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Implant Abutments (implant + abutment)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

The ZiReal Post: A New Ceramic Implant Abutment

JOURNAL OF ESTHETIC AND RESTORATIVE DENTISTRY, Issue 1 2003
URS BRODBECK DMD
ABSTRACT Restorations in the anterior esthetic zone present significant challenges in both the surgical and prosthetic phases of implant dentistry. Titanium has been established as the material of choice for endosseous implants, resulting in a high degree of predictability. Many types of implants require transmucosal abutments to retain implant restorations. Ceramics may be the ideal material to replace natural teeth, but most transmucosal abutments are made of titanium. However, ceramics may also be used as abutments in implant restorations. This combination of ceramics for abutment and crown provides better translucency for the implant restoration than is available with metal abutments and porcelain-fused-to-metal crowns. Ceramic abutments and implant restorations also minimize the gray color associated with metal components that is transmitted through the peri-implant tissues. Customized emergence profiles also may be obtained with ceramic abutments; this generally improves the predictability and consistency of the esthetics obtainable in implant restorations. Zirconia as a ceramic material offers not only outstanding material properties but also a well-documented biocompatibility. CLINICAL SIGNIFICANCE This article discusses the clinical and laboratory features of a new ceramic abutment, ZiRealÔ Post (Implant Innovations, Inc., Palm Beach Gardens, Florida). [source]

Marginal Adaptation of All-Ceramic Crowns on Implant Abutments

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 4 2008
DR MED DENT, Wael Att DDS
ABSTRACT Background: Studies focusing on the marginal accuracy of all-ceramic crowns on implant abutments are in short supply. Purpose: This study evaluated the marginal accuracy of all-ceramic crowns on different implant abutments. Materials and Methods: Ninety-six standardized maxillary central incisor crowns (48 alumina and 48 zirconia) were fabricated for each of the six test groups (n = 16) (Ti1, titanium abutments,alumina crowns; Ti2, titanium abutments,zirconia crowns; Al1, alumina abutments,alumina crowns; Al2, alumina abutments,zirconia crowns; Zr1, zirconia abutments,alumina crowns; Zr2, zirconia abutments,zirconia crowns). The crowns were adhesively luted using a resin luting agent. The marginal gaps were examined on epoxy replicas before and after luting as well as after masticatory simulation at 200× magnification. Results: The geometrical mean (95% confidence limits) marginal gap values before cementation, after cementation, and after masticatory simulation were group Ti1: 39(37,42), 57(53,62), and 49(46,53); group Ti2: 43(40,47), 71(67,76), and 64(59,69); group Al1: 57(54,61), 87(85,90), and 67(65,69); group Al2: 66(63,69), 96(90,101), and 75(72,78); group Zr1: 54(51,57), 79(76,82), and 65(63,67); and group Zr2: 64(60,68), 85(80,91), and 75(70,81). The comparison between non-cemented and cemented stages in each group demonstrated a significant increase in the marginal gap values after cementation in all groups (p < .001), while the comparison between cemented and aged stages in each group showed a significant decrease in the marginal gap values in groups Al1, Al2, and Zr1 (p < .0001). This reduction was not significant for groups Ti1, Ti2, and Zr2 (p > .05). Conclusion: The marginal accuracy of all tested restorations meets the requirements for clinical acceptance. [source]

A Laboratory Procedure for Optimal Implant Abutment Preparation

JOURNAL OF PROSTHODONTICS, Issue 6 2009
Tuncer Burak Özcelik DDS
Abstract Simplicity and predictability have made cement-retained implant crowns the recent restoration of choice. The taper of the abutment is of particular importance for cement-retained implant restorations. The ideal taper of the implant abutment allows the clinician to control the overall retention of restorations. The technique described in this report presents the laboratory preparation of an implant abutment for a cement-retained crown using a counter gauge to control the preparation taper. [source]

Mechanical Properties of Magnetic Attachments for Removable Prostheses on Teeth and Implants

JOURNAL OF PROSTHODONTICS, Issue 8 2008
Arne F. Boeckler DMD
Abstract Purpose: Magnetic attachments on teeth and implants may be used to improve stability, support, and retention of removable prostheses. Various forms of magnetic attachments are available, divided according to the design, the mechanical properties of the attachments, and the clinical indication. Recently developed attachment systems are small and promise improved retentive capacity, while existing magnetic attachments continue to be technologically modified and improved. This investigation reviewed and compared maximum retentive forces and characteristic curves for magnetic attachments indicated for use as root anchors and on implants. Materials and Methods: Twenty-four samarium-cobalt (SmCo) and neodym-iron-boron (NeFeB) magnetic attachments (12 tooth- and 12 implant-borne) were evaluated. Specimens were delivered by the manufacturers or fabricated according to their instructions. Five magnet pairs of each product and each combination were tested 10 times in a calibrated universal testing machine using a nonmagnetic test device (s = 40 mm, v = 20 mm/min). Results were recorded electronically and compared to manufacturers' details. Results: Maximum retentive forces for root keepers ranged from 1.4 to 6.6 N. Maximum retentive forces for magnetic attachments on implants ranged from 0.7 to 5.8 N. After a distance of 0.1 mm, a complete reversed distribution of the different systems became obvious. The retentive force provided by the manufacturer was achieved in one implant abutment, with retentive force (as compared to those provided by the manufacturers) for root keepers ranging between 42.5% and 92.9% and for implant abutments between 43.0% and 99.4%. Conclusion: There were differences between magnetic attachments for both the initial retentive capabilities and the characteristic curves. Recently introduced products provided relatively high initial retentive forces despite their small size. The measured retentive forces and the manufacturer's information differed in the majority of magnetic systems evaluated. [source]

Cement Selection for Cement-Retained Crown Technique with Dental Implants

JOURNAL OF PROSTHODONTICS, Issue 2 2008
James L. Sheets DDS
Abstract Purpose: The purpose of this study was to assess and compare the retentive nature of common dental cements that have been adapted for use in the implant abutment cement-retained crown (CRC) technique with those specifically formulated for this purpose. Materials and Methods: Ten regular diameter implant analogs were embedded in stainless steel disks. Unmodified CRC abutments were attached and torqued to 30 Ncm. Test crowns were waxed and cast with base metal alloy. Castings were fitted, cleaned with aluminum oxide, and steam cleaned prior to application of the cement. The cements used were: (1) Temp Bond, (2) UltraTemp, regular, (3) UltraTemp firm, (4) ImProv with petroleum jelly coating of crown, (5) ImProv without petroleum jelly, (6) Premier Implant with KY Jelly coating of abutment, (7) Premier Implant without KY jelly, (8) TR-2, (9) Fleck's, (10) Ketac Cem Aplicap, and (11) Fuji Plus Capsule. After cementation, assemblies were stored for 24 hours. Each sample was subjected to a pull-out test using an Instron universal testing machine at a crosshead speed of 5.0 mm/min. Loads required to remove the crowns were recorded, and mean values for each group determined. A one-way ANOVA and a post hoc least square difference (LSD) test were done for pairwise comparison at a confidence interval of 95%. Results: The mean values (±SD) of loads at failure (n = 10) for various cements were as follows (N): Ultratemp, regular 358.6 (±38.2) (Group A), ImProv without petroleum jelly 172.4 (±59.6) (Group B), Fleck's 171.8 (±62.2) (Group B), Ketac Cem 167.8 (±69.1) (Group B), UltraTemp firm 158.8 (±62.7) (Group BC), Fuji Plus 147.5 (±69.7) (Group BC), Premier without KY jelly 131.6 (±31.8) (Group BC), ImProv using petroleum jelly 130.8 (±42.5) (Group BC), Temp Bond 117.8 (±48.3) (Group C), TR-2 41.2 (±16.6) (Group D), and Premier with KY jelly 31.6 (±24.8) (Group D). Groups with the same letter were not significantly different. Conclusions: Within the limitations of this in vitro study, it is not suggested that any one cement is better than another at retaining cement-retained crowns (CRCs) to implant abutments or that a threshold value must be accomplished to ensure retention. The ranking of cements presented is meant to be a discretionary guide for the clinician in deciding the amount of desired retention between castings and implant abutments. [source]

Long-term outcomes for cross-arch stabilizing bridges in periodontal maintenance patients , a retrospective study

JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 3 2010
Øystein Fardal
Fardal Ø, Linden GJ. Long-term outcomes for cross-arch stabilizing bridges in periodontal maintenance patients , a retrospective study. J Clin Periodontol 2010; 37: 299,304. doi: 10.1111/j.1600-051X.2009.01528.x. Abstract Background: Cross-arch bridges are used to stabilize teeth for patients with reduced periodontal support. Little is known about technical or biological complications, whether teeth and implants can be combined in this type of bridge and the long-term effects on tooth loss. Materials and methods: All patients treated in a specialist periodontal practice who received cross-arch stabilizing bridgework and were subsequently maintained for at least 7 years were included in the study. The patients were selected from all patients who underwent initial periodontal therapy after 1986 in a Norwegian periodontal practice. The bridges were assessed for biological and technical complications. Bridges retained by teeth or by a combination of teeth and implants were included in the study. Results: Ninety-four rigid fixed bridges (77 teeth supported, 17 teeth and implant supported) in 80 patients (46 females, 34 males) were observed for an average of 10 years (range 7,22 years). In four patients, a bridge became loose and had to be re-cemented, and in one case the metal framework of a bridge fractured and the bridge had to be remade. In total, eight abutment teeth were lost from five patients but no implant abutments were lost. Overall, a higher rate of tooth loss was observed for patients provided with stabilizing bridges compared with control maintenance patients not treated with bridgework (p<0.0001); however, the rates in both groups were very low. Conclusion: Cross-arch stabilizing bridges constructed for periodontal patients as part of their periodontal maintenance therapy had few complications and were associated with low rates of abutment tooth loss. Combining teeth and implants did not affect the performance of these bridges. [source]

Some soft tissue characteristics at implant abutments with different surface topography

JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 1 2003
A study in humans
Abstract Background: If an implant with a rough surface is exposed to the oral cavity, it may accumulate greater amounts of plaque than a smooth surface, which may lead to severe problems with mucositis and peri-implantitis. The purpose of the present paper was to investigate the early inflammatory response to mucosa-penetrating abutments prepared with varying surface roughness. Methods: Nine patients had all five of their original abutments exchanged to test abutments for a 4-week period. The test abutments were prepared with five different roughnesses. The surface roughness was measured with an optical profilometer. At the end of the test period, clinical evaluation was performed; the health of the surrounding mucosa, the amount of accumulated plaque and marginal bleeding were registered. One biopsy was taken from each test abutment. Qualitative and quantitative histological evaluations were performed. Results: There was a statistically significant difference between patients regarding the amount of accumulated plaque on the abutment surfaces and inflammatory cells, but no difference between the surface modifications in relation to plaque accumulation or number of inflammatory cells. Conclusion: No relation was found between inflammatory response and abutment surface roughness after an evaluation time of 4 weeks in a human test model. Zusammenfassung Hintergrund: Wenn ein Implantat mit einer rauhen Oberfläche der Mundhöhle ausgesetzt wird, kann es zu stärkerer Plaqueakkumulation kommen als bei glatten Oberflächen, was zu ernsthaften Problemen mit Mukositis und Periimplantitis führen kann. Zielsetzung: Untersuchung der frühen Entzündungsreaktion auf durch die Schleimhaut tretende Implantatpfeiler mit unterschiedlicher Oberflächenrauhigkeit. Methoden: Bei jedem von 9 Patienten wurden alle 5 ursprünglichen Implantatpfeiler für einen Zeitraum von 4 Wochen gegen Testpfeiler ausgetauscht. Die Testpfeiler waren jeweils mit unterschiedlichen Oberflächenrauhigkeiten präpariert. Die Rauhigkeiten waren mit einem Profilometer gemessen worden. Am Ende des Untersuchungszeitraumes wurden klinische Parameter bestimmt: der Zustand der periimplantären Mukosa, die Menge der akkumulierten Plaque und marginales Bluten. An jedem Pfeiler wurde eine Biopsie entnommen, die jeweils qualitativ und quantitativ histologisch ausgewertet wurde. Ergebnisse: Es bestanden statistisch signifikante interindividuelle Unterschiede zwischen den Patienten hinsichtlich abgelagerter Plaque und Zahl der Entzündungszellen an den Implantatpfeilern, aber keine diesbezüglichen intraindividuellen Unterschiede zwischen den verschiedenen Oberflächenrauhigkeiten. Schlussfolgerung: In einem menschlichen Versuchsmodell wurden über einen Zeitraum von 4 Wochen keine Beziehungen zwischen Entzündungsreaktion und Implantatpfeileroberflächenrauhigkeit beobachtet. Résumé Origine: Lorsqu'un implant à surface rugueuse est exposé dans la cavité buccale, il peut accumuler davantage de plaque qu'une surface lisse, ce qui peut conduire à des problèmes graves associés à une mucite ou une péri-implantite. Le but de cette étude était d'examiner la réponse inflammatoire précoce aux implants pénétrant la muqueuse et ayant une rugosité de surface variable. Méthodes: Les cinq implants d'origine de chacun des neuf patients ont été remplacés par des implants expérimentaux pour une période de quatre semaines. Ces implants expérimentaux ont été conçus avec cinq rugosités différentes. La rugosité de surface a été mesurée à l'aide d'un profilomètre optique. A l'issue de la période expérimentale, une évaluation clinique a été réalisée: l'état de la muqueuse environnante, la quantité de plaque accumulée et le saignement marginal ont été relevés. Une biopsie a été prélevée sur chaque implant expérimental et des évaluations histologiques qualitatives et quantitatives ont été faites. Résultats: Il y avait une différence statistiquement significative entre les patients en ce qui concerne la quantité de plaque accumulée à la surface des implants et les cellules inflammatoires, mais aucune différence entre les modifications de surface en rapport avec l'accumulation de plaque ou le nombre de cellules inflammatoires. Conclusion: Aucune relation n'a étéétablie entre la réponse inflammatoire et la rugosité de surface des implants au bout de quatre semaines d'évaluation dans un modèle expérimental humain. Mots clés: Pilier d'implant; réponse des tissus mous; étude clinique; histologie. [source]

Relative effectiveness of powered and manual toothbrushes in elderly patients with implant-supported mandibular overdentures

JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 4 2002
A. Tawse-Smith
Abstract Aim: The aim of this study was to compare the clinical effectiveness of a powered toothbrush (Braun Oral-B Plaque Remover 3-D) and a manual soft toothbrush (Oral-B Squish-grip brush) for the control of supragingival plaque and soft tissue inflammation around implants supporting mandibular overdentures. Material and methods: The study sample involved 40 edentulous subjects, aged 55,80 years, having 2 unsplinted mandibular implants supporting a complete removable overdenture opposed by a maxillary complete denture. In this single-blinded, randomised, cross-over clinical trial, two 6-week experimental phases were separated by a 2-week wash-out period. 2 weeks prior to each experimental phase (pre-entry visits), implant abutments were polished to remove all plaque and a standardised instruction in the use of the toothbrush was given. Modified plaque and bleeding indices were recorded at the start and end of each experimental period. Mean index scores at each phase were analysed using paired t -test, and the mean number of sites showing a change in plaque or mucositis were compared using the Mann-Whitney U -test. Combined data from 2 different implant systems were considered after controlling for implant type. Results: Only minor changes in plaque and bleeding scores were observed following the two test periods. There were no statistically significant differences between the manual and powered toothbrushes. Conclusion: Manual and powered brushes were found to be of comparable efficacy with regard to improvement in peri-implant bleeding and plaque indices. Zusammenfassung Zielsetzung: Untersuchung der klinischen Effektivität einer elektrischen Zahnbürste (Braun Oral-B Plaque Remover 3-D) im Vergleich zu einer weichen Handzahnbürste (Oral-B Squish-grip brush) zur Kontrolle supragingivaler Plaque und Weichgewebsentzündung an Implantaten, die Unterkiefer-Totalprothesen tragen. Material und Methoden: Das Untersuchungskollektiv bestand aus 40 zahnlosen Patienten im Alter zwischen 55 und 80 Jahren, die 2 unverblockte Unterkiefer-Implantate zur Unterstützung einer Totalprothese aufwiesen. Der Oberkiefer war jeweils mit einer total schleimhautgetragenen Prothese versorgt. In dieser einfach verblindeten, randomisierten klinischen Cross-over-Studie wurden 2 6-wöchige experimentelle Phasen von einer 2-wöchigen Auswaschperiode unterbrochen. 2 Wochen vor jeder experimentellen Phase wurden die supragingivalen Implantatflächen von sämtlicher Plaque gereinigt und die Patienten erhielten eine Instruktion im Gebrauch der Zahnbürsten. Modifizierte Plaque- und Blutungsindizes wurden zu Beginn und am Ende jeder experimentellen Phase erhoben. Die Mittelwerte für die Indizes wurden mittels des paarigen t -Tests und die Zahl der Stellen, die eine Veränderung in Plaque und Mucositis aufwiesen, wurden durch den Mann-Whitney U -Test verglichen. Die Daten für 2 Implantatsysteme wurden zusammengefasst, nachdem der Einfluss des Implantatsystems überprüft worden war. Ergebnisse: Es wurden nur geringe Veränderungen der Plaque- und Blutungsindizes am Ende beider Testphasen beobachtet. Ein statistisch signifikanter Unterschied zwischen elektrischer und Handzahnbürste konnte nicht gezeigt werden. Schlussfolgerungen: Hand- und elektrische Zahnbürsten erwiesen sich als gleich effektiv für die Verbesserung periimplantärer Plaque- und Blutungsindizes. Résumé But: Le but de cette étude était de comparer l'efficacité clinique d'une brosse à dent électrique (Plaque remover 3D de Braun Oral B) et une brosse souple manuelle (squish grip d'oral B) pour le contrôle de la plaque supra-gingivale et l'inflammation des tissus mous autour d'implants supportant des overdentures mandibulaires. Matériaux et méthodes: L'échantillon étudié comprenait 40 sujets édentés, âgés de 55 à 80 ans, ayant 2 implants mandibulaires non reliés supportant une overdenture amovible complète et une prothèse maxillaire antagoniste complète. Dans cet essai clinique croisé en aveugle simple, randomisée, 2 phases expérimentales de 6 semaines encadraient une période d'arrêt de 2 semaines. 2 semaines avant chaque phase expérimentale, (visite de pré-entrée), les piliers implantaires étaient polis afin d'éliminer toute la plaque et des instructions standardisées d'utilisation de la brosse étaient données. On notait les indices, de saignement et de plaque modifié, au début et à la fin de chaque période expérimentale. Les notes d'indices moyens à chaque phase étaient analysées par le test t apparié et le nombre moyen de sites présentant une modification de la plaque ou de la mucosite était comparé par le test U de Mann Whitney. Les données combinées des 2 systèmes implantaires étaient considérées après cotrôle pour chaque type d'implant Résultats: De minimes modifications des notes de plaque et de saignement étaient observées après les deux périodes de test. Il n'y avait pas de différences statistiques significatives entre les brosses manuelles et électriques. Conclusion: Les brosses manuelles et électriques ont une efficacité comparable du point de vue de l'amélioration des indices de saignement et de plaque peri-implantaires. [source]

Corrosion of Dental Magnet Attachments for Removable Prostheses on Teeth and Implants

JOURNAL OF PROSTHODONTICS, Issue 4 2009
Arne F. Boeckler DMD, Dr Med Dent
Abstract Purpose: For a long time, the use of magnets for the anchorage of dental prostheses failed due to lack of biocompatibility and the magnets' high susceptibility to corrosion in the mouth. These facts make encapsulation of the magnetic alloy with a corrosion-resistant, tight, and functionally firm sealing necessary. Due to different products and analysis methods, it is not feasible to compare the findings for contemporary products with the sparse and rather old test results in the literature. Therefore, the aim of this study was the standardized control and the comparison of the corrosion behavior of modern magnetic attachments for use on teeth and dental implants. Materials and Methods: Thirty-seven components of magnetic attachments on implants and natural teeth from different alloys (NdFeB, SmCo, Ti, CrMoMnTiFe, etc.) as delivered by the manufacturers or fabricated according to their instructions were examined for their corrosion behavior using the statical immersion analysis (ISO 10271:2001). Four specimens of every product with the same design were used. An uncased SmCo magnet served as control. Analyses after 1, 4, 7, and 28 days of the storage in corrosion solution were made. The eluate was examined quantitatively on the alloy components of the respective component with the help of optical emission spectrometry (,g/cm2). The results were compared to the requirements of ISO standard 22674:2006. In addition, existing corrosion products were also defined in the solution after 28 days. The results were analyzed descriptively and statistically to determine possible significant differences (t -test and Mann-Whitney-Wilcoxon rank-sums test; p < 0.05). Results: Dissolved metal ions could be found on all tested products. The release after 1 and 4 days was different for all specimens. In the group of implant abutments, the highest ion release after 7 days was found (all measurements ,g/cm2): Fe (13.94, Magfit-IP-IDN dome type), Pd (1.53, Medical-anchor), Cr (1.32, Magfit-IP-IDN dome type), Ti (1.09, Magfit-IP-IDN abutment), Co (0.81, Medical-anchor), and B (0.6, Magfit-IP-IDN dome type). After 28 days, the analyzed ion release increased irregularly: Fe (173.58, Magfit-IP-IDN dome type), Pd (44.17, Medical-anchor), Cr (2.02, Magfit-IP-IDN dome type), Ti (2.11, Magfit-IP-IDN abutment), Co (26.13, Medical-anchor), B (1.77, Magfit-IP-IDN dome type), and Nd (79.18, Magfit-IP-IDN dome type). In the group of magnetic systems on natural teeth, the highest ion release after 7 days was found for Fe (4.81, Magfit DX 800 keeper), Cr (1.18, Magfit DX 800 keeper), Pd (0.21, Direct System Keeper), Ni (0.18, WR-Magnet S3 small), Co (0.12, Direct System Keeper), and Ti (0.09, Magna Cap , Mini). After 28 days, the analyzed ion release increased non-uniformly: Fe (31.92, Magfit DX 800 Keeper), Cr (6.65, Magfit DX 800 Keeper), Pd (18.19, Direct System Keeper), Ni (0.61, WR-Magnet S3 small), Co (10.94, Direct System Keeper), Ti (0.83, Magna Cap , Mini), and Pd (2.78, EFM Alloy). In contrast, the uncased control magnet showed an exponential release after 7 days of Sm ions (55.06) and Co-ions (86.83), after 28 days of Sm ions (603.91) and Co ions (950.56). The release of corrosion products of all tested products stayed significantly under the limit of 200 ,g/cm2 (ISO 22674:2006). In contrast, the non-encapsulated control magnet exceeded that limit significantly. Conclusion: The analysis of the corrosion behavior of modern magnetic attachments for use on teeth and dental implants according to ISO 10271:2001 showed that metal ions had dissolved on all specimens. In the case of one product, the magnet corroded. For this product, an improvement of the capsulation would be desirable. None of the products reached the limit specified in ISO 22674:2006. All products seem to be suitable for dental application. Further studies in regard to the specific biocompatibility and possible cytotoxic effects on mucosa and tissue would be desirable. [source]

Mechanical Properties of Magnetic Attachments for Removable Prostheses on Teeth and Implants

Cement Selection for Cement-Retained Crown Technique with Dental Implants

CAD/CAM to fabricate ceramic implant abutments and crowns: a preliminary in vitro study

AUSTRALIAN DENTAL JOURNAL, Issue 1 2009
MA Alfarsi
Abstract Background:, This study evaluated the feasibility of fabricating implant abutments and crowns from pre-sintered feldspathic porcelain blocks using the chair-side CAD/CAM, CEREC3D® system. Methods:, Thirty-two implant analogues were divided into two groups. In the control group, prefabricated machined anatomical titanium (Ti) abutments were screw-retained to the analogues. In the test group, machined feldspathic porcelain abutments were cemented on prefabricated machined Ti links and screw-retained to the implant analogues. These feldspathic porcelain abutments were fabricated out of pre-sintered feldspathic porcelain blocks as duplicates of the abutments in the control group using the CAD/CAM, CEREC3D® system. Thirty-two feldspathic porcelain crowns, also fabricated out of pre-sintered ceramic blocks, were then cemented with resin cement on all the abutments in both groups. All samples were subsequently subjected to fracture strength testing under static load. An unpaired t-test was used to compare fracture load values between the two groups. Results:, The test group using feldspathic porcelain abutments and crowns showed statistically significant higher mean fracture strength than the control group with the Ti abutments and feldspathic porcelain crowns. Conclusions:, This preliminary study showed that the chair-side CAD/CAM technology can be utilized to fabricate customized ceramic abutments with their associated ceramic crowns using pre-sintered feldspathic porcelain blocks. [source]

Marginal Adaptation of All-Ceramic Crowns on Implant Abutments

Syncrystallization: A Technique for Temporization of Immediately Loaded Implants with Metal-Reinforced Acrylic Resin Restorations

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 3 2006
Marco Degidi MD
ABSTRACT Background, Rigid temporization has been recognized to have a significant impact on the peri-implant tissue response in immediate implant loading since it reduces the mechanical stress exerted on each implant. Purpose, A successful protocol for immediate loading of multiple implants depends on an adequate fixation and immobility of the implants to prevent the risk of micromovements in relation to the surrounding bone. The objective of this article was to evaluate a prosthetic concept for an accelerated rigid splinting of multiple implants for same-day immediate loading with metal-reinforced provisional restorations using a technique of welding temporary implant abutments with a prefabricated titanium bar directly in the oral cavity (syncrystallization). Materials and Methods, Between June 2004 and January 2005, immediate loading of threaded implants with a metal- reinforced acrylic resin provisional restoration at stage 1 surgery was evaluated in 40 consecutive patients. A total of 192 implants were placed in selected edentulous or partially edentulous patients using the syncrystallization technique. Once the titanium bar was welded intraorally to the abutments, opaque was applied and the provisional restoration was relined and screw-retained the same day. In addition, a comparison of deformations and stress distributions in implant-supported, metal-reinforced and nonmetal-reinforced resin provisional restorations was analyzed in the edentulous mandible by a three-dimensional finite element model (FEM). Results, All of the 192 rigidly temporized immediately loaded implants osseointegrated. An implant success rate of 100% was achieved over a period of 6 months postplacement. No fracture or luting cement failure of the provisional restoration occurred during the observation time. Compared to mere acrylic superstructures, a significant reduction of deformation and strain within metal-reinforced provisional restorations was detected by FEM analysis. Conclusion, The results of this study indicate that the syncrystallization technique allows an expedite and adequate rigid splinting of multiple immediately loaded implants. The advantages of the technique are: (1) reduction of treatment time for immediate temporization at stage 1 surgery; (2) predictable fixation and immobility of implants in the early stages of bone healing; and (3) less time for repairing provisional restorations as a result of no or rare fracture. [source]

Evaluation on the movement of endosseous titanium implants under continuous orthodontic forces: an experimental study in the dog

CLINICAL ORAL IMPLANTS RESEARCH, Issue 6 2008
Yao-Dung Hsieh
Abstract Objectives: The purpose of this study was to evaluate the movement of pure titanium implants under different continuous forces in the edentulous alveolar ridge. Material and methods: Four pairs of titanium implants were inserted into the right maxillary and mandibular post-extraction edentulous ridge of the experimental dog. Three different levels of continuous force (100, 200, and 500 g) were loaded onto three pairs of adjacent implant abutments using a memory Ni,Ti coil spring for up to 6 months and the remaining two implant abutments as the control group received no force. The positions of implant abutments were observed and the distances between the implants abutment at the top, middle and base levels were measured at the 0th, 2nd, 3rd, 6th and 8th month of the follow-up period. Results: There was no significant change in the distances between adjacent abutments loaded with 100 or 200 g continuous forces throughout the entire study period. However, significantly more movement of implant abutments was noted in the 500 g pair after the 3rd month of loading when compared with the 200 or the 100 g pair (both P<0.001). This change further increased at the 6th month (P<0.001, 0.01, respectively). Moreover, the difference in the measurements at the top, middle and base level indicated that the two adjacent implants moved in a tipping manner in the 500 g pair after 3 and 6 months of loading. Conclusion: The osseointegrated implants remained stable and rigid with a pulling force of 100 and 200 g after 6 months of loading. However, when the force reached 500 g, the implants moved in an inward-tipping pattern. The results suggested that endosseous titanium implants might not necessarily be rigid anchorages under all circumstances. [source]

Retention of luting agents on implant abutments of different height and taper

CLINICAL ORAL IMPLANTS RESEARCH, Issue 5 2005
Mario Bresciano
Abstract Objective: The purpose of this study was to evaluate the retention of four cements used to lute metal restorations onto computer designed and manufactured titanium implant abutments of different heights and convergence angles. Material and methods: Test specimens consisted of metal coping cemented on Procera® titanium abutments of 5, 7, and 9 mm of height, and of 0°, 4°, and 8° of convergence angle. The cements used were zinc-phosphate, zinc oxide-eugenole, polyurethane resin with and without vaseline. The samples were tested in a universal testing machine. The mean uniaxial load at point of separation was determined. The results were statistically evaluated with ANOVA. Results: The luting agent, the height, and the taper influence the retention of metal casting on customized CAD,CAM implant abutments. Conclusion: The most retentive cement was zinc-phosphate, followed by polyurethane, polyurethane plus vaseline, and zinc oxide-eugenol. Résumé Le but de cette étude a été d'évaluer la rétention de quatre ciments utilisés pour cimenter des restaurations métalliques sur des piliers implantaires en titane usinés et conçus par ordinateur de différentes hauteurs et angles de convergence. Des spécimens tests consistaient en capsules métalliques cimentées sur des piliers titane Procera de cinq, sept et neuf mm de hauteur et des angles de convergence de zéro, quatre et huit degrés. Les ciments utilisés ont été le phosphate de zinc, l'eugénol oxyde de zinc, la résine polyuréthane avec ou sans vaseline. Les échantillons ont été testés par une machine à test universelle. La charge uniaxiale moyenne au point de séparation a été déterminée. Les résultats étaient statistiquement évalués par l'ANOVA. Tous les éléments influençaient la rétention de ces piliers implantaires. Le ciment le plus rétentif était le phosphate de zinc suivi par le polyuréthane, polyuréthane+vaseline et enfin l'eugénol oxyde de zinc. Zusammenfassung Ziele:,Das Ziel der Studie war, die Retention von vier Zementen, welche für die Befestigung von Metallrekonstruktionen auf im Computer entworfenen und durch Computer hergestellten Implantatsekundärteilen aus Titan mit verschiedenen Höhen und Konvergenzwinkeln verwendet werden, zu untersuchen. Material und Methoden:,Die Testkörper bestanden aus Metallkappen, welche auf Procera Titansekundärteile mit einer Länge von 5, 7 und 9 mm und mit einem Konvergenzwinkel von 0°, 4° und 8° zementiert wurden. Die verwendeten Zemente waren Zink-Phosphat, Zinkoxid-Eugenol und Poliurethan-Resin mit und ohne Vaseline. Die Proben wurden in einer Universal-Testmaschine untersucht. Es wurde der mittlere uniaxiale Belastungspunkt der Separation bestimmt. Die Resultate wurden mittles ANOVA statistisch ausgewertet. Resultate:,Der Zement, die Höhe und die Konizität beeinflussen die Retention von Metallkappen auf individuell hergestellten CAD,CAM Implantatsekundärteilen. Schlussfolgerung:,Der retentivste Zement war Zink-Phosphat, gefolgt von Poliurethan, Poliurethan plus Vaseline und Zinkoxid-Eugenol. Resumen Objetivo:,La intención de este estudio fue evaluar la retención de cuatro cementos usados para cementar restauraciones metálicas sobre pilares de titanio de implantes diseñados y manufacturados por ordenador de diferentes alturas y ángulos de convergencia. Material y métodos:,Los especimenes de prueba consistieron en copins de metal cementados sobre pilares de titanio Procera de 5, 7 years 9 mm de altura, y 0°, 4° years 8° de ángulo de convergencia. Los cementos utilizados fueron fosfato de zinc, óxido de zinc-eugenol, resina de poliuretano con o sin vaselina. Las muestras se probaron con una máquina universal de pruebas. Se determinó la carga media uniaxial en el punto de separación. Los resultados se evaluaron estadísticamente con ANOVA. Resultados:,El agente cementante, la altura, y la influencia de la conicidad la retención del vaciado metálico sobre los pilares de implantes CAD,CAM hechos a medida. Conclusión:,El cemento mas retentivo fue el de fosfato de zinc, seguido por poliuretano, poliuretano mas vaselina, y óxido de zinc-eugenol. [source]

A systematic review of the survival and complication rates of fixed partial dentures (FPDs) after an observation period of at least 5 years

CLINICAL ORAL IMPLANTS RESEARCH, Issue 6 2004
II. Combined tooth, implant-supported FPDs
Abstract Objectives: The objective of this systematic review was to assess the 5- and 10-year survival of combined tooth,implant-supported fixed partial dentures (FPDs) and the incidence of biological and technical complications. Methods: An electronic MEDLINE search supplemented by manual searching was conducted to identify prospective and retrospective cohort studies on FPDs with a mean follow-up time of at least 5 years. Patients had to have been examined clinically at the follow-up visit. Assessment of the identified studies and data abstraction was performed independently by two reviewers. Failure and complication rates were analyzed using random-effects Poisson regression models to obtain summary estimates of 5- and 10-year survival proportions. Results: From a total of 3844 titles and 560 abstracts, 176 articles were selected for full-text analysis, and 13 studies met the inclusion criteria. Meta-analysis of these studies indicated an estimated survival of implants in combined tooth,implant-supported FPDs of 90.1% (95 percent confidence interval (95% CI): 82.4,94.5%) after 5 and 82.1% (95% CI: 55.8,93.6%) after 10 years. The survival rate of FPDs was 94.1% (95% CI: 90.2,96.5%) after 5 and 77.8% (95% CI: 66.4,85.7%) after 10 years of function. There was no significant difference in survival of tooth and implant abutments in combined tooth,implant FPDs. After an observation period of 5 years, 3.2% (95% CI: 1.5,7.2%) of the abutment teeth and 3.4% (95% CI: 2.2,5.3%) of the functionally loaded implants were lost. After 10 years, the corresponding proportions were 10.6% (95% CI: 3.5,23.1%) for the abutment teeth and 15.6% (95% CI: 6.5,29.5%) for the implants. After a 5 year observation period, intrusion was detected in 5.2% (95% CI: 2,13.3%) of the abutment teeth. Intrusion of abutment teeth were almost exclusively detected among non-rigid connections. Conclusion: Survival rates of both implants and reconstructions in combined tooth,implant-supported FPDs were lower than those reported for solely implant-supported FPDs (Pjetursson et al. 2004). Hence, planning of prosthetic rehabilitation may preferentially include solely implant-supported FPDs. However, anatomical aspects, patient centered issues and risk assessments of the residual dentition may still justify combined tooth,implant-supported reconstructions. It was evident from the present search that tooth,implant-supported FPDs have not been studied to any great extent and hence, there is a definitive need for more longitudinal studies examining these reconstructions. Résumé L'objectif de cette revue systématique a été de vérifier la survie à cinq et dix années de prothèses partielles fixées portées sur implants et dents et l'incidence des complications techniques et biologiques. Une recherche Medline ainsi que manuelle ont identifié les études prospectives et rétrospectives avec un suivi d'au minimum cinq années. Les patients avaient dû subir un examen clinique lors de ce suivi. L'identification des études et l'analyse des données ont été effectuées indépendamment par deux personnes. Les taux d'échecs et de complications ont été analysés en utilisant les modèles de régression Poisson avec effets hasard pour obtenir des estimations à cinq et dix ans. De 3 844 titres et 560 résumés, 176 articles ont été sélectionnés pour l'analyse approfondie et treize études atteignaient les critères d'inclusion. La méta-analyse de ces études indiquaient une estimation de survie des implants en combinaison des prothèses fixées sur implants et dents de 90,1%(intervalle de confidence 95% : 82,4 à 94,5%) après cinq années et de 82,1% (55,8 à 93,6% après dix années. Le taux de survie de ces prothèses étaient de 94,1% (90,2 à 96,5%) après cinq ans et de 77,8% (66,4 à 85,7%) après dix années. Il n'y avait aucune différence significative dans la survie des piliers dentaires et implantaires dans ces prothèses sur implants et dents. Après une observation de cinq années, 3,2% (1,5 à 7,2%) des piliers dentaires et 3,4% (2,2 à 5,3%) des implants ont été perdus. Après dix années, les proportions correspondantes étaient de 10,6 % (3,5 à 23,1%) pour les dents et de 15,6%(6,5%à 29,5%) pour les implants. Après une observation de cinq années, l'intrusion a été détectée dans 5,2% (2,0 à 13,3%) des dents piliers. L'intrusion des dents piliers étaient presque exclusivement détectée le long des connexions non-rigides. Le taux de survie de ces prothèses sur pilier dents et implants étaient inférieur à celui rapporté pour le même type de prothèse seulement placé sur implants (Pjetursson et al. 2004). Le plan de prothèse pourrait donc avoir une préférence pour ne placer des prothèses que sur des implants. Cependant les aspects anatomiques, le respect du patient et les risques pour la dentition résiduelle peuvent justifier les reconstructions sur implants et dents. Il était évident que lors de la recherche présente les bridges sur implants et dents n'avaien pas été beaucoup étudiés; il s'avère donc nécessaire de débuter davantage d'études longitudinales. Zusammenfassung Ziel: Ziel dieser systematischen Übersicht war einerseits die Bestimmung der Überlebenszeit von kombiniert zahn-implantat-getragenem festsitzendem Zahnersatz (FPDs) nach 5 und 10 Jahren und andererseits die Häufigkeit von biologischen und technischen Komplikationen zu beschreiben. Methoden: Man führte eine manuell ergänzte elektronische Medline-Suche durch, um prospektive und retrospektive Kohortenstudien über FPDs mit einer durchschnittlichen Beobachtungszeit von mindestens 5 Jahren zu identifizieren. Die Patienten mussten bei den Nachkontrollen auch klinisch untersucht worden sein. Die Aufnahme der ausgewählten Studien und die Abstraktion der Daten wurde von zwei Personen unabhängig voneinander durchgeführt. Mit Hilfe eines Poission Regressionsmodells analysierte man die Misserfolgs- und Komplikationsraten und erhielt so zusammenfassende schätzwerte für die über lebenswahrscheindichkeit nach 5 und 10 Jahren. Resultate: Die Suche lieferte 3844 Titel und 560 Abstracts. Die Analyse des gesamten Textes erfolgte bei 176 Artikeln, von denen aus 13 Studien, die Einschlusskriterien erfüllten. Die Meta-Analyse dieser Studien ergab eine geschätzte Überlebensrate der Implantate in gemischt zahn-implantat-getragenen FPDs von 90.1% (95% CI: 82.4,94.5%) nach 5 Jahren und 82.1% (95% CI: 55.8,93.6%) nach 10 Jahren. Die Überlebensrate der FPDs betrug 94.1% (95% CI: 90.2,96.5%) nach 5 Jahren und 77.8% (95% CI: 66.4,85.7%) nach 10 Jahren in Funktion. Man fand bei den kombiniert zahn-implantat-getragenen FPDs keine signifikanten Unterschiede bei der Überlebensrate von Zahn- und Implantatpfeilern. Nach einer Beobachtungszeit von 5 Jahren waren 3.2% (95% CI: 1.5,7.2%) der Pfeilerzähne und 3.4% (95% CI: 2.2,5.3%) der funktionell belasteten Implantate verloren gegangen. Nach 10 Jahren betrugen die entsprechenden Werte 10.6% (95% CI: 3.5,23.1%) für die Pfeilerzähne und 15.6% (95% CI: 6.5,29.5%) für die Implantate. Nach einer Beobachtungszeit von 5 Jahren konnte man bei 5.2% (95% CI: 2,13.3%) der Pfeilerzähne eine Intrusion feststellen. Eine Intrusion war fast ausschliesslich bei nicht-starren Verbindungen festzustellen. Zusammenfassung: Die Überlebensraten für Implantate und Rekonstruktionen in kombiniert zahn-implantat-getragenen FPDs waren tiefer als die, welche in der Partnerstudie (Pjetursson et al. 2004) für allein implantat-getragene FPDs festgestellt worden sind. Daher müsste die Planung von prothetischen Rehabilitationen eigentlich vorzüglich mit rein implantat-getragenen FPDs durchgeführt werde. Anatomische Aspekte, patientenspezifische Gründe und die Risikoanalysen der Restbezahnung können aber weiterhin kombiniert zahn-implantat-getragene Rekonstruktionen rechtfertigen. Bei dieser Untersuchung wurde klar, dass die zahn-implantat-getragenen FPD's noch nicht in grösserem Ausmass studiert worden sind, was einen dringenden Bedarf an weiteren Lanzeitstudien, die diese Rekonstruktionen erforschen, zeigt. Resumen Objetivos: El objetivo de esta revisión sistemática fue valorar la supervivencia de dentaduras parciales fijas soportadas por implantes (FPDs) y describir la incidencia de complicaciones biológicas y técnicas. Métodos: Se llevó a cabo una búsqueda electrónica por Medline complementada con una búsqueda manual para identificar estudios cohorte prospectivos y retrospectivos acerca de FPDs con un tiempo de seguimiento medio de al menos 5 años. Los pacientes tenían que haber sido examinados clínicamente en la visita de seguimiento. La valoración de los estudios encontrados y de la abstracción de datos se llevó a cabo independientemente por dos revisores. Los índices de fracaso y complicación se analizaron usando modelos de regresión de efectos aleatorios de Poisson para obtener estimaciones de los sumarios de las proporciones de supervivencia a los 5 y 10 años. Resultados: De un total de 3844 títulos y 560 resúmenes, se seleccionaron 176 artículos para análisis, y 13 estudios coincidieron con los criterios de inclusión. Un meta análisis de estos estudios indicaron una supervivencia estimada de los implantes en FPDs soportados por dientes e implantes combinados del 90.1% (95% CI: 82.4,94.5%) tras 5 años, y 82.1% (95% CI: 55.8,93.6%) tras 10 años. El índice de supervivencia de los FPDs fue del 94.1% (95% CI: 90.2,96.5%) tras 5 años, y 77.8% (95% CI: 66.4,85.7%) tras 10 años en función. No hubo diferencias significativas en la supervivencia de los pilares de implantes o dientes en FPDs de dientes e implantes combinados. Tras un periodo de observación de 5 años, el 3.2% (95% CI: 1.5,7.2%) de los dientes pilares y 3.4% (95% CI: 2.2,5.3%) de los implantes en carga funcional se perdieron. Tras 10 años, las proporciones correspondientes fueron del 10.6% (95% CI: 3.5,23.1%) para los dientes pilares y 15.6% (95% CI: 6.5,29.5%) para los implantes. Tras un periodo de observación de 5 años, se detectó intrusión en 5.2% (95% CI: 2,13.3%) de los dientes pilares. La intrusión de los dientes pilares se casi exclusivamente detectada entre las conexiones no rígidas. Conclusión: Los índices de supervivencia de los implantes y las reconstrucciones en FPDs soportadas por dientes e implantes combinados fueron menores que los reportados para FPDs soportados por implantes únicamente (Pjetursson et al. 2004). Por lo tanto, la planificación de la rehabilitación prostética puede incluir preferentemente FPDs soportados solo por implantes. De todos modos, los aspectos anatómicos, las necesidades exactas del paciente y las valoraciones de riesgo de la dentición residual pueden todavía justificar las reconstrucciones soportadas por dientes e implantes combinados. Fue evidente de la presente búsqueda que los FPDs soportados por dientes e implantes no han sido estudiados extensamente y por lo tanto, existe definitivamente una necesidad para mas estudios longitudinales que examinen estas reconstrucciones. [source]

Organization of the connective tissue barrier around long-term loaded implant abutments in man

CLINICAL ORAL IMPLANTS RESEARCH, Issue 5 2002
Gianmario Schierano
Abstract: The study aimed to investigate the connective tissue seal and the spatial organization of collagen fibers around long-term loaded implants in man. Block specimens containing smooth titanium implant abutments and the surrounding supracrestal connective tissue were obtained from patients rehabilitated for at least 1 year with implant-retained overdentures or implant-supported fixed prostheses and were histologically investigated. The histological features of the connective tissue around long-term loaded titanium abutments were specific: the tissue was rich in collagen fibers, organized in bundles, presenting a constant spatial arrangement, similar to that reported in animal studies. Circular fibers, the most numerous, were located externally, and longitudinal fibers internally. Radial fibers inserted on the abutment surface, similar to those of the periodontal system, were not observed in any case. No histological differences were found between tissue sampled around implants supporting a fixed restoration and those anchoring an overdenture. [source]