Skip to main content
Top
Published in:

01-11-2024 | Research

Exploratory study on a novel minimally invasive tunnel like flap approach for orthodontic movement of dental implants

Authors: Mahmoud Sedky Adly, Frederic Cuisinier, Aya Sedky Adly, Elias Estephan, Afnan Sedky Adly, Philippe Bousquet

Published in: Clinical Oral Investigations | Issue 11/2024

Login to get access

Abstract

Objectives

To propose a new flap design that utilize a minimally invasive approach to move implants. We also propose a 3D method to track changes in implant position without the need for CBCT.

Materials and methods

Implants were inserted in two mongrel dogs then a minimally invasive tunnel like flap was made. Bone cutting around implants was done using piezotome device and orthodontic force was applied on the implants. For tracking positional changes of implants, an impression was taken then scanned with an identical implant copy inside. The pre- and post-treatment 3D images were then superimposed over each other to detect changes in implant position.

Results

Healing of the flap was rapid with minimal swelling and edema. The position of the interdental papilla was preserved maintaining optimal esthetic outcome. Implant pocket depth was maintained. Our 3D imaging method was able to accurately detect the movement that occurred in the dental implants after their movement with significantly higher resolution than CBCT (6 μm for this method versus 76–300 μm for the CBCT).

Conclusions

This flap can preserve the esthetic soft tissue contour of implants during orthodontic movement allowing rapid healing with minimum swelling and edema. Moreover, our proposed 3D method has many advantages over CBCT in tracking the movement of implants by being non harmful and cheap thus allowing several follow up points.

Clinical relevance

Orthodontic movement of implants can be required in cases of improperly placed implants or to intentionally place the implant in a certain position then altering it to avoid the need for bone grafting.
Literature
1.
go back to reference Bousquet P, Ansermino H, Canal P, Renaud M, Artz C (2016) Croissance Et implants dentaires: évaluation et prévention du risque esthétique. L’Orthodontie Française 87:321–328CrossRefPubMed Bousquet P, Ansermino H, Canal P, Renaud M, Artz C (2016) Croissance Et implants dentaires: évaluation et prévention du risque esthétique. L’Orthodontie Française 87:321–328CrossRefPubMed
2.
go back to reference Bohner L, Hanisch M, Kleinheinz J, Jung S (2019) Dental implants in growing patients: a systematic review. Br J Oral Maxillofac Surg 57:397–406CrossRefPubMed Bohner L, Hanisch M, Kleinheinz J, Jung S (2019) Dental implants in growing patients: a systematic review. Br J Oral Maxillofac Surg 57:397–406CrossRefPubMed
3.
go back to reference Bokobza A, Lauwers L, Raoul G, Nicot R, Ferri J (2022) Implant repositioning with segmental osteotomy. J Stomatology Oral Maxillofacial Surg 123:2–8CrossRef Bokobza A, Lauwers L, Raoul G, Nicot R, Ferri J (2022) Implant repositioning with segmental osteotomy. J Stomatology Oral Maxillofacial Surg 123:2–8CrossRef
4.
go back to reference Hadi A, Marius C, Avi S, Mariel W, Galit B-B (2018) Ankylosed permanent teeth: incidence, etiology and guidelines for clinical management. Med Dent Res 1:1–11CrossRef Hadi A, Marius C, Avi S, Mariel W, Galit B-B (2018) Ankylosed permanent teeth: incidence, etiology and guidelines for clinical management. Med Dent Res 1:1–11CrossRef
5.
go back to reference Guerrero CA, Laplana R, Figueredo N, Rojas AJIJO, Implants M (1999) Surgical implant repositioning: a clinical report. 14 Guerrero CA, Laplana R, Figueredo N, Rojas AJIJO, Implants M (1999) Surgical implant repositioning: a clinical report. 14
6.
go back to reference Oduncuoglu BF, Alaaddinoglu EE, Oguz Y, Uckan S Erkut SJJoo and surgery m (2011) repositioning a prosthetically unfavorable implant by vertical distraction osteogenesis. 69:1628–1632 Oduncuoglu BF, Alaaddinoglu EE, Oguz Y, Uckan S Erkut SJJoo and surgery m (2011) repositioning a prosthetically unfavorable implant by vertical distraction osteogenesis. 69:1628–1632
7.
go back to reference Ramaglia L, Cicciù M, Fiorentino E, Saviano R, Blasi A, Cervino G, Isola G (2019) Effectiveness of a piezoelectric-assisted distraction osteogenesis procedure for the treatment of ankylosed permanent front teeth. J Craniofac Surg 30:e356–e359CrossRefPubMed Ramaglia L, Cicciù M, Fiorentino E, Saviano R, Blasi A, Cervino G, Isola G (2019) Effectiveness of a piezoelectric-assisted distraction osteogenesis procedure for the treatment of ankylosed permanent front teeth. J Craniofac Surg 30:e356–e359CrossRefPubMed
8.
go back to reference Shahroudi AS, Golmohammadi S (2020) Miniscrew-assisted single-tooth distraction osteogenesis to align an ankylosed infraoccluded maxillary central incisor: a case report. J Orthodont 47:345–353CrossRef Shahroudi AS, Golmohammadi S (2020) Miniscrew-assisted single-tooth distraction osteogenesis to align an ankylosed infraoccluded maxillary central incisor: a case report. J Orthodont 47:345–353CrossRef
9.
go back to reference You K-H, Min Y-S, Baik H-S (2012) Treatment of ankylosed maxillary central incisors by segmental osteotomy with autogenous bone graft. Am J Orthod Dentofac Orthop 141:495–503CrossRef You K-H, Min Y-S, Baik H-S (2012) Treatment of ankylosed maxillary central incisors by segmental osteotomy with autogenous bone graft. Am J Orthod Dentofac Orthop 141:495–503CrossRef
10.
go back to reference Bousquet P, Artz C, Renaud M, Canal P (2016) Relocation of infrapositioned ankylosed teeth: description of orthodontic bone stretching and case series. J Oral Maxillofac Surg 74:1914–1925CrossRefPubMed Bousquet P, Artz C, Renaud M, Canal P (2016) Relocation of infrapositioned ankylosed teeth: description of orthodontic bone stretching and case series. J Oral Maxillofac Surg 74:1914–1925CrossRefPubMed
11.
go back to reference Bousquet P, Barthélemi S, Artz C, Delsol L (2021) The application of orthodontic bone stretching for correcting malpositioned dental implants. Head Face Med 17:1–11CrossRef Bousquet P, Barthélemi S, Artz C, Delsol L (2021) The application of orthodontic bone stretching for correcting malpositioned dental implants. Head Face Med 17:1–11CrossRef
12.
go back to reference Windisch P, Iorio-Siciliano V, Palkovics D, Ramaglia L, Blasi A, Sculean A (2022) The role of surgical flap design (minimally invasive flap vs. extended flap with papilla preservation) on the healing of intrabony defects treated with an enamel matrix derivative: a 12-month two-center randomized controlled clinical trial. Clin Oral Investig 26:1811–1821. https://doi.org/10.1007/s00784-021-04155-5CrossRefPubMed Windisch P, Iorio-Siciliano V, Palkovics D, Ramaglia L, Blasi A, Sculean A (2022) The role of surgical flap design (minimally invasive flap vs. extended flap with papilla preservation) on the healing of intrabony defects treated with an enamel matrix derivative: a 12-month two-center randomized controlled clinical trial. Clin Oral Investig 26:1811–1821. https://​doi.​org/​10.​1007/​s00784-021-04155-5CrossRefPubMed
14.
go back to reference Hakim MA, McCain JP, Ahn DY, Troulis MJ (2019) Minimally invasive endoscopic oral and maxillofacial surgery. Oral Maxillofac Surg Clin North Am 31:561–567CrossRefPubMed Hakim MA, McCain JP, Ahn DY, Troulis MJ (2019) Minimally invasive endoscopic oral and maxillofacial surgery. Oral Maxillofac Surg Clin North Am 31:561–567CrossRefPubMed
15.
go back to reference Khiabani K, Amirzade-Iranaq MH, Babadi A (2021) Does minimal-invasive envelope flap reduce side effects compared to conventional envelope flap following impacted third molar surgery? A split-mouth randomized clinical trial. J Oral Maxillofac Surg 79:2411–2420CrossRefPubMed Khiabani K, Amirzade-Iranaq MH, Babadi A (2021) Does minimal-invasive envelope flap reduce side effects compared to conventional envelope flap following impacted third molar surgery? A split-mouth randomized clinical trial. J Oral Maxillofac Surg 79:2411–2420CrossRefPubMed
16.
go back to reference Mohd J, Abid H, Lalit KJCE, Health G (2019) Current status and applications of 3D scanning in dentistry. 7:228–233 Mohd J, Abid H, Lalit KJCE, Health G (2019) Current status and applications of 3D scanning in dentistry. 7:228–233
17.
go back to reference Shahakbari R, Labafchi A, Salami S, Samieirad SJJM, Surgery O (2021) Piezotome versus surgical bur: which is more effective in reducing the postoperative pain and edema following open sinus lift surgery? 20:642–648 Shahakbari R, Labafchi A, Salami S, Samieirad SJJM, Surgery O (2021) Piezotome versus surgical bur: which is more effective in reducing the postoperative pain and edema following open sinus lift surgery? 20:642–648
19.
go back to reference Capella Cobos JC (2020) Using Extracted Teeth as a Novel Graft Material in Atrophic Ridge Augmentation: A Report of Two Cases with Histology and Cone–Beam Computed Tomography. International Journal of Growth Factors & Stem Cells in Dentistry 3 Capella Cobos JC (2020) Using Extracted Teeth as a Novel Graft Material in Atrophic Ridge Augmentation: A Report of Two Cases with Histology and Cone–Beam Computed Tomography. International Journal of Growth Factors & Stem Cells in Dentistry 3
20.
go back to reference Adly MS, Adly AS, Alreshidi SF, Alotaibi AM, Alreshidi MF, Adly AS (2021) Can Paracetamol lower stress and anxiety by blunting emotions during and after computer guided dental implant surgeries? Findings from a randomized crossover clinical trial. J Dent Sci 16:137–144CrossRefPubMed Adly MS, Adly AS, Alreshidi SF, Alotaibi AM, Alreshidi MF, Adly AS (2021) Can Paracetamol lower stress and anxiety by blunting emotions during and after computer guided dental implant surgeries? Findings from a randomized crossover clinical trial. J Dent Sci 16:137–144CrossRefPubMed
21.
go back to reference Tyndall DA, Price JB, Tetradis S, Ganz SD, Hildebolt C, Scarfe WC (2012) Position statement of the American Academy of Oral and maxillofacial Radiology on selection criteria for the use of radiology in dental implantology with emphasis on cone beam computed tomography. Oral surgery, oral medicine. Oral Pathol Oral Radiol 113:817–826. https://doi.org/10.1016/j.oooo.2012.03.005CrossRef Tyndall DA, Price JB, Tetradis S, Ganz SD, Hildebolt C, Scarfe WC (2012) Position statement of the American Academy of Oral and maxillofacial Radiology on selection criteria for the use of radiology in dental implantology with emphasis on cone beam computed tomography. Oral surgery, oral medicine. Oral Pathol Oral Radiol 113:817–826. https://​doi.​org/​10.​1016/​j.​oooo.​2012.​03.​005CrossRef
23.
go back to reference Al-Juboori MJ, AbdulRahaman SB (2015) The effect of flapless and full-thickness flap techniques on implant stability during the healing period. open Dentistry J 9:243CrossRef Al-Juboori MJ, AbdulRahaman SB (2015) The effect of flapless and full-thickness flap techniques on implant stability during the healing period. open Dentistry J 9:243CrossRef
24.
go back to reference Fickl S, Kebschull M, Schupbach P, Zuhr O, Schlagenhauf U, Hürzeler MB (2011) Bone loss after full-thickness and partial‐thickness flap elevation. J Clin Periodontol 38:157–162CrossRefPubMed Fickl S, Kebschull M, Schupbach P, Zuhr O, Schlagenhauf U, Hürzeler MB (2011) Bone loss after full-thickness and partial‐thickness flap elevation. J Clin Periodontol 38:157–162CrossRefPubMed
25.
go back to reference Zabalegui I, Sicilia A, Cambra J, Gil J, Sanz M (1999) Treatment of multiple adjacent gingival recessions with the tunnel subepithelial connective tissue graft: a clinical report. Int J Periodontics Restor Dentistry 19 Zabalegui I, Sicilia A, Cambra J, Gil J, Sanz M (1999) Treatment of multiple adjacent gingival recessions with the tunnel subepithelial connective tissue graft: a clinical report. Int J Periodontics Restor Dentistry 19
26.
go back to reference Mayta-Tovalino F, Barboza JJ, Pasupuleti V, Hernandez AV (2023) Efficacy of tunnel technique (TUN) versus coronally advanced flap (CAF) in the management of multiple gingival recession defects: a meta-analysis. Int J Dent 2023:8671484CrossRefPubMedPubMedCentral Mayta-Tovalino F, Barboza JJ, Pasupuleti V, Hernandez AV (2023) Efficacy of tunnel technique (TUN) versus coronally advanced flap (CAF) in the management of multiple gingival recession defects: a meta-analysis. Int J Dent 2023:8671484CrossRefPubMedPubMedCentral
28.
go back to reference Mohsin AHB, Sheethi K, Priyanka M, Karre D, Ahmed MQ (2019) Regenerative surgical flap to maintain interdental papilla around dental implant. Int J Appl Basic Med Res 9:188–190CrossRef Mohsin AHB, Sheethi K, Priyanka M, Karre D, Ahmed MQ (2019) Regenerative surgical flap to maintain interdental papilla around dental implant. Int J Appl Basic Med Res 9:188–190CrossRef
29.
go back to reference Gallucci GO, Papaspyridakos P, Ashy LM, Kim GE, Brady NJ, Weber H-P, Dent M (2011) Clinical accuracy outcomes of closed-tray and open-tray implant impression techniques for partially edentulous patients. Int J Prosthodont 24 Gallucci GO, Papaspyridakos P, Ashy LM, Kim GE, Brady NJ, Weber H-P, Dent M (2011) Clinical accuracy outcomes of closed-tray and open-tray implant impression techniques for partially edentulous patients. Int J Prosthodont 24
30.
go back to reference Kim KR, Seo K-y, Kim S (2019) Conventional open-tray impression versus intraoral digital scan for implant-level complete-arch impression. J Prosthet Dent 122:543–549CrossRefPubMed Kim KR, Seo K-y, Kim S (2019) Conventional open-tray impression versus intraoral digital scan for implant-level complete-arch impression. J Prosthet Dent 122:543–549CrossRefPubMed
31.
go back to reference Maret D, Telmon N, Peters OA, Lepage B, Treil J, Inglèse J, Peyre A, Kahn J-L, Sixou M (2012) Effect of Voxel size on the accuracy of 3D reconstructions with cone beam CT. Dentomaxillofacial Radiol 41:649–655CrossRef Maret D, Telmon N, Peters OA, Lepage B, Treil J, Inglèse J, Peyre A, Kahn J-L, Sixou M (2012) Effect of Voxel size on the accuracy of 3D reconstructions with cone beam CT. Dentomaxillofacial Radiol 41:649–655CrossRef
32.
go back to reference Nascimento HAR, Andrade MEA, Frazão MAG, Nascimento EHL, Ramos-Perez FMM, Freitas DQ (2017) Dosimetry in CBCT with different protocols: emphasis on small FOVs including exams for TMJ. Braz Dent J 28:511–516CrossRefPubMed Nascimento HAR, Andrade MEA, Frazão MAG, Nascimento EHL, Ramos-Perez FMM, Freitas DQ (2017) Dosimetry in CBCT with different protocols: emphasis on small FOVs including exams for TMJ. Braz Dent J 28:511–516CrossRefPubMed
33.
go back to reference Mawya K, Albadawi GH (2023) Assessment of Scattered Dose to the Eye in Dentistry: A Systematic Review. Cureus 15 Mawya K, Albadawi GH (2023) Assessment of Scattered Dose to the Eye in Dentistry: A Systematic Review. Cureus 15
34.
go back to reference Ling S, Bhatt AD, Brown NV, Nguyen P, Sipos JA, Chakravarti A, Rong Y (2017) Correlative study of dose to thyroid and incidence of subsequent dysfunction after head and neck radiation. Head Neck 39:548–554CrossRefPubMed Ling S, Bhatt AD, Brown NV, Nguyen P, Sipos JA, Chakravarti A, Rong Y (2017) Correlative study of dose to thyroid and incidence of subsequent dysfunction after head and neck radiation. Head Neck 39:548–554CrossRefPubMed
35.
go back to reference Almuqrin AH, Tamam N, Abdelrazig A, Elnour A, Sulieman A (2020) Organ dose and radiogenic risk in dental cone-beam computed tomography examinations. Radiat Phys Chem 176:108971CrossRef Almuqrin AH, Tamam N, Abdelrazig A, Elnour A, Sulieman A (2020) Organ dose and radiogenic risk in dental cone-beam computed tomography examinations. Radiat Phys Chem 176:108971CrossRef
36.
go back to reference Hegazy MA, Cho MH, Cho MH, Lee SY (2023) Metal artifact reduction in Dental CBCT images using direct Sinogram correction combined with metal path-length weighting. Sensors 23:1288CrossRefPubMedPubMedCentral Hegazy MA, Cho MH, Cho MH, Lee SY (2023) Metal artifact reduction in Dental CBCT images using direct Sinogram correction combined with metal path-length weighting. Sensors 23:1288CrossRefPubMedPubMedCentral
37.
go back to reference Pettersson A, Kero T, Gillot L, Cannas B, Fäldt J, Söderberg R, Näsström, KJTJopd (2010) Accuracy of CAD/CAM-guided surgical template implant surgery on human cadavers: part I. 103:334–342 Pettersson A, Kero T, Gillot L, Cannas B, Fäldt J, Söderberg R, Näsström, KJTJopd (2010) Accuracy of CAD/CAM-guided surgical template implant surgery on human cadavers: part I. 103:334–342
38.
go back to reference Komiyama A, Pettersson A, Hultin M, Näsström K (2011) Virtually planned and template-guided implant surgery: an experimental model matching approach. 22:308–313Klinge BJCoir Komiyama A, Pettersson A, Hultin M, Näsström K (2011) Virtually planned and template-guided implant surgery: an experimental model matching approach. 22:308–313Klinge BJCoir
39.
go back to reference Charavet C, Charpenay L, Kernitsky J, Dibart S (2024) The biological effects of Piezocision™ on bone for accelerated tooth movement: a systematic review of animal studies. Int Orthod 22:100870CrossRefPubMed Charavet C, Charpenay L, Kernitsky J, Dibart S (2024) The biological effects of Piezocision™ on bone for accelerated tooth movement: a systematic review of animal studies. Int Orthod 22:100870CrossRefPubMed
40.
go back to reference Shahakbari R, Labafchi A, Salami S, Samieirad S (2021) Piezotome versus surgical bur: which is more effective in reducing the postoperative pain and edema following open sinus lift surgery? J Oral Maxillofac Surg 20:642–648CrossRef Shahakbari R, Labafchi A, Salami S, Samieirad S (2021) Piezotome versus surgical bur: which is more effective in reducing the postoperative pain and edema following open sinus lift surgery? J Oral Maxillofac Surg 20:642–648CrossRef
41.
go back to reference Dibart S, Keser E, Nelson D (2015) Piezocision™-assisted orthodontics: past, present, and future. Book title. Elsevier Dibart S, Keser E, Nelson D (2015) Piezocision™-assisted orthodontics: past, present, and future. Book title. Elsevier
42.
go back to reference Hou H-Y, Li C-H, Chen M-C, Lin P-Y, Liu W-C, Tsai Y-WC, Huang R-YJAJO, Orthopedics D (2019) A novel 3D-printed computer-assisted piezocision guide for surgically facilitated orthodontics. 155:584–591 Hou H-Y, Li C-H, Chen M-C, Lin P-Y, Liu W-C, Tsai Y-WC, Huang R-YJAJO, Orthopedics D (2019) A novel 3D-printed computer-assisted piezocision guide for surgically facilitated orthodontics. 155:584–591
43.
go back to reference Abdelsalam RA, Hassan SA, Abdelmoniem NAJA-ADJG (2020) Flapless Ridge splitting technique with platelet Rich Fibrin for Immediate Implant Placement in Atrophic Alveolar Ridge. 7:113–118 Abdelsalam RA, Hassan SA, Abdelmoniem NAJA-ADJG (2020) Flapless Ridge splitting technique with platelet Rich Fibrin for Immediate Implant Placement in Atrophic Alveolar Ridge. 7:113–118
44.
go back to reference Renapurkar S, Nagamalla SJO, Clinician, MSft (2021) Piezosurgery in Oral and Maxillofacial Surgery.831–839 Renapurkar S, Nagamalla SJO, Clinician, MSft (2021) Piezosurgery in Oral and Maxillofacial Surgery.831–839
46.
go back to reference Dibart S, Alasmari A, Zanni O, Salih E (2016) Effect of corticotomies with different instruments on cranial bone biology using an ex vivo calvarial bone organ culture model system. Int J Periodontics Restor Dentistry 36 Dibart S, Alasmari A, Zanni O, Salih E (2016) Effect of corticotomies with different instruments on cranial bone biology using an ex vivo calvarial bone organ culture model system. Int J Periodontics Restor Dentistry 36
Metadata
Title
Exploratory study on a novel minimally invasive tunnel like flap approach for orthodontic movement of dental implants
Authors
Mahmoud Sedky Adly
Frederic Cuisinier
Aya Sedky Adly
Elias Estephan
Afnan Sedky Adly
Philippe Bousquet
Publication date
01-11-2024
Publisher
Springer Berlin Heidelberg
Published in
Clinical Oral Investigations / Issue 11/2024
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI
https://doi.org/10.1007/s00784-024-05992-w

Other articles of this Issue 11/2024

Clinical Oral Investigations 11/2024 Go to the issue