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PubMed2004

Cantilever fixed prostheses utilizing dental implants: a 10-year retrospective analysis.

OBJECTIVE: The dental literature has been unclear about long-term success of fixed cantilever prostheses supported by dental implants. The disappointing results reported when cantilever fixed partial dentures (FPDs) are supported with natural teeth are not directly applicable to implant cantilever FPDs. This article reports on 10 years of implant-retained fixed prostheses primarily in the maxillary arch using the ITI dental implant system. METHOD AND MATERIALS: Sixty cantilever prostheses using 115 ITI dental implants on 36 patients were placed and monitored over a 10-year period. RESULTS: No implant fractures, abutment fractures, porcelain fractures, prosthesis fractures, soft tissue recession, or radiographic bone loss were recorded. All 60 cantilevered prostheses remain in satisfactory function. CONCLUSION: Positive, long-term results, using implant-retained cantilever FPDs can be achieved by: (1) using a rough surface implant of 4.1 mm or greater; (2) using an implant/abutment design that reduces stacked moving parts and reduces the implant-to-crowns ratio; and (3) using a cementable prosthesis design that eliminates the need for occlusal screw retention.

Adult↗
PubMed1993

Dental implants.

The use of dental implants in the oral rehabilitation of partially or fully edentulous patients has become a frequently used treatment modality in everyday practice. The main reason for this development is that critical principles for implant predictability have been established in the last twenty years. Today, researchers and clinicians of all dental subspecialties including cosmetic dentistry are working at refining techniques and extending the limits of the field. This paper is intended to point the reader to interesting publications from 1991 through 1992.

Animals↗
PubMed2007

Effect of stress on information processing in the dental implant surgery setting.

OBJECTIVES: Dental implantation is a stressful experience, both physically and psychologically. The effect of anxiety on the patient's ability to process relevant information prior to a stressful clinical situation (implant insertion) was evaluated. MATERIALS AND METHODS: The study included 98 healthy patients, scheduled for implant insertion. Two different audio-tapes with relevant information regarding implant insertion were listened to immediately pre-operatively. Recognition questionnaires, consisting of 21 statements (correct and false information) were prepared, one for each tape. The dental anxiety scale (DAS), degree of state anxiety (SA), evaluation of pain expected during surgery, and extent to which patients understood the information provided were examined on 100 mm visual analogue scales. RESULTS: A significant positive correlation was found between patients' DAS and SA and between patients' expectation to experience pain during the surgical procedure. Certainty of understanding (CU) significantly contributed to the explanation of correctly classified statements (beta=-0.43, t=3.71, P<0.01). CU was positively related to SA and negatively to DAS. CONCLUSIONS: In a stressful pre-surgical situation, the ability to process relevant information may be severely impaired and should not be given to patients immediately before planned treatment.

Adult↗
PubMed2006

The effects of loading time on osseointegration and new bone formation around dental implants: a histologic and histomorphometric study in dogs.

BACKGROUND: Immediate loading of dental implants has been introduced as a method of reducing implant treatment time without compromising its prognosis. In this research, the effects of loading time on the amount of bone-to-implant contact and bone formation around dental implants were evaluated histologically. METHODS: Three months prior to implantation, the lower premolar teeth of 15 dogs were extracted. Three or four dental implants were placed in the healed extraction sites for each dog (N = 48). Dividing the dogs into three groups, the implants were either loaded 48 hours or 1 week later with metallic or prefabricated acrylic crowns or were left unloaded until the time of sacrifice. Three months after implant insertion, the animals were sacrificed and samples were investigated to define the amount of bone-to-implant contact, lamellar and woven bone percentage, and local inflammation of the newly formed bone. RESULTS: No significant difference in the observed criteria was reported among the three groups (P >0.05); however, the unloaded group had the highest degree of bone-to-implant contact and the group loaded 48 hours after the primary implant insertion had the least. The prosthesis type had no significant effect on the implant success rate (P >0.05). The lamellar and woven bone percentage of newly formed bone also did not differ in the three groups (P >0.05). One implant from each group failed in this study. CONCLUSION: Loading time does not seem to significantly affect the degree of osseointegration and bone-to-implant contact and the composition of newly formed bone around dental implants.

Acrylic Resins↗
PubMed2005

Interventions for replacing missing teeth: dental implants in zygomatic bone for the rehabilitation of the severely deficient edentulous maxilla.

BACKGROUND: Dental implants are used for replacing missing teeth. Placing dental implants is limited by the presence of adequate bone volume permitting their anchorage. Several bone augmentation procedures have been developed to solve this problem. Zygomatic implants are long screw-shaped implants developed as a partial or complete alternative to bone augmentation procedures for the severely atrophic maxilla. One to three zygomatic implants can be inserted through the posterior alveolar crest and maxillary sinus to engage the body of the zygomatic bone. A couple of conventional dental implants are also needed in the frontal region of the maxilla to stabilize the prosthesis. The potential main advantages of zygomatic implants could be that in some situations bone grafting may not be needed and a fixed denture could be fitted sooner. Another specific indication for using zygomatic implants could be the need of maxillary reconstruction after maxillectomy in cancer patients. OBJECTIVES: To test the hypothesis of no difference in outcomes between zygomatic implants with and without bone augmenting procedures in comparison with conventional dental implants in augmented bone for severely resorbed maxillae. SEARCH STRATEGY: We searched the Cochrane Oral Health Group's Trial Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE. We handsearched several dental journals. No language restrictions were applied. Personal contacts and all known zygomatic implant manufacturers were contacted to identify unpublished trials. Most recent search: May 2005. SELECTION CRITERIA: Randomised controlled clinical trials (RCTs) including patients with severely resorbed maxillae who could not be rehabilitated with conventional dental implants, treated with zygomatic implants with and without bone grafts versus patients treated with conventional dental implants in conjunction with bone augmentation procedures having a follow up of at least 1 year. Outcome measures considered were: prosthesis and implant failures, side effects, patient satisfaction and cost effectiveness. DATA COLLECTION AND ANALYSIS: Screening of eligible studies, assessment of the methodological quality of trials and data extraction were to be conducted in duplicate and independently by two authors. Results were to be expressed as random-effects models using weighted mean differences for continuous outcomes and risk ratio for dichotomous outcomes with 95% confidence interval. Heterogeneity was to be investigated including both clinical and methodological factors. MAIN RESULTS: No RCTs or controlled clinical trials (CCTs) were identified. AUTHORS' CONCLUSIONS: There is the need for RCTs in this area to assess whether zygomatic implants offer some advantages over alternative bone augmentation techniques for treating atrophic maxillae.

Alveolar Ridge Augmentation↗
PubMed2003

Prosthodontic complications of Spline dental implants.

Access to accurate clinical data on the frequency of prosthodontic complications encountered in dental implant restorations can provide dentists with important information for evaluating dental implant systems. The complication of prosthetic screw loosening, for example, has often been ignored or under-reported. Only limited published clinical data exists on the use of the Spline connections for dental implant restorations. This paper reports on an in-vitro investigation of prosthodontic complications encountered with the Spline dental implant system restored by students and residents at The Ohio State University's School of Dentistry. From a comprehensive list of implant patients generated from the University's computer records, an extensive chart review was conducted, and all patients who were treated with Spline dental implants were entered into the study. During a second chart review, data on all prosthodontic complications with Spline implant restorations were gathered on reporting forms then entered into a computer database and subjected to statistical analysis. The results showed that 95.75% of the prostheses were free of any complications. Iatrogenic factors that resulted in screw loosening were identified. Based on the findings of this relatively short-term study ranging from 29 to 59 months of post-restoration clinical follow-up, Spline dental implants provided a stable implant prosthetic connection.

Adolescent↗
PubMed2000

A retrospective study of dental implants in diabetic patients.

The efficacious placement of dental implants in diabetic patients remains controversial. Definitive guidelines with objective criteria, including the type of diabetes, age of onset, and level of long-term control, have not been determined. In addition, few relevant literature citations assess the survival rate of implants in diabetic patients. Therefore, it is the purpose of this study to assess the success and survival rates of dental implants in diabetic patients. In this retrospective analysis, 215 implants placed in 40 patients at 2 clinical centers were evaluated. Chart reviews and interviews provided medical and implant data. From the analysis, 31 failures occurred, for an overall success rate of 85.6%. Of these failures, 24 occurred within the first year of functional loading. The mean time of functional load was 4.05 +/- 2.6 years. When the success rate was analyzed by implant location, success rates for the maxilla and mandible were 85.5% and 85.7%, respectively. For the anterior and posterior regions, success rates were 83.5% and 85.6%, respectively. The lifetable analysis revealed a cumulative success rate of 85.7% after 6.5 years of function. Based on the data, the survival rate of dental implants in controlled diabetic patients is lower than that documented for the general population, but there is still a reasonable success rate. The increase in failure rate occurs during the first year following prosthetic loading.

Blood Glucose↗
PubMed2003

[Evaluation of the clinical efficiency of allogenic lyophilized dura mater membrane in immediate and early delayed dental implantation].

Immediate and early dental implantation helps timely restore the functional and cosmetic intactness of the maxillodental system. Seventy-four patients were operated on by these methods and 116 implants were inserted. The results were evaluated by common clinical, special computer-aided x-ray methods, and biopsy. Comparative studies proved that allogenic lyophilized dura mater membrane promoted recovery of the alveolar bone tissue structure and compactness, improved the implant osteointegration, and reduced the incidence of unfavorable outcomes.

Adult↗
PubMed2002

Macro design morphology of endosseous dental implants.

STATEMENT OF PROBLEM: The identification of dental implant bodies in patients without available records is a considerable problem due to increased patient mobility and to the large number of implant systems with different designs. PURPOSE: The purpose of this study was to document the designs of selected implants to help clinicians identify these implants from their radiographic images. MATERIAL AND METHODS: More than 50 implant manufacturers were contacted and asked to provide implants with dimensions as close as possible to 3.75 mm (diameter) x 10 mm (length). Forty-four implants were donated, separated into threaded and non-threaded categories, and further sorted into tapered and non-tapered categories. The implants were examined visually, and features on the entire circumference and length of each implant were recorded and categorized as coronal, midbody, or apical. RESULTS: A series of tables describe the 44 implants according to coronal, midbody, and apical features. CONCLUSION: The results of this project offer dentists basic knowledge of the design of selected dental implants. Such knowledge can aid the radiographic identification of these implants.

Dental Implantation, Endosseous↗
PubMed1993

Educating a patient with dental implants.

A functional dentition can be restored for edentulous and partially edentulous patients through the placement of dental implants. Dental assistants have a significant role in the education of implant patients so that meticulous oral self-care can be accomplished. Only through the combined team efforts of the dental office staff and patients themselves will the continued success of dental implantology be insured.

Dental Assistants↗
PubMed2004

Patterns of tissue remodeling after placement of ITI dental implants using an osteotome technique: a longitudinal radiographic case cohort study.

The aim of this prospective study was to document radiographically tissue remodeling patterns around ITI implants placed according to an osteotome technique. In 19 consecutive patients from a private practice, 25 implants of the ITI Dental Implant System were placed subjacent to the sinus floor. Implant beds were pre-prepared with pilot drills and/or using the Summers Osteotome Kit. Bio Oss particles were mixed with autologous bone and inserted into the apex area. Implants were placed self-tapping. The sinus floors were thereby pushed up with attempts not to sever the Schneiderian membrane. Healing occurred submerged or semi-submerged and was uneventful in 24/25 implants. At 1 year, all implants had been restored with crowns or short fixed partial dentures. One implant was lost in the first 3 weeks, but was replaced 6 months later in a second attempt. Intraoral radiographs were obtained presurgically and postsurgically at 3 and 12 months. The mean preoperative distance between the sinus floor and the crest was 7.0 mm (range 2.3-10.3 mm). The mean distances between the implant apex and the initial sinus floor were: 3.66 +/- 1.74 mm mesially and 4.44 +/- 1.62 mm distally. The mean height of the new bone reaching apically and mesially to the implants was 1.52 +/- 2.48 mm at surgery, but was reduced significantly to 1.24 +/- 1.30 mm at 3 months and 0.29 +/- 1.91 mm after 12 months (Hotelling's test P< or =0.01). Similar values were obtained at the disto-apical aspects. In an attempt to assess periapical bone/graft remodeling, a novel index was applied: 0=no bone/graft visible, 1=cloudy appearance of new bone/graft, 2=clearly visible new bone/graft disappearing structures of original sinus floor, 3=new bone/graft with new cortical plate and the former boundary of the sinus floor disappearing. This index increased statistically significantly from baseline to 12 months (Hotelling's test P< or =0.02). In conclusion, this study shows that in areas with reduced bone height subjacent to the sinus, an osteotome technique may provide a minimally invasive way to obtain implant abutments predictably. The grafted area apical to the implants undergoes shrinkage and remodeling. The original boundary of the sinus is eventually consolidated and replaced by a new cortical plate. In addition to the linear measurements, the novel index may assist in assessing periapical remodeling at implants placed with an osteotome technique.

Adult↗
PubMed2006

Measuring mobility of 2 dental implant fixtures of different configurations: an in vitro study.

OBJECTIVES: To our knowledge, it has not as yet been determined if mini-dental implants can be used as a long-term treatment method compared to endosseous standard root-form dental implant fixtures. This in vitro study investigates the stability of 2 different implants, 1 mini-dental implant and 1 endosseous standard root form dental implant, under lateral forces. METHODS: There were 2 different screw-type dental implants with the O-ring/ball attachment prosthetic heads used. A mini-dental implant (Sendax MDI MAX; IMTEC, Corp., Ardmore, OK) 13 mm in length and 2.2 mm in diameter, and root form implant (Brånemark; Nobel Biocare AB, Goteborg, Sweden) 13 mm in length and 4 mm in diameter. These implants were then embedded into a matrix mixture of pumice, two-fifths BaSO4 powder and one-fifth plaster. Parallel periapical radiographs were taken pretest and after lateral forces were applied. The implants were vibrated using electric toothbrushes. They were attached to O-rings on the implants. Periapical radiographs were secured periodically every 5 minutes. The first discrepancy was observed at the 35th minute. Mobility and discrepancy values were recorded at the instances of 35th, 60th, 90th, and 120th minutes. Stability was measured and recorded using a manual stress and tension gauge. Radiographic discrepancy values were measured using a stereomicroscope. RESULTS: The Brånemark implant showed less mobility and discrepancy values than the mini-dental implant. The discrepancies were observed mostly at the cervical region of the 2 implants. CONCLUSIONS: According to the experimental results of this study, the Brånemark implant was more stable than the mini-dental implant at the end of 2 minutes.

Dental Implants↗
PubMed1992

Public awareness and acceptance of dental implants.

To investigate public awareness and acceptance of dental implants, 120 adult US citizens were asked to answer a questionnaire. Of the 109 persons who completed the questionnaire, 77% had heard about dental implants, mostly through media and lay persons. Only 17% named a dentist or physician as the source of information. Persons with many missing teeth were not more aware of implants than those with fewer missing teeth. Of 19 removable denture prosthesis wearers, 15 knew about implants but only one third learned of them from their dentist or physician. Of 84 persons with information about implants, 51 would consider implant treatment, 17 would not, and 16 were undecided. Esthetics was the most frequent motivating factor favoring implants, while high cost was the most frequent argument against them. Younger interviewees were significantly more often in favor of implants than older persons. It was concluded that public awareness and acceptance of dental implants are high. Dentists and physicians, however, play only a minor role as sources of information.

Adult↗
PubMed1991

[Implant study of glass-ceramics in rat femurs--evaluations for dental implant applications].

In order to evaluate the possibility of dental implant application of glass-ceramics (GC), an implant study using rat femurs was performed. This GC contains crystalline apatite, wollastonite and diopside in a CaO-P2O5-MgO-SiO2-CaF2 glassy matrix. The cylindrical GC were implanted in the drilled holes of the femurs and the histologic reactions to the GC and the crystallographic changes of the GC were investigated at the timed sequence for one year. The GC provoked the endosteal bone formation. The intervening fibrous tissue between the encapsulating bone and the GC was replaced by bone tissue which was outgrowing from the encapsulating bone surface. Finally, the interface between them was bonded. The surface layer of the GC was changed morphologically and crystallographically. During these bonding phenomena, the X-ray intensities of Ca, P, Si and Mg and the crystalline pattern of the apatite crystal in this reactive zone changed. These changes might be closely related to the bone-bonding between the encapsulating bone and the GC. These results indicate the excellent biocompatibility of the GC and suggest the effective clinical application of the GC as a dental implant.

Animals↗
PubMed2000

Sinus lift procedure of the maxilla in patients with inadequate bone for dental implants: radiographic appearance.

OBJECTIVE: Dental implants have gained popularity for treating edentulism, but some patients develop jaw atrophy, which leaves insufficient bone for implants. To treat these patients, the sinus lift procedure, which augments bone, was developed. Altered anatomy from this procedure has an unusual radiographic appearance, confusing those unfamiliar with it. We describe the sinus lift procedure and its radiographic appearance. CONCLUSION: With knowledge of this surgery and some of its pitfalls, radiographs can be more easily and accurately interpreted.

Aged↗
PubMed1998

Primary insertion of osseointegrated dental implants into fibula osteoseptocutaneous free flap for mandible reconstruction.

Twelve patients with segmental mandibular defects were reconstructed with fibula osteoseptocutaneous flaps and simultaneous placement of osseointegrated implants. Decision to perform this procedure was based on the facts that all patients had benign diseases, did not require postoperative radiotherapy, were in good general and oral conditions, and were psychologically motivated. A total of 34 fixtures was inserted in the first stage. Eight patients underwent second stage surgery, which consisted of connection of the implant abutments to the fixtures and the use of palatal mucosal grafts around the implants. Final dental prostheses were fixed 1 month later in seven patients, at this time. All flaps survived after surgery, and no implant failure was observed after a mean follow-up period of 25 months. Only one fixture was not used during the subsequent stage and was left as a sleeper. Fixed dental prostheses were used in five patients and removable overlay prostheses in the other two. Chewing function was recovered between 4 and 6 weeks after the start using the definitive dental prosthesis. In contrast to previous results, we conclude that excellent results can be achieved when this combined procedure is used in carefully selected patients. In addition, it is confirmed that the fibula osteoseptocutaneous flap is a versatile, reliable composite tissue that facilitates primary placement of osseointegrated dental implants during mandible reconstruction, thus allowing full oral rehabilitation in a shorter period of time.

Adolescent↗
PubMed2005

The role of implant surface modifications, shape and material on the success of osseointegrated dental implants. A Cochrane systematic review.

We tested the hypothesis of no difference in implant failures between various dental implant types. We searched for all randomised clinical trials comparing different implant types/systems with a follow up of at least one year on four databases. Screening of eligible trials, quality assessment and data extraction were conducted in duplicate. Thirty-one trials were identified. Twelve trials, reporting results of 512 patients, were included. No significant differences were observed for implant failures. There were minor statistically significant differences for peri-implant bone level changes. Turned surfaces had a 20% reduction in risk of being affected by perimplantitis over a 3-year period.

Dental Implantation, Endosseous↗