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Percorrer por autor "Donos, Nikos"

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  • Consensus Report of Group 1 of the 1st Global Consensus for Clinical Guidelines for the Rehabilitation of the Edentulous Maxilla : number of implants, timing of implant placement and loading
    Publication . Donos, Nikos; Ng, Ethan; Pannuti, Claudio Mendes; Romito, Giuseppe Alexandre; Francisco, Helena Cristina Oliveira; Abou-Ayash, Samir; Avila-Ortiz, Gustavo; Carames, Joao Manuel Mendez; Casentini, Paolo; Chackartchi, Tali; Chappuis, Vivianne; Chen, Stephen; Fugazzotto, Paul; Giannobile, William V.; Hagiwara, Yoshiyuki; Hamilton, Adam; Ivanovski, Saso; Kahn, Sergio; Kan, Joseph; Lambert, France; Levine, Robert Alan; Navarro, Jose Manuel; Ornekol, Turker; Payer, Michael; Schoenbaum, Todd; Singh, Manish Kumar; Thacker, Sejal; Alcoforado, Gil
    Objectives: The 1st Global Consensus for Clinical Guidelines (GCCG) in Implant Dentistry introduced an innovative, evidence-based approach to developing patient-centered and practical recommendations for the rehabilitation of the edentulous maxilla. Within this framework, Group 1 aimed to formulate clinical recommendations on the number of implants required, timing of implant placement, and timing of loading. Materials and Methods: Group 1 followed the S2k-level guideline framework of the Association of the Scientific Medical Societies in Germany (AWMF), using a structured nominal group technique. The evidence base included three systematic reviews evaluating clinician-reported outcomes (ClinROs) and patient-reported outcomes (PROs), supplemented by structured single-round international surveys involving expert clinicians, patients, and cross-disciplinary experts. Survey content covered diagnostics, treatment planning, clinical procedures, and maintenance care. Draft recommendations were discussed during the in-person consensus meeting in Boston (June 16–18, 2025) and finalized through anonymous plenary voting. Consensus was defined as ≥ 75% and ≤ 95% agreement and strong consensus as > 95% agreement. Results: Group 1 formulated 12 clinical recommendations across the workflow domains of diagnostic tools, treatment planning, and treatment procedure. During plenary voting, three of these recommendations reached strong consensus, and nine achieved consensus. The number of voters per recommendation ranged from 61 to 90, with an average of 83. Conclusions: This consensus report provides structured, evidence-based recommendations on implant number, placement timing, and loading protocols for rehabilitation of the edentulous maxilla. These guidelines are intended to support individualized, patient-centered care while also identifying priority areas for future research.
    2026-02Contributo em revista Acesso aberto Ver mais
  • Prosthetic outcomes of implant-assisted maxillary restorations in the edentulous maxilla : a systematic review and meta-analysis
    Publication . Ng, Ethan; Tay, John Rong Hao; Rahmat, Maria; Mezzomo, Luis; Alcoforado, Gil; Donos, Nikos
    Objectives: To evaluate the prosthetic outcomes of implant-assisted maxillary full-arch restorations with ≥ 3 years of follow-up. Materials and Methods: A systematic electronic literature search was conducted in five databases to identify randomised controlled trials and prospective clinical studies involving patients who received full-arch rehabilitation in the maxilla. The primary outcome was prosthesis loss; secondary outcomes included complication-free prosthesis survival, complication-free implant survival, implant loss, technical complications, patient-reported outcome measures (PROMS), and marginal bone loss. Meta-analyses of proportions using random-effects models were performed to estimate pooled rates of prosthetic survival, success, and complications. Results: A total of 20 studies involving 913 patients were included. Among these, 542 patients received fixed prostheses and 371 received removable prostheses. Most of the studies had an observation period in the range of 3 to 6 years, with only two studies (overdentures) reaching 10 years. Overall prosthesis loss was 4.6% (95% CI: 1.2%–10.1%) and complication-free prosthesis survival was 61.9% (95% CI: 48.4%–74.5%). Overall complication-free implant survival was 46.5% and technical complications were 62.9%. Pooled implant loss was 5.5% after adjusting for clustering effects and mean marginal bone loss was < 0.8 mm. Subgroup analysis of fixed and removable prosthesis over a similar observation period revealed similar outcomes. Conclusions: Implant-assisted maxillary full-arch restorations have low rates of prosthesis and implant loss. However, complication-free survival is moderate, underscoring the importance of maintenance and patient education.
    2026-06Contributo em revista Acesso aberto Ver mais