Biomechanics/risk management (working group 2)

Members of Working Group:Klaus GotfredsenFlemming IsidorFranck RenouardPhoebus MadianosCarlos MadridPascal MarquartVictor PalarieAlberto SiciliaJose ZurdoRafael Juan Blanes Key words: anticoagulants, bisphosphonates, cantilevers, crown–implant ratio, guided Mariano Sanz, Department of Prosthetic Dentistry, implant surgery, implant-supported restorations Universidad Complutense de Madrid, Madrid, SpainIgnace Naert, Department of Periodontology,Katholieke Universiteit Leuven, Leuven, Belgium Introduction: The remit of this workgroup was to update the existing knowledge base in biomechanical factors, navigation systems and medications that may affect the outcome of Material and methods: The literature was systematically searched and critically reviewed.
Five manuscripts were produced in five specific topics identified as areas where innovative Fax: þ 32 16 33 23 09e-mail: ignace.naert@med.kuleuven.ac.be approaches have been developed in biomechanical factors, navigation systems and medications that may affect the outcome of implant therapy.
Conflict of interest and source of funding statement: Results: The results and conclusions of the review process are presented in the following The authors have declared no conflicts of interest.
Workgroup 2 participants declared that they had no papers, together with the group consensus statements, clinical implications and directions  To what extent do cantilevers affect survival and complications of implant supported restorations in partially dentate patients?  To what extent does the crown–implant ratio affect survival and complications of implant  A systematic review on the accuracy and the clinical outcome of computer-guided  What is the impact of systemic bisphosphonates on patients undergoing oral implant therapy?  What is the impact of anticoagulants on patients undergoing oral implant therapy? The remit of this workgroup was to update nical factors, navigation systems and med- implant therapy. For this purpose the lit- critically reviewed. Five manuscripts were plant ratio affect survival and complica- produced in five specific topics identified To cite this article:Sanz M, Naert I. Biomechanics/risk management were deemed to be strategically important Clin. Oral Impl. Res. 20 (Suppl. 4), 2009; 107–111.
doi: 10.1111/j.1600-0501.2009.01780.x guided template based implant dentistry.
Sanz & Naert Á Biomechanics/risk management 4. What is the impact of systemic bispho- extension (one unit) is an acceptable re- storative therapy, and might be considered as an alternative to procedures that require Zurdo, J., Romao, C. Wennstro¨m, J.
effects of cantilevers, consisting of one dies with at least 5 years of follow-up.
C/I ratio on survival rates, peri-implant tial effects of C/I ratio on the survival arch locations (e.g., anterior, posterior).
among studies with respect to data collec- tion and study design, the following con- 108 | Clin. Oral Impl. Res. 20 (Suppl. 4), 2009 / 107–111 Sanz & Naert Á Biomechanics/risk management ciated with the prosthesis material or im- proper seating. The tolerance and effect of accuracy and clinical application in com- Based on the data analysis of this systema- reported in a total of six studies with 79 based implant treatment are available. Dif- ferent types of software, template produc- tion and template stabilization as well as plant failure rates are similar to conven- variations of the surgical and prosthetic data and relatively short observation peri- ods are available in the literature reporting Group’s consensusIn order to evaluate the accuracy and clin- guided systems; there is a need of informa- The analysis of the acquired data revealed that the mean horizontal deviation of the 0.5 mm in height and 5–61 in axis. Devia- tion to the clinical pre-operatory design supported by bone, teeth or implants pro- firmed .The same applies for the deviation dependent on template production; stereo- of mean deviation with free-hand drilling in single-tooth gaps is similar to the results It seems that the reliability of the compu- ter-guided systems is insufficient to justify accuracy including partially and fully eden- a ‘blind’ implantation. Thus, the diagnos- tic and surgical procedures require constant verification after each step. Especially in flapless procedures, when visual control is Peri-operative surgical complications oc- curred in 9.1% of the patients. Early pros- thetic complications occurred in 18.8% of implant surgery, together with their inher- restoration and prefabricated prostheses.
actual implant position leading to a misfit of the restoration (7.2%) as well as exten- 109 | Clin. Oral Impl. Res. 20 (Suppl. 4), 2009 / 107–111 Sanz & Naert Á Biomechanics/risk management are considered at low risk for BRONJ.
years, there is no evidence derived frompopulation studies.
ratio (INR) 2–4] that do not discontinue bone regeneration, sinus lift, etc., there ered a low risk for developing BRONJ.
gery (dental extraction, periodontal sur- the patient’s bone metabolic disease.
been demonstrated by clinical research.
in preventing postoperative bleeding.
tagonists, e.g. warfarin, cumarin) is the evaluate the patient’s anticoagulation.
110 | Clin. Oral Impl. Res. 20 (Suppl. 4), 2009 / 107–111 Sanz & Naert Á Biomechanics/risk management from 2–3 (low to moderate risk) to 2.5– and record previous bleeding events.
in preventing postoperative bleeding.
cal flaps, bone harvesting, sinus lift, etc.) cussed with the patient’s physician and patient informed consent documented.
be referred to his/her physician for dose tient requesting implant therapy should be: bleeding in implant surgical protocols.
Blanes, R. (2009) To what extent does the crown– Madrid, C. & Sanz, M. (2009b) What is the impact template based implant dentistry. Clinical Oral implant ratio affect survival and complications of of anticoagulants on patients undergoing oral im- Implant Research 20 (Suppl. 4): 73–86.
implant supported restorations. Clinical Oral Im- plant therapy? Clinical Oral Implant Research 20 Zurdo, J., Romao, C. & Wennstro¨m, J. (2009) To plant Research 20 (Suppl. 4): 67–72.
what extent do cantilevers affect survival and Madrid, C. & Sanz, M. (2009a) What is the impact Schneider, D., Marquardt, P., Zwahlen, M. & Jung, complications of implant supported restorations of systemic bisphosphonates on patients under- R.E. (2009) A systematic review on the accuracy in partially dentate patients. Clinical Oral Im- going oral implant therapy? Clinical Oral Implant and the clinical outcome of computer-guided plant Research 20 (Suppl. 4): 59–66.
111 | Clin. Oral Impl. Res. 20 (Suppl. 4), 2009 / 107–111

Source: http://www.clinicasicilia.es/abstract/03_group2_2009.pdf