specimens increased as a result of prophylaxis cup treatment (0.221 to 0.346 Ra) (P<.01) and stainless steel curette treatment (0.264 to 1.835 Ra) (P<.01). The results for bacterial adhesion to gold alloy proved inconclusive. A quantitative comparison indicated no statistically significant differences in pretreatment and posttreatment surface roughness values for lithium disilicate and zirconia specimens. In spite of these similarities, the overall bacterial adherence values for lithium disilicate were significantly greater than those recorded for gold alloy or zirconia (P<.05). Instrumentation of the lithium disilicate and zirconia with the stainless steel curette significantly increased bacterial adhesion compared with the control (P<.05). CONCLUSIONS: The results of this investigation indicate that Type III gold alloy exhibited increased surface roughness values after stainless steel curette and prophylaxis cup treatments. Zirconia was less susceptible to bacterial adhesion than lithium disilicate, and greater bacterial adhesion was found for the stainless steel curette than the other instrumentation methods.
PMID: 24831748
ISSN: 1097-6841
CID: 2426362
Evaluation of the sealing capability of implants to titanium and zirconia abutments against Porphyromonas gingivalis, Prevotella intermedia, and Fusobacterium nucleatum under different screw torque values
Smith, Nicole A; Turkyilmaz, Ilser
STATEMENT OF PROBLEM: When evaluating long-term implant success, clinicians have always been concerned with the gap at the implant-abutment junction, where bacteria can accumulate and cause marginal bone loss. However, little information regarding bacterial leakage at the implant-abutment junction, or microgap, is available. PURPOSE: The purpose of this study was to evaluate sealing at 2 different implant-abutment interfaces under different screw torque values. MATERIAL AND METHODS: Twenty sterile zirconia abutments and 20 sterile titanium abutments were screwed into 40 sterile implants and placed in test tubes. The ability of a bacterial mixture of Prevotella intermedia, Porphyromonas gingivalis, and Fusobacterium nucleatum to leak through an implant-titanium abutment seal under 20 and 35 Ncm torque values and an implant-zirconia abutment seal under 20 and 35 Ncm torque values was evaluated daily until leakage was noted. Once a unit demonstrated leakage, a specimen was plated. After 4 days, the number of colonies on each plate was counted with an electronic colony counter. Plating was used to verify whether or not bacterial leakage occurred and when leakage first occurred. The implant-abutment units were removed and rinsed with phosphate buffered saline solution and evaluated with a stereomicroscope. The marginal gap between the implant and the abutment was measured and correlated with the amount of bacterial leakage. The data were analyzed with ANOVA. RESULTS: Bacterial leakage was noted in all specimens, regardless of material or screw torque value. With titanium abutments, changing the screw torque value from 20 to 35 Ncm did not significantly affect the amount of bacterial leakage. However, with zirconia abutments, changing the screw torque value from 20 to 35 Ncm was statistically significant (P<.017). Overall, the marginal gap noted was larger at the zirconia-abutment interface (5.25 +/-1.99 mum) than the titanium-abutment interface (12.38 +/-3.73 mum), irrespective of the screw torque value. Stereomicroscopy revealed a nonuniform marginal gap in all specimens. CONCLUSION: The results of this study showed that, over time, bacteria will leak through the implant-abutment microgap at the implant-abutment interface. Implants with a titanium abutment demonstrate a smaller microgap than implants with a zirconia abutment. Tightening the zirconia abutment screw from 20 to 35 Ncm decreases the size of the microgap, which suggests a more intimate fit between the implant and the abutment.
PMID: 24656409
ISSN: 1097-6841
CID: 2426382
Management of a malpositioned implant using custom abutment and screw-retained fixed dental prosthesis [Case Report]
Turkyilmaz, Ilser
A 32-year-old woman with missing permanent mandibular right molars and left first molar presented for treatment. One of the implants were misaligned during the placement due to sudden mouth closure of the patient. All implants success fully osseointegrated. However, the misaligned implant resulted in substantial mechanical and esthetic restorative challenges. The prosthodontic treatment included a custom abutment and a screw-retained fixed dental prosthesis on the right side. The patient did not report any problems with the implants and restorations during the first year of service. The treatment presented in this clinical report may be an alternative option to restore malpositioned implants.
PMID: 25307826
ISSN: 1526-3711
CID: 2426342