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Oral Implants (oral + implant)

Distribution by Scientific Domains
Medical Sciences94%
Distribution within Medical Sciences
Implant Dentistry67%
Periodontology22%
2 Other Subdomains11%

Terms modified by Oral Implants

  • oral implant placement
    		•

    Selected Abstracts

    Electrosprayed Enzyme Coatings as Bioinspired Alternatives to Bioceramic Coatings for Orthopedic and Oral Implants

    ADVANCED FUNCTIONAL MATERIALS, Issue 5 2009
    Lise T. de Jonge
    Abstract The biological performance of orthopedic and oral implants can be significantly improved by functionalizing the non-physiological metallic implant surface through the application of biologically active coatings. In this paper, a cost-effective alternative to traditional biomedical coatings for bone substitution through exploitation of the specific advantages of the electrospray deposition technique for the immobilization of the enzyme alkaline phosphatase (ALP) onto the implant surface is presented. Since ALP increases the local inorganic phosphate concentration required for physiological mineralization of hard tissues, ALP coatings will enable enzyme-mediated mineralization onto titanium surfaces. To evaluate the bone-bioactive capacity of the ALP-coated titanium surface, soaking experiments are performed. Although the purely inorganic so-called simulated body fluid is the standard in vitro procedure for predictive studies on potential bone bonding in vivo, an alternative testing solution is proposed that also contains organic phosphates (cell culture medium supplemented with the organic ,-b; -glycerophosphate (,-b; -GP) and serum proteins), thereby resembling the in vivo conditions more closely. Under these physiological conditions, the electrosprayed ALP coatings accelerated mineralization onto the titanium surface as compared to noncoated implant material by means of enzymatic pathways. Therefore, this novel approach toward implant fixation holds significant promise. [source]

    In Search of Truth: The Role of Systematic Reviews and Meta-Analyses for Assessing the Effectiveness of Rehabilitation with Oral Implants

    CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 2 2001
    Marco Esposito DDS
    Abstract: Background: It is difficult to determine the effectiveness or potential harm of dental therapies. Thus, any tools able to condense reliable scientific information would be of benefit. Purpose: To discuss methods for the assessment of the scientific literature and, in particular, of systematic reviews for evaluating the effectiveness of oral implant rehabilitation procedures. Materials and Methods: Various study designs and methods to identify scientific evidence are described, discussed, and ranked. Issues on how to critically appraise randomized controlled clinical trials (RCTs) and systematic reviews are presented. Results: Properly conducted RCTs and structured critical systematic reviews are the gold standard of clinical research for assessing whether a therapeutic intervention is effective. In the field of oral implantology, there is an urgent need to implement more RCTs and to summarize their results in systematic reviews. Conclusions: Searching of the truth requires training and critical skill. Dentists should be trained on how to integrate their clinical experience with evidence-based research and on how to discriminate between clinically useful scientific information and less useful research. [source]

    Oral implants , the future

    AUSTRALIAN DENTAL JOURNAL, Issue 2008
    A Jokstad
    Abstract The current and future application of implants to support intra- and extra-oral prostheses is a function not primarily of a current or eventual future, e.g., implant surface configuration, treatment procedure or loading protocol. In contrast, it must be understood by a more complex conceptualization of the practical application of the osseointegration phenomenon. This review will attempt to address the future use of oral implants based on current cutting edge research within the fundamentals that constitute the practical applications of the osseointegration concept. [source]

    Alveolar ridge augmentation using implants coated with recombinant human growth/differentiation factor-5: histologic observations

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 8 2010
    Giuseppe Polimeni
    Polimeni G, Wikesjö UME, Susin C, Qahash M, Shanaman RH, Prasad HS, Rohrer MD, Hall J. Alveolar ridge augmentation using implants coated with recombinant human growth/differentiation factor-5: histologic observations. J Clin Periodontol 2010; 37: 759-768 doi: 10.1111/j.1600-051X.2010.01579.x. Abstract Objectives: In vitro and in vivo preclinical studies suggest that growth/differentiation factor-5 (GDF-5) may induce local bone formation. The objective of this study was to evaluate the potential of recombinant human GDF-5 (rhGDF-5) coated onto an oral implant with a purpose-designed titanium porous oxide surface to stimulate local bone formation including osseointegration and vertical augmentation of the alveolar ridge. Materials and Methods: Bilateral, critical-size, 5 mm, supraalveolar peri-implant defects were created in 12 young adult Hound Labrador mongrel dogs. Six animals received implants coated with 30 or 60 ,g rhGDF-5, and six animals received implants coated with 120 ,g rhGDF-5 or left uncoated (control). Treatments were alternated between jaw quadrants. The mucoperiosteal flaps were advanced, adapted, and sutured to submerge the implants for primary intention healing. The animals received fluorescent bone markers at weeks 3, 4, 7, and 8 post-surgery when they were euthanized for histologic evaluation. Results: The clinical examination showed no noteworthy differences between implants coated with rhGDF-5. The cover screw and implant body were visible/palpable through the alveolar mucosa for both rhGDF-5-coated and control implants. There was a small increase in induced bone height for implants coated with rhGDF-5 compared with the control, induced bone height averaging (±SD) 1.6±0.6 mm for implants coated with 120 ,g rhGDF-5 versus 1.2±0.5, 1.2±0.6, and 0.6±0.2 mm for implants coated with 60 ,g rhGDF-5, 30 ,g rhGDF-5, or left uncoated, respectively (p<0.05). Bone formation was predominant at the lingual aspect of the implants. Narrow yellow and orange fluorescent markers throughout the newly formed bone indicate relatively slow new bone formation within 3,4 weeks. Implants coated with rhGDF-5 displayed limited peri-implant bone remodelling in the resident bone; the 120 ,g dose exhibiting more advanced remodelling than the 60 and 30 ,g doses. All treatment groups exhibited clinically relevant osseointegration. Conclusions: rhGDF-5-coated oral implants display a dose-dependent osteoinductive and/or osteoconductive effect, bone formation apparently benefiting from local factors. Application of rhGDF-5 appears to be safe as it is associated with limited, if any, adverse effects. [source]

    Influence of forces on peri-implant bone

    CLINICAL ORAL IMPLANTS RESEARCH, Issue S2 2006
    Flemming Isidor
    Abstract: Occlusal forces affect an oral implant and the surrounding bone. According to bone physiology theories, bones carrying mechanical loads adapt their strength to the load applied on it by bone modeling/remodeling. This also applies to bone surrounding an oral implant. The response to an increased mechanical stress below a certain threshold will be a strengthening of the bone by increasing the bone density or apposition of bone. On the other hand, fatigue micro-damage resulting in bone resorption may be the result of mechanical stress beyond this threshold. In the present paper literature dealing with the relationship between forces on oral implants and the surrounding bone is reviewed. Randomized controlled as well as prospective cohorts studies were not found. Although the results are conflicting, animal experimental studies have shown that occlusal load might result in marginal bone loss around oral implants or complete loss of osseointegration. In clinical studies an association between the loading conditions and marginal bone loss around oral implants or complete loss of osseointegration has been stated, but a causative relationship has not been shown. [source]

    Force transmission of one- and two-piece morse-taper oral implants: a nonlinear finite element analysis

    CLINICAL ORAL IMPLANTS RESEARCH, Issue 4 2004
    Murat Cavit Çehreli
    Abstract Purpose: To compare force transmission behaviors of one-piece (1-P) and two-piece (2-P) morse-taper oral implants. Material and methods: A three-dimensional finite element model of a morse-taper oral implant and a solid abutment was constructed separately. The implant,abutment complex was embedded in a Ø 1.5 cm × 1.5 cm acrylic resin cylinder. Vertical and oblique forces of 50 N and 100 N were applied on the abutment and solved by two different analyses. First, contact analysis was performed in the implant,abutment complex to evaluate a 2-P implant. Then, the components were bonded with a separation force of 1020 N to analyze a 1-P implant. Results: Von Mises stresses in the implant, principal stresses, and displacements in the resin were the same for both designs under vertical loading. Under oblique loading, principal stresses and displacement values in the resin were the same, but the magnitudes of Von Mises stresses were higher in the 2-P implant. The principal stress distributions around both implants in the acrylic bone were similar under both loading conditions. Conclusion: 2-P implants experience higher mechanical stress under oblique loading. Nevertheless, the 1-P- or 2-P morse-taper nature of an implant is not a decisive factor for the magnitude and distribution of stresses, and displacements in supporting tissues. Résumé Le but de cette étude a été de comparer les comportements de la transmission de la force desimplants buccaux en deux pièces. Un modèle d'éléments finis tridimensionnels d'un implant buccal et d'un pilier solide ont été construits séparément. Le complexe implant/pilier a été enfoui dans un cylindre de résine acrylique d'un diamètre 1,5 × 1,5 cm. Des forces obliques et verticales de 50 et 100 N ont été appliquées sur les piliers et analysées par deux méthodes. D'abord, l'analyse de contraste a été effectuée dans le complexe implant/pilier pour évaluer un implant en deux pièces. Ensuite, les composants ont été reliés avec une force de séparation de 1020N pour analyser un implant en une pièce. Les stress de Von Mises dans l'implant, les principaux stress et les déplacements dans la résine étaient les mêmes pour les deux modèles sous charge verticale. Lorsqu'une charge oblique était appliquée, les stress principaux et les valeurs de déplacements dans la résine étaient semblables mais l'amplitude des stress de Von Mises était plus importante dans l'implant à deux pièces. Les distributions des stress principaux autour des deux implants dans l'os acrylique était semblable sous les deux conditions de charge. Les implants en deux pièces subissent un stress mécanique plus important sous une charge oblique. Cependant, l'implant en une ou deux pièces avec un cône morse n'est pas un facteur décisif sur l'amplitude et la distribution des stress, et les déplacements des tissus de support. Zusammenfassung Ziel: Die Kraftübertragungsverhältnisse von ein- und zweiteiligen oralen Implantaten mit konischem Sitz der Sekundärteile zu untersuchen. Material und Methode: Es wurde je ein separates dreidimensionales Finite Element Modell eines oralen Implantats mit konischem Sitz der Sekundärteile und ein Massivsekundärteil konstruiert. Der Implantat-Sekundärteilkomplex wurde in einem Zylinder aus Acryl mit Durchmesser 1.5cm und Länge 1.5cm eingebettet. Vertikale und schräge Kräfte von 50 N und 100 N wurden auf das Sekundärteil appliziert und durch zwei verschiedene Analysen ausgewertet. Zuerst wurde eine Kontaktanalyse im Implantat-Sekundärteilkomplex zur Auswertung eines zweiteiligen Implantats durchgeführt. Dann wurden die Komponenten mit einer Separationskraft von 1020 N verbunden, um ein einteiliges Implantat zu analysieren. Resultate: Unter vertikaler Belastung waren der Van Mises Stress im Implantat, der generelle Stress und die Displatzierung im Kunststoff für beide Konstruktionen gleich. Unter schräger Belastung waren der generelle Stress und die Displatzierungswerte im Kunststoff die gleichen, jedoch war das Ausmass des von Mises Stress im zweiteiligen Implantat grösser. Die generelle Stressverteilung im Akrylknochen um die Implantate war unter beiden Belastungsbedingungen ähnlich. Schlussfolgerung: Zweiteilige Implantate erleiden grösseren mechanischen Stress unter schräger Belastung. Jedoch ist die ein- oder zweiteilige Konstruktion mit konischem Sitz der Sekundärteile bei Implantaten kein entscheidender Faktor für das Ausmass und die Verteilung des Stresses und für die Displatzierung in den Verankerungsgeweben. Resumen Intención: Comparar los comportamientos de transmisión de fuerzas de implantes orales en cono morse de una o dos piezas. Material y métodos: Se construyeron separadamente un modelo tridimensional de elemento finito de un implante oral de cono morse y un pilar sólido. El complejo implante-pilar se embebió en un cilindro de resina acrílica de , 1.5 cm × 1.5 cm. Se aplicaron fuerzas oblicuas de 50 N y 100 N sobre el pilar y se resolvieron por medio de dos análisis diferentes. Primero, se llevó a cabo un análisis de contacto en el complejo implante-pilar para evaluar un implante de dos piezas. Después, se unieron los componentes con una fuerza de separación de 1020 N para analizar un implante de una sola pieza. Resultados: El estrés de Von Mises, el estrés principal, y el desplazamiento en la resina fueron los mismos para ambos diseños bajo carga vertical. Bajo carga oblicua, los valores de estrés principal y desplazamiento en resina fueron los mismos, pero la magnitud de los estreses de Von Mises fueron mayores en los implantes de dos piezas. Las distribuciones del estrés principal alrededor de ambos implantes in el hueso acrílico fueron similares bajo ambas condiciones de carga. Conclusión: Los implantes de dos piezas experimentan un estrés mecánico mas alto bajo carga oblicua. Sin embargo, la naturaleza de un implante de cono morse de una o dos piezas no es un factor decisivo en la magnitud y distribución de los estreses, y desplazamientos en los tejidos de soporte. [source]

    Electrosprayed Enzyme Coatings as Bioinspired Alternatives to Bioceramic Coatings for Orthopedic and Oral Implants

    ADVANCED FUNCTIONAL MATERIALS, Issue 5 2009
    Lise T. de Jonge
    Abstract The biological performance of orthopedic and oral implants can be significantly improved by functionalizing the non-physiological metallic implant surface through the application of biologically active coatings. In this paper, a cost-effective alternative to traditional biomedical coatings for bone substitution through exploitation of the specific advantages of the electrospray deposition technique for the immobilization of the enzyme alkaline phosphatase (ALP) onto the implant surface is presented. Since ALP increases the local inorganic phosphate concentration required for physiological mineralization of hard tissues, ALP coatings will enable enzyme-mediated mineralization onto titanium surfaces. To evaluate the bone-bioactive capacity of the ALP-coated titanium surface, soaking experiments are performed. Although the purely inorganic so-called simulated body fluid is the standard in vitro procedure for predictive studies on potential bone bonding in vivo, an alternative testing solution is proposed that also contains organic phosphates (cell culture medium supplemented with the organic ,-b; -glycerophosphate (,-b; -GP) and serum proteins), thereby resembling the in vivo conditions more closely. Under these physiological conditions, the electrosprayed ALP coatings accelerated mineralization onto the titanium surface as compared to noncoated implant material by means of enzymatic pathways. Therefore, this novel approach toward implant fixation holds significant promise. [source]

    Alveolar ridge augmentation using implants coated with recombinant human growth/differentiation factor-5: histologic observations

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 8 2010
    Giuseppe Polimeni
    Polimeni G, Wikesjö UME, Susin C, Qahash M, Shanaman RH, Prasad HS, Rohrer MD, Hall J. Alveolar ridge augmentation using implants coated with recombinant human growth/differentiation factor-5: histologic observations. J Clin Periodontol 2010; 37: 759-768 doi: 10.1111/j.1600-051X.2010.01579.x. Abstract Objectives: In vitro and in vivo preclinical studies suggest that growth/differentiation factor-5 (GDF-5) may induce local bone formation. The objective of this study was to evaluate the potential of recombinant human GDF-5 (rhGDF-5) coated onto an oral implant with a purpose-designed titanium porous oxide surface to stimulate local bone formation including osseointegration and vertical augmentation of the alveolar ridge. Materials and Methods: Bilateral, critical-size, 5 mm, supraalveolar peri-implant defects were created in 12 young adult Hound Labrador mongrel dogs. Six animals received implants coated with 30 or 60 ,g rhGDF-5, and six animals received implants coated with 120 ,g rhGDF-5 or left uncoated (control). Treatments were alternated between jaw quadrants. The mucoperiosteal flaps were advanced, adapted, and sutured to submerge the implants for primary intention healing. The animals received fluorescent bone markers at weeks 3, 4, 7, and 8 post-surgery when they were euthanized for histologic evaluation. Results: The clinical examination showed no noteworthy differences between implants coated with rhGDF-5. The cover screw and implant body were visible/palpable through the alveolar mucosa for both rhGDF-5-coated and control implants. There was a small increase in induced bone height for implants coated with rhGDF-5 compared with the control, induced bone height averaging (±SD) 1.6±0.6 mm for implants coated with 120 ,g rhGDF-5 versus 1.2±0.5, 1.2±0.6, and 0.6±0.2 mm for implants coated with 60 ,g rhGDF-5, 30 ,g rhGDF-5, or left uncoated, respectively (p<0.05). Bone formation was predominant at the lingual aspect of the implants. Narrow yellow and orange fluorescent markers throughout the newly formed bone indicate relatively slow new bone formation within 3,4 weeks. Implants coated with rhGDF-5 displayed limited peri-implant bone remodelling in the resident bone; the 120 ,g dose exhibiting more advanced remodelling than the 60 and 30 ,g doses. All treatment groups exhibited clinically relevant osseointegration. Conclusions: rhGDF-5-coated oral implants display a dose-dependent osteoinductive and/or osteoconductive effect, bone formation apparently benefiting from local factors. Application of rhGDF-5 appears to be safe as it is associated with limited, if any, adverse effects. [source]

    Evaluation of nano-technology-modified zirconia oral implants: a study in rabbits

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 7 2009
    Jaebum Lee
    Abstract Objective: The objective of this study was to screen candidate nano-technology-modified, micro-structured zirconia implant surfaces relative to local bone formation and osseointegration. Materials and Methods: Proprietary nano-technology surface-modified (calcium phosphate: CaP) micro-structured zirconia implants (A and C), control micro-structured zirconia implants (ZiUniteÔ), and titanium porous oxide implants (TiUniteÔ) were implanted into the femoral condyle in 40 adult male New Zealand White rabbits. Each animal received one implant in each hind leg; thus, 20 animals received A and C implants and 20 animals received ZiUniteÔ and TiUniteÔ implants in contralateral hind legs. Ten animals/group were euthanized at weeks 3 and 6 when biopsies of the implant sites were processed for histometric analysis using digital photomicrographs produced using backscatter scanning electron microscopy. Results: The TiUniteÔ surface demonstrated significantly greater bone,implant contact (BIC) (77.6±2.6%) compared with the A (64.6±3.6%) and C (62.2±3.1%) surfaces at 3 weeks (p<0.05). Numerical differences between ZiUniteÔ (70.5±3.1%) and A and C surfaces did not reach statistical significance (p>0.05). Similarly, there were non-significant differences between the TiUniteÔ and the ZiUniteÔ surfaces (p>0.05). At 6 weeks, there were no significant differences in BIC between the TiUniteÔ (67.1±4.2%), ZiUniteÔ (69.7±5.7%), A (68.6±1.9%), and C (64.5±4.1%) surfaces (p>0.05). Conclusion: TiUniteÔ and ZiUniteÔ implant surfaces exhibit high levels of osseointegration that, in this model, confirm their advanced osteoconductive properties. Addition of CaP nano-technology to the ZiUniteÔ surface does not enhance the already advanced osteoconductivity displayed by the TiUniteÔ and ZiUniteÔ implant surfaces. [source]

    Alveolar ridge augmentation using implants coated with recombinant human bone morphogenetic protein-7 (rhBMP-7/rhOP-1): radiographic observations

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 10 2008
    Knut N. Leknes
    Abstract Aim: The objective of this study was to radiographically evaluate the potential of a purpose-designed titanium porous-oxide implant surface coated with recombinant human bone morphogenetic protein-7 (rhBMP-7), also known as recombinant human osteogenic protein-1 (rhOP-1), to stimulate alveolar ridge augmentation. Material and Methods: Six young-adult Hound Labrador mongrel dogs were used. Three 10 mm titanium oral implants per jaw quadrant were placed 5 mm into the alveolar ridge in the posterior mandible following surgical extraction of the pre-molar teeth and reduction of the alveolar ridge leaving 5 mm of the implants in a supra-alveolar position. The implants had been coated with rhBMP-7 at 1.5 or 3.0 mg/ml and were randomized to contralateral jaw quadrants using a split-mouth design. The mucoperiosteal flaps were advanced, adapted, and sutured to submerge the implants. Radiographic registrations were made immediately post-surgery (baseline), and at weeks 4 and 8 (end of study). Results: rhBMP-7-coated implants exhibited robust radiographic bone formation. At 8 weeks, bone formation averaged 4.4 and 4.2 mm for implants coated with rhBMP-7 at 1.5 and 3.0 mg/ml, respectively. There were no significant differences between the rhBMP-7 concentrations at any observation interval. A majority of the implant sites showed voids within the newly formed bone at week 4 that generally resolved by week 8. The newly formed bone assumed characteristics of the resident bone. Conclusions: The titanium porous-oxide implant surface serves as an effective carrier for rhBMP-7 showing a clinically significant potential to stimulate local bone formation. [source]

    A biomechanical assessment of the relation between the oral implant stability at insertion and subjective bone quality assessment

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 4 2007
    Ghada Alsaadi
    Abstract Aim: The study was set to evaluate the validity of subjective jaw bone quality assessment. Materials and Methods: A total of 298 patients (198 females, mean age 56.4) were treated with oral implants at the Periodontology Department at the University Hospital of KUL. A total of 761 TiUniteÔ implants have been installed. Subjective bone quality assessment was performed on radiographs and by the surgeon's tactile sensation and was compared with torque measurements. In a subset of patients, implant stability was also assessed by implant stability quotient and/or periotest values. Results: Subjective assessment of bone quality was related to the PTV, ISQ and placement torque [in the crestal, the second and the apical third (N cm)], respectively; in grade 1: ,5.3, 73.3 (4.2, 9.6, 15.2), and grade 3 or 4: ,1.6, 55 (3.3, 5.5, 8.4). For the surgeon's tactile sensation, a good correlation was noted for the presence of a thick cortex: ,4.6, 70.3 (4.2, 9.7, 15.1), or a thin one: ,0.3, 65.9 (3.6, 6.9, 10.1). For dense trabecular bone, the values were ,2.8, 69.4 (4.4, 9.7,14.8), while for poor trabecular bone, the values were,1.7, 66.4 (3.6, 6.4, 9.8). Conclusions: Subjective assessment of bone quality is related to PTV, ISQ and placement torque measurements at implant insertion. [source]

    The critical-size supraalveolar peri-implant defect model: characteristics and use

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 11 2006
    Ulf M. E. Wikesjö
    Abstract Objective: Novel implant technologies and reconstructive therapies for alveolar augmentation require pre-clinical evaluation to estimate their biologic potential, efficacy, and safety before clinical application. The objective of this report is to present characteristics and use of the critical-size, supraalveolar, peri-implant defect model. Methods: Bilateral extraction of the mandibular premolars was performed in 12 Hound Labrador mongrel dogs following horizontal surgical cut-down of the alveolar ridge approximating 6 mm. Each jaw quadrant received three custom-produced TiUniteÔ, ,4.0 × 10 mm threaded implants placed into osteotomies prepared into the extraction sites of the third and fourth premolars. The implants exhibited a reference notch 5 mm from the implant platform to facilitate surgical placement leaving 5 mm of the implant in a supraalveolar position, and to serve as a reference point in the radiographic, histologic and histometric analysis. The implants were submerged under the mucoperiosteal flaps for primary intention healing. Fluorescent bone markers were administered at weeks 3 and 4 post-surgery, and pre-euthanasia. The animals were euthanized following an 8-week healing interval when block biopsies were collected for analysis. Results: Healing was generally uneventful. The radiographic and histometric evaluations demonstrate the limited osteogenic potential of this defect model. Whereas lingual peri-implant sites exhibited a mean (±SE) bone gain of 0.4±0.1 mm, resorption of the buccal crestal plate resulted in a mean bone loss of 0.4±0.2 mm for an overall osteogenic potential following sham-surgery averaging 0.0±0.1 mm. Overall bone density and bone,implant contact in the contiguous resident bone averaged 79.1±1.1% and 76.9±2.3%, respectively. Conclusion: The results suggest that the critical-size, supraalveolar, peri-implant defect model appears a rigorous tool in the evaluation of candidate technologies for alveolar reconstruction and osseointegration of endosseous oral implants. Limited innate osteogenic potential allows critical evaluation of osteogenic, osteoconductive, or osteoinductive technologies in a challenging clinical setting. [source]

    Three-dimensional force measurements on oral implants: a methodological study

    JOURNAL OF ORAL REHABILITATION, Issue 9 2000
    J. Duyck
    This paper describes a methodology that allows in vitro and in vivo quantification and qualification of forces on oral implants. Strain gauges are adapted to the outer surface of 5·5 and 7 mm standard abutments (Brånemark System®, Nobel Biocare, Sweden). The readings of the strain gauges are transformed into a numerical representation of the normal force and the bending moment around the X- and Y- axis. The hardware and the software of the 3D measuring device based on the strain gauge technology is explained and its accuracy and reliability tested. The accuracy level for axial forces and bending moments is 9.72 N and 2.5 N·cm, respectively, based on the current techniques for strain gauged abutments. As an example, an in vivo force analysis was performed in a patient with a full fixed prosthesis in the mandible. Since axial loads of 450 N and bending moments of 70 N·cm were recorded, it was concluded that the accuracy of the device falls well within the scope of our needs. Nevertheless, more in vivo research is needed before well defined conclusions can be drawn and strategies developed to improve the biomechanics of oral implants. [source]

    Ceramic abutments and ceramic oral implants.

    PERIODONTOLOGY 2000, Issue 1 2008
    An update
    First page of article [source]

    Treatment of small defects adjacent to oral implants with various biomaterials

    PERIODONTOLOGY 2000, Issue 1 2003
    William Becker
    First page of article [source]

    Oral implants , the future

    AUSTRALIAN DENTAL JOURNAL, Issue 2008
    A Jokstad
    Abstract The current and future application of implants to support intra- and extra-oral prostheses is a function not primarily of a current or eventual future, e.g., implant surface configuration, treatment procedure or loading protocol. In contrast, it must be understood by a more complex conceptualization of the practical application of the osseointegration phenomenon. This review will attempt to address the future use of oral implants based on current cutting edge research within the fundamentals that constitute the practical applications of the osseointegration concept. [source]

    Marginal Bone Loss at Implants: A Retrospective, Long-Term Follow-Up of Turned Brånemark System® Implants

    CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 1 2009
    Odont Lic, Solweig Sundén Pikner DDS
    ABSTRACT Background: Lately, presence of progressive bone loss around oral implants has been discussed. Purpose: The aim of this study was to report in a large patient group with different prosthetic restorations marginal bone level and its change as measured in radiographs obtained from prosthesis insertion up to a maximum 20 years in service. Further, it also aimed to study the impact of gender, age, jaw, prosthetic restoration, and calendar year of surgery. Materials and Methods: Out of 1,716 patients recorded for clinical examination during 1999, 1,346 patients (78.4%) could be identified. A total of 640 patients (3,462 originally installed Brånemark System® implants, Nobel Biocare, Göteborg, Sweden) with a follow-up of ,5 years were included in the study, while patients with continuous overdentures and augmentation procedures were not. Distance between the fixture/abutment junction (FAJ) and the marginal bone level was recorded. Results: The number of implants with a mean bone level of ,3 mm below FAJ increased from 2.8% at prosthesis insertion to 5.6% at year 1, and 10.8% after 5 years. Corresponding values after 10, 15, and 20 years were 15.2, 17.2, and 23.5%, respectively. Implant-based bone loss was as a mean 0.8 mm (SD 0.8) after 5 years, followed by only minor average changes. Mean bone loss on patient level followed a similar pattern. Disregarding follow-up time, altogether 183 implants (107 patients) showed a bone loss ,3 mm from prosthesis insertion to last examination. Significantly larger bone loss was found the older the patient was at surgery and for lower jaw implants. Conclusions: Marginal bone support at Brånemark implants was with few exceptions stable over years. [source]

    Turned Brånemark System® Implants in Wide and Narrow Edentulous Maxillae: A Retrospective Clinical Study

    CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 2 2008
    Bertil Friberg DDS
    ABSTRACT Background: The available jawbone volume is regarded as one of the most important factors when assessing the prognosis of oral implants in the rehabilitation of the edentulous maxilla. Purpose: The aim of the current investigation was to retrospectively evaluate and compare the outcome of implants placed in edentulous maxillae with either wide or narrow jaw shapes. The marginal bone loss and implant cumulative survival rates (CSRs) were calculated and analyzed with special reference to smoking habits. Materials and Methods: The study included 75 individuals with edentulous maxillae, of which 33 patients exhibited wide (group A) and 42 patients exhibited narrow jaw shapes (group B). A total of 506 turned Brånemark System® (Nobel Biocare AB, Göteborg, Sweden) implants were inserted (226 in group A and 279 in group B) and followed clinically up to 7 years. Smoking habits were recorded. Radiographs were obtained at connection of prostheses, and at the 1- and 5-year follow-up visit. The marginal bone loss was calculated for the groups and analyzed using t -test. Results: Twenty-eight implants were lost during the study period, revealing implant CSRs at 7 years of 94.6% (11/226) and 93.6% (17/279) for wide and narrow crests, respectively. No difference in marginal bone loss was seen between the two groups, although a trend toward more bone loss was recorded for patients with wide crests. Smoking habits were more common in group A (45%) than in group B (31%). During the first year of function, smokers lost significantly more marginal bone than nonsmokers (p = .0447), albeit this difference did not prevail (p > .05) at the end of the study period. Conclusions: The implant CSRs at 7 years were equally good for the two groups of patients with various jaw shapes. Initially, smokers showed significantly more marginal bone loss than nonsmokers. [source]

    One-Year Prospective Three-Center Study Comparing the Outcome of a "Soft Bone Implant" (Prototype Mk IV) and the Standard Brånemark Implant

    CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 2 2003
    Bertil Friberg DDS
    ABSTRACT Background: Oral implant treatment ad modum Brånemark has been used for decades in the rehabilitation of edentate and partially dentate patients. Posterior jaw regions frequently exhibit bone of poor texture, and it is often difficult to obtain primary stability. Thus, it may prove beneficial to deviate from the original protocol and to use implants with a modified design, for example, with a slightly tapered geometry. Purpose: The purpose of the investigation was to compare the early behavior of a modified (prototype Mk IV, Branemark System, Nobel Biocare AB, Gothenburg, Sweden; test) implant with that of the standard Brånemark implant (control) in regions of mainly type 4 bone. Materials and Methods: Three Swedish centers participated, and a total of 44 patients were treated with oral implants for 39 maxillas and 5 mandibles. The study focused on the most distal right and left implant sites (88 implants), which were randomized to receive either a test or a control implant. Various parameters were recorded, such as registered insertion torque (OsseoCare, Nobel Biocare AB), wobbling during insertion, primary and secondary stability (as measured with resonance frequency), and marginal bone loss. The implants were followed up for 1 year. Results.: The test implant more frequently required a higher insertion torque and showed a significantly higher primary stability than the control implant. This difference in stability leveled out over time, and test and control implants exhibited similar secondary stability at abutment operation and at the 1-year visit. Wobbling during insertion was rarely recorded for either of the implant designs. The 1-year cumulative success rate was 93.1% for test implants and 88.4% for control implants. Conclusions: The modified implant design resulted in an increased primary stability, which may be important when placing implants in jaw regions of type 4 bone. However, independent of the achieved primary stability, successful implants tended to approach similar secondary stability in the two designs tested. [source]

    Subjective Need for Implant Treatment among Middle-aged People in Sweden and Denmark

    CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 1 2002
    Mats Kronström DDS
    ABSTRACT Background: The use of oral implants in prosthodontics has become widespread and regarded as a predictable treatment modality. However, there is a lack of knowledge among the general population about the prevalence and need for implant treatments. Purpose: This study was undertaken to register and compare the prevalence of dental implants and the subjective need for implant treatment among people in Sweden and Denmark. Materials and Methods: Random samples taken from the national population registers in Sweden and Denmark comprised 1001 Swedish subjects aged 55 to 79 years and 1175 Danish subjects aged 45 to 69 years. Subjects were requested to fill out questionnaires regarding dental conditions, subjective need for implant treatment, whether they had received treatment with dental implants during the previous 10 years, and so on. Results: Of the Swedes, 4.8% reported that they had dental implants, compared with 2.5% of the Danes. In the Swedish sample, age was significantly associated with subjective need for implant treatment. In the Danish sample, women showed a significantly higher subjective need for implant treatment than did men. Conclusions: Compared with the Swedish sample, the subjective need for treatment with dental implants was higher in the Danish sample, although the patient fees were substantially higher in Denmark. [source]

    Augmentation of Exposed Implant Threads with Autogenous Bone Chips: Prospective Clinical Study

    CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 4 2000
    Göran Widmark DDS
    ABSTRACT Background: Autogenous bone chips can be harvested during drilling of implant sites and may be used as a graft material for bone augmentation and coverage of exposed implant threads. Purpose: The aim of this prospective study was to evaluate the possibility of augmenting exposed implant threads with autogenous bone chips. Materials and Methods: Twenty-one consecutive patients treated with screw-shaped oral implants with exposed threads due to buccal fenestration or marginal defects were augmented with autogenous bone harvested with a bone trap during drilling of the implant site. Both marginal (9 sites) and fenestration defects (12 sites), with 4 to 14 exposed implant threads, were registered clinically and with photography. The number of exposed implant threads was measured before and at second-stage surgery 6 months after augmentation. Results: Complete bone coverage of the exposed implant threads was seen in 12 of the 21 implant sites. Six sites showed one to two remaining exposed threads, two showed about 40% coverage, and one showed flattening of the defect but with eight of nine exposed threads at 6 months follow-up. The mean bone gain was 81% in patients with a marginal defect and 82% in patients with a fenestration defect. Conclusion: The results from this clinical study show that it is possible to gain bone over exposed implant threads by augmentation with autogenous bone chips. Conclusion It is concluded that it is possible to achieve coverage of exposed implant threads by augmentation with autogenous bone chips harvested during drilling of implant sites. [source]

    Effect of platelet-rich plasma on the early bone formation around Ca-P-coated and non-coated oral implants in cortical bone

    CLINICAL ORAL IMPLANTS RESEARCH, Issue 2 2008
    Dimitris Nikolidakis
    Abstract Objectives: The purpose of the present study was to investigate the effect of local application of platelet-rich plasma (PRP) on the early healing of cortical bone around Ti implants with two different surface configurations. Material and methods: Six goats were used in this study. PRP fractions were obtained from a venous blood sample of the goats and administered immediately before implant insertion. PRP was applied via gel preparation and installation of the gel into the implant site, or via dipping of the implants in PRP fraction before insertion. A total of 36 implants (18 non-coated and 18 Ca-P-coated) were placed into the tibial cortical bone. The animals were sacrificed at 6 weeks after implantation and implants with surrounding tissue were prepared for histological examination. Histomorphometrical variables like the percentage of implant surface with direct bone,implant contact and the percentage of new and old bone adjacent to the implant were evaluated. Results: More interfacial bone-to-implant contact was observed for all the three groups of Ca-P-coated implants and the Ti/PRP liquid group. All groups revealed similar percentages of old and new bone adjacent to the implant. Conclusions: It was concluded that the additional use of PRP did not have any effect on the early cortical bone response to the Ca-P-coated implants, while PRP in a liquid form showed a tendency to increase bone apposition to roughened titanium implants. [source]

    Speech adaptation after treatment of full edentulism through immediate-loaded implant protocols

    CLINICAL ORAL IMPLANTS RESEARCH, Issue 1 2008
    Liene Molly
    Abstract Objectives: The objective of the present study was to evaluate the influence of immediate loading of implants on speech adaptation. Material and methods: Ten patients (mean age 54, 6 females) were examined before surgery and 1, 3, 6 and 12 months afterwards. Articulation analysis was done using objective DAT-recoded data evaluated by two groups of speech and language therapists and a computer software program. Besides, patient VAS-scores, myofunctional problems and hearing impairment were recorded and analysed. Results: In the present study only one patient suffered from deteriorated speech after immediate loading. Other patients showed unaffected or improved articulation 3 to 6 months after surgery with a strident and interdental pronunciation mostly becoming addental. Furthermore, myofunctional problems occurred in one patient, other patients adapted to the new situation after three months. Hearing impairment did not influence speech pathology in this study. Conclusion: Immediate loading of oral implants does not seem to compromise the normal 3,6 months speech adaptation period. Whether such procedure presents advantages to the conventional 2-stage rehabilitation remains to be investigated. [source]

    Histological evaluation of oral implants inserted with different surgical techniques into the trabecular bone of goats

    CLINICAL ORAL IMPLANTS RESEARCH, Issue 4 2007
    Manal M. Shalabi
    Abstract Objective: The aim of this study was to investigate the influence of implant surface topography and surgical technique on bone response. Material and methods: For the experiment, 48 screw-designed implants were used with two different surface finishes, i.e. machined and ,blasted, etched'. The implants were inserted into the left and right medial femoral condyle of eight goats using three different surgical approaches: press-fit (implant diameter=implant bed diamete(r), undersized (implant bed diameter[source]

    Influence of forces on peri-implant bone

    CLINICAL ORAL IMPLANTS RESEARCH, Issue S2 2006
    Flemming Isidor
    Abstract: Occlusal forces affect an oral implant and the surrounding bone. According to bone physiology theories, bones carrying mechanical loads adapt their strength to the load applied on it by bone modeling/remodeling. This also applies to bone surrounding an oral implant. The response to an increased mechanical stress below a certain threshold will be a strengthening of the bone by increasing the bone density or apposition of bone. On the other hand, fatigue micro-damage resulting in bone resorption may be the result of mechanical stress beyond this threshold. In the present paper literature dealing with the relationship between forces on oral implants and the surrounding bone is reviewed. Randomized controlled as well as prospective cohorts studies were not found. Although the results are conflicting, animal experimental studies have shown that occlusal load might result in marginal bone loss around oral implants or complete loss of osseointegration. In clinical studies an association between the loading conditions and marginal bone loss around oral implants or complete loss of osseointegration has been stated, but a causative relationship has not been shown. [source]

    Augmentation procedures for the rehabilitation of deficient edentulous ridges with oral implants

    CLINICAL ORAL IMPLANTS RESEARCH, Issue S2 2006
    Matteo Chiapasco
    Abstract Objectives: To analyze publications related to augmentation procedures and to evaluate the success of different surgical techniques for ridge reconstruction and the survival/success rates of implants placed in the augmented areas. Material and methods: Clinical investigations published in English involving at least 5 patients and with a minimum follow-up of 6 months were included. The following procedures were considered: a) Guided bone regeneration (GBR); 2) Onlay bone grafts; 3) Inlay grafts; 4) Bone splitting for ridge expansion (RE); 5) Distraction osteogenesis (DO); and 6) Revascularized flaps. Success rates of augmentation procedures and related morbidity, as well as survival and success rates of implants placed in the augmented sites were analyzed. Results: Success rates of surgical procedures ranged from 60% to 100% for GBR, from 92% to 100% for onlay bone grafts, from 98% to 100% for ridge expansion techniques, from 96,7% to 100% for DO, and was 87.5% for revascularized flaps, whereas survival rates of implants ranged from 92% to 100% for GBR, from 60% to 100% for onlay bone grafts, from 91% to 97.3% for RE, from 90.4% to 100% for DO, and, finally, was 88.2% for revascularized flaps. Conclusion: On the basis of available data it was shown that it was difficult to demonstrate that a particular surgical procedure offered better outcome as compared to another. The main limit encountered in this review has been the overall poor methodological quality of the published articles. Therefore larger well-designed long term trials are needed. [source]

    Fast element mapping of titanium wear around implants of different surface structures

    CLINICAL ORAL IMPLANTS RESEARCH, Issue 2 2006
    Ulrich Meyer
    Abstract: The effect of unintended titanium release around oral implants remains a biological concern. The current study was undertaken to evaluate a new detection system of element mapping in biological probes. A new scanning electron microscopy-energy dispersive spectroscopy detection method was used to map the features of titanium contamination in peri-implant bone around implants with different surface structures. The amount of titanium wear was highest adjacent to titanium-plasma-sprayed surfaces, followed by sandblastered large grid acid-etched and smooth surfaces. A high sensitivity of titanium detection over large areas of bone tissue was observed. A high spatial resolution of titanium wear particles (20 nm) could be reached and correlated to the ultrastructural morphological features of peri-implant tissue. Cells adjacent to titanium wear revealed no signs of morphological alterations on a nanoscale level at early periods of implant/bone interaction. The new technique may serve as a fast and effective tool to evaluate titanium release effects in biological probes. [source]

    Therapy of peri-implantitis with resective surgery

    CLINICAL ORAL IMPLANTS RESEARCH, Issue 1 2005
    A 3-year clinical trial on rough screw-shaped oral implants.
    Abstract: The purpose of this randomized clinical trial was to compare the clinical outcome of two different surgical approaches for the treatment of peri-implantitis. Seventeen patients with ITI® implants were included consecutively over a period of 5 years. The patients were randomized with a lottery assignment. Ten patients were treated with resective surgery and modification of surface topography (test group). The remaining seven patients were treated with resective surgery only (control group). Clinical parameters (suppuration, modified plaque index , mPI, modified bleeding index , mBI, probing pocket depth , PPD, pseudopocket , DIM, mucosal recession , REC, probing attachment level , PAL) were recorded at baseline, as well as 6, 12, 24 and 36 months after treatment. The cumulative survival rate for the implants of the test group was 100% after 3 years. After 24 months, two hollow-screw implants of control group were removed because of mobility. Consequently, the cumulative survival rate was 87.5%. The recession index in the control group was significantly lower than in the test group at 24 months (Student's t -value of ,2.14). On the contrary, control group showed higher PPD, PAL and mBI indexes than test group (Student's t -values of +5.5, +2.4 and +9.61, respectively). The PPD and mBI indexes for the implants of the control group were significantly higher at baseline than 24 months later (Student's t -values of +3.18 and +3.33, respectively). Recession and PAL indexes resulted in values significantly lower than baseline (Student's t -values of ,4.62 and ,2.77, respectively). For the implants of the test group PPD and mBI indexes were significantly higher at baseline than 36 months after (Student's t -values of +11.63 and +16.02, respectively). Recession index resulted in values significantly lower at baseline (Student's t -value of ,5.05). No statistically significant differences were found between PAL index measurement at baseline and 36 months later (Student's t -value of +0.89). In conclusion, resective therapy associated with implantoplasty seems to influence positively the survival of oral implants affected by inflammatory processes. Résumé Le but de cet essai clinique randomisé a été de comparer la guérison clinique de deux approches chirurgicales différentes pour le traitement de la paroïmplantite. Dix-sept patients avec des implants ITI® ont été inclus dans cette étude durant une période de cinq années. Les patients étaient répartis au hasard. Dix patients étaient traités avec une chirugie de résection et une modification de la topographie de surface (groupe test). Les derniers sept patients ont été traités avec la chirurgie de résection seulement (groupe contrôle). Des paramètres cliniques [suppuration, indice de plaque modifiée (mPI), indice de saignement modifié (mBI), profondeur de poche au sondage (PPD), pseudo poches (DIM), récession de la muqueuse (Rec), niveau d'attache au sondage (PAL)] ont été mesurés lors de l'examen initial et après six, douze, 24 et 36 mois. Le taux cumulatif pour les implants dans le groupe test était de 100% après trois années. Après 24 mois, deux implants vis creux du groupe contrôle ont été enlevés à cause de la mobilité. En conséquence, le taux de survie cumulatif était de 87,5%. L'indice de récession dans le groupe contrôle était significativement inférieur à celui du groupe test à 24 mois (valeur du test T de Student ,2,14). Par contre le groupe contrôle montrait des indices plus importants de PPD, PAL et mBI que le groupe test (valeurs du test T de Student respectivement de+5,50,+2,40,+9,61). Les indices PPD et mBI pour les implants du groupe contrôle étaient significativement plus importants lors de l'examen initial que 24 mois plus tard (valeurs du test T de Student respectivement de+ 3,18 et+3,33). Les indices de récession et de PAL résultaient en indices significativement inférieures que lors de l'examen initial (valeurs du test T de Student respectivement de ,4,62, ,2,77). Pour les implants du groupe test, les indices PPd et mBI étaient significativement plus importants lors de l'examen initial que 36 mois plus tard (valeurs du test T de Student respectivement de+11,63, 16,02). L'indice de récession résultait en indice significativement inférieur lors de l'examen initial (valeurs du test T de Student ,5,05). Aucune différence significative n'a été trouvée pour la mesure de l'indice PAL entre l'examen initial et 36 mois (valeur du test T de Student de+0,89). En conclusion, le traitement de résection associéà une plastieimplantaire semble influencer de manière positive la survie des implants dentaires affectés par les processus infectieux. Zusammenfassung Das Ziel dieser randomisierten klinischen Studie war, die klinischen Resultate von zwei verschiedenen chirurgischen Behandlungsvarianten der Periimplantitis zu vergleichen. Man nahm während einer Zeitdauer von fünf Jahren 17 Patienten mit ITI®-Implantaten fortlaufend in die Studie auf. Mit einem lotterieartigen System teilte man die Patienten zufällig auf. 10 der Patienten erhielten eine resektive Chirurgie und man modifizierte zusätzlich die Implantatoberfläche (Testgruppe). Bei den übrigen 7 wandte man ausschliesslich die resektive Chirurgie an (Kontrollgruppe). Zu Beginn sowie 6, 12, 24 und 36 Monate nach der Behandlung erhob man folgende klinischen Parameter: Eiterung, modifizierter Plaqueindex , mPI, modifizierter Blutungsindex , mBI, Sondierungstiefe , PPD, Pseudotaschen , DIM, Mukosarezession , Rec, sondierbares Attachmentniveau , PAL. Die kumulative Überlebensrate der Implantate in der Testgruppe betrug nach 3 Jahren 100%. Nach 24 Monaten mussten infolge Mobilität 2 Hohlschraubenimplantate der Kontrollgruppe entfernt werden. Daher betrug die kumulative Überlebensrate hier 87.5%. Der Rezessionsindex nach 24 Monaten war in der Kontrollgruppe signifikant tiefer als in der Testgruppe (T-Student Wert ,2.14). Dagegen zeigte die Kontrollgruppe höhere Indices bei der PPD, dem PAL und beim mBI als die Testgruppe (T-Student Werte von +5.5/+2.4 und +9.61). Die PPD und die mBI-Indices der Implantate aus der Kontrollgruppe waren zu Beginn signifikant höher als 24 Monate später (T-Student Werte von +3.18 und +3.33). Die Rezessions- und PAL-Indices waren dagegen signifikant tiefer als zu Beginn (T-Student Werte von ,4.62 und ,2.77). Bei den Implantaten der Testgruppe waren die PPD- und mBI-Indices zu Beginn signifikant höher als nach 36 Monaten (T-Student Werte von +11.63 und +16.02). Der Rezessionsindex war bei Studienbeginn signifikant tiefer (T-Student Wert von ,5.05). Bei den Messungen des PAL-Index konnte man zwischen den Anfangswerten und denjenigen nach 36 Monaten keine statistisch signifikanten Unterschiede erkennen (T-Student Wert von +0.89). Zusammenfassend kann man feststellen, dass eine resektive Therapie verbunden mit einer Oberflächenveränderung, die Überlebensrate der von einem entzündlichen Prozess betroffenen Implantate positiv zu beeinflussen vermag. Resumen El propósito de este estudio clínico aleatorio fue comparar los resultados clínicos de dos enfoques quirúrgicos diferentes para el tratamiento de periimplantitis. Se incluyeron a diecisiete pacientes consecutivos con implantes ITI® durante un periodo de cinco años. Los pacientes se asignaron aleatoriamente por medio de un sistema de lotería. Se trató a diez pacientes con cirugía resectiva y modificación de la topografía de superficie (grupo de prueba). Los siete pacientes restantes se trataron con cirugía resectiva solamente (grupo de control). Se recogieron parámetros clínicos (supuración, índice de placa modificado , mPI, índice de sangrado modificado , mBI, profundidad de sondaje de la bolsa , PPD, pseudobolsa , DIM, recesión mucosa , REC, nivel de inserción al sondaje , PAL) al inicio, al igual que a los 6, 12, 24 y 36 meses tras el tratamiento. El índice acumulativo de éxito del grupo de prueba tras 3 años fue del 100%. A los 24 meses se retiraron dos implantes huecos roscados del grupo de control debido a movilidad. Consecuentemente el índice acumulado de supervivencia fue del 87.5%. El índice de recesión en el grupo de control fue significativamente más bajo que en el grupo de prueba a los 24 meses (valor T-student de ,2.14). Por el contrario, el grupo de control mostró unos índices PPD, PAL y mBI mas altos que en el grupo de prueba (valores de T-student de +5.5 +2.4 y +9.61 respectivamente). Los índices PPD y mBI para los implantes del grupo de control fueron significativamente mas altos al inicio que 24 meses mas tarde (valores de T-student de +3.18 y +3.33 respectivamente). Los índices de recesión y PAL resultaron significativamente mas bajos que al inicio (valores de T-student de ,4.62 y ,2.77 respectivamente). Para los implantes del grupo de prueba los índices PPD y mBI fueron significativamente mas altos al inicio que tras 36 meses (valores de T-student de +11.63 y +16.02 respectivamente). El índice de recesión resultó ser significativamente más bajo al inicio (valores de T-student de ,5.05). No se encontraron diferencias estadísticamente significativas para las mediciones de índice de PAL al inicio y 36 meses mas tarde (valores de T-student de +0.89). En conclusión, la terapia resectiva asociada con implantoplastia parece influir positivamente sobre la supervivencia de los implantes orales afectados por procesos inflamatorios. [source]

    Bone formation at titanium porous oxide (TiUniteÔ) oral implants in type IV bone

    CLINICAL ORAL IMPLANTS RESEARCH, Issue 1 2005
    Yi-Hao Huang
    Abstract Background: Several oral implant design advances have been suggested to overcome poor bone quality, an impediment for successful implant treatment. A novel titanium porous oxide (TPO) surface has been shown to offer favorable results in several settings. The objective of this study was to evaluate the local bone formation and osseointegration at TPO-modified implants in type IV bone. Method: Three TPO surface-modified implants (TiUniteÔ) were installed into the edentulated posterior maxilla in each of 8 Cynomolgus monkeys. The animals were injected with fluorescent bone labels at 2, 3, 4 and 16 weeks post-surgery and were euthanized at week 16 when block biopsies were collected for histologic analysis. Results: The predominant observation of the TPO implant surface was a thin layer of new bone covering most of the implant threads. Mean (±SE) bone,implant contact for the whole study group was 74.1±4.8%. There was a significant variability in bone,implant contact between animals (P=0.0003) and between sites of the same animal (P<0.0001). The variance in bone,implant contact was 30% larger among sites of the same animal than between different animals (187.5 vs. 144.8, respectively). There was a small but significant difference in bone density immediately outside, compared to within the threaded area of the implants (37.1±3.2% vs. 32.1±3.2%, P<0.0001). Bone density outside the implant threads was significantly correlated (,=0.682, P<0.0001) with the bone density within thethreaded area. Bone density within the threaded area was significantly correlated (,=0.493, P=0.0002) with bone,implant contact, whereas bone density outside the implant threads did not have a significant effect (,=0.232, P=0.1). Conclusions: The results suggest that the TPO surface possesses a considerable osteoconductive potential promoting a high level of implant osseointegration in type IV bone in the posterior maxilla. Résumé Différents nouveaux modèles d'implants ont été suggéréspour tenter de compenser la mauvaise qualité osseuse qui est un problème pour le traitement implantaire à succès. Une nouvelle surface en oxyde poreux de titane (TPO) a apporté des résultats favorables en différentes occasions. L'objectif de cette étude a été d'évaluer la formation osseuse locale et l'ostéoïntégration d'implants modifiés TPO dans de l'os de qualité type IV. Trois implants dont la surface était modifiée TPO (TiUniteTM) ont été insérés dans un maxillaire édenté postérieur de huit singes cynomolgus. Les animaux ont subi des injections de marqueurs osseux par flurorescence à deux, trois, quatre et seize semaines après la chirurgie et ont été euthanasiés à la semaine 16 quand des biopsies en bloc ont été prélevées pour l'analyse histologique. L'observation prédominante de la surface implantaire TPO était une fine couche de nouvel os couvrant la plupart des filetages implantaires. La moyenne ±SE du contact os-implant pour tout le groupe étudiéétait de 74±5%. Il y avait une variation significative dans le contact os-implant entre les animaux (P<0,0003) et entre les sites d'un même animal (P<0,0001). La variance du contact os-implant était 30% plus importante parmi les sites du même animal qu'entre différents animaux (respectivement 187 et 145). Il y avait une différence significative bien que faible dans la densité osseuse immédiatement á l'extérieur comparéà l'intérieur des zones à filetage des implants (37±3% vs 32±3%, P<0,0001). La densité osseuse en dehors des filetages implantaires était en corrélation significative (ß=0,682, P<0,0001) avec la densité osseuse à l'intérieur des zones de filetage. La densité osseuse à l'intérieur des zones de filetage était en corrélation significative (ß=0,493, P<0,0002) avec le contact os-implant, tandis que la densité osseuse en dehors des filetages implantaires n'avait pas d'effet significatif (ß=0,232, P=0,1). Ces résultats suggèrent que la surface TPO possède un potentiel ostéoconducteur considérable qui peut promouvoir une ostéoïntégration implantaire de haut niveau dans l'os de type IV dans la région maxillaire postérieure. Zusammenfassung Ziel: Um trotz schlechter Knochenqualität die Aussicht auf eine erfolgreiche implantologische Behandlung zu verbessern, wurden verschiedene Entwicklungen des Designs von Zahnimplantaten vorgeschlagen. Bei verschiedenen Gelegenheiten hat eine neue poröse Titanoxidoberfläche (TPO) scheinbar vorteilhafte Resultate gezeigt. Das Ziel dieser Studie war, die lokale Knochenbildung und die Osseointegration von Implantaten mit einer TPO-modifizierten Oberfläche im Typ IV Knochen zu untersuchen. Methode: In die zahnlosen posterioren Oberkiefern eines jeden von 8 Cynomolgus-Affen implantierte man drei Implantate mit einer TPO-modifizierten Oberfläche (TiUnite®). Den Tieren wurden 2, 3, 4 und 16 Wochen nach dem chirurgischen Eingriff fluoreszierende Knochenmarker injiziert und in der Wochen 16 wurden sie eingeschläfert und für die histologische Analyse Blockbiopsien entnommen. Resultate: Die wichtigste Beobachtung bei der TPO-Implantatoberfläche war eine dünne Schicht neuen Knochens, welche die meisten Schraubenwindungen des Implantates bedeckte. Der mittlere Knochen-Implantatkontakt (±SE) betrug in der ganzen Testgruppe 74.1±4.8%. Man fand eine signifikante Variabilität des Knochen-Implantatkontaktes unterhalb der Tiere (P=0.0003) und auch unterhalb der verschiedenen Impantate desselben Tieres (P<0.0001). Innerhalb der Implantate desselben Tieres war die Varianz des Knochen-Implantatkontaktes bis zu 30% grösser, als zwischen den verschiedenen Tieren (187.5 gegenüber 144.8). Man fand auch einen kleinen, aber signifikanten Unterschied der Knochendichte im Bereich direkt ausserhalb der Schraubenwindungen, verglichen mit dem inneren Bereich (37.1±3.2% gegenüber 32.1±3.2%, P<0.0001). Diese beiden Knochendichten waren aber signifikant miteinander korreliert (0.682, P<0.0001). Die Knochendichte innerhalb der Schraubenwindungen korrelierte signifikant mit dem Knochen-Implantat-Kontakt (ß=0.493, P=0.0002), währenddem die Knochendichte ausserhalb des Bereiches der Schraubenwindungen in dieser Beziehung keine signifikante Korrelation aufwies (ß=0.232, P=0.1). Zusammenfassung: Die Resultate lassen vermuten, dass die TPO-Oberfläche eine beachtliche osteokonduktive Fähigkeit hat, die im posterioren Oberkieferbereich mit Typ IV Knochen zu einer sehr guten Osseointegration führt. Resumen Antecedentes: Se han sugerido varios avances en los diseños de los implantes orales para superar una baja calidad de hueso, un impedimento para un tratamiento exitoso de implantes. Se ha presentado una nueva superficie de óxido de titanio poroso (TPO) que ofrece resultados favorables en diversas situaciones. El objetivo de este estudio fue evaluar la formación local de hueso y la osteointegración en implantes TPO modificados en hueso tipo IV. Método: Se instalaron tres implantes (TiUniteTM) con superficie modificada TPO en el maxilar posterior edéntulo en 8 monos Cynomolgus. Los animales fueron inyectados con marcadores óseos fluorescentes en la semana 2, 3, 4 y 16 tras la cirugía y se sacrificaron en la semana 16 recogiéndose biopsias en bloque para análisis histológicos. Resultados: La observación predominante de la superficie TPO del implante fue una fina capa de hueso nuevo cubriendo la mayor parte de las roscas. El contacto hueso-implante medio (±SE) para todo el grupo de estudio fue de 74.1±4.8%. Hubo una variabilidad significativa en el contacto hueso-implante entre animales (P=0.0003) y entre lugares del mismo animal (P<0.0001). La varianza en el contacto hueso-implante fue un 30% mayor entre lugares del mismo animal que entre los diferentes animales (187.5 vs. 144.8, respectivamente). Hubo una pequeña pero significativa diferencia en la densidad ósea inmediatamente por fuera comparada con el área roscada de los implantes (37.1±3.2% vs. 32.1±3.2%, P<0.0001). La densidad ósea por fuera de las roscas del implante se correlacionó significativamente (,=0.682, P<0.0001) con la densidad ósea entre las áreas de roscas. La densidad ósea entre las áreas de roscas se correlacionó significativamente (,=0.492, P<0.0002) con el contacto hueso implante, mientras que la densidad ósea por fuera de las roscas del implante no tuvo un efecto significativo (,=0.232, P=0.1). Conclusiones: Los resultados sugieren que la superficieTPOposee un considerable potencial osteoconductivo promoviendo un alto nivel de osteointegracióndel implante en hueso tipo IV en el maxilar posterior. [source]

    Impact of IL-1 genotype and smoking status on the prognosis of osseointegrated implants

    CLINICAL ORAL IMPLANTS RESEARCH, Issue 4 2004
    Boris Gruica
    Abstract Aim: This study evaluated the impact of the IL-1 genotype and smoking status on the prognosis and development of complications of osseointegrated implants. Material and methods: The clinical charts of 180 consecutively admitted patients were analyzed with respect to the occurrence of biological complications in conjunction with oral implants. Biologic complications were defined as clinical conditions with suppuration from the peri-implant sulcus, development of a fistula or peri-implantitis with radiologic bone loss. All patients had received one or more ITI® dental implants, which had been in function for at least 8 (range: 8,15) years. This patient population had received 292 implants. From these, 51 implants in 34 patients showed late (infectious) biologic complications, and 241 implants had survived without any biologic complications at all. Results: Of the 180 patients, 53 were smokers, who were subdivided in a series of classes according to their intensity of smoking and 127 were never smokers. Sixty-four of 180 (36%) patients tested positive for the IL-1 genotype polymorphism. This prevalence corresponds to previous reports for the prevalence of European descent populations. The results for the non-smoking group indicated no significant correlation between implant complications and a positive IL-1 genotype. However, there was a clear association for heavy smokers between a positive IL-1 genotype and implant complications. 6 of 12 or half of the heavy smokers and IL-1 genotype-positive patients had either an implant failure, i.e. loss of implant, or a biologic complication during the follow-up period. Conclusions: These findings have led to the conclusion that there is a synergistic effect between a positive IL-1 genotype and smoking that puts dental implants at a significantly higher risk of developing biologic complications during function. Résumé Le but de cette étude a été d'évaluer l'impact du génotype IL-1 du tabagisme sur le pronostic et le développement de complication des implants buccaux ostéoïntégrés. Les dossiers cliniques de 180 patients ont été analysés en ce qui concerne l'arrivée de complications biologiques en association avec les implants buccaux. Des complications biologiques étaient définies en tant que conditions cliniques avec suppuration depuis le sillon paroïmplantaire, le développement d'une fistule ou d'une paroïmplantite avec perte osseuse radiologique. Tous les patients avait reçu un ou plusieurs implants buccaux ITI qui avaient été en fonction pour au moins huit années (de 8 à 15 ans). Les patients avaient reçu 292 implants. Parmi ceux-ci 51 chez 34 patients ont montré des complications biologiques tardives (infectieuses) et 241 avaient survécu sans aucune complication biologique. Des 180 patients, 53 étaient fumeurs qui ont été divisés en une série de classes suivant l'intensité du tabagisme tandis que 127 étaient non-fumeurs. Soixante-quatre des 180 patients (36%) ont été testés positifs pour le polymorphisme du génotype IL-1. Cette fréquence globale correspond au rapport précédent pour la fréquence globale des populations européennes. Les résultats pour le groupe non-fumeur indiquait qu'il n'y avait aucune relation significative entre les complications implantaires et un génotype IL-1 positif. Cependant, il y avait une association évidente pour les gros fumeurs entre le génotype IL-1 positif et des complications implantaires. Six des douze soit la moitié des gros fumeurs et des patients au génotype IL-1 positif avaient soit un échec implantaire (c.-à-d. la perte de l'implant) soit une complication biologique durant le suivi. Ces résultats ont conduit à la conclusion qu'il y a un effet synergétique entre le génotype IL-1 positif et le tabagisme mettant les implants buccaux à un risque beaucoup plus important à développer des complications biologiques durant leur mise en fonction. Zusammenfassung Ziel: Diese Studie untersuchte den Einfluss des IL-1 Genotyps und der Rauchgewohnheiten auf die Prognose und auf die Entwicklung von Komplikationen bei osseointegrierten Implantaten. Material und Methoden: Die Krankengeschichten von 180 aufgenommenen Patienten wurden auf biologische Komplikationen in Zusammenhang mit Zahni Implantaten untersucht. Biologische Komplikationen wurden definiert als klinische Zustände mit Suppuration aus dem periimplantären Sulcus, Entwicklung einer Fistel oder Periimplantitis mit radiologischem Knochenverlust. Alle Patienten waren mit einem oder mehreren ITI® Implantaten versorgt worden, welche für mindestens 8 Jahre (Bandbreite: 8,15 Jahre) in Funktion standen. Diese Patientenpopulation war mit 292 Implantaten versorgt worden. Von diesen 292 Implantaten zeigten 51 Implantate bei 34 Patienten biologische (infektiöse) komplikationen und 241 Implantate hatten ohne biologische Komplikationen überlebt. Resultate: Von den 180 Patienten waren 53 Raucher, welche in Untergruppen gemäss Schweregrad des Rauchens aufgeteilt wurden und 127 waren Nicht-Raucher. 64 der 180 Patienten (36%) zeigten ein positives Testergebnis bezüglich IL-1 Genotyp Polymorphismus. Diese Prävalenz entspricht früheren Berichten über die Prävalenz bei einer Population europäischer Abstammung. Die Resultate der Nicht-Raucher Gruppe zeigten keine signifikanten Korrelationen zwischen Implantatkomplikationen und einem positiven IL-1 Genotyp. Jedoch bestand bei den starken Rauchern eine klare Assoziation zwischen dem positiven IL-1 Genotyp und Implantatkomplikationen. 6 von 12 oder die Hälfte der starken Raucher und IL-1 Genotyp positiven Patienten zeigten entweder einen Implantat Misserfolg, z.B. Verlust des Implantats, oder eine biologische Komplikation während der Beobachtungsperiode. Schlussfolgerung: Die Ergebnisse haben zur Schlussfolgerung geführt, dass ein synergistischer Effekt zwischen einem IL-1 positiven Genotyp und Rauchen besteht, welcher Zahni Implantate einem signifikant höheren Risiko für die Entwicklung von biologischen Misserfolgen während der Funktion aussetzt. Resumen Intención: Este estudio evaluó el impacto del genotipo IL-1 y el estatus de fumador en el pronóstico y desarrollo de complicaciones de implantes orales osteointegrados. Material y métodos: Se analizaron las historias clínicas de 180 pacientes admitidos consecutivamente en lo referente a la ocurrencia de complicaciones biológicas en conjunción implantes orales. Se definieron las complicaciones orales como condiciones clínicas con supuración del surco periimplantario, desarrollo de una fístula o de periimplantitis con pérdida radiológica de hueso. Todos los pacientes recibieron uno o mas implantes orales ITI®, que levaban al menos 8 (rango 8,15) años en función. Esta población de pacientes recibió 292 implantes orales. De estos, 51 implantes de 34 pacientes mostraron (infecciones) complicaciones biológicas tardías, y 241 implantes sobrevivieron sin ninguna complicación biológica. Resultados: De los 180 pacientes, 53 eran fumadores que se subdividieron en una serie de categorías de acuerdo con su intensidad de consumo de tabaco y 127 nunca fueron fumadores. 64 de 180 (36%) dieron positivo al test del polimorfismo genético de la IL-1. Esta prevalencia corresponde con informes previos de prevalencia en poblaciones de origen europeo. Los resultados para el grupo de los no fumadores no indicó relación significativa entre complicaciones de los implantes y genotipo IL-1 positivo. Sin embargo, hubo una asociación clara para los fumadores intensos entre complicaciones de los implantes y un genotipo IL-1 positivo. 6 de 12 o la mitad de los fumadores intensos y los pacientes genotipo IL-1 positivo tuvieron o fracaso del implante i.e. pérdida del implante o una complicación biológica durante el periodo de seguimiento. Conclusiones: Estos hallazgos nos han conducido a la conclusión de que hay un efecto sinérgico entre genotipo IL-1 positivo y tabaquismo que colocan a los implantes orales en un riesgo significativamente mas alto para desarrollar complicaciones biológicas durante la función. [source]