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Implant Survival (implant + survival)

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Medical Sciences	95%

Terms modified by Implant Survival

implant survival rate

Selected Abstracts

Outcomes of dental implants placed in a surgical training programme

AUSTRALIAN DENTAL JOURNAL, Issue 4 2009
LP Smith
Abstract Background:, This study evaluates surgical outcomes and survival rates of implants placed in a multidisciplinary implant teaching programme. Methods:, A retrospective review of all implant surgery performed over a 6-year period by accredited oral and maxillofacial surgery trainees at the Royal Dental Hospital of Melbourne was undertaken. Patients were reviewed for a minimum of 6 months post-implant placement. Implant survival was defined as those implants which were not removed, were clinically integrated as assessed by torque testing and in an appropriate position to receive a subsequent prosthesis. Kaplan-Meier analysis was used to assess overall survival and univariate factors affecting survival. Multivariate analysis used Cox proportional hazards models. Results:, Over 6 years, 127 patients were treated. Follow-up data were present for 105 patients with 236 implants placed. Survival of implants at 1 and 5 years was 94 per cent and 92.8 per cent, respectively. The only univariate and multivariate factor which affected implant survival was perioperative bone grafting. All failed implants were single stage. Other factors such as patient age, smoking status, implant site, anaesthetic type, immediate or delayed placement, implant length and diameter, and medical comorbidities did not significantly affect implant survival. Conclusions:, A satisfactory implant survival rate was found in a tertiary teaching centre. Perioperative bone grafting significantly increased the risk of implant failure. [source]

Clinical Outcome of Overdenture Treatment on Two Nonsubmerged and Nonsplinted Astra Tech MicrothreadÔ Implants

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 2 2009
Hugo De Bruyn DDS
ABSTRACT Background: The use of two implants for mandibular overdenture stabilization improves the patients' comfort and well-being. This treatment could be more cost-effective if surgery and prosthetic treatment could be performed by one clinician in the normal setting of a dental clinic. Purpose: The aim of this retrospective clinical study was to describe implant success, restorative outcome, and the patients' opinion of mandibular overdenture treatment on two early-loaded, nonsplinted Astra Tech TiOblast MicrothreadÔ (Astra Tech Dental, Mölndal, Sweden) implants. Materials and Methods: Thirty-seven consecutive patients treated with implant-supported mandibular overdentures were invited for a clinical examination. Implant survival, marginal bone level, quality of implant and prosthetic treatment, and the patients' opinion by means of questionnaires were scored. Results: Thirty-four patients attended the examination. Two implants were lost in one patient and the failure rate for the total group of patients was 3%. As 8 of the 33 remaining patients were still in the provisional loading stage, they were not included in the final clinical and radiographic examination. Based on 25 patients and 50 implants with a mean follow-up of 18.8 months (range 4,33), implant positioning and occlusion/articulation scored perfect in 74 to 80% of the cases. Retention of the dentures was rated perfect in 80%, but 20% needed minor activation of the attachments, 20% showed signs of abrasion, and 20% had already been repaired. The average marginal bone level was 0.8 mm below the reference point. The mean pocket depth was 2.1 mm, and 54% of the peri-implant tissues were free of bleeding. The patients were appreciative of the work carried out by their dentist and they indicated a significant improvement in their well-being and quality of life. Conclusions: It can be concluded that the Astra Tech implant system was successfully used by the general dentist both surgically and prosthetically with minimal implant failures and prosthetic complications and that this led to high levels of patient appreciation and overall satisfaction. [source]

Clinical and radiographic characteristics of single-tooth replacements preceded by local ridge augmentation: a prospective randomized clinical trial

CLINICAL ORAL IMPLANTS RESEARCH, Issue 12 2008
L. Meijndert
Abstract Objectives: To assess in a randomized-clinical trial the influence of three augmentation techniques (chinbone with or without a Bio-Gide® membrane and Bio-Oss® with a Bio-Gide® membrane) on the clinical and radiographic characteristics of hard and soft tissues around implants and adjacent teeth in the reconstructed maxillary anterior region, up to 1 year after functional loading. Materials and methods: Ninety-three patients requesting single-tooth replacement and presenting with a horizontal (bucco-palatinal) bone deficiency were included. After augmentation, 93 ITI-EstheticPlus implants were placed. Clinical variables, standardized photographs and radiographs were analysed to assess the impact on the levels of the marginal gingiva (MGL) and marginal bone (MBL) around implants and adjacent teeth, viz at pre-augmentation, pre-implantation (TPI) and 1 (T1) and 12 (T12) months after final crown placement. Results: Implant survival was 97.8%. No significant differences were observed in the treatment outcomes of the three augmentation modalities. Combining the three modalities, a slight but significant increase in the implants approximal pocket depth was found between T1 and T12. Approximal bone loss at the implant between T1 and T12 was 0.14 ± 0.76 mm (mesial) and 0.14 ± 0.47 mm (distal); the approximal MGL slightly increased (mesial: 0.24 ± 0.46 mm, distal: 0.25 ± 0.66 mm), and the buccal MGL decreased (0.11 ± 0.61 mm). Bone loss at the adjacent teeth, although minor, was significant between TPI and T1. No correlations were observed in changes of MBL and MGL. Conclusions: None of the three applied augmentation technique procedures influenced the characteristics of the MGL and MBL or the implant survival of single-tooth replacements. Peri-implant hard and soft tissues were very stable in the first year after loading. [source]

Variation in the TNF Gene Promoter and Risk of Osteolysis After Total Hip Arthroplasty

JOURNAL OF BONE AND MINERAL RESEARCH, Issue 11 2003
FRCS, J Mark Wilkinson PhD
Abstract Genetic factors may influence implant failure caused by osteolysis after THA. In an association study of 481 subjects after THA, we found that carriage of the TNF - 238A allele was associated with an increased incidence of osteolysis versus noncarriage (odds ratio, 1.7) and was independent of other risk factors. Genetic and environmental factors influence implant survival after THA. Introduction: Tumor necrosis factor (TNF) is thought to play a role in osteolysis, the major cause of implant failure after total hip arthroplasty (THA). Natural sequence variations at ,238 and ,308 in the TNF gene promoter are associated with differences in susceptibility to several TNF-mediated diseases. We tested whether these polymorphisms are associated with osteolysis after THA. Materials and Methods: A total of 481 whites (214 with failed versus 267 with intact implants) were recruited 11.7 ± 4 years after cemented THA. Genomic DNA was extracted from peripheral blood and genotyped for the ,238 and ,308 polymorphisms using the Taqman 5, nuclease method. Healthy controls (n = 500) from the background population were also genotyped to establish the local prevalence of these alleles. Results: The carriage of ,238A was 8.8% in the background population and 10.9% in the THA controls (p > 0.05). Carriage of ,238A in the osteolysis group was 17.3% (odds ratio, 1.7; 95% CI, 1.0,2.9). Carriage was highest (20.5%) in patients with more widespread osteolysis (OR, 2.1; 1.2,3.8). The association of ,238A with osteolysis was independent of other risk factors for osteolysis (logistic regression analysis: OR, 1.8; 1.0,3.2). Carriage of ,308A was not associated with osteolysis. Conclusion: Genetic, as well as environmental factors, influence implant failure after THA. Whether the TNF - 238 polymorphism causes a biological change that predisposes to loosening or is in linkage disequilibrium with such a locus is not yet known. [source]

A systematic review of the success of sinus floor elevation and survival of implants inserted in combination with sinus floor elevation

JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 2008
Part I: Lateral approach
Abstract Objectives: The objectives of this systematic review were to assess the survival rate of grafts and implants placed with sinus floor elevation. Material and Methods: An electronic search was conducted to identify studies on sinus floor elevation, with a mean follow-up time of at least 1 year after functional loading. Results: The search provided 839 titles. Full-text analysis was performed for 175 articles resulting in 48 studies that met the inclusion criteria, reporting on 12,020 implants. Meta-analysis indicated an estimated annual failure rate of 3.48% [95% confidence interval (CI): 2.48%,4.88%] translating into a 3-year implant survival of 90.1% (95% CI: 86.4%,92.8%). However, when failure rates was analyzed on the subject level, the estimated annual failure was 6.04% (95% CI: 3.87%,9.43%) translating into 16.6% (95% CI: 10.9%,24.6%) of the subjects experiencing implant loss over 3 years. Conclusion: The insertion of dental implants in combination with maxillary sinus floor elevation is a predictable treatment method showing high implant survival rates and low incidences of surgical complications. The best results (98.3% implant survival after 3 years) were obtained using rough surface implants with membrane coverage of the lateral window. [source]

Immediate single-tooth implants in the anterior maxilla: a 1-year case cohort study on hard and soft tissue response

JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 7 2008
Tim 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]

Monitoring surgical performance: an application to total hip replacement

JOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 3 2009
David J. Biau MD
Abstract Rationale, aims and objectives, Inadequate surgical implantation of a hip replacement may result in decreased patient satisfaction and reduced implant survival. The objective was to monitor surgical performance in hip replacement. Method, The study took place at a teaching centre. All primary total hip replacements were prospectively included in the series. For each hip replacement, intraoperative technical errors, cup and stem fixation and position, and postoperative complications were recorded. If all items rated were correct, the procedure was considered as correct. The Cumulative Sums (CUSUM) test was used to monitor the performance of the centre. A 90% proportion of successful procedures was considered as adequate performance and a 75% proportion of successful procedures was deemed as inadequate performance. Meetings were conducted to discuss the results of monitoring. Results, Eighty-three total hip replacements were monitored. Overall, 28 procedures (34%) were considered inadequate. The most potent reasons for inadequate performance were cup positioning and stem fixation. The CUSUM test signalled after the second procedure that performance was inadequate. After the first meeting, despite an improvement was seen, the CUSUM test raised an alarm indicating inadequate performance. The study was stopped after the second meeting because of funding reasons before it could be demonstrated that performance had reached the desired level. Conclusion, This study has demonstrated that implementing a dedicated system to monitor surgical performance in a teaching hospital improves the quality of implantation of total hip replacements. Nonetheless, the target of ninety percent of adequate primary total hip replacement could not be reached and efforts should be continued. [source]

THA loading arising from increased femoral anteversion and offset may lead to critical cement stresses

JOURNAL OF ORTHOPAEDIC RESEARCH, Issue 5 2003
Ralf U. Kleemann
Abstract Aseptic loosening of artificial hip joints is believed to be influenced by the design and orientation of the implant. It is hypothesised that variations in implant anteversion and offset lead to changes in the loading of the proximal femur, causing critical conditions to both the bone and cement. The goal of this study was therefore to analyse the role of these parameters on loading, bone strains and cement stresses in total hip arthroplasty (THA). A validated musculo-skeletal model was used for the analysis of muscle and joint contact forces during walking and stair climbing. Two different anteversion angles (4° vs. 24°) and prostheses offsets (standard vs. long) were analysed. The loads for each case were applied to a cemented THA finite element model. Generally, stair climbing caused higher bone strains and cement stresses (max. +25%) than walking. Variations in anteversion and offset caused changes in the loading environment, bone strain distribution and cement stresses. Compared to the standard THA configuration, cement stresses were raised by increasing anteversion (max. +52%), offset (max. +5%) and their combination (max. +67%). Femoral anteversion, offset and their combination may therefore lead to an increased risk of implant loosening. Analyses of implant survival should consider this as a limiting factor in THA longevity. In clinical practice, implant orientation, especially in regard to pre- and post-operative anteversion, should be considered to be more critical. © 2003 Orthopaedic Research Society. Published by Elsevier Science Ltd. All rights reserved. [source]

Outcomes of dental implants placed in a surgical training programme

A retrospective analysis of 1000 consecutively placed implants in private practice

AUSTRALIAN DENTAL JOURNAL, Issue 2 2009
KC Nixon
Abstract Background:, There have been numerous reports evaluating clinical outcomes of implants placed in institutional settings, but there are few studies relating to implants placed in private practice. The aim of this retrospective study was to analyse the clinical outcomes of 1000 consecutively placed Straumann implants in private specialist periodontal practice. Methods:, A hand-search of patient records was undertaken to identify 1000 consecutively placed implants. Data extracted included patient demographics, details of implants placed, implant sites, timing of placement after extraction, hard and soft tissue augmentation procedures, loading protocols, type of prostheses and treatment outcomes (implant survival, implant success and complications). Results:, The majority of implants (71.5 per cent) placed in patients aged 40 to 69, and the majority of patients (88.6 per cent) received 1 or 2 implants. During the period of the study, 9 implants were lost and 45 presented with complications requiring chairside intervention. A life table analysis showed 5 and 10-year cumulative survival rates of 99.2 per cent and 98.4 per cent respectively, and 5 and 10-year cumulative success rates of 93.1 per cent and 90.9 per cent respectively. Conclusions:, With careful treatment planning and adherence to recommended surgical and prosthetic protocols, high implant survival and success rates can be achieved in a private practice setting. [source]

Implant Placement in Patients with Oral Bisphosphonate Therapy: A Case Series

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 3 2010
Ghasem 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]

Parameters for Successful Implant Integration Revisited Part I: Immediate Loading Considered in Light of the Original Prerequisites for Osseointegration

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 2010
FACD, Oded Bahat BDS
ABSTRACT Purpose: With the increasing popularity and publication of loading implants at the time of placement, including at time of dental extraction and simultaneous with reconstructive procedures, the objective was to evaluate known variables identified for a traditional unloaded healing period and determine the applicability of these variables to immediate loading. Materials: A total of 124 published reports available as of January 2008 that contained information about loading from the time of surgery up to 3 months postsurgically were examined in light of published variables affecting osseointegration based on a 2 stage surgical approach. Methods: The articles were examined to differentiate between immediate loading (within the initial 48 hours) and early/delayed loading of implants. Success or survival criteria were noted, and where reasons for failure were available, categorized according to six variables considered as determinants for maintaining a long-term bone-to-implant contact. Results: Approximately 60 of the 124 reports described immediately loading implants within 48 with single-tooth, partial, and full-arch restorations, as well as implant overdentures. The implant success or survival rates ranged from 70.8% to 100%. Most studies considered implant survival to be the only criterion for success. Conclusions: Of six parameters identified in 1981 as influencing osseointegration, two parameters (the status of the bone/implant site and implant loading conditions) appear to have diagnostic implications, whereas three (implant design, surgical technique, and implant finish) may affect immediate loading positively or adversely. [source]

Parameters for Successful Implant Integration Revisited Part II: Algorithm for Immediate Loading Diagnostic Factors

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 2010
FACD, Oded Bahat BDS
ABSTRACT Immediate loading of dental implants has become a widely reported practice with success rates ranging from 70.8% to 100%. Although most studies have considered implant survival to be the only measure of success, a better definition includes the long-term stability of the hard and soft tissues around the implant(s) and other adjacent structures, as well as the long-term stability of all the restorative components. The parameters identified in 1981 by Albrektsson and colleagues as influencing the establishment and maintenance of osseointegration have been reconsidered in relation to immediate loading to improve the chances of achieving such success. Two of the six parameters (status of the bone/implant site and implant loading conditions) have preoperative diagnostic implications, whereas three (implant design, surgical technique, and implant finish) may compensate for less-than-ideal site and loading conditions. Factors affecting the outcome of immediate loading are reviewed to assist clinicians attempting to assess its risks and benefits. [source]

Minimally Invasive Antral Membrane Balloon Elevation , Results of a Multicenter Registry

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 2009
Efraim 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]

Outcome of Oral Implant Treatment in Partially Edentulous Jaws Followed 20 Years in Clinical Function

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 4 2006
Odont Dr/PhD, Ulf Lekholm DDS
ABSTRACT Background:, Most long-term follow-up studies of implants in partially edentulous jaws present their outcomes as mean values of implant survival and follow-up time, and few address the fate of the remaining teeth. Purpose:, The aim of this study was to investigate the results of oral implant treatment in partially edentulous jaws after 20 years, and simultaneously to assess what happens to teeth present at the time of implant placement. Materials and Methods:, Seventeen partially edentulous patients, of 27 originally treated individuals, were retrospectively reviewed after receiving implants from 1983 to 1985. The parameters studied were implant survival, prosthesis stability, marginal bone loss at teeth and implants, treatment complications, need for dental treatment, and patient's satisfaction with the outcome. Results:, The cumulative survival rate was 91%, when all 27 patients were assessed, that is, including the 10 dropouts. Of the 69 inserted and followed implants (Brånemark system®; Nobel Biocare AB, Göteborg, Sweden), six failed (8.7%) during the 20-year period, four during the first decade, and the remaining two during the second. A majority (n=4) of the losses were due to implant fractures, two after 8 years, and two after 17 years. In all, 10 of the original fixed bridges being followed (n=24) remained in function during the entire investigation period, whereas 12 were exchanged for new constructions after an average of 7 years. The mean marginal bone loss at teeth was 0.7 mm, and at implants it was 1.0 mm. The major complication observed during the second decade was veneer material fractures, which occurred 14 times in six patients. Component loosening and abutment- and bridge-locking screw fractures were the second most common problems seen, indicating material/component fatigue. Most patients were satisfied with their treatment and many mentioned that they did not think of the constructions as anything but a part of their own body. Conclusion:, Over the decades, treatment of partially edentulous jaws with turned titanium implants seems to function well and to provide patients with good support for fixed short-span bridge constructions. [source]

Minimally Invasive Flapless Implant Surgery: A Prospective Multicenter Study

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 2005
ODhc, William Becker DDS
ABSTRACT Background: Placement of implants with a minimally invasive flapless approach has the potential to minimize crestal bone loss, soft tissue inflammation, and probing depth adjacent to implants and to minimize surgical time. Purpose: The aim of this multicenter study was to evaluate implant placement using a minimally invasive one-stage flapless technique up to 2 years. Materials and Methods: Fifty-seven patients ranging in age from 24 to 86 years were recruited from three clinical centers (Tucson, AZ, USA; Tel Aviv, Israel; Göteborg, Sweden). Seventy-nine implants were placed. A small, sharp-tipped guiding drill was used to create a precise, minimally invasive initial penetration through the mucosa and into bone (Nobel Biocare, Yorba, Linda, CA, USA). Implants were placed according to the manufacturer's instructions, with minimal countersinking. The parameters evaluated were total surgical time, implant survival, bone quality and quantity, implant position by tooth type, depth from mucosal margin to bone crest, implant length, probing depth, inflammation, and crestal bone changes. At 2 years, for 79 implants placed in 57 patients, the cumulative success rate using a minimally invasive flapless method was 98.7%, indicating the loss of 1 implant. Changes in crestal bone for 77 baseline and follow-up measurements were insignificant (radiograph 1: mean 0.7 mm, SD 0.5 mm, range 2.8 mm, minimum 0.2 mm, maximum 3.0 mm; radiograph 2: mean 0.8 mm, SD 0.5 mm, range 3.4 mm, minimum 0.12 mm, maximum 3.5 mm). Using descriptive statistics for 78 patients (one implant lost), mean changes for probing depth and inflammation were clinically insignificant. The average time for implant placement was 28 minutes (minimum 10 minutes, maximum 60 minutes, SD 13.1 minutes). Average depth from mucosal margin to bone was 3.3 mm (SD 0.7 mm, minimum 2 mm, maximum 5 mm, range 3 mm). Thirty-two implants were placed in maxillae and 47 in mandibles. Conclusions: The results of this study demonstrate that following diagnostic treatment planning criteria, flapless surgery using a minimally invasive technique is a predictable procedure. The benefits of this procedure are lessened surgical time; minimal changes in crestal bone levels, probing depth, and inflammation; perceived minimized bleeding; and lessened postoperative discomfort. [source]

Prospective Follow-Up Study of 95 Patients with Edentulous Mandibles Treated According to the Branemark Novum Concept

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 1 2003
Per Engstrand DDS
ABSTRACT Background: The long-term predictability reported with the traditional two-staged Brånemark method has led to developments aimed at simplifying the technique and reducing healing time. Results from a pilot study using the Brånemark Novum concept are promising, and it has been shown possible to fabricate and deliver an implant-supported fixed prosthesis to the patient on the day of surgery. Purpose: The objective of this study is to report clinical and radiographic outcomes in a group of patients treated according to the Brånemark Novum concept. Materials and Methods: Ninety-five patients with edentulous mandibles were consecutively included in the study. Three specially designed fixtures were placed in each patient (285 fixtures in total) using drilling templates. The fixtures were immediately splinted with a prefabricated substructure, and fixed prostheses were delivered the same day in 67% of the patients. For the rest, prosthesis delivery ranged from 1 to 40 days (mean 5.6 d). Clinical and radiographic examinations were performed after 3 months, 6 months, 1 year, and then annually. The follow-up time was 1 to 5 years (mean 2.5 yr). Results: The cumulative prosthesis survival rate was 99%. Eighteen fixtures (6.3%) failed in 13 patients. Kaplan-Meier survival estimates demonstrated a probability implant survival at 1 year of 95.0% (94 patients), at 3 years of 93.3% (47 patients), and at 5 years of 93.3% (9 patients). The mean bone loss was 0.73 mm between the examinations at 3 months and 1 year, 0.16 mm during the second year, and 0.13 mm annually during years 3 to 5. Conclusions: Comparable results, related to continuous prosthesis stability, were shown for the Novum approach compared with the traditional two-staged procedure. Survival of individual fixtures is lower when immediate loading is applied. [source]

Ten-Year Results of a Prospective Study Using Porous-Surfaced Dental Implants and a Mandibular Overdenture

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 4 2002
Douglas Deporter DDS
ABSTRACT Background: Numerous investigators have used osseointegrated dental implants as retention for mandibular overdentures, but few have reported 10-year outcomes or incorporated carefully standardized radiographs to document crestai bone loss. Purpose: The purpose of this study was to use a prospective clinical trial design to assess the performance of short sintered porous-surfaced dental implants with a mandibular complete overdenture when all patients in the trial had undergone 10 years of continuous function. Materials and Methods: Fifty-two fully edentulous patients, most with advanced alveolar ridge resorption, each received three free-standing Endopore implants (7,10 mm in length, mean length, 8.7 mm; Innova Corporation, Toronto, ON, Canada) in the mandibular symphysis region. After 10 weeks of submerged healing, these implants were used to support an overdenture. Carefully standardized radiographs, using a customized stainless steel filmholder attached to each implant and the x-ray tube, were collected at baseline, 3 months, 6 months, yearly to 5 years, and then again at 7 and 10 years. Results: Life table analysis revealed a 10-year implant survival of 92.7% and a mean annual bone loss after year 1 of 0.03 mm. Conclusion: Short free-standing dental implants with a sintered porous surface used for implant fixation are a predictable and effective means of retaining a mandibular overdenture in patients with advanced mandibular ridge resorption. [source]

Clinical and radiographic characteristics of single-tooth replacements preceded by local ridge augmentation: a prospective randomized clinical trial

Immediate and early non-occlusal loading of Straumann implants with a chemically modified surface (SLActive) in the posterior mandible and maxilla: interim results from a prospective multicenter randomized-controlled study

CLINICAL ORAL IMPLANTS RESEARCH, Issue 5 2008
Axel Zöllner
Abstract Objective: Immediate and early loading of dental implants can simplify treatment and increase overall patient satisfaction. The purpose of this 3-year prospective randomized-controlled multicenter study was to assess the differences in survival rates and bone level changes between immediately and early-loaded implants with a new chemically modified surface (SLActive). This investigation shows interim results obtained after 5 months. Material and methods: Patients ,18 years of age missing at least one tooth in the posterior maxilla or mandible were enrolled in the study. Following implant placement, patients received a temporary restoration either on the day of surgery (immediate loading) or 28,34 days after surgery (early loading); restorations consisted of single crowns or two to four unit fixed dental prostheses. Permanent restorations were placed 20,23 weeks following surgery. The primary efficacy variable was change in bone level (assessed by standardized radiographs) from baseline to 5 months; secondary variables included implant survival and success rates. Results: A total of 266 patients were enrolled (118 males and 148 females), and a total of 383 implants were placed (197 and 186 in the immediate and early loading groups, respectively). Mean patient age was 46.3±12.8 years. After 5 months, implant survival rates were 98% in the immediate group and 97% in the early group. Mean bone level change from baseline was 0.81±0.89 mm in the immediate group and 0.56±0.73 mm in the early group (P<0.05). Statistical analysis revealed a significant center effect (P<0.0001) and a significant treatment × center interaction (P=0.008). Conclusions: The results suggested that Straumann implants with an SLActive can be used predictably in time-critical (early or immediate) loading treatment protocols when appropriate patient selection criteria are observed. The mean bone level changes observed from baseline to 5 months (0.56 and 0.81 mm) corresponded to physiological observations from other studies, i.e., were not clinically significant. The presence of a significant center effect and treatment × center interaction indicated that the differences in bone level changes between the two groups were center dependent. [source]

Early loading (2 or 6 weeks) of sandblasted and acid-etched (SLA) ITI® implants in the posterior mandible

CLINICAL ORAL IMPLANTS RESEARCH, Issue 2 2004
A 1-year randomized controlled clinical trial
Abstract: The aim of this 1-year prospective controlled clinical trial was to evaluate the effect of early loading of ITI® solid screw titanium implants with a sandblasted and acid-etched (SLA) surface on clinical and radiographic parameters. Material and methods: Twenty-seven consecutively admitted patients presenting bilateral edentulous posterior mandibular areas and in need of prosthetic reconstruction were recruited. Sixty-seven ITI® standard solid screw implants with an SLA surface, a diameter of 4.1 mm and a length of 8, 10 or 12 mm were installed bilaterally in molar and premolar areas according to a one-stage surgical protocol. One week (test) and 5 weeks (control) after implant placement, solid ITI® prosthetic abutments were connected using a torque of 35 N cm. No provisional restoration was fabricated. Two weeks (test) and 6 weeks (control) after implant placement, porcelain-fused-to-metal single-tooth crowns were cemented. Clinical measurements were obtained at day 0 and 2, 6, 12, 24 and 52 weeks thereafter. Periapical radiographs were taken immediately after implant placement, after 6 weeks and at the 1-year examination. Results: After 1 year, implant survival was 100%. Two test and one control implants rotated at the time of abutment connection and were left unloaded for 12 additional weeks. At the 1-year examination, no statistically significant differences were found between the test and control sites with respect to pocket probing depths (2.6 mm±0.5 vs. 2.7 mm±0.5), mean clinical attachment levels (3.1 mm±0.4 vs. 3.2 mm±0.5), mean percentages of sites bleeding on probing (9.7% vs. 8.3%), mean widths of keratinized mucosa (1.8 mm±0.4 vs. 1.9 mm±0.5), mean PerioTest® values (,1.4 PTV±0.9 vs. ,1.6 PTV±0.8) or mean crestal bone loss measurements (0.57 mm±0.49 vs. 0.72 mm±0.50). Conclusion: Based on these results, loading of titanium implants with an SLA surface as early as 2 weeks did not appear to jeopardize the osseointegration healing process in the posterior mandible. Furthermore, implants rotating at 35 N cm, if left unloaded for additional 12 weeks, did not negatively affect clinical and radiographic outcomes. Résumé Le but de cet essai clinique contrôlé prospectif d'une année a été d'évaluer l'effet de la mise en charge précoce d'implants en titane vis solide ITI® avec une surface sablée et mordancée (SLA) sur des paramètres cliniques et radiographiques. Vingt-sept patients présentant des aires bilatérales mandibulaires postérieures édentées et nécessitant donc une reconstruction prothétique ont été recrutés. Soixante-sept implants ITI® d'un diamètre de 4,1 mm et d'une longueur de 8, 10 ou 12 mm ont été placés bilatéralement dans les zones molaires et prémolaires suivant le processus chirurgical en une étape. Une semaine (test) et cinq semaines (contrôle) après leur placement des piliers prothétiques ITI® ont été serrés avec une force de 35 Ncm. Aucune restauration provisoire n'a été fabriquée. Deux semaines (test) et six semaines (contrôle) après le placement des implants des couronnes céramo-métalliques indépendantes ont été cimentées. Des mesures cliniques ont été obtenues aux jours 0 et deux, et aux semaines 6, 12, 24 et 52. Des radiographies périapicales ont été prises immédiatement après le placement des implants, après six semaines et une année. Après une année, le taux de survie implantaire était de 100%. Deux implants tests et un contrôle pivotaient au moment de la connexion du pilier et ont été laissés non-chargés pour 12 semaines supplémentaires. Après une année, aucune différence statistique n'a été trouvée entre les sites tests et contrôles en ce qui concerne les profondeurs de poches au sondage (2,6 ±0,5 mm vs 2,7± 0,5 mm), les niveaux d'attache clinique moyens (3,1±0,4 vs 3,2±0,5 mm,) les pourcentages moyens de sites saignant au sondage (9,7% vs 8,3%), les largeurs moyennes de muqueuse attachée (1,8±0,4 mm vs 1,9±0,5 mm), les valeurs Periotest moyennes (,1,4±0,9 PTV vs ,1,6 ±0,8 PTV) ou les mesures de perte osseuse crestale moyennes (0,57 ± 0,49 mm vs 0,72±0,52 mm). La charge d'implants en titane avec surface SLA aussitôt que deux semaines après leur placement ne semblait pas mettre en danger le processus d'ostéoïntégration dans la partie postérieure de la mandibule. De plus, les implants pivotant à 35 Ncm, si laissés non-chargés pour douze semaines supplémentaires, n'affectaient pas de manière négative les mesures cliniques et radiographiques. Zusammenfassung Material und Methoden: Es wurden siebenundzwanzig Patienten mit beidseits zahnlosem Seitenzahnbereich im Unterkiefer, welche eine prothetische Versorgung benötigten, in die Studie aufgenommen. Es wurden 67 ITI® Standard Vollschraubenimplantate mit einem Durchmesser von 4.1 mm und einer Länge von 8, 10 oder 12 mm beidseits in der Molaren- und Prämolarenregion transmukosal eingesetzt. Eine Woche (Test) und 5 Wochen (Kontrolle) nach Implantation wurden ITI® Massivsekundärteile mit einem Drehmoment von 35 Ncm eingesetzt. Es wurde keine provisorische Versorgung angefertigt. Zwei Wochen (Test) und 6 Wochen (Kontrolle) nach Implantation wurden Gold-Porzellan Einzelkronen einzementiert. Klinische Messungen wurden am Tag 0 und nach 2, 6, 12, 24, und 52 Wochen aufgenommen. Periapikale Röntgenaufnahmen wurden sofort nach der Implantation, nach 6 Wochen und anlässlich der 1 Jahreskontrolle angefertigt. Resultate: Nach einem Jahr betrug die Implanta-tüberlebensrate 100%. Zwei Test- und ein Kontrollimplantat drehten sich beim Einschrauben der Sekundärteile und wurden für zusätzliche 12 Wochen unbelastet belassen. Bei der 1 Jahresuntersuchung konnten zwischen Test- und Kontrolli-mplantaten keine statistisch signifikanten Unterschiede bezüglich Sondierungswerten (2.6mm+/,0.5 gegenüber 2.7mm +/,0.5), mittlerem klinischem Attachmentniveau (3.1mm +/,0.4 gegenüber 3.2mm +/,0.5), mittlerem Prozentanteil beim Bluten auf Sondieren (9.7% gegenüber 8.3%), mittlerer Breite der keratinisierten Mukosa (1.8mm +/,0.4 gegenüber 1.9mm +/,0.5), mittleren Periotest® Werten (,1.4 PTV +/,0.9 gegenüber ,1.6 PTV +/,0.8) oder mittlerem marginalem Knochenverlust (0.57mm +/,0.49 gegenüber 0.72mm +/,0.50) gefunden werden. Schlussfolgerung: Gemäss dieser Resultate schien die Belastung von Titanimplantaten mit SLA Oberfäche bereits nach 2 Wochen den Heilungsprozess der Osseointegration im posterioren Unterkiefer nicht zu beeinträchtigen. Implantate, die bei 35Ncm rotierten und daraufhin für weitere 12 Wochen unbelastet blieben, beeinflussten die klinischen und radiologischen Resultate nicht negativ. Resumen La intención de este ensayo clínico prospectivo controlado fue evaluar el efecto de una carga temprana sobre implantes macizos roscados de titanio con una superficie pulverizada con arena y gravada con ácido (SLA) sobre parámetros clínicos y radiográficos. Material y Métodos: Se reclutaron veintisiete pacientes consecutivamente admitidos que presentaron áreas edéntulas bilaterales en la mandíbula posterior y necesitando reconstrucción protésica. Se instalaron bilateralmente en las áreas molar y premolar sesenta y siete implantes ITI® estándar macizos roscados de titanio con una superficie SLA, un diámetro de 4.1 mm y una longitud de 8, 10 o 12 mm de acuerdo con un protocolo quirúrgico de una sola fase. Una semana (prueba) y 5 semanas (control) tras la colocación del implante, se conectaron pilares prostéticos macizos ITI usando un torque de 35 Ncm. No se fabricaron restauraciones provisionales. Dos semanas (prueba) y 6 semanas (control) tras la colocación de los implantes, se cementaron coronas unitarias metalocerámicas. Se obtuvieron medidas clínicas en el día 0 y tras 2, 6, 12, 24 y 52 semanas. Se tomaron radiografías periapicales inmediatamente tras la colocación del implante, a las 6 semanas y en el examen de 1 año. Resultados: Tras 1 año, la supervivencia de los implantes fue del 100%. Dos implantes de prueba y uno de control rotaron en el momento de la conexión del pilar y se dejaron sin carga durante 12 semanas más. En el examen de 1 año, no se encontraron diferencias significativas entre los lugares de prueba y los de control respecto a las profundidades de sondaje (2.6 mm±0.5 vs. 2.7 mm±0.5), niveles medios de inserción clínica (3.1±mm±0.4 vs. 3.2 mm±0.5), porcentaje medio de lugares con sangrado al sondaje (9.7% vs. 8.3%), anchura media de mucosa queratinizada (1.8 mm±0.4 vs. 1.9 mm±0.5), valores medios de Perio Test® (,1.4 PTV±0.9 vs. ,1.6 PTV±0.8) o a las medidas medias de perdida de hueso crestal (0.57 mm±0.49 vs. 0.72 mm±0.50). Conclusiones: Basándose en estos resultados, la carga de implantes de titanio con superficie SLA tan pronto como a las 2 semanas no pareció comprometer el proceso de cicatrización de la osteointegración en la mandíbula posterior. Mas aun, los implantes que rotaron a 35 Ncm, si se dejan sin carga durante 12 semanas más, no afectaron negativamente los resultados clínicos y radiográficos. [source]