Akademie für orale Implantologie

The PRECISE protocol (Prosthetic Reconstruction Engineered through CBCT Integration and Skeletal Engagement) presents a fully digital workflow for full-arch immediate implant loading, combining intra-oral photogrammetry (IPG) with skeletal-based cone beam CT referencing to enhance prosthetic accuracy and occlusal precision. This protocol integrates simplified data acquisition, remote prosthetic design, in-house 3D printing and a nurse-led finishing protocol, enabling same-day delivery while reducing surgical time, biological risk and technical complexity. Early clinical experience demonstrates promising accuracy and efficiency; however, further research is required to validate long-term outcomes and assess applicability across a broader range of cases. The PRECISE protocol offers a reproducible and predictable approach to full-arch rehabilitation. CPD/Clinical Relevance: This protocol enhances the accuracy and predictability of full-arch immediate implant loading through intra-oral photogrammetry, cone beam CT integration, remote design and 3D printing.

The maintenance of the fluid balance of surgical patients is one of the most important responsibilities of the modern surgical team and the proper replacement of blood is perhaps one of the most important phases of this maintenance Although most surgeons and anaesthesiologists well appreciate this fact, they are often faced with the problem of accurately estimating blood loss in order to avoid under-replacement or over-replacement, both of which can have adverse effects in compromised patients. A total number of 50 subjects, both males and females in the age group of 15-50 years who reported to our centre for major surgical procedures under maxillofacial surgery were included in the study. The study was conducted between September 2012 to November 2014.: The intraoperative blood loss in various oral and maxillofacial surgeries ranged from 63.6 – 1343 ml. 15 had 101-200 ml, 5 patients had 301-500 ml and 12 had >500 ml of blood loss. The average intraoperative blood loss in various oral and maxillofacial surgeries was 343.3 ± 256.3 ml.: The necessity of replacement of blood depends on the amount of blood loss peri-operatively. In order to have optimal effects, the blood must be administered as it is being lost and in proper amounts. In this study Gravimetric method was used for estimation of blood loss. The gravimetric method offers the surgical team a simple and practical means of estimating the amount of blood loss during the surgery. It will also help in having an analytical idea about the average blood loss and mean reduction in haemoglobin percentage in the various oral and maxillofacial surgeries which will be helpful in evaluating the postoperative necessity of blood transfusion. Therefore there are very few instances where blood replacement is warranted in majority of the cases of that were operated.

Cranioplasty has numerous indications, and its main objective is to support the underlying noble structures, along with restoring shape and aesthetics. The treatment of choice is controversial, and is mainly related to the type of material to be used.

ObjectivesThe aim of this study was to demonstrate a possible correlation between radiographic trabecular bone quantified with fractal dimensions analysis and values of primary implant stability deliberated using the Osstell® monitor (Integration Diagnostics AB, Goteborgsvagen, Sweden) with the density of bone specimens harvested from the implant recipient sites and calculated using the mass and volume of the bone bloc specimens.Material and methodsFifty implants of the same brand, diameter, and length were inserted with the same surgical procedures; 25 implants in the molar premolar region of the maxilla and 25 implants in the mandibular posterior region of only healthy male patients between 20 and 50 years of age. Prior to the placement of the implants, biopsies were taken from the selected site for density calculation using a calibrated trephine. Two photostimulable phosphor digital periapical radiographs were obtained for each patient and two regions of interest were selected for a fractal dimension analysis: one site before implantation and the same site immediately postoperatively adjacent to the implant.ResultsThere were correlations between the fractal dimensions and implant stability quotient as well as between fractal dimensions and bone density. No significant difference was found between the fractal dimensions of pre- and postoperative periapical radiographs for the same region of interest and between implant stability quotient values of the maxillae and mandible sites.ConclusionAll executed analyses were helpful in assessing the bone density in the recipient site of implant placement using fractal dimensions, offering complementary information about predictable bone density assessed on a periapical radiograph.

Acute kidney injury (AKI) is a syndrome characterized by rapid loss of renal excretory function with high in-hospital mortality. The excess generation of reactive oxygen species (ROS) in the kidneys during AKI has been considered a major cause of renal failure. Currently available antioxidants for AKI treatment often lack the required antioxidative efficacy or renal accumulation rate. Herein, inspired by the structure of natural phenolic antioxidants, phenol-like group functionalized graphene quantum dots (h-GQDs) with both high ROS scavenging efficacy and renal specificity are constructed for AKI antioxidative therapy. Similar to natural polyphenols, the abundant phenol-like groups on h-GQDs are demonstrated to be the active components exerting antioxidative effects. Further exhaustive mechanistic investigations indicate that the ultrahigh antioxidative activity of h-GQDs originates not solely from the phenol-like groups, but also from the synergy between adjacent phenol-like groups, as well as the removal of unfavorable carbonyl groups on h-GQDs. In AKI mice, h-GQDs can effectively protect the kidneys from oxidative injury with only a one-sixteenth dose of the clinical antioxidant N-acetylcysteine (NAC) and show no evidence of toxicity. The findings of this study will facilitate development of high-performance carbon-based antioxidative platforms via structure–activity relationships for treating AKI and other ROS-related diseases.

Background Immediate placement of single-tooth implants at the time of tooth extraction has become daily routine in anterior regions of the mandible due to several advantages- less surgical interventions and associated patient morbidity, reduction of total treatment time and the possibility of fixed immediate provisionals within 1 day after tooth removal. Aim/Hypothesis The aim of the present retrospective study was to evaluate whether delayed placement should be favoured in posterior regions of the jaw because of higher occlusal forces and reduced need for provisional restoration. Material and Methods A total of 4,217 single-tooth implants were placed in mandibular molar positions (i.e. 36, 37, 46 or 47) at the Academy for Oral Implantology in Vienna in the years 2004–2019. Delayed implant placement was performed in 1,230 patients (3,691 implants) and immediate implant placement was performed in 175 patients (526 implants). Implant survival was compared after a mean follow-up of 7 years using chi-squared tests. Results The survival rate of delayed implants was 97.1% compared to 94.3% of immediate implants in the posterior maxilla (P = 0.008). No difference between single-tooth gaps and free-end situations could be determined for both delayed (P = 0.811) and immediate (0.419) implants. Conclusion and Clinical Implications It can be concluded that immediate placement of single-tooth implants in the posterior mandible may be significantly associated with a 2.8% higher implant failure rate compared to delayed placement.

Background Immediate placement of single-tooth implants at the time of tooth extraction has become daily routine in anterior regions of the maxilla due to several advantages- less surgical interventions and associated patient morbidity, reduction of total treatment time and the possibility of fixed immediate provisionals within 1 day after tooth removal. Aim/Hypothesis The aim of the present retrospective study was to evaluate whether delayed placement should be favoured in posterior regions of the jaw because of higher occlusal forces and reduced need for provisional restoration. Material and Methods A total of 3441 single-tooth implants were placed in maxillary molar positions (i.e. 16, 17, 26 or 27) at the Academy for Oral Implantology in Vienna in the years 2004–2019. Delayed implant placement was performed in 952 patients (2856 implants) and immediate implant placement was performed in 195 patients (585 implants). Implant survival was compared after a mean follow-up of 7 years using chi-squared tests. Results The survival rate of delayed implants was 97.0% compared to 95.4% of immediate implants in the posterior maxilla (P = 0.042). No difference between single-tooth gaps and free-end situations could be determined for both delayed (P = 0.218) and immediate (0.956). Conclusion and Clinical Implications It can be concluded that immediate placement of single-tooth implants in the posterior maxilla may be significantly associated with a 1.6% higher implant failure rate compared to delayed placement.

Background Predictable results and low positional deviation may be achieved when dental implants are placed via stereolithographic templates in the healed alveolar ridge. However, when guided implant placement into fresh extraction sockets is attempted, drilling precision may be compromised due to the steep angle between drill and alveolar wall. Aim/Hypothesis To investigate the influence of drilling protocol as well as angle between drill and bone on the precision of template-guided implant placement in an artificial bone and soft tissue model of a human maxilla. Material and Methods Four different angles between drill and bone surface were investigated (69 drills each)- 10°, 20°, 30° (representing immediate implant placement) and 90° (representing late implant placement). The drilling protocol involved 2 mm pilot drills with or without prior use of precision drills. Differences were evaluated via Wilcoxon tests and multivariate regression analysis. Results No difference in angular deviation of late implants (2.5°) was observed between both drilling protocols. A significantly higher deviation of immediate implants was seen at 10°–30° angle (P < 0.001)- a mean deviation of 5.3° after pilot drilling without and 4.3° with prior use of precision drills (P < 0.001). Conclusions and Clinical Implications A significant 2.2-fold increase of angular deviation must be expected when immediate implants are placed in the maxilla via surgical templates due to the steep angle between the drill and the palatal alveolar wall. The use of precision drills prior to 2 mm pilot drilling may help to significantly reduce positional inaccuracy in guided immediate implant placement.

The amount of marginal bone resorption around dental implants is considered to have a significant impact on implant stability as well as implant survival rates. The aim of this prospective study was to investigate the influence of prosthetic as well as patient specific factors on marginal bone loss around short dental implants. Seventy-six implants, which supported splinted crowns were included for investigation. All implants were from the same type and had an intraosseous length of 6.5 mm and a diameter of 4.0 mm. Twenty implants were additionally splinted onto longer ones. Measurements of marginal bone loss were performed at a mean of 12.38 months after prosthetic loading and the mean follow-up for clinical evaluation was 20.52 months. Overall two implant failures were recorded, revealing a survival rate of 97.3%. Marginal bone resorption around 72 short implants measured 0.71 mm (SD: 0.74 mm) and was found to have a strong correlation with calculated Crown-to-Implant ratio (r = .71; P < .001). Age, gender, insertion torque, implant surface area, location, position, bone quality, and insertion torque did not influence peri-implant bone loss after one year of loading. Within the limitations of the study, it is suggested that Crown-to-Implant ratios should not exceed 1.7 to avoid increased early marginal bone loss.