Home About us Contact
|
Home About us Contact | ||
|
|
||
Implant Placement (implant + placement)
Kinds of Implant Placement Selected AbstractsImmediate Implant Placement: Clinical Decisions, Advantages, and DisadvantagesJOURNAL OF PROSTHODONTICS, Issue 7 2008Monish Bhola DDS Abstract Implant placement in fresh extraction sockets in conjunction with appropriate guided bone regeneration is well documented. The decision to extract teeth and replace them with immediate implants is determined by many factors, which ultimately affect the total treatment plan. The goal of this article is to review some of the important clinical considerations when selecting patients for immediate implant placement, and to discuss the advantages and disadvantages of this mode of therapy. [source] Dental Applications of Computerized Tomography: Surgical Planning for Implant PlacementJOURNAL OF PROSTHODONTICS, Issue 3 2007Alfonso Navarrete DDS [source] Implant Placement in Patients with Oral Bisphosphonate Therapy: A Case SeriesCLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 3 2010Ghasem Omati Shabestari DDS ABSTRACT Background: Although the effect of bisphosphonates on dental implant osseointegration is not clear, dental implant failures attributable to oral bisphosphonate therapy have been reported in patients with osteoporosis. Purpose: The aim of this study was to evaluate implant survival in patients with a history of bisphosphonate therapy in a retrospective survey. Materials and Methods: A total of 46 ITI implants placed in 21 osteoporotic patients (females; average age 53 years, range 42,79 years) were evaluated with regard to probing depth, mobility, thread exposure, and bleeding on probing. All patients were under oral bisphosphonate therapy. Results: None of implants showed mobility and all patients could be considered free from peri-implantitis. Time of bisphosphonate therapy before and after implant insertion showed no statistically significant influence on PD, BOP, and TE. Likewise, implant location, prosthetic type, and opposing dentition had no statistically significant influence on the clinical and radiological parameters of implants. Conclusion: Within the limitations of this study, it could be concluded that neither being on oral bisphosphonate treatment before implant placement nor starting bisphosphonate therapy after implant installation might jeopardize the successful osseointegration and clinical and radiographic condition of the implants. [source] Provisional Implants: A Clinical Prospective Study in 45 Patients, from Implant Placement to Delivery of the Final BridgeCLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 3 2004Par-Olov Östman DDS ABSTRACT Background: Protocols for submerged healing of dental implants often require the patient to have no teeth until suture removal and to wear a removable prosthesis during the remaining healing period. This may be inconvenient for the patient, and healing may be influenced negatively by the removable prosthesis. Purpose: The aim of the present prospective clinical study was to evaluate the use of provisional implants (PIS) to provide patients with a provisional fixed bridge during the healing of permanent implants. Materials and Methods: Twenty female and 25 male patients were consecutively included in the study. The 45 patients were treated for either partial (16 patients) or total (29 patients) edentulism in the maxilla. The permanent implants were placed first; as many PIS as possible were then installed between the permanent implants. After suturing, impressions from which to manufacture provisional bridges (to be cemented to the PIS) were taken. The patients were monitored with clinical and radiographic follow-up from implant placement to delivery of the final prosthesis. Results: Five (2.2%) of the 230 permanent Brånemark System® implants (Nobel Biocare AB, Gothenburg, Sweden) did not integrate. None of the failures could be related to the presence of PIS between the permanent implants. Seven PIS failed during the observation period. In addition, 17 (9%) of the 192 PIS showed mobility at the second-stage surgery although they had supported the provisional bridges without clinical symptoms. Forty-four of 45 patients showed stabile PI bridges at the time of second-stage surgery. Conclusion: Based on our experiences we concluded that provisional implants can be successfully used to provide patients with a fixed provisional bridge during the healing of permanent implants. [source] Cutting Torque Measurements in Conjunction with Implant Placement in Grafted and Nongrafted Maxillas as an Objective Evaluation of Bone Density: A Possible Method for Identifying Early Implant Failures?CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 1 2004Björn Johansson DDS ABSTRACT Background: Bone grafts are frequently used to enable the placement of dental implants in atrophied jaws. The biomechanical properties of bone grafts used in one- or two-stage implant procedures (in comparison with the use of nongrafted bone) are not well known. Purpose: The purpose of this study was (1) to measure cutting torques during the placement of self-tapping dental implants in nongrafted bone and in bone grafts, either as blocks or in a milled particulate form, in patients undergoing implant treatment in an edentulous maxilla and (2) to identify implants with reduced initial stability and to correlate these findings with a clinical classification of jawbone quality. Materials and Methods: The study included 40 consecutive patients with edentulous maxillas, 27 of whom were subjected to bone grafting prior to or in conjunction with implant placement (grafting group) and 13 of whom received implants without grafting (nongrafted group). Grafted bone from the iliac crest bone was used (1) as onlay blocks, (2) as maxillary sinus inlay blocks, or (3) in particulate form in the maxillary sinus. Implants were placed after 6 to 7 months of healing, except in the maxillary sinus inlay blocks, where implants were placed simultaneously. Cutting torque values were obtained from 113 grafted implant sites and from 109 nongrafted implant sites. Results: Significantly lower cutting torque values were assessed in grafted regions than in nongrafted regions, irrespective of grafting technique. Lower values were also seen for implants placed in block grafts after 6 months when compared to other grafting techniques used. The cutting torque values revealed an inverse linear relation to the Lekholm and Zarb bone quality index. Conclusion: The cutting torque values correlated well with the Lekholm and Zarb index of bone quality. Significantly lower cutting torque values were seen in grafted bone than in nongrafted bone. [source] Maxillary Sinus Elevation Surgery: An OverviewJOURNAL OF ESTHETIC AND RESTORATIVE DENTISTRY, Issue 5 2003ELIAZ KAUFMAN DDS ABSTRACT Maxillary sinus elevation surgery was developed to increase the height of bone available for implant placement in the posterior maxilla. The efficacy and predictability of this procedure have been determined in numerous studies. The basic approach to the sinus (Caldwell-Luc operation) involves an osteotomy performed on the lateral maxillary wall, elevation of the sinus membrane, and placement of bone graft material. The graft materials can be categorized into four groups: autogenous bone, allografts (harvested from human cadavers), alloplasts (synthetic materials), and xenografts (grafts from a nonhuman species). These graft materials can be used alone or in combination with each other. Implant placement can occur at the same surgical procedure (immediate placement) or following a healing period of 6 to 9 months (delayed placement). A more conservative approach to the sinus, the osteotome technique, has been described as well. CLINICAL SIGNIFICANCE This article provides an overview of the surgical technique, with emphasis on anatomic considerations, preoperative patient evaluation (clinical and radiographic), indications and contraindications to the procedure, and possible risks and complications. [source] Immediate Implant Placement: Clinical Decisions, Advantages, and DisadvantagesJOURNAL OF PROSTHODONTICS, Issue 7 2008Monish Bhola DDS Abstract Implant placement in fresh extraction sockets in conjunction with appropriate guided bone regeneration is well documented. The decision to extract teeth and replace them with immediate implants is determined by many factors, which ultimately affect the total treatment plan. The goal of this article is to review some of the important clinical considerations when selecting patients for immediate implant placement, and to discuss the advantages and disadvantages of this mode of therapy. [source] A prospective, randomized-controlled clinical trial to evaluate bone preservation using implants with different geometry placed into extraction sockets in the maxillaCLINICAL ORAL IMPLANTS RESEARCH, Issue 1 2010Mariano Sanz Abstract Aim: The primary objective of this study was to determine the association between the size of the void established by using two different implant configurations and the amount of buccal/palatal bone loss that occurred during 16 weeks of healing following their installation into extraction sockets. Material and methods: The clinical trial was designed as a prospective, randomized-controlled parallel-group multicenter study. Adults in need of one or more implants replacing teeth to be removed in the maxilla within the region 15,25 were recruited. Following tooth extraction, the site was randomly allocated to receive either a cylindrical (group A) or a tapered implant (group B). After implant installation, a series of measurements were made to determine the dimension of the ridge and the void between the implant and the extraction socket. These measurements were repeated at the re-entry procedure after 16 weeks. Results: The study demonstrated that the removal of single teeth and the immediate placement of an implant resulted in marked alterations of the dimension of the buccal ridge (43% and 30%) and the horizontal (80,63%) as well as the vertical (69,65%) gap between the implant and the bone walls. Although the dimensional changes were not significantly different between the two-implant configurations, both the horizontal and the vertical gap changes were greater in group A than in group B. Conclusions: Implant placement into extraction sockets will result in significant bone reduction of the alveolar ridge. To cite this article: Sanz M, Cecchinato D, Ferrus J, Pjetursson EB, Lang NP, Jan L. A prospective, randomized-controlled clinical trial to evaluate bone preservation using implants with different geometry placed into extraction sockets in the maxilla. Clin. Oral Impl. Res. 21, 2009; 13,21. [source] Modeling of the buccal and lingual bone walls of fresh extraction sites following implant installationCLINICAL ORAL IMPLANTS RESEARCH, Issue 6 2006Mauricio G. Araújo Abstract Objective: To determine whether the reduction of the alveolar ridge that occurs following tooth extraction and implant placement is influenced by the size of the hard tissue walls of the socket. Material and methods: Six beagle dogs were used. The third premolar and first molar in both quadrants of the mandible were used. Mucoperiostal flaps were elevated and the distal roots were removed. Implants were installed in the fresh extraction socket in one side of the mandible. The flaps were replaced to allow a semi-submerged healing. The procedure was repeated in the contra later side of the mandible after 2 months. The animals were sacrificed 1 month after the final implant installation. The mandibles were dissected, and each implant site was removed and processed for ground sectioning. Results: Marked hard tissue alterations occurred during healing following tooth extraction and implant installation in the socket. The marginal gap that was present between the implant and the walls of the socket at implantation disappeared as a result of bone fill and resorption of the bone crest. The modeling in the marginal defect region was accompanied by marked attenuation of the dimensions of both the delicate buccal and the wider lingual bone wall. Bone loss at molar sites was more pronounced than at the premolar locations. Conclusion: Implant placement failed to preserve the hard tissue dimension of the ridge following tooth extraction. The buccal as well as the lingual bone walls were resorbed. At the buccal aspect, this resulted in some marginal loss of osseointegration. [source] Single-tooth implant treatment in the anterior region of the maxilla for treatment of tooth loss after trauma: a retrospective clinical and interview studyDENTAL TRAUMATOLOGY, Issue 3 2003Lars Andersson Abstract,,, The aim of this study was to evaluate the results of single-tooth implant treatment in patients where teeth have been lost as a result of trauma. Also, the patients' and professionals' opinions regarding the final outcome of treatment were assessed. Thirty-four patients with 42 lost teeth were evaluated by clinical and radiographic examinations and interviews 2,5 years after treatment. A professional who had not taken part in the treatment evaluated the implant crowns. Central maxillary incisors were the most frequently lost and replaced teeth after trauma (75%) followed by lateral incisors (21%). In patients with incomplete growth, implant treatment was generally postponed until completion of growth. Lack of space was treated by presurgical orthodontics (7%) or by selecting an implant with a reduced diameter (5%). Deficiency of bone was seen in 17% and was treated by bone grafting or local augmentation prior to implant surgery. Patients who had lost two or more teeth after trauma were all subjected to bone grafting. Preservation of roots in the alveolar process seemed to maintain the bone volume enabling better conditions for later implant placement. Forty-one implants (97.6%) were integrated successfully. Complications were few and of minor importance (9.5% before and 12% after cementation of crowns) and could all be managed. No or minimal bone loss was seen. In general, the patients felt that they received good care and that they were well informed about their treatment. Some patients reported that the local anesthesia procedure was not pain-free, but 71% of the patients experienced the treatment as pain-free. For each of the variables (color, shape, height, and size of the crowns), the highest degree of satisfaction was noted in 93,98% of the patients and 91,95% of the single evaluating professional. Given that the patients have finished growth and a careful treatment planning and timing are performed, the functional and esthetical outcome of single-tooth implant treatment today is excellent and can be recommended for replacing tooth losses after trauma in the anterior region of the maxilla. [source] Treatment choices for negative outcomes with non-surgical root canal treatment: non-surgical retreatment vs. surgical retreatment vs. implantsENDODONTIC TOPICS, Issue 1 2005STEVEN A. COHN The revision of negative treatment outcomes is a significant part of current endodontic practice. Both non-surgical and surgical retreatment procedures share the problem of a significant negative outcome in the presence of apical periodontitis. More positive results may be achieved in certain teeth with a combination of both procedures rather than either alone. However, there are pressures to replace these ,failed' endodontically treated teeth with implants. When comparable criteria are applied to outcomes, the survival rates of endodontic treatment and implant placement are the same. Time, cost, and more flexible clinical management indicate that endodontic retreatment procedures should always be performed first unless the tooth is judged to be untreatable. Endodontists should be trained in implantology to assist patients and referring colleagues in making informed treatment decisions. [source] Functional behaviour of bone around dental implants,GERODONTOLOGY, Issue 2 2004Clark M. Stanford Achieving a long-term stable implant interface is a significant clinical issue when there is insufficient cortical bone stabilisation at implant placement. Clinical outcomes studies suggest that the higher risk implants are those placed in compromised cortical bone (thin, porous, etc.) in anatomical sites with minimal existing trabecular bone (characterised as type IV bone). In establishing and maintaining an implant interface in such an environment, one needs to consider the impact of masticatory forces, the response of bone to these forces and the impact of age on the adaptive capacity of bone. These forces, in turn, have the potential to create localised changes in interfacial stiffness through viscoelastic changes at the interface. Changes in bone as a function of age (e.g. localised hypermineralised osteopetrosis and localised areas of osteopenia) will alter the communication between osteocytes and osteoblasts creating the potential for differences in response of osteoblastic cells in the older population. A key to understanding the biomechanical and functional behaviour of implants in the older population is to control the anticipated modelling and remodelling behaviour through implant design that takes into account how tissues respond to the mechanically active environment. [source] Immediate implants at fresh extraction sockets: an experimental study in the beagle dog comparing four different implant systems.JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 8 2010Soft tissue findings de Sanctis M, Vignoletti F, Discepoli N, Muñoz F, Sanz M. Immediate implants at fresh extraction sockets: an experimental study in the beagle dog comparing four different implant systems. Soft tissue findings. J Clin Periodontol 2010; 37: 769-776 doi: 10.1111/j.1600-051X.2010.01570.x. Abstract Objectives: To evaluate whether different implants placed immediately upon tooth extraction may affect the dimension and composition of the peri-implant soft tissues. Material and Methods: Eight beagle dogs received implants randomly installed into the distal socket of 3P3 and 4P4. Four commercially available implant systems were evaluated: 3i Osseotite Certain straight; Astra MicroThreadÔ -OsseoSpeedÔ; Thommen SPI Element®; and Straumann ITI standard. Each animal provided four test implant sites. All animals were sacrificed 6 weeks after implant placement, providing specimens for the evaluation of the soft tissue dimensions by histometric analysis. Results: The biological width at 6 weeks after implant placement consisted of a junctional epithelium measuring between 2 and 2.7 mm and a connective tissue component between 1 and 1.8 mm with no statistical differences among the four implant systems. Conclusion: This study failed to demonstrate differences in the soft tissue healing outcome when placing four different implant systems into fresh extraction sockets. Nevertheless, the length of the epithelium achieved with the four implant systems is longer than what has been reported when placing implants in healed-ridge experimental models. [source] Accuracy assessment of computer-assisted flapless implant placement in partial edentulismJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 4 2010N. Van Assche Van Assche N, van Steenberghe D, Quirynen M, Jacobs R. Accuracy assessment of computer-assisted flapless implant placement in partial edentulism. J Clin Periodontol 2010; 37: 398,403. doi: 10.1111/j.1600-051X.2010.01535.x Abstract Aim: To assess the accuracy of implants placed flapless by a stereolithographic template in partially edentulous patients. Material and Methods: Eight patients, requiring two to four implants (maxilla or mandible), were consecutively recruited. Radiographical data were obtained by means of a cone beam or a multi-slice CT scan and imported in a software program. Implants (n=21) were planned in a virtual environment, leading to the manufacture of one stereolithographic template per patient to guide the implant placement in a one-stage flapless procedure. A postoperative cone beam CT was performed to calculate the difference between virtual implant (n=21) positions in the preoperative planning and postoperative situation. Results: A mean angular deviation of 2.7° (range 0.4,8, SD 1.9), with a mean deviation at the apex of 1.0 mm (range 0.2,3.0, SD 0.7), was observed. If one patient, a dropout because of non-conformity with the protocol, was excluded, the angular deviation was reduced to 2.2° (range 0.6,3.9, SD 1.1), and the apical deviation to 0.9 mm (range 0.2,1.8). Conclusion: Based on this limited patient population, a flapless implant installation appears to be a useful procedure even when based on accurate and reliable 3D CT-based image data and a dedicated implant planning software. [source] Immediate implants at fresh extraction sockets: bone healing in four different implant systemsJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 8 2009Massimo De Sanctis Abstract Objectives: To describe the differences in bone healing, when placing four different implant systems in fresh extraction sockets. Material and Methods: Eight beagle dogs received implants randomly installed into the distal socket of three P3 and four P4. Four-implant systems were evaluated. Each animal provided four test implant sites. All animals were sacrificed at 6 weeks after implant placement, providing specimens for histo-morphometric analysis of bone to implant contact (BIC), bone area, new bone formation, as well as histometric measurements of the ridge alterations. Results: No statistically significant difference was observed among the four-implant systems. The mean BIC % ranged between 58.5% and 72.1%. Bone modelling of the buccal plate was marked and amounted approximately to 2.5 mm, independently of the system used. Conclusion: This study failed to demonstrate differences in the healing pattern after 6 weeks when placing four different implant systems in fresh extraction sockets. In spite of achieving predictable osteointegration with the four implants studied, the occurrence of buccal bone resorption may limit the use of this surgical approach. [source] Implants placed in combination with an internal sinus lift without graft material: an analysis of short-term failureJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 2 2009Olaf Gabbert Abstract Aim: Investigation of the short-term survival of implants placed in combination with an internal sinus lift (ISL) without graft material. Material and Methods: Thirty-six patients received 92 screw-shaped dental implants in combination with an ISL. No bone grafts or bone substitutes were used. Forty-four patients with 77 implants in the native posterior maxilla served as controls. X-rays taken after implant placement and 6 months later were evaluated for the presence of bone gain at the apical aspect of the implants. Kaplan,Meier survival curves and Cox regression analysis were used to estimate survival curves and to isolate risk factors for implant failures. Results: Within a mean observation period of 1.2 years (minimum 9 months; maximum 3.7 years), four failures were recorded in the experimental group and two in the controls. The probability of survival was above 94% for both groups. Six,nine months after surgery, bone gain was observed in 29 out of 92 implants. Comparison of the experimental group and controls revealed no effect of ISL and membrane perforation on the probability of survival. Conclusions: Promising short-term outcomes were observed for implants with ISL without graft material; for a substantial proportion of implants, apical bone gain was observed in the first 6,9 months. [source] Immediate single-tooth implants in the anterior maxilla: a 1-year case cohort study on hard and soft tissue responseJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 7 2008Tim De Rouck Abstract Aim: The objective of the present study was to assess implant survival rate, hard and soft tissue response and aesthetic outcome 1 year after immediate placement and provisionalization of single-tooth implants in the pre-maxilla. All patients underwent the same strategy, that is mucoperiosteal flap elevation, immediate implant placement, insertion of a grafting material between the implant and the socket wall and the connection of a screw-retained provisional restoration. Material and Methods: Thirty consecutive patients were treated for single-tooth replacement in the aesthetic zone by means of immediate implant placement and provisionalization. Reasons for tooth loss included caries, periodontitis or trauma. At 6 months, provisional crowns were replaced by the permanent ones. Clinical and radiographic evaluation was completed at 1, 3, 6 and 12 months to assess implant survival and complications, hard and soft tissue parameters and patient's aesthetic satisfaction. Results: One implant had failed at 1 month of follow-up, resulting in an implant survival rate of 97%. Radiographic examination yielded 0.98 mm mesial, respectively, 0.78 mm distal bone loss. Midfacial soft tissue recession and mesial/distal papilla shrinkage were 0.53, 0.41and 0.31 mm, respectively. Patient's aesthetic satisfaction was 93%. Conclusions: The preliminary results suggest that the proposed strategy can be considered to be a valuable treatment option in well-selected patients. [source] Correlation between early perforation of cover screws and marginal bone loss: a retrospective studyJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 1 2008Nele Van Assche Abstract Aim: This retrospective study aimed to determine the consequence of early cover screw exposure on peri-implant marginal bone level. Material and Methods: Sixty Astra Tech® MicroThread implants installed in partially edentulous jaws were compared: 20 implants were placed following a two-stage procedure and were unintentionally exposed to the oral cavity (two-stage exposed), 20 implants were placed following a two-stage procedure and were surgically exposed after a subgingival healing time of 3,6 months (two-stage submerged), and 20 implants were placed following a one-stage surgical protocol (one-stage). Digital radiographs were taken at implant placement for all implants, and after abutment surgery for the two-stage exposed and two-stage submerged groups or after 3 months for the one-stage group. Bone loss mesially and distally was measured with an on-screen cursor after calibration. Results: Mean bone re-modelling was 1.96 mm (range: 0.2,3.2 mm) around the two-stage exposed implants, 0.01 mm (range: 0.0,0.3 mm) around the two-stage submerged implants and 0.14 mm (range: 0.0,1.2 mm) around the one-stage implants. Conclusion: The unintentional perforation of two-stage implants resulted in significant bone destruction, probably because the biological width was not considered. [source] Accuracy of implant placement based on pre-surgical planning of three-dimensional cone-beam images: a pilot studyJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 9 2007N. Van Assche Abstract Aim: To evaluate the precision of transfer of a computer-based three-dimensional (3D) planning, using re-formatted cone-beam images, for oral implant placement in partially edentulous jaws. Material and Methods: Four formalin-fixed cadaver jaws were imaged in a 3D Accuitomo FPD® cone-beam computed tomography (CT). Data were used to produce an accurate implant planning with a transfer to surgery by means of stereolithographic drill guides. Pre-operative cone-beam CT images were subsequently matched with post-operative ones to calculate the deviation between planned and installed implants. Results: Placed implants (length: 10,15 mm) showed an average angular deviation of 2° (SD: 0.8, range: 0.7,4.0°) as compared with the planning, while the mean linear deviation was 1.1 mm (SD: 0.7 mm, range 0.3,2.3 mm) at the hex and 2.0 mm (SD: 0.7 mm, range 0.7,2.4 mm) at the tip. Conclusions: Cone-beam images could be used for implant planning, taking into account a maximal 4° angular and 2.4 mm linear deviation at the apical tip. [source] Bone regeneration in dehiscence-type defects at chemically modified (SLActive®) and conventional SLA titanium implants: a pilot study in dogsJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 1 2007Frank Schwarz Abstract Objectives: The aim of the present study was to evaluate bone regeneration in dehiscence-type defects at titanium implants with chemically modified (mod) and conventional sand-blasted/acid-etched (SLA) surfaces. Material and Methods: Standardized buccal dehiscence defects (height: 3 mm, width: 3 mm) were surgically created following implant site preparation in both the upper and lower jaws of four beagle dogs. modSLA and SLA implants were inserted bilaterally according to a split-mouth design. The animals were sacrificed after 2 and 12 weeks (n=2 animals each). Dissected blocks were processed for histomorphometrical analysis: defect length, new bone height (NBH), percent linear fill (PLF), percent of bone-to-implant contact (BIC-D) and area of new bone fill (BF). Results: Wound healing at SLA implants was predominantly characterized by the formation of a dense connective tissue at 2 and 12 weeks, without significant increases in mean NBH, PLF, BIC-D or BF values. In contrast, modSLA implants exhibited a complete defect fill at 12 weeks following implant placement. In particular, histomorphometrical analysis revealed the following mean values at 12 weeks: NBH (3.2±0.3 mm), PLF (98%), BIC-D (82%) and BF (2.3±0.4 mm2). Conclusion: Within the limits of the present study, it was concluded that modSLA titanium surfaces may promote bone regeneration in acute-type buccal dehiscence defects at submerged implants. [source] The amount of newly formed bone in sinus grafting procedures depends on tissue depth as well as the type and residual amount of the grafted materialJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 2 2005Zvi Artzi Abstract Objectives: Bone replacement substitutes are almost unavoidable in augmentation procedures such as sinus grafting. The objective of the present study was to evaluate the osteoconductive capability of two different scaffold fillers in inducing newly formed bone in this procedure. Material and Methods: Sinus floor augmentation and implant placement were carried out bilaterally in 12 patients. Bovine bone mineral (BBM) was grafted on one side and , -tricalcium phosphate (, -TCP) on the contralateral side. Both were mixed (1:1 ratio) with autogenous cortical bone chips harvested from the mandible by a scraper. Hard tissue specimen cores were retrieved from the augmented sites (at the previous window area) at 12 months. Decalcified sections were stained with haematoxylin,eosin and the fraction area of new bone and filler particles was measured. In addition to the effect of the filler on new bone formation, the latter was tested to determine whether it correlated with the tissue depth and residual amount of the grafted material. Results: Bone area fraction increased significantly from peripheral to deeper areas at both grafted sites in all cores: from 26.0% to 37.7% at the , -TCP sites and from 33.5% to 53.7% at the BBM-grafted sites. At each depth the amount of new bone in BBM sites was significantly greater than that in TCP sites. However, the average area fraction of grafted material particles was similar in both fillers and all depth levels (, -TCP=27.9,23.2% and BBM=29.2,22.6%, NS). A significant negative correlation was found between bone area fraction and particle area fraction at the middle (p=0.009) and deep (p=0.014) depths in the , -TCP sites, but not at the BBM sites. Conclusion: At 12 months post-augmentation, the two examined bone fillers, , -TCP and BBM, promoted new bone formation in sinus grafting but the amount of newly formed bone was significantly greater in BBM-grafted sites. However, both exhibited similar residual grafted material area fraction at this healing period. This could imply that BBM possesses better osteoconductive properties. [source] Recombinant human bone morphogenetic protein-7 in maxillary sinus floor elevation surgery in 3 patients compared to autogenous bone graftsJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 9 2000A clinical pilot study Abstract Background/Aims: This pilot study was designed to determine the clinical bone formation ability of a human recombinant DNA bone morphogenetic protein-7, also referred to as Osteogenic Protein-1 [OP-1] combined with a collagen carrier, implanted in the maxillary sinus of 3 patients. The results were compared with a group of 3 patients treated with sinus floor elevation and autogenous bonegrafts. Methods: 6 consecutive patients, 4 female and 2 male, between 48 and 57 years of age were treated by means of sinus floor elevation for insufficient bone height in the posterior maxilla for implant surgery. 3 patients, 2 female and 1 male, were treated with OP-1 attached to a collagen device. In these patients, 4 maxillary sinus grafting procedures according to Tatum's method were carried out. 1 g of collagen carrier containing 2.5 mg rhOP-1 mixed with 3 ml of saline was placed between the bony floor and the elevated mucosal lining of the most caudal part of the maxillary sinus, in order to increase the vertical bone dimension to place dental implants of a sufficient length. The 3 other patients, also 2 female and 1 male, with a total of 5 sinus sites, were treated with sinus floor elevation and autogenous iliac crest bonegrafts. After 6 months, during dental implant preparation, bone cores were taken for histology. Thus, clinical, radiological and histological results of the 2 groups of 3 patients were compared. Results: 6 months after sinus grafting with OP-1, in 1 male, well-vascularized bonelike tissue of good quality was observed clinically. This could be confirmed by histology. In the second, female, patient no bone formation was observed at all. A cyst-like granular tissue mass, without purulent content, was removed. In the 3rd, female, patient, who received bilateral sinus grafts, some bonelike formation was seen, however it showed flexible tissue which led to the decision that at 6 months after the sinus grafting, the implant placement had to be postponed. In all 5 autogenous grafted sinuses a bone appearance similar to normal maxillary bone was observed clinically as well as histologically and dental implants could be placed six months after sinus floor elevation surgery. Conclusions: These findings indicate that the OP-1 device has the potential for initiating bone formation in the human maxillary sinus within 6 months after a sinus floor elevation operation. However, the various findings in these 3 patients indicate that the behaviour of the material is at this moment insufficiently predictable, in this indication area. Further investigation is indicated before OP-1 can be successfully used instead of the "gold standard" autogenous bone graft. [source] Maxillary Sinus Elevation Surgery: An OverviewJOURNAL OF ESTHETIC AND RESTORATIVE DENTISTRY, Issue 5 2003ELIAZ KAUFMAN DDS ABSTRACT Maxillary sinus elevation surgery was developed to increase the height of bone available for implant placement in the posterior maxilla. The efficacy and predictability of this procedure have been determined in numerous studies. The basic approach to the sinus (Caldwell-Luc operation) involves an osteotomy performed on the lateral maxillary wall, elevation of the sinus membrane, and placement of bone graft material. The graft materials can be categorized into four groups: autogenous bone, allografts (harvested from human cadavers), alloplasts (synthetic materials), and xenografts (grafts from a nonhuman species). These graft materials can be used alone or in combination with each other. Implant placement can occur at the same surgical procedure (immediate placement) or following a healing period of 6 to 9 months (delayed placement). A more conservative approach to the sinus, the osteotome technique, has been described as well. CLINICAL SIGNIFICANCE This article provides an overview of the surgical technique, with emphasis on anatomic considerations, preoperative patient evaluation (clinical and radiographic), indications and contraindications to the procedure, and possible risks and complications. [source] Assessment of correlation between computerized tomography values of the bone, and maximum torque and resonance frequency values at dental implant placementJOURNAL OF ORAL REHABILITATION, Issue 12 2006I. TURKYILMAZ summary, The aim of this study was to determine the bone density in the designated implant sites using computerized tomography (CT), the fastening torque values of dental implants, and the implant stability values using resonance frequency analysis. Further aim was to evaluate a possible correlation between bone density, fastening torque and implant stability. Eighty-five patients were treated with 158 Brånemark System implants. CT machine was used for preoperative evaluation of the jawbone for each patient, and bone densities were recorded in Hounsfield units (HU). The fastening torque values of all implants were recorded with the OsseoCare equipment. Implant stability measurements were performed with the Osstell machine. The average bone density and fastening torque values were 751·4 ± 256 HU and 39·7 ± 7 Ncm for 158 implants. The average primary implant stability was 73·2 ± 6 ISQ for seventy implants. Strong correlations were observed between the bone density, fastening torque and implant stability values of Brånemark System TiUnite MKIII implants at implant placement (P < 0·001). These results strengthen the hypothesis that it may be possible to predict and quantify initial implant stability and bone quality from pre-surgical CT diagnosis. [source] Anatomical study of the pyramidal process of the palatine bone in relation to implant placement in the posterior maxillaJOURNAL OF ORAL REHABILITATION, Issue 2 2001S. P. Lee The placement of dental implants in the molar region of the maxilla is often difficult because of insufficient bone volume and the inferior bone quality. In order to avoid these limitations, the pillar of bone, which is composed of the maxillary tuberosity, the pyramidal process of the palatine bone and the pterygoid process of the sphenoid bone, was introduced for implant placement. In fact, the pyramidal process is the posterior structure where implants are placed but until now, there is no available data of the size or shape of the pyramidal process. Therefore, we measured the height, anteroposterior distance and mediolateral distance of the pyramidal process and observed the shape of lateral and posterior surfaces of the pyramidal process of 54 Korean edentulous dry skulls in this study. The height was 13·1 mm (male: 13·6 mm, female: 12·4 mm). The anteroposterior distance was 6·5 mm (male: 6·7 mm, female: 6·1 mm). The mediolateral distance was 9·5 mm (male: 9·9 mm, female: 9·0 mm). The most common type was the right-angled triangle in the lateral surface (44·4%) and in the posterior surface (66·7%). There was no statistical significance between the male and the female in all items (P > 0·05). These results provide anatomical features in relation to placement of dental implants in the molar region of the maxilla and would be useful in treatment planning of partially or completely edentulous patients. [source] A biomechanical effect of wide implant placement and offset placement of three implants in the posterior partially edentulous regionJOURNAL OF ORAL REHABILITATION, Issue 1 2000Y. Sato To prevent loosening or fracture of screws retaining the prosthesis to the implants in the posterior partially edentulous region, the use of staggered buccal and lingual offset placement or wide implants is suggested. However, it is not known how this usage compensates for the torque produced by lateral occlusal forces. This study evaluated the effectiveness of offset placement of three implants and a wide implant placement at the most posterior site. Three-dimensional geometric analysis was used to calculate the tensile force applied to gold screws in clinical situations with buccal or lingual loading perpendicular to cuspal inclination (10 or 20°). Four variations of the placement of three implants (, 3·75 mm) are: (1) straight; (2) buccal offset of the second implant; (3) lingual offset of the second implant; (4) a wide implant (, 5 mm) placement at most posterior site. The offset placement did not always decrease tensile force at the gold screw, but wide implant placement and decrease in cuspal inclination did. [source] Immediate Implant Placement: Clinical Decisions, Advantages, and DisadvantagesJOURNAL OF PROSTHODONTICS, Issue 7 2008Monish Bhola DDS Abstract Implant placement in fresh extraction sockets in conjunction with appropriate guided bone regeneration is well documented. The decision to extract teeth and replace them with immediate implants is determined by many factors, which ultimately affect the total treatment plan. The goal of this article is to review some of the important clinical considerations when selecting patients for immediate implant placement, and to discuss the advantages and disadvantages of this mode of therapy. [source] Evaluation of interarch space for implant restorations in edentulous patients: A laboratory techniqueJOURNAL OF PROSTHODONTICS, Issue 2 2000Nicolas F. AbuJamra DDS This article describes a laboratory procedure for the visual evaluation of interarch space and its effect on implant prosthesis design. The method is applicable to patients presenting with completely edentulous arches. Silicone impression material is used to form a resilient cast and an external mold from an existing denture. The denture is duplicated using autopolymerizing acrylic resin. The duplicate denture and resilient cast are mounted on an articulator. Spatial relationships of anatomic landmarks can be evaluated, and a quantitative evaluation of available space can be made. The duplicate denture can also be used as a surgical template to direct implant placement. Reference tables are provided to serve as guidelines in the correlation between available space and minimum space required for various implant-assisted restorations. [source] Histological evaluation on bone regeneration of dental implant placement sites grafted with a self-setting ,-tricalcium phosphate cementMICROSCOPY RESEARCH AND TECHNIQUE, Issue 2 2008Masayoshi Nakadate Abstract This study aimed to evaluate the histological characteristics of the new bone formed at dental implant placement sites concomitantly grafted with a self-setting tricalcium phosphate cement (BIOPEX-R®). Standardized defects were created adjacent to the implants in maxillae of 4-week-old male Wistar rats, and were concomitantly filled with BIOPEX-R®. Osteogenesis was examined in two sites of extreme clinical relevance: (1) the BIOPEX-R®-grafted surface corresponding to the previous alveolar ridge (alveolar ridge area), and (2) the interface between the grafting material and implants (interface area). At the alveolar ridge area, many tartrate-resistant acid phosphatase (TRAPase)-reactive osteoclasts had accumulated on the BIOPEX-R® surface and were shown to migrate toward the implant. After that, alkaline phosphatase (ALPase)-positive osteoblasts deposited new bone matrix, demonstrating their coupling with osteoclasts. On the other hand, the interface area showed several osteoclasts initially invading the narrow gap between the implant and graft material. Again, ALPase-positive osteoblasts were shown to couple with osteoclasts, having deposited new bone matrix after bone resorption. Transmission electron microscopic observations revealed direct contact between the implant and the new bone at the interface area, although few thin cells could still be identified. At both the alveolar ridge and the interface areas, newly formed bone resembled compact bone histologically. Also, concentrations of Ca, P, and Mg were much alike with those of the preexistent cortical bone. In summary, when dental implant placement and grafting with BIOPEX-R® are done concomitantly, the result is a new bone that resembles compact bone, an ideal achievement in reconstructive procedures for dental implantology. Microsc. Res. Tech., 2008. © 2007 Wiley-Liss, Inc. [source] OC8 The short-term efficacy of osseointegrated implants in patients with non-malignant oral mucosal disease: a case seriesORAL DISEASES, Issue 2006TA Hodgson Purpose, The spectrum of patients who may wish or warrant osseointegrated implants is increasing, despite few reports of the impact of non-malignant oral mucosal disease upon implant placement. This report details the implant placement outcomes in three patients with pre-existing oral mucosal disease. Case reports,A: Four implants were placed in the lower anterior region of a 78-year-old female with longstanding mucous membrane pemphigoid (MMP) in 2004. The MMP had resulted in extensive cicatrisation of the upper and lower buccal and labial vestibules. One implant failed to osseointegrate, but was successfully replaced. There have been no other postplacement adverse events, despite the MMP remaining mildly active. B: A 36-years-old male with orofacial granulomatosis characterised by recurrent lip swelling and gingival enlargement, had a single implant placed in the upper canine region in 2001. Although still in situ significant peri-implant alveolar bone loss has occurred and has been stabilised by repeated debridement, local administration of topical minocycline and several courses of systemic metronidazole. C: A 53-years-old female with oral manifestations of diffuse systemic sclerosis and fibrosing alveolitis had four lower anterior mandibular implants placed in 1995 to support an 8 unit bridge. One episode of peri-implant inflammation was controlled with local debridement and topical chlorhexidine mouthrinse. The implants remain satisfactory 11 years postinsertion. Conclusion, The short-term failure of osseointegrated implant integration appears uncommon in patients with non-malignant oral mucosal disease. There remains a need to establish appropriate case selection criteria and monitor outcomes. [source] | ||||||||||