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: [email protected]
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
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