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Implant Loading (implant + loading)
Selected AbstractsMinimally Invasive Antral Membrane Balloon Elevation , Results of a Multicenter RegistryCLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 2009Efraim Kfir DMD ABSTRACT Background and Purpose: Frequently, the posterior maxilla lacks sufficient bone mass to support dental implants. This multiphysician registry assessed the feasibility and safety of minimally invasive antral membrane balloon elevation (MIAMBE), followed by bone augmentation and implant fixation. Materials and Methods: One hundred twelve consecutive patients were referred for MIAMBE. Following pre-procedural assessment and informed consent, patients underwent alveolar crest exposure, and 3 mm osteotomy followed by MIAMBE. Platelet-rich fibrin and bone substitutes were injected under the antral membrane; implant placement and primary closure were executed at the same sitting. Implant loading was carried out 6 to 9 months later. Results: One hundred nine (97.3%) patients successfully concluded the initial procedure. Three patients had membrane tear requiring procedure abortion. One case of infection was documented at 4 weeks. Procedure time was 58 ± 23 minutes. Incremental bone height consistently exceeded 10 mm, and implant survival of 95% was observed at 6 to 9 months. Conclusion: MIAMBE can be applied to all patients in need of posterior maxilla bone augmentation with high procedural success, low complication rate, and satisfactory bone augmentation and implant survival. As it is minimally invasive and associated with minimal discomfort, MIAMBE should be an alternative to the currently employed methods of maxillary bone augmentation. [source] Influence of controlled immediate loading and implant design on peri-implant bone formationJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 2 2007Katleen Vandamme Abstract Aim: Tissue formation at the implant interface is known to be sensitive to mechanical stimuli. The aim of the study was to compare the bone formation around immediately loaded versus unloaded implants in two different implant macro-designs. Material and Methods: A repeated sampling bone chamber with a central implant was installed in the tibia of 10 rabbits. Highly controlled loading experiments were designed for a cylindrical (CL) and screw-shaped (SL) implant, while the unloaded screw-shaped (SU) implant served as a control. An F -statistic model with ,=5% determined statistical significance. Results: A significantly higher bone area fraction was observed for SL compared with SU (p<0.0001). The mineralized bone fraction was the highest for SL and significantly different from SU (p<0.0001). The chance that osteoid- and bone-to-implant contact occurred was the highest for SL and significantly different from SU (p<0.0001), but not from CL. When bone-to-implant contact was observed, a loading (SL versus SU: p=0.0049) as well as an implant geometry effect (SL versus CL: p=0.01) was found, in favour of the SL condition. Conclusions: Well-controlled immediate implant loading accelerates tissue mineralization at the interface. Adequate bone stimulation via mechanical coupling may account for the larger bone response around the screw-type implant compared with the cylindrical implant. [source] Syncrystallization: A Technique for Temporization of Immediately Loaded Implants with Metal-Reinforced Acrylic Resin RestorationsCLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 3 2006Marco 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] Report of a Case Receiving Full-Arch Rehabilitation in Both Jaws Using Immediate Implant Loading Protocols: A 1-Year Resonance Frequency Analysis Follow-UpCLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 1 2006Michael Portmann DDS ABSTRACT Background:, Immediate occlusal implant loading has been documented as a viable treatment option for various indications. However, documentations related to full-arch rehabilitation are usually limited to treatment of one jaw at a time, thereby leaving the opposing dentition unchanged. Furthermore, clinical documentation using traditional, well-accepted measuring techniques may not be adequate when it comes to short-term evaluation of the success or failure of implants subjected to immediate occlusal loading. Purpose:, The purpose of this case report is to (1) present an implant stability follow-up of a patient receiving an immediate, implant-supported full-arch rehabilitation in both jaws and (2) evaluate the patient's acceptance of this rehabilitation. Materials and Methods:, A 68-year-old patient scheduled for implant treatment was selected for an immediate implant loading protocol in both jaws. During two surgical events 3 weeks apart, eight maxillary and four mandibular Brånemark System® Mk IV TiUniteTM fixtures (Nobel Biocare AB, Göteborg, Sweden) were inserted and subsequently used to immediately support a cross-arch fixed prosthesis in the maxilla and a bar-retained overdenture in the mandible. Implant stability was recorded from the day of surgery periodically during a 1-year follow-up using resonance frequency analysis (RFA). Results:, At the 1-year follow-up, based on clinical, RFA, and radiographic evaluations, all implants and the reconstructions were classified as successful. All maxillary implants showed a decrease in the implant stability quotient (ISQ) value from the measurement at the time of surgery to the first follow-up, whereas two of four mandibular implants revealed an initial drop in stability. Irrespective of a specific ISQ level measured at implant surgery (ISQ range 53,74) and despite an initial decrease in stability, measurements recorded at the 12-month follow-up indicated similar stability levels for all maxillary implants (ISQ range 64,68) or the group of mandibular implants (ISQ range 72,75) but with a higher ISQ level for mandibular implants. Furthermore, the patient's acceptance of the immediate full-arch rehabilitation in both jaws was high. Conclusions:, The present case report demonstrates that a slightly staged approach for full-arch rehabilitation in both jaws using immediate implant loading protocols is a realistic treatment option. Furthermore, RFA follow-up indicates that immediately occlusally loaded implants placed in reduced bone quality and quantity are more prone to loose stability in the early healing period compared with implants placed in dense bone quality. [source] Clinical outcome of submerged vs. non-submerged implants placed in fresh extraction socketsCLINICAL ORAL IMPLANTS RESEARCH, Issue 12 2009Luca Cordaro Abstract Aim: The aim of this study was to compare the clinical outcome of submerged vs. non-submerged tapered implants placed into fresh extraction sockets. Materials and methods: A prospective, controlled, multicenter, randomized, clinical trial has been performed in two centers in Rome and Torino (Italy). Thirty healthy patients were recruited according to the following inclusion criteria: need for an immediate post extraction implant, ages between 18 and 70, horizontal defect depth <2 mm, smokers <10 cigarettes/day and absence of any circumstance or condition that could represent contraindications to implant surgery. The patients were randomly allocated to submerged or non-submerged treatment groups immediately after flap elevation and tooth extraction. Submerged implants were exposed 8 weeks after the first surgery; all implants were loaded with provisional restorations 12 weeks after the first surgery and with definitive restoration 12 weeks thereafter. Clinical and radiographic parameters were evaluated at baseline, at implant loading and at the 1-year follow-up visit. Results: The results showed statistically significant differences between the two groups in the mean value of keratinized tissue (KT) height after surgery that was significantly reduced for submerged implants when compared with transmucosal implants (mean reduction of KT at year follow-up: T group 0.2 mm, S group 1.3 mm; P=0.007). Conclusion: Similar outcomes were found for submerged and non-submerged implants placed in fresh extraction sockets with a horizontal peri-implant defect smaller than 2 mm, except for a reduction of KT in the submerged group. Either with a submerged or a non-submerged procedure, 1 mm of mean soft tissue recession is seen after 1 year when compared with the pre-extraction situation. [source] The effect of maximum bite force on marginal bone loss in mandibular overdenture treatment: an in vivo studyCLINICAL ORAL IMPLANTS RESEARCH, Issue 5 2005Frits Van Kampen Abstract: The impact of bite force on the marginal bone response around implants is a subject of debate. This study focused on the effect of maximum bite force on marginal bone levels in mandibular implant overdenture treatment. In addition, the effect of the sequence of 3 different loading conditions on marginal bone loss was evaluated in vivo. The patient population consisted of a group of 18 patients. They received 2 implants in the mandible and a new denture without attachments during the period of submerged implant healing. After second stage surgery, the denture was provided with a ball, magnet or bar-clip attachment. There was a transition of attachment type after 3 and 6 months of function. The sequence in which the attachments were used was randomised. Radiographic marginal bone loss was measured after the period of submerged implant healing and after 3, 6 and 9 months of functional implant loading. Maximum bite force measurements were obtained just prior to second stage surgery with the new denture without attachment. Bite force measurements were also obtained after 3, 6 and 9 months of loading with the implant-retained overdenture. The latter 3 values were averaged. The mean bone loss during the period of submerged healing and during functional loading was 1.7 mm (0.7 mm) and 1.3 mm (0.6 mm), respectively. A relationship between maximum bite force during the period of submerged healing or during the period of functional loading on the one hand and the amount of marginal bone loss on the other could not be demonstrated. The sequence in which the different attachment types were used did not influence the observed amount of marginal bone loss. Résumé L'impact des forces d'occlusion sur la réponse de l'os marginal autour d'implants est sujet à débat. Cette étude s'est centrée sur l'effet de la force d'occlusion maximale sur les niveaux d'os marginaux dans le traitement de prothèses mandibulaires sur implants. De plus l'effet de la séquence de trois conditions de mise en charge différentes sur la perte osseuse marginale a étéévaluée in vivo. Les patients étaient au nombre de douze. Ils avaient reçu deux implants dans la mandibule et une nouvelle prothèse sans attache durant la période de guérison lorsque les implants étaient enfouis. Après la deuxième chirurgie, la prothèse amovible a été utilisée avec une boule, un aimant ou une barre comme attache. Il y avait une transition du type d'attache après trois et six mois de mise en fonction. La séquence suivant laquelle les attaches étaient utilisées était effectuée au hasard. La perte osseuse marginale radiographique a été mesurée après la période de guérison des implants enfouis et après trois, six et neuf mois de mise en fonction. Les mesures de force d'occlusion maximale ont été obtenues juste avant la deuxième chirurgie avec la nouvelle prothèse sans attache. Les mesures de forces d'occlusion ont également été obtenues après trois, six et neuf mois de mise en charge lorsque les implants retenaient la prothèse. Les trois dernières valeurs ont été mélangées. Les pertes osseuses moyennes durant la période de guérison avec les implants enfouis et durant la charge de mise en fonction étaient respectivement de 1,7±0,7 mm et de 1,3±0,6 mm. Une relation entre la force d'occlusion maximale durant la période de guérison avec les implants enfouis ou durant la période de mise en charge fonctionnelle d'une part et la quantité de perte osseuse marginale d'autre part n'a pas pûêtre démontrée. La séquence dans laquelle les différents types d'attache ont été utilisés n'influençaient pas la quantité observée de perte osseuse marginale. Zusammenfassung Der Einfluss der Kaukraft auf die Reaktion des marginalen Knochens um Implantate wir immer wieder diskutiert. Diese Studie konzentrierte sich auf den Einfluss der maximalen Kaukraft auf das marginale Knochenniveau bei Unterkieferimplantaten und Hybridprothesen. Zusätzlich untersuchte man in vivo den Einfluss von drei Phasen mit unterschiedlichen Belastungstypen auf den marginalen Knochenverlust. Es handelte sich um eine Gruppe von 18 Probanden. Alle erhielten zwei Implantate im Unterkiefer und eine neue Prothese, während der submukösen Einheilphase der Implantate noch ohne Retentionselemente. Nach der chirurgischen Freilegung der Implantate fixierte man die Prothesen mit einem Kugelanker, einem Magneten oder einem Steg. Der Wechsel zum nächsten Retentionstyp erfolgte jeweils nach 3 bis 6 Monaten normaler Funktion der Prothesen. Die Abfolge, in welcher man die Retentionselemente einsetzte, wurde zufällig ausgewählt. Den radiologischen marginalen Knochenverlust mass man nach der submukösen Einheilphase der Implantate, sowie nach 3, 6 und 9 Monate einer funktionellen Implantatbelastung. Die maximale Kaukraft wurde genau vor der chirurgischen Freilegung der Implantate mit der neuen Prothese und ohne Attachments gemessen. Zusätzliche Messungen der Kaukraft erfolgten 3, 6 und 9 Monate nach funktioneller Belastung der implantatgetragenen Hybridprothesen. Die letzten drei Werte wurden gemittelt. Der mittlere Knochenverlust während der submukösen Einheilphase betrug 1.7 mm (0.7 mm) und während der funktionellen Belastung 1.3 mm (0.6 mm). Eine Beziehung zwischen der maximalen Kaukraft während der submukösen Einheilung oder während der funktionellen Belastung auf der einen Seite und dem marginalen Knochenverlust auf der anderen Seite konnte nicht gezeigt werden. Die Abfolge, in der die verschiedenen Retentionstypen verwendet wurden, beeinflusste das Ausmass des beobachteten marginalen Knochenverlustes nicht. Resumen El impacto de la fuerza de mordida sobre la respuesta del hueso marginal alrededor de los implantes es motivo de debate. Este estudio está enfocado sobre el efecto de la fuerza de máxima mordida en los niveles de hueso marginal en el tratamiento de sobredentadura mandibular implantosoportada. Además, se evaluó el efecto de la secuencia de 3 condiciones diferentes de carga sobre la pérdida de hueso marginal in vivo. La población de4 pacientes consistió en un grupo de 18 pacientes. Estos recibieron 2 implantes en la mandíbula y una nueva dentadura sin anclajes durante el periodo de cicatrización sumergida de los implantes. Tras la cirugía de segunda fase se suministró una dentadura con anclajes de bola, imanes o barra. Se realizó un cambio en el sistema de anclaje tras 3 y 6 meses en función. La secuencia en la que se emplearon los anclajes fue aleatoria. Se midió la pérdida de hueso marginal radiográfica tras un periodo de cicatrización sumergida y tras 3, 6 y 9 meses de carga funcional de los implantes con la sobredentadura implantosoportada. Los últimos 3 valores se promediaron. La pérdida de hueso media durante el periodo de cicatrización sumergida y durante la carga funcional fue de 1.7 mm (0.7 mm) y 1.3 mm (0.6 mm) respectivamente. No se pudo demostrar una relación entre la fuerza de máxima mordida durante el periodo de cicatrización sumergida o durante el periodo de carga funcional por un lado y la cantidad de pérdida de hueso marginal por otro. La secuencia en la que se emplearon los diferentes tipos de anclajes no influyó en la cantidad de la cantidad de pérdida de hueso marginal observado. [source] Positive effect of early loading on implant stability in the bi-cortical guinea-pig modelCLINICAL ORAL IMPLANTS RESEARCH, Issue 4 2005Els De Smet Abstract: Loading, early after implant placement, has gained rapid interest in dentistry. Primary implant stability, as e.g. defined by resonance frequency instrumentation, has been isolated as a predicator when immediate and early implant loading is applied. The aim of this study was to investigate the effect of early (after 7 days) mechanical loading on the establishment of osseointegration by means of resonance frequency analysis (RFA). Percutaneous titanium implants were installed in both tibiae of 10 guinea-pigs. One week after implant installation, one implant (test) was loaded daily for 6 weeks, while the contra-lateral served as the unloaded one (control). A sinusoidally varying bending moment was applied at a frequency of 3 Hz and a force amplitude of 5 N, for 1800 cycli. Resonance frequency was measured at implant installation and from then on weekly using the RFA-device (Osstell®). Contrary to control implants, that showed a decrease in stability 1 week after installation, reaching a minimum at 3 weeks (,200 Hz), test implants showed a progressive increase in stability over time. After 6 weeks, the mean resonance frequency of test and control implants reached the same values. As confirmed by recent literature, early loading does not have to endanger the establishment of osseointegration of titanium implants. On the contrary, controlled loading is beneficial to maintain the implant stability during the early critical healing period as determined by RFA-measurements. Résumé La mise en charge précoce après l'insertion de l'implant acquière beaucoup d'intérêt en médecine dentaire. La stabilité primaire de l'implant, qui est par exemple définie par l'instrumentation de fréquence de résonnance RFA, a été isolée comme un annonciateur lorsque la mise en charge de l'implant était précoce ou immédiate. Le but de cette étude a été d'étudier l'effet d'une mise en charge précoce (sept jours) sur l'établissement de l'ostéïntégration à l'aide de RFA (Osstell®). Des implants titane percutanés ont été insérés dans les deux tibias de dix cobayes. Une semaine après le placement des implants, un implant test a été mis en charge tous les jours pendant six semaines tandis que le contralatéral servait de contrôle et n'était pas mis en charge. Un moment sinusoïdal a été appliquéà une fréquence de trois hertz et une amplitute d'une force de 5 N pour 1 800 cycles. La fréquence de résonnance a été mesurée lors de l'insertion de l'implant et ensuite hebdomadairement en utilisant le RFA. Contrairement aux implants contrôles, qui accusaient une diminution de la stabilité une semaine après leur insertion atteignant un minimum après trois semaines (,200 Hz), les implants tests ont montré une augmentation progressive de la stabilité avec le temps. Après six semaines, la fréquence de résonnance moyenne des implants tests et contrôles atteignaient les mêmes valeurs. Comme décrit dans la littérature récente, la mise en charge précoce ne met pas en danger l'établissement de l'ostéoïntégration des implants en titane. Au contraire, une mise en charge contrôlée est bénéfique au maintien de la stabilité implantaire durant la période de guérison critique précoce comme déterminée par les mesures RFA. Zusammenfassung Die Belastung kurz nach der Implantatplatzierung hat in der Zahnmedizin schnell an Interesse gewonnen. Die Primärstabilität der Implantate, bestimmt z.B. durch Messung der Resonanzfrequenz, hat sich als Voraussagewert herauskristallisiert, wenn eine Sofort-oder Frühbelastung der Implantate durchgeführt wird. Das Ziel dieser Studie war, den Einfluss der frühen (nach 7 Tagen) mechanischen Belastung auf die Ausbildung der Osseointegration mittels Resonanzfrequenzanalyse (RFA) zu untersuchen. In die beiden Tibias von 10 Meerschweinchen wurden perkutane Titanimplantate eingesetzt. Eine Woche nach der Implantation wurde ein Implantat (Test) während 6 Wochen täglich belastet, während das kontralaterale Implantat unbelastet blieb (Kontrolle). Es wurde ein Biegemoment mit sinusoidalen Schwankungen mit einer Frequenz von 3 Hz und einer Kraftamplitude von 5 N in 1800 Zyklen appliziert. Die Resonanzfrequenz wurde nach der Implantation und dann wöchentlich mit einem RFA-Gerät (Osstell®) gemessen. Im Gegensatz zu den Kontrollimplantaten, welche eine Woche nach dem Setzen eine Stabilitätsabnahme zeigten und das Minimum nach drei Wochen (,200 Hz) erreichten, konnte bei den Testimplantaten eine progressive Zunahme der Stabilität über die Zeit beobachtet werden. Nach sechs Wochen erreichten die mittleren Resonanzfrequenzen der Test-und Kontrollimplantate dieselben Werte. Die frühe Belastung gefährdet die Ausbildung einer Osseointegration bei Titanimplantaten nicht, was auch durch die neuere Literatur bestätig wird. Im Gegenteil, eine kontrollierte Belastung ist von Vorteil für den Erhalt der Implantatstabilität während der kritischen frühen Einheilphase. Dies konnte mittels RFA Messungen ermittelt werden. Resumen La carga temprana tras la colocación del implante ha ganado rápidamente interesen odontología. Se ha aislado como predictor, la estabilidad primaria del implante, definida por instrumentación de frecuencia de resonancia, cuando se aplica la carga temprana al implante. La intención del estudio fue investigar el efecto de carga mecánica temprana (tras 7 días) en el establecimiento de la osteointegración por medio del análisis de la frecuencia de resonancia (RFA). Se instalaron implantes de titanio percutaneos en ambas tibias de 10 conejos de indias. Una semana tras la instalación, un implante (prueba) se cargó diariamente durante 6 semanas, mientras que el contralateral sirvió como el implante sin carga (control). Se aplicó un momento de flexión variante sinusoidalmente a una frecuencia de 3 Hz y una amplitud de la fuerza de 5 N, durante 1899 ciclos. Se midió la frecuencia de resonancia al instalar el implante y a partir de ahí semanalmente usando el dispositivo RFA (Ostell®). Contrariamente a los implantes de control, que mostraron una disminución de la estabilidad una semana después de la instalación, alcanzando un mínimo a las tres semanas (,200 Hz), los implantes de prueba mostraron un incremento progresivo de la estabilidad a lo largo del tiempo. Tras seis semanas, la frecuencia de resonancia de los implantes de prueba y de control alcanzaron los mismos valores. Tal como se confirma por la literatura reciente, la carga temprana no debe hacer peligrar el establecimiento de la osteointegración de los implantes de titanio. Por lo contrario, la carga controlada es beneficiosa para mantener la estabilidad de los implantes durante el periodo crítico de la cicatrización determinado por las mediciones de RFA. [source] | ||||||||||