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Functional Loading (functional + loading)

Distribution by Scientific Domains
Medical Sciences95%

Kinds of Functional Loading

  • immediate functional loading
    		•

    Selected Abstracts

    Immediate Functional Loading of Single-Tooth TIO2 Grit-Blasted Implant Restorations: A Controlled Prospective Study in a Porcine Model.

    CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 4 2007
    Part I: Clinical Outcome
    ABSTRACT Background:, Although favorable integration occurs with immediately loaded implants, the relationship between implant outcome, levels of occlusion, and diet requires optimization. Purpose:, Pertubating load on single implant restorations immediately after placement by a hard food diet will increase the strains at the bone-implant interface, increasing the risk for failure. Materials and Methods:, Forty-eight implants replaced the first and third mandibular premolars in 12 pigs, allocated into two groups based on soft- and hard-diet feeding. Cylindrical and tapered implants replaced the first and third premolars, respectively. Each animal received at random four different masticatory loading conditions (group 1 control]: implant with either a cover screw or a healing abutment, and group 2 test]: implant with a crown either with or without occlusal contacts). Results:, Thirteen implants out of 44 failed in 11 animals (one with a cover screw, one with a healing abutment, three with nonocclusal, and eight with occlusal restorations). The failure rate of restored implants (either in occlusion or not) was significantly higher in the third premolar sites (p=.007), although diet had no significant effect (p=.421). Conclusions:, While diet had no effect on the failure pattern of immediately loaded single implants, the position and type of load under the masticatory mode were significant. Immediately loaded implants both in and out of occlusion were less successful than the controls, and this is probably attributed to detrimental strain induced on the bone-implant interface. [source]

    Early Functional Loading of Unsplinted Roughened Surface Implants with Mandibular Overdentures 2 Weeks after Surgery

    CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 3 2003
    Alan G.T. Payne BDS, FCD (SA), MDent
    ABSTRACT Background: Before early functional loading of unsplinted implants with mandibular overdentures can become widespread, more clinical studies are needed to investigate the success of the approach. Purpose: To evaluate the success rates of two types of roughened titanium surface implants with early 2-week functional loading of paired mandibular interforaminal implants with overdentures. Materials and Methods: Random allocation divided 24 strictly selected edentulous participants into two groups, with each group to receive a different implant system (ITI Dental Implant System, Straumann AG, Waldenburg, Switzerland; or Southern Implant System, Southern Implants, Irene, South Africa). Two implants were placed in the anterior mandible of all participants using one-stage standardized surgical procedures. Previously constructed conventional mandibular dentures (opposing maxillary complete dentures) were temporarily relined and worn by the participants for the first 2 weeks; participants used a soft diet. Two weeks after implant surgery and following some mucosal healing, the mandibular dentures had the tissue conditioner removed and the appropriate matrices included for an unsplinted prosthodontic design. Results: No implant from either group was lost. Resonance frequency analysis (RFA) indicated higher primary stability at surgery for the Southern group than for the ITI group, with a statistically significant difference between the groups throughout the study period. The drop in RF values between surgery and 6 weeks was significant and was greater for the Southern group. RFA also indicated stabilized osseointegration between 6 to 12 and 12 to 52 weeks, with no participant showing any decrease in those values over time. Participants with type 3 bone showed a significant improvement in RF values between 12 and 52 weeks, eventually matching those of participants with type 2 bone. There were no significant differences in marginal bone loss, periimplant parameters, or prosthodontic maintenance between the groups over the study period. Conclusions: Using only strict patient selection criteria, 1-year follow-up data indicate that early functional loading of ITI and Southern implants with mandibular two-implant overdentures is possible as early as 2 weeks after implant surgery. [source]

    Early Functional Loading of Brånemark Dental Implants: 5-Year Clinical Follow-up Study

    CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 2 2000
    Ingvar Ericsson DDS
    ABSTRACT Background: Short-term clinical studies have indicated the possibility of one-stage surgery and early loading of machined titanium implants. However, long-term data comparing the outcome to the conventional two-stage technique are missing. Purpose: A clinical and radiographic study was performed to compare the outcome of oral rehabilitation of the endentulous mandible by fixed suprastructures connected to implants installed according to either (1) a one-stage surgical procedure and early loading (experimental group - EG) or (2) the original two-stage concept (reference group - RG). The EG and RG comprised 16 and 11 subjects, respectively. Materials and Methods: The following specific inclusion criterion were adopted: (1) all patients had to consider themselves to be in good general health, (2) the amount of bone had to enable the installation of five to six, at least 10-mm long fixtures (Mk II fixtures; Nobel Biocare AB, Göteborg, Sweden) between the mental foramina, and (3) the patients had to be available for the follow-up and maintenance program. A total of 88 implants were placed in the EG compared to 30 in the RG. In the EG, fixed appliances were connected to the implants within 20 days following implant installation while the fixed appliances in the RG were connected about 4 months following fixture installation. At delivery of the suprastructures, all patients were radiographically examined, an examination that was repeated at the 18- and 60-month follow-ups. Results: The analysis of the radiographs from the EG disclosed that during the observation period, between 18 and 60 months, the mean loss of bone support amounted to 0.2 mm (SD = 0.4). The corresponding value observed in the RG was 0.0 mm (SD = 0.5). During the 60-month observation period, no fixture was lost in any of the two groups examined. The implants under study as well as those in the reference material were at all observation intervals found to be clinically stable. Conclusions: This clinical study demonstrated that it is, at least based on a 5-year observation period, possible to successfully load via a permanent fixed rigid cross-arch suprastructure titanium dental implants soon after installation. However, such a treatment approach has to be strictly limited to the interforamina area of the endentulous mandible. Furthermore, the bone resorption was found to be within the same range around such implants as around implants installed and loaded according to the original two-stage protocal. [source]

    Perspective: Postmenopausal Osteoporosis as a Failure of Bone's Adaptation to Functional Loading: A Hypothesis,

    JOURNAL OF BONE AND MINERAL RESEARCH, Issue 11 2001
    Lance Lanyon
    Abstract There is substantial evidence that bones' ability to withstand functional loading without damage depends on the processes of bone modeling and remodeling, which are responsible for establishing and maintaining bone architecture, being influenced by a feedback mechanism related to the control of functional strains. It is probably useful to consider the diminished ability to maintain bone strength in postmenopausal osteoporosis as a failure of this mechanism. Acceptance of this approach would not only increase understanding of the etiology of postmenopausal osteoporosis but also significantly influence the ways in which it is investigated and treated. This would not mean that the many other factors affecting bone mass and bone cell activity will be ignored, but rather these factors will be put in perspective. Research to prevent or treat osteoporosis could be directed usefully to understanding how osteoblasts, lining cells, and osteocytes respond to mechanically derived information and how these responses are converted into stimuli controlling structurally appropriate modeling and remodeling. Evidence suggesting that early strain-related responses of bone cells in males and females involve the estrogen receptor (ER) could explain decreased effectiveness of this pathway when ER levels are low. [source]

    Mandibular overdentures supported by two Brånemark, IMZ or ITI implants: a ten-year prospective randomized study

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 9 2009
    Henny J. A. Meijer
    Abstract Objectives: The aim of this prospective comparative study was to evaluate the survival rate, condition of peri-implant tissues, patient satisfaction and surgical and prosthetic aftercare of the IMZ-implant system (two-stage cylinder type), the Brånemark-implant system (two-stage screw type) and the ITI-implant system (one-stage screw type) supporting a mandibular overdenture during a 10-year follow-up period. Materials and Methods: Three groups of 30 edentulous patients were treated with two endosseous implants in the interforaminal region of the mandible. Clinical and radiographic parameters were evaluated immediately after completion of the prosthetic treatment and after 1, 5 and 10 years of functional loading. Prosthetic and surgical aftercare was scored during the evaluation period, as well as patient satisfaction. Results: The 10-year survival rate was 93% for the IMZ group, 98% for the Brånemark group and 100% for the ITI group (IMZ[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]

    A systematic review of the success of sinus floor elevation and survival of implants inserted in combination with sinus floor elevation Part II: Transalveolar technique

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 2008
    Wah Ching Tan
    Abstract Objectives: The objectives of this systematic review were to assess the survival rate of implants placed in sites with transalveolar sinus floor elevation. Material and Methods: An electronic search was conducted to identify prospective and retrospective cohort studies on transalveolar sinus floor elevation, with a mean follow-up time of at least 1 year after functional loading. Failure and complication rates were analyzed using random-effects Poisson regression models to obtain summary estimates/ year proportions. Results: The search provided 849 titles. Full-text analysis was performed for 176 articles, resulting in 19 studies that met the inclusion criteria. Meta-analysis of these studies indicated an estimated annual failure rate of 2.48% (95% confidence interval (95% CI): 1.37,4.49%) translating to an estimated survival rate of 92.8% (95% CI): 87.4,96.0%) for implants placed in transalveolarly augmented sinuses, after 3 years in function. Furthermore, subject-based analysis revealed an estimated annual failure of 3.71% (95% CI: 1.21,11.38%), translating to 10.5% (95% CI: 3.6,28.9%) of the subjects experiencing implant loss over 3 years. Conclusion: Survival rates of implants placed in transalveolar sinus floor augmentation sites are comparable to those in non-augmented sites. This technique is predictable with a low incidence of complications during and post-operatively. [source]

    Bone reactions to longstanding functional load at implants: an experimental study in dogs

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 9 2005
    T. Berglundh
    Abstract Objectives: The aims of the present investigation were (i) to study marginal bone level alterations following implant installation, abutment connection and functional loading and (ii) to analyse bone tissue reactions to functional load. Material and Methods: Six beagle dogs, about 1-year old, were used. All mandibular pre-molars were extracted. Three months later four implants of the Astra Tech Implants® Dental System were installed in one side of the mandible and four standard fixtures of the Brånemark System® were placed in the contralateral side of the mandible. Abutment connection was performed 3 months later and a plaque control programme was initiated. Three months after abutment connection fixed partial dentures (FPDs) made in gold were cemented to the maxillary canines and pre-molars. FPDs were also connected to the three posterior implants in each side of the mandible, while the mesial implant in each side was used as an unloaded control. Radiographs were obtained from all implant sites following implant installation, abutment connection and FPD placement. Ten months after the FPD placement the radiographic examination was repeated. The animals were sacrificed and biopsies from all implant sites were obtained and prepared for histological analysis. Results: The radiographic analysis revealed that largest amount of bone loss occurred following implant installation and abutment connection and that this loss was more pronounced at Brånemark than at Astra implants. The bone level alterations that were observed at implants exposed to 10 months of functional load in both implant systems were small and did not differ from control sites. The histological analysis revealed that implants exposed to functional load exhibited a higher degree of bone-to-implant contact than control implants in both implant systems. Conclusion: It is suggested that functional load at implants may enhance osseointegration and does not result in marginal bone loss. [source]

    Calcium Phosphate-Based Resorbable Ceramics: Influence of MgO, ZnO, and SiO2 Dopants

    JOURNAL OF THE AMERICAN CERAMIC SOCIETY, Issue 9 2006
    Amit Bandyopadhyay
    Resorbable calcium phosphate (CaP)-based biomaterials are important because they can significantly improve health care by shortening the time necessary for restoration of functional loading of grafted bones. Although synthetic CaPs show exceptional similarities to natural bone, however, they are deficient in one major area, in that they do not have the same mineral content of bone. The focus of our work is to understand the influence of dopants on the physical, mechanical, and biological properties of tricalcium phosphate (TCP) resorbable ceramics with special emphasis toward in vitro strength degradation and cell,materials interactions as a function of time. For this purpose, ,-TCP was doped with magnesia (MgO), zinc oxide (ZnO), and silica (SiO2). Those dopants were added as individual dopants, and their binary and ternary compositions. It was found that these dopants significantly influenced densification behavior and as sintered microstructures of TCP. In vitro mineralization studies in simulated body fluids (SBF) for 12 weeks showed apatite growth on the highly porous compositions either on the surface or inside. From scanning electron microscopic analysis it was evident that surface degradation occurred on all compositions in SBF. Compression strengths for samples up to 12 weeks in SBF showed that it is possible to tailor strength loss behavior through compositional modifications. The highest compression strength was found for binary MgO,ZnO doped TCP. Overall, samples showed either a similar strength level during the 12 weeks test period, or a continuous decrease or a continuous increase in strength depending on dopant chemistry or amount. In vitro human osteoblast cell culture was used to determine influence of dopants on cell-materials interactions. All samples were non-toxic and biocompatible. Dopant chemistry also influenced adhesion, proliferation, and differentiation of osteoblastic precursor cell line 1 (OPC1) cells on these matrices. [source]

    A New Technique for Reconstruction of the Atrophied Narrow Alveolar Crest in the Maxilla Using Morselized Impacted Bone Allograft and Later Placement of Dental Implants

    CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 2 2008
    Per Holmquist DDS
    ABSTRACT Background: In cases when the alveolar crest is too narrow to host an implant, lateral augmentation is required. The use of autogenous bone blocks harvested from the iliac crest is often demanded. One disadvantage is the associated patient morbidity. Purpose: The purpose of this study was to clinically and histologically evaluate the use of morselized impacted bone allograft, a novel technique for reconstruction of the narrow alveolar crest. Materials and Methods: Two patients with completely edentulous maxillae and one partially edentulous, with a mean age of 77 years (range 76,79 years) were included in the study. The alveolar crest width was <3 mm without possibility to place any implant. Bone grafts were taken from a bone bank in Gävle Hospital. Bone from the neck of femur heads was milled to produce bone chips. The milled bone was partially defatted by rinsing in 37°C saline solution. After compression of the graft pieces with a size of 15 mm (height), 30 mm (length), and 6 mm (width), they were then fit to adapt to the buccal surface of the atrophied alveolar crest. One piece was placed to the right and one to the left side of the midline. On both sides fibrin glue was used (Tisseel®, Baxter AG, Vienna, Austria) to stabilize the graft. After 6 months of graft healing, dental implants were placed, simultaneously biopsies were harvested and in one patient two oxidized microimplants were placed. At the time of abutment connection, microimplants were retrieved with surrounding bone for histology. Fixed screw-retained bridges were fabricated in mean of 7 months after implant surgery. Radiographs were taken before and after implant surgery and after 1 year of loading. Results: Sixteen implants with an oxidized surface were placed (TiUnite®, Nobel Biocare AB, Göteborg, Sweden). After 1 year of functional loading, all implants were clinically stable. The marginal bone loss was 1.4 mm (SD 0.3) after 1 year of loading. The histological examination showed resorption and subsequent bone formation on the allograft particles. There were no signs of inflammatory cell infiltration in conjunction with the allograft. The two microimplants showed bone formation directly on the implant surface. Conclusions: This study shows that morselized impacted bone allograft can be used to increase the width of the atrophied narrow alveolar crest as a good alternative to autogenous bone grafts in elderly patients. The histological examination of biopsies revealed a normal incorporation process and no signs of an immunological reaction. Further studies with larger samples are of important to be able to conclude if equal results can be obtained using morselized impacted bone allograft as for autogenous bone graft. [source]

    Functional Restoration of Implants on the Day of Surgical Placement in the Fully Edentulous Mandible: A Case Series

    CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 1 2005
    Alexandre-Amir Aalam DDS
    ABSTRACT Purpose: The purpose of this article is to report the clinical experience and outcome of a study of the functional rehabilitation of 16 completely edentulous mandibles with immediately loaded cross-arch screw-retained hybrid prostheses at the University of Southern California. Materials and Methods: After signing informed consent forms 16 patients (9 male, 7 female) aged 47 to 84 years (mean age, 62.6 ± 11.6 years) received 90 Brånemark System® Mk III dental implants (Nobel Biocare USA, Yorba Linda, CA, USA). Stability and radiographs of the dental implants were evaluated at the time of surgery, at 3 months, at 1 year, and at 3 years post loading. Results: Three implants failed to meet the criteria of success, bringing the cumulative success rate to 96.6%, with a 100% prosthetic success rate at 3 years. Thirty-nine (43.3%) of the dental implants placed were 15 mm in length. Seventy-seven (85.5%) of the dental implants were placed in high-density bone. At 3 years post loading, the average bone loss was ,1.2 ± 0.1 mm. Conclusion: Within the limitations of this study, restoration of implants by unreinforced hybrid prostheses at the time of placement provided satisfactory results. The outcome was stable at 3 years post restoration. Mandibular rehabilitation by functional loading of the implants on the day of the insertion requires the comprehension and proper application of surgical and restorative principles. [source]

    A 5-Year Prospective Follow-Up Study of Implant-Supported Fixed Prostheses in Patients Subjected to Maxillary Sinus Floor Augmentation with an 80:20 Mixture of Bovine Hydroxyapatite and Autogenous Bone

    CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 2 2004
    Mats Hallman DDS
    ABSTRACT Background: Prospective long-term follow-up studies evaluating the use of bone substitutes to enable dental implant placement and integration are rare. Purpose: This study was undertaken to evaluate the survival rate of dental implants placed 6 months after maxillary sinus floor augmentation using a mixture of 80% bovine hydroxyapatite (BH) and 20% autogenous bone (AB). Material and Methods: Twenty patients subjected to 30 maxillary sinus floor grafting procedures using fibrin glue and an 80:20 mixture of BH and AB to enable placement of dental implants 6 months later were followed for 5 years of functional loading. Clinical and radiographic examinations of the grafts and implants were performed. Results: After 5 years of functional loading with fixed bridges, 15 of 108 implants had been lost, giving a cumulative survival rate of 86%. The mean marginal bone loss after 5 years was 1.3 ± 1.1 mm. Conclusion: Grafting of the maxillary sinus with a mixture of BH and AB and later placements of turned implants could be performed with predictable long-term results. All but one of the patients who were observed had functional fixed bridges after 5 years of functional loading. [source]

    Early Functional Loading of Unsplinted Roughened Surface Implants with Mandibular Overdentures 2 Weeks after Surgery

    CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 3 2003
    Alan G.T. Payne BDS, FCD (SA), MDent
    ABSTRACT Background: Before early functional loading of unsplinted implants with mandibular overdentures can become widespread, more clinical studies are needed to investigate the success of the approach. Purpose: To evaluate the success rates of two types of roughened titanium surface implants with early 2-week functional loading of paired mandibular interforaminal implants with overdentures. Materials and Methods: Random allocation divided 24 strictly selected edentulous participants into two groups, with each group to receive a different implant system (ITI Dental Implant System, Straumann AG, Waldenburg, Switzerland; or Southern Implant System, Southern Implants, Irene, South Africa). Two implants were placed in the anterior mandible of all participants using one-stage standardized surgical procedures. Previously constructed conventional mandibular dentures (opposing maxillary complete dentures) were temporarily relined and worn by the participants for the first 2 weeks; participants used a soft diet. Two weeks after implant surgery and following some mucosal healing, the mandibular dentures had the tissue conditioner removed and the appropriate matrices included for an unsplinted prosthodontic design. Results: No implant from either group was lost. Resonance frequency analysis (RFA) indicated higher primary stability at surgery for the Southern group than for the ITI group, with a statistically significant difference between the groups throughout the study period. The drop in RF values between surgery and 6 weeks was significant and was greater for the Southern group. RFA also indicated stabilized osseointegration between 6 to 12 and 12 to 52 weeks, with no participant showing any decrease in those values over time. Participants with type 3 bone showed a significant improvement in RF values between 12 and 52 weeks, eventually matching those of participants with type 2 bone. There were no significant differences in marginal bone loss, periimplant parameters, or prosthodontic maintenance between the groups over the study period. Conclusions: Using only strict patient selection criteria, 1-year follow-up data indicate that early functional loading of ITI and Southern implants with mandibular two-implant overdentures is possible as early as 2 weeks after implant surgery. [source]

    Effect of conical configuration of fixture on the maintenance of marginal bone level: preliminary results at 1 year of function

    CLINICAL ORAL IMPLANTS RESEARCH, Issue 4 2010
    Jung-Joo Kim
    Abstract Objectives: To evaluate and to compare the effect of the conical neck design on marginal bone loss around the fixtures, when both implants were provided with micro-threads to the top of the fixture. Materials and methods: Two types of implant, one with a straight shape (S) and the other with a conical neck design (C) provided with a retentive element to the top of the fixture, were placed adjacent to each other in the partially edentulous areas of 12 patients. Bone loss around each implant was analyzed after 1 year of functional loading. The bone losses after loading were compared using Wilcoxon's signed-rank test. Results: The mean marginal bone losses (S, 0.05±0.09 mm; C, 0.07±0.14 mm) were not statistically significant between the two groups (P=0.578). Conclusions: There was no significant difference between conical and straight neck implants in terms of marginal bone loss after 1 year of loading. To cite this article: Kim J-J, Lee D-W, Kim C-K, Park K-H, Moon I-S. Effect of conical configuration of fixture on the maintenance of marginal bone level: preliminary results at 1 year of function. Clin. Oral Impl. Res. 21, 2010; 439,444 doi: 10.1111/j.1600-0501.2009.01871.x [source]

    Radiographic evaluation of marginal bone levels adjacent to parallel-screw cylinder machined-neck implants and rough-surfaced microthreaded implants using digitized panoramic radiographs

    CLINICAL ORAL IMPLANTS RESEARCH, Issue 6 2009
    Hans-Joachim Nickenig
    Abstract Objective: The purpose of this split-mouth study was to compare macro- and microstructure implant surfaces at the marginal bone level during a stress-free healing period and under functional loading. Material and methods: From January to February 2006, 133 implants (70 rough-surfaced microthreaded implants and 63 machined-neck implants) were inserted in the mandible of 34 patients with Kennedy Class I residual dentitions and followed until February 2008. The marginal bone level was radiographically determined, using digitized panoramic radiographs, at four time points: at implant placement (baseline level), after the healing period, after 6 months of functional loading, and at the end of follow-up. Results: The median follow-up time was 1.9 (range: 1.9,2.1) years. The machined-neck group had a mean crestal bone loss of 0.5 mm (range: 0,2.3) after the healing period, 0.8 mm after 6 months (range: 0,2.4), and 1.1 mm (range: 0,3) at the end of follow-up. The rough-surfaced microthreaded implant group had a mean bone loss of 0.1 mm (range: ,0.4,2) after the healing period, 0.4 mm (range: 0,2.1) after 6 months, and 0.5 mm (range: 0,2.1) at the end of follow-up. The two implant types showed significant differences in marginal bone levels (healing period: P=0.01; end of follow-up: P<0.01). Conclusions: Radiographic evaluation of marginal bone levels adjacent to machined-neck or rough-surfaced microthreaded implants showed that implants with the microthreaded design caused minimal changes in crestal bone levels during healing (stress-free) and under functional loading. [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]

    Bone level changes at implants supporting crowns or fixed partial dentures with or without cantilevers

    CLINICAL ORAL IMPLANTS RESEARCH, Issue 10 2008
    Gian Andrea Hälg
    Abstract Objective: The aim of this study was to analyze whether or not a cantilever extension on a fixed dental prosthesis (FDP) supported by implants increased the amount of peri-implant bone loss or technical complications compared with reconstructions without cantilevers. Materials and Methods: Fifty-four partially dentate patients with a total of 54 FDPs supported by 78 implants were enrolled in the study. Twenty-seven FDPs were with cantilever and 27 FDPs were without cantilever (control group). All FDPs were supported by one or two implants and were located in the posterior maxilla or mandible. The primary outcome variable was change in peri-implant marginal bone level from the time of FDP placement to the last follow-up visit. FDPs were under functional loading for a period of 3 up to 12.7 years. Statistical analysis was carried out with Student's t -test. Regression analyses were carried out to evaluate the influence of confounding factors on the peri-implant bone level change. In addition, implant survival rates were calculated and technical complications assessed. Results: After a mean observation period of 5.3 years, the mean peri-implant bone loss for the FDPs with cantilevers was 0.23 mm (SD±0.63 mm) and 0.09 mm (SD±0.43 mm) for FDPs without cantilever. Concerning the bone level change at implants supporting FDPs with or without cantilevers no statistically significant differences were found. The regression analysis revealed that jaw of implant placement had a statistically significant influence on peri-implant bone loss. When the bone loss in the cantilever group and the control group were compared within the maxilla or mandible separately, no statistically significant difference was found. Implant survival rates reached 95.7% for implants supporting cantilever prostheses and 96.9% for implants of the control group. Five FDPs in the cantilever group showed minor technical complications, none were observed in the control group. Conclusion: Within the limitations of this study it was concluded that cantilever on FDPs did not lead to a higher implant failure rate and did not lead to more bone loss around supporting implants compared with implants supporting conventional FDPs. In contrast to these results more technical complications were observed in the group reconstructed with cantilever. [source]

    Immediate functional loading of implants in single tooth replacement: a prospective clinical multicenter study

    CLINICAL ORAL IMPLANTS RESEARCH, Issue 8 2008
    Mauro Donati
    Abstract Objectives: The aim of the present study was to evaluate the outcome of immediate functional loading of implants in single-tooth replacement using two different installation procedures. Material and Methods: One hundred and fifty-one subjects, who required single-tooth rehabilitation in the area of 15,25 and 35,45, were enrolled in eight private clinics in Italy. The implant sites were randomly allocated to one of the following treatment groups. In the control group, in which a standard preparation procedure for implant placement and submerged healing of the implant was used, abutment connection and loading of the implants were performed 3 months after installation. In the test group 1, a standard preparation procedure for the implant placement and immediate functional loading of implant was carried out. In the test 2 group, however, a modified implant installation procedure (osteotome technique) was used followed by immediate functional loading of the implant. Clinical and radiographic examinations were performed at 3 and 12 months of follow-up at all sites. Results: Three implants (5.5%) from the test 2 group (osteotome preparation) and one (2%) from the test 1 group (conventional drill preparation) failed to integrate and were removed one and three months after implant installation. The mean marginal bone loss assessed at 12 months was 0.31 mm (test 1), 0.25 mm (test 2) and 0.38 mm (control) (no statistically significant differences were found between the three treatment groups.) Conclusion: It is suggested that immediate functional loading of implants that are placed with a conventional installation technique and with sufficient primary stability may be considered as a valid treatment alternative in a single-tooth replacement. [source]

    Immediate functional loading of TiOblast dental implants in full-arch edentulous mandibles: a 3-year prospective study

    CLINICAL ORAL IMPLANTS RESEARCH, Issue 7 2008
    H. De Bruyn
    Abstract Introduction: Implant-prosthetic rehabilitation of the completely edentulous mandible has evolved to a simplified procedure with shorter treatment time and survival rates of 95,100% depending on the implant system used. Purpose: The aim was to evaluate the 3-year clinical success of Astra Tech TiOblast implants, functionally loaded on the day of surgery with a fixed full-arch bridge in the mandible. Materials and methods: One hundred and twenty-five implants of 3.5,4 mm width and 11,17 mm length were installed in 25 edentulous mandibles of 15 female and 10 male patients. Implants were functionally loaded on the day of surgery with a provisional, acrylic, glassfibre reinforced, 10 unit bridge. After 3,4 months, the final 12-unit bridge was constructed. Radiographical bone loss was measured on peri-apical radiographs after 3, 12, 24 and 36 months. Results: All implants were functional during the whole study period yielding a survival rate of 100%. None of the fixtures showed pain or mobility after manual torque with 20 N cm at the 3-month control. Mean radiographical bone loss after 3 months and 1, 2 and 3 years was 0.6 mm (SD 0.7), 0.8 mm (SD 0.8), 1 mm (SD 0.8) and 1.3 (SD 1) respectively, which was statistically significantly increasing up to 1 year. Conclusion: Immediate loading of full-arch mandibular bridgework on five TiOblast implants offers a long-lasting clinical result with 100% fixture survival and stable bone-to-implant contact up to 3 years. [source]

    Prosthetic treatment of maxillary lateral incisor agenesis with osseointegrated implants: a 24,39-month prospective clinical study

    CLINICAL ORAL IMPLANTS RESEARCH, Issue 1 2006
    Fernando Zarone
    Abstract Objectives: The present study aimed at evaluating the marginal bone resorption and the peri-implant tissue conditions around Narrow-Neck ITI implants in the implant,prosthetic treatment of the agenesis of maxillary lateral incisors. Material and methods: Thirty patients affected by monolateral or bilateral agenesis of the maxillary lateral incisors were selected. Thirty-four ITI-SLA Narrow Neck implants were inserted and loaded about 4 months after the surgical procedure. The final restorations were realized using Aureo Galvan Crowns veneered with feldspathic ceramics. The follow-up period ranged from 24 to 39 months. Both marginal bone resorption and soft tissue quality were evaluated. The data were statistically analysed using analysis of variance (ANOVA) for repeated measures, one-way ANOVA and Tukey's post hoc test (P=0.05). Results: During the 24,39-month follow-up period, no implant showed either pain and sensitivity or mobility. After 39 months of functional loading, a cumulative survival rate of 97.06% and a cumulative success rate of 94.12% were calculated. Conclusions: In case of maxillary lateral incisor agenesis, the implant,prosthetic approach has proved to be a reliable and predictable treatment for both re-establishment of function and aesthetics. Satisfactory values of marginal bone resorption over time and optimal conditions of peri-implant tissue around Narrow-Neck ITI implants were found. [source]

    The effect of maximum bite force on marginal bone loss in mandibular overdenture treatment: an in vivo study

    CLINICAL ORAL IMPLANTS RESEARCH, Issue 5 2005
    Frits 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]

    Mandibular overdentures supported by two or four endosseous implants

    CLINICAL ORAL IMPLANTS RESEARCH, Issue 1 2005
    A 5-year prospective study
    Abstract Objective: The aim of this 5-year prospective comparative study was to evaluate treatment outcome (survival rate, condition of hard and soft peri-implant tissues, patient satisfaction, prosthetic and surgical aftercare) of mandibular overdentures supported by two or four implants. Material and methods: Sixty edentulous patients with a mandibular height between 12 and 18 mm participated. Thirty patients were treated with an overdenture supported by two IMZ implants (group A) and 30 patients were treated with an overdenture supported by four IMZ implants (group B). Standardised clinical and radiographic parameters were evaluated 6 weeks after completion of the prosthetic treatment and after 1, 2, 3, 4 and 5 years of functional loading. Prosthetic and surgical aftercare was scored during the evaluation period. Results: One implant was lost (group A) during the healing period. There were no significant differences with regard to any of the studied clinical or radiographic parameters of the peri-implant tissues between the groups. None of the patients reported sensory disturbances in the lip or chin region. No differences in satisfaction were observed between the groups. With regard to aftercare, there was a tendency of a greater need of prosthetic interventions in group A, while correction of soft-tissue problems was restricted to patients of group B. Conclusion: There is no difference in clinical and radiographical state of patients treated with an overdenture on two or four implants during a 5-year evaluation period. Patients of both groups were as satisfied with their overdentures. Résumé Le but de cette étude comparative et prospective de cinq années a été d'évaluer la guérison (taux de survie, condition des tissus paroïmplantaires mous et durs, satisfaction du patient, prothèse et chirurgie) de prothèses mandibulaires sur deux ou quatre implants. Soixante édentés avec une hauteur mandibulaire entre douze et 18 mm ont participé. Trente patients ont été traités avec une prothèse ancrées sur deux implants IMZ (groupe A) tandis que les trente autres ont été traités avec une prothèse ancrée sur quatre implants IMZ (groupe B). Les paramètres radiographiques et cliniques standards ont étéévalués six semaines après la mise en place de la prothèse et ensuite une, deux, trois, quatre et cinq années après la mise en charge fonctionnelle. Le suivi chirurgical et prothétique a étéévalué durant cette période. Un implant a été perdu dans le groupe A durant la période de guérison. Il n'y avait aucune différence significative en ce qui concerne aucun des paramètres radiographiques et cliniques étudiés des tissus paroïmplantaires entre les deux groupes. Aucun des patients n'a rapporté d'ennuis sensoriels au niveau de la lèvre ou du menton. Aucune différence dans la satisfaction n'a été observée entre les deux groupes. En ce qui concerne le maintien, une nécessité plus importante d'intervention au niveau des prothèses était constatée dans le groupe A tandis que la correction des problèmes des tissus mous n'a dûêtre effectuée que chez les patients du groupe B. Il n'y a donc aucune différence radiographique ou clinique chez les patients traités avec une prothèse ancrée sur deux ou quatre implants durant un suivi de cinq années. Les patients des deux groupes étaient autant satisfaits de leurs prothèses. Zusammenfassung Ziel: Das Ziel dieser prospektiven vergleichenden Studie über 5 Jahre war, das Behandlungsresultat (Ueberlebensrate, Zustand der peri-implantären Hart- und Weichgewebe, Patientenzufriedenheit, prothetische und chirurgische Nachsorge) von Hybridprothesen im Unterkiefer, welche von 2 oder 4 Implantaten getragen werden, zu untersuchen. Material und Methoden: An der Studie nahmen 60 zahnlose Patienten mit einer Unterkieferhöhe zwischen 12 und 18 mm teil. 30 Patienten wurden mit einer Hybridprothese getragen von 2 IMZ Implantaten versorgt (Gruppe A), und 30 Patienten erhielten eine Hybridprothese auf 4 IMZ Implantaten (Gruppe B). Standardisierte klinische und radiologische Parameter wurden 6 Wochen nach Eingliederung der Rekonstruktion und nach 1,2,3,4 und 5 Jahren funktioneller Belastung ausgewertet. Die prothetische und chirurgische Nachsorge wurde während der Beobachtungsperiode aufgezeichnet. Resultate: 1 Implantat ging während der Einheilphase verloren (Gruppe A). Es bestanden keine signifikanten Unterschiede in Bezug auf die untersuchten klinischen und radiologischen Parameter der peri-implantären Gewebe zwischen den zwei Gruppen. Keiner der Patienten beklagte Gefühlsstörungen im Bereich der Lippe oder des Kinns. Zwischen den zwei Gruppen bestanden keine Unterschiede bezüglich Zufriedenheit. Bei der Nachsorge bestand eine Tendenz eines grösseren Bedarfs an prothetischen Interventionen in Gruppe A, während Korrekturen von Weichteilproblemen auf Patienten der Gruppe B beschränkt waren. Schlussfolgerung: Es bestehen keine Unterschiede in den klinischen und radiologischen Befunden bei Patienten, welche für eine Beobachtungsperiode von 5 Jahren mit Hybridprothesen auf 2 oder 4 Implantaten versorgt worden waren. Die Patienten beider Gruppen waren mit ihren Hybridprothesen zufrieden. Resumen Objetivo: La intención de este estudio fue prospectivo comparativo de 5-años fue evaluar los resultados del tratamiento (índice de supervivencia, condiciones de los tejidos duros y blandos periimplantarios, satisfacción del paciente, mantenimiento postquirúrgico y postprotesico) de sobredentaduras mandibulares soportadas por 2 o 4 implantes. Material y Métodos: Participaron 60 pacientes edéntulos con una altura mandibular entre 12 y 18 mm. Se trataron 30 pacientes con una sobredentadura soportada por 2 implantes IMZ (grupo A) y 30 pacientes se trataron con una sobredentadura soportada por 4 implantes IMZ (grupo B). Se evaluaron parámetros clínicos y radiológicos a las 6 semanas tras conclusión del tratamiento protésico y tras 1, 2, 3, 4 y 5 años de carga funcional. Se tomó nota del mantenimiento prostético y quirúrgico durante el periodo de evaluación. Resultados: Se perdió un implante (grupo A) durante el periodo de cicatrización. No hubo diferencias significativas respecto a ninguno de los parámetros clínicos y radiográficos estudiados de los tejidos periimplantarios entre los grupos. Ninguno de los pacientes informó sobre molestias sensoriales en el labio o la región del mentón. No se observaron diferencias entre los grupos respecto a la satisfacción. Respecto al mantenimiento, hubo una tendencia a una mayor necesidad de intervenciones prostéticas en el grupo A, mientras que las correcciones en los tejidos blandos se circunscribieron al grupo B. Conclusiones: No hay diferencias en el estado clínico y radiográfico de los pacientes tratados con una sobredentadura en 2 o 4 implantes durante un periodo de evaluación de 5 años. Los pacientes de ambos grupos estaban satisfechos con sus sobredentaduras. [source]