Bone loss in implants placed at subcrestal and crestal level: A systematic review and meta-analysis

Background: To assess differences in marginal bone loss in implants placed at subcrestal versus crestal level. Methods: An electronic and a manual research of articles written in English from Jaunary 2010 to January 2018 was performed by two independent reviewers. Clinical trials comparing bone loss for implants placed at crestal and subcrestal level were included. Pooled estimates from comparable studies were analyzed using a continuous random-effects model meta-analysis with the objective of assessing differences in crestal bone loss between the two vertical positions. Results: 16 studies were included; 10 studies did not encounter statistically significant differences between the two groups with respect to bone loss. Three articles found greater bone loss in subcrestal implants; while 3 found more bone loss in crestal implants. A meta-analysis for randomized control trial (RCT) studies reported an average and non-statistically different crestal bone loss of 0.028 mm. Conclusions: A high survival rate and a comparable bone loss was obtained both for crestal and subcrestal implants’ placement. Quantitative analysis considering a homogenous sample confirms that both vertical positions are equally valid in terms of perimplant bone loss. However, with respect to soft tissue; in presence of a thin tissue; a subcrestal placement of the implant should be preferred as it may reduce the probability for the implant to become exposed in the future and thus avoid the risk of suffering from peri-implant pathologies

Implant treatment by transcrestal maxillary sinus elevation. A 3-year follow-up study

Introducción. El objetivo del presente estudio era mostrar los resultados del tratamiento con implantes dentales insertados mediante la técnica de elevación transcrestal en el maxilar superior. Pacientes y Metodos. 47 pacientes (18 hombres y 29 mujeres) con pérdidas dentales maxilares fueron tratados con 60 implantes IPX ® Galimplant con conexión interna y superficie arenada y grabada fueron insertados mediante la técnica de elevación sinusal transcrestal para la rehabilitación del maxilar posterior. Los implantes fueron cargados después de un periodo de cicatrización de 6 meses. Resultados. Los hallazgos clínicos indican una supervivencia y éxito de los implantes del 100%. La ganancia media de hueso vertical fué de 4,8 mm (rango: 2-6,5 mm). 46,7% de los implantes se insertaron en localización molar y el 53,3% en la localización premolar. Biomateriales fueron utilizados en el 91,7% de los implantes. Después de un periodo medio de carga funcional de 37,6 meses (rango: 24-52 meses), no ha habido complicaciones tardías. El 70% de los implantes fueron rehabilitados con coronas unitarias y el 30% con puentes fijos. Conclusiones. Este estudio indica que el tratamiento con implantes dentales mediante su inserción con elevación transcrestal del seno maxilar superior constituye una terapéutica implantológica con éxito.Introduction. The aim of this study was to report the outcome of treatment with maxillary dental implants inserted by transcrestal sinus elevation. Patients and Methods. 47 patients (18 males and 29 females) with maxillary tooth loss were treated with 60 IPX ® Galimplant internal connection and sandblasted and acid-etched surface implants inserted by transcrestal sinus elevation for rehabilitation of posterior maxilla. Implants were loaded after a healing free-loading period of 6 months. Results. Clinical results indicate a survival and success rate of implants of 100%. The mean elevation height was 4.8 mm (range: 2-6.5 mm). 46.7% of implants were inserted in molar and 53.3% in premolar localization. Bone substitutes were used in 91.7% of implants. After a mean functioning period of 37.6 months (range: 24-52 months), no late complications were reported. 70% of implants were restored with single crowns and 30% with fixed bridges. Conclusions. This study indicate that treatment with dental implants inserted in maxilla by transcrestal sinus elevation constitute a successful implant treatment

Implants inserted by ridge expansion with osteotomes in the maxilla. A 3-year clinical study

Introducción: El objetivo del presente estudio era mostrar los resultados del tratamiento con implantes dentales insertados mediante la técnica de expansión ósea en el maxilar superior. Pacientes y métodos: Setenta y tres pacientes con pérdidas dentales maxilares fueron tratados con 149 implantes IPX Galimplant® con conexión interna y superficie arenada y grabada para la rehabilitación mediante la técnica de expansión ósea con osteótomos roscados. Los implantes fueron cargados después de un periodo de cicatrización de 3 meses. Resultados: Los hallazgos clínicos indican una supervivencia y éxito de los implantes del 97,4%. Se perdieron 4 implantes durante el periodo de cicatrización. El 57,7% de los implantes se insertaron en el sector anterior maxilar y el 42,3%, en el sector posterior maxilar. Después de un periodo medio de carga funcional de 36,4 meses no ha habido complicaciones tardías. El 88,6% de los pacientes fueron rehabilitados con puentes fijos y el 11,5%, con coronas unitarias. Conclusiones: Este estudio indica que el tratamiento con implantes dentales mediante su inserción con expansión ósea en el maxilar superior constituye una terapéutica implantológica con éxito.Introduction: The aim of this study was to report the outcome of treatment with maxillary dental implants inserted by ridge expansion technique. Patients and Methods: 73 patients with maxillary tooth loss were treated with 149 IPX Galimplant® internal connection and sandblasted-acid-etched surface implants for rehabilitation by bone expansion technique. Implants were loaded after a healing free-loading period of 3 months. Results: Clinical results indicate a survival and success rate of implants of 97.4%. 4 implants were lost during the healing period. 57.7% of implants were inserted in anterior maxilla and 42.3% in posterior maxilla. After a mean functioning period of 36.4 months, no late complications were reported. 88.6% of patients were restored with fixed bridges and 11.5% with single crowns. Conclusions: This study indicate that treatment with dental implants inserted in maxilla by ridge expansion constitute a successful implant treatment

Development and applications of the finite point method to compressible aerodynamics problems

This work deals with the development and application of the Finite Point Method (FPM) to compressible aerodynamics problems. The research focuses mainly on investigating the capabilities of the meshless technique to address practical problems, one of the most outstanding issues in meshless methods. The FPM spatial approximation is studied firstly, with emphasis on aspects of the methodology that can be improved to increase its robustness and accuracy. Suitable ranges for setting the relevant approximation parameters and the performance likely to be attained in practice are determined. An automatic procedure to adjust the approximation parameters is also proposed to simplify the application of the method, reducing problem- and user-dependence without affecting the flexibility of the meshless technique. The discretization of the flow equations is carried out following wellestablished approaches, but drawing on the meshless character of the methodology. In order to meet the requirements of practical applications, the procedures are designed and implemented placing emphasis on robustness and efficiency (a simplification of the basic FPM technique is proposed to this end). The flow solver is based on an upwind spatial discretization of the convective fluxes (using the approximate Riemann solver of Roe) and an explicit time integration scheme. Two additional artificial diffusion schemes are also proposed to suit those cases of study in which computational cost is a major concern. The performance of the flow solver is evaluated in order to determine the potential of the meshless approach. The accuracy, computational cost and parallel scalability of the method are studied in comparison with a conventional FEM-based technique. Finally, practical applications and extensions of the flow solution scheme are presented. The examples provided are intended not only to show the capabilities of the FPM, but also to exploit meshless advantages. Automatic hadaptive procedures, moving domain and fluid-structure interaction problems, as well as a preliminary approach to solve high-Reynolds viscous flows, are a sample of the topics explored. All in all, the results obtained are satisfactorily accurate and competitive in terms of computational cost (if compared with a similar mesh-based implementation). This indicates that meshless advantages can be exploited with efficiency and constitutes a good starting point towards more challenging applications

Simple and efficient numerical tools for the analysis of parachutes

This work describes a set of simple yet effective, numerical method for the design and evaluation of parachute-payload system. The developments include a coupled fluidstructural solver for unsteady simulations of ram-air type parachutes. For an efficient solution of the aerodynamic problem, an unsteady panel method has been chosen exploiting the fact that large areas of separated flow are not expected under nominal flight conditions of ram-air parachutes. A dynamic explicit finite element solver is used for the structure. This approach yields a robust solution even when highly non-linear effects due to large displacements and material response are present. The numerical results show considerable accuracy and robustness. An added benefit of the proposed aerodynamic and structural techniques is that they can be easily vectored and thus suitable for use in parallel architectures. The main features of the computational tools are described and several numerical examples are provided to illustrate the performance and capabilities of the technique

An improved finite point method for tridimensional potential flows

At the local level, successful meshless techniques such as the Finite Point Method must have two main characteristics: a suitable geometrical support and a robust numerical approximation built on the former. In this article we develop the second condition and present an alternative procedure to obtain shape functions and their derivatives from a given cloud of points regardless of its geometrical features. This procedure, based on a QR factorization and an iterative adjust of local approximation parameters, allows obtaining a satisfactory minimization problem solution, even in the most difficult cases where usual approaches fail. It is known that high-order meshless constructions need to include a large number of points in the local support zone and this fact turns the approximation more dependent on the size, shape and spatial distribution of the local cloud of points. The proposed procedure also facilitates the construction of high-order approximations on generic geometries reducing their dependence on the geometrical support where they are based. Apart from the alternative solution to the minimization problem, the behaviour of high-order Finite Point approximations and the overall performance of the proposed methodology are shown by means of several numerical tests

A 3D low-order panel method for unsteady aerodynamic problems

An unsteady low-order panel method for three-dimensional subsonic analyses is presented. The method, which is based on well-established techniques in computational aerodynamics, is intended to achieve a cost-effective solution of unsteady flows around arbitrary aerodynamic configurations. This work has two main objectives. First, to relax geometry discretization requirements and, second, to simplify the treatment of problems in which the analysis configuration moves along specified flight paths and/or changes its geometry during the simulation. Following this aim, a time-marching solution procedure is adopted in conjunction with a free-wake model which avoids iterative solutions for wake shape and position. The suitability of the present approach for solving typical aerodynamic problems is illustrated by means of several numerical examples

A finite point method for adaptive three-dimensional compressible flow calculation

The Finite Point Method (FPM) is a meshless technique which is based on both, a Weighted Least-Squares numerical approximation on local clouds of points and a collocation technique which allows obtaining the discrete system of equations. The research work we present is part of a major investigation into the capabilities of the FPM to deal with threedimensional applications concerning real compressible fluid flow problems. In the first part of this work, the upwind biased scheme employed for solving the flow equations is described. Secondly, with the aim of exploiting meshless capabilities, an h-adaptive methodology for two and three-dimensional compressible flow calculations is developed. This adaptive technique applies a solution-based indicator in order to identify local clouds where new points should be inserted in or existing points could be safely removed from the computational domain. The flow solver and the adaptive procedure have been evaluated and the results are highly encouraging. Several numerical examples are provided throughout the article in order to illustrate their performance