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PubMed2004

Mandibular reconstruction with microsurgical bone flap and dental implants.

Functional reconstruction of the mandible following resection or traumatic injury depends on the bony reconstruction and support dental implants. Microsurgical bone flaps allow the transfer of bone and soft tissue with a rich vascular supply and provide a firm basis for placement of dental implants in mandible reconstruction. Endosseous dental implants may improve functional restoration by ensuring the stable dentition essential for normal mastication and speech. In this review article, donor sites of microsurgical bone flaps, criteria for placement of dental implants, timing for dental implantation, bone resorption, role of radiotherapy and hyperbaric oxygen, and success rate of dental implants are discussed.

Animals↗
PubMed2005

Amine fluoride/stannous fluoride and chlorhexidine mouthwashes as adjuncts to single-stage dental implants: a comparative study.

BACKGROUND: The growing popularity of non-submerged dental implants in recent years requires a greater emphasis on microbial plaque control. Chlorhexidine (CHX), the most commonly used mouthwash in implant surgery, is sometimes associated with tooth staining and alteration in taste perception. Amine fluoride/stannous fluoride (AmF/SnF2) mouthwash has been shown to have anti-infective properties; however, it has not been tested as an adjunct anti-infective means in non-submerged dental implants. The purpose of this trial was to compare AmF/SnF2 and CHX mouthwashes as adjuncts to single-stage dental implants. METHODS: Thirty-three patients aged 34 to 79 (mean 54.30 +/- 8.69 SD) requiring dental implants were accepted into the study. Following comprehensive periodontal therapy patients received one to three non-submerged dental implants (maxilla: 17; mandible: 45; anterior: 3, posterior: 59). After surgery patients were given analgesics and antibiotics as well as 2,400 ml of coded mouthwash bottles previously randomized between the two above mentioned formulations. Clinical and radiographic parameters were recorded at baseline and 3 and 12 months post-surgery. RESULTS: Twelve-month survival rates were 100% and 92.9% for the AmF/SnF2 and CHX groups, respectively. Compliance was slightly higher in the AmF/SnF2 group (84.35% +/- 3.39% versus 78.15% +/- 4.59% SE) but statistically similar. There was no statistically significant difference between the AmF/SnF2 and CHX groups in staining index at 3 months (1.519 +/- 0.22 versus 1.457 +/- 0.24 SE) and patient subjective evaluation of the mouthwashes. Radiographic bone loss was 0.79 +/- 0.23 and 1 +/- 0.13 SE at 3 months and 1.06 +/- 0.13 and 1.27 +/- 0.25 at 12 months for the CHX and AmF/SnF2 groups, respectively; the difference was statistically insignificant (P = 0.388 and 0.504, respectively). CONCLUSION: Both CHX and AmF/SnF2 mouthwashes can be used post-surgically after one-stage implant surgery.

Adult↗
PubMed1975

Composite materials for dental implants.

The requirements of endosteal dental implants are unique and stringent. The materials currently applied to implantation do not offer convincing evidence of satisfying these needs. This preliminary study reports on attempts at developing materials which would aid in obtaining a mucosal seal to maintain the integrity of the osseous, periosteal, and submucosal compartments from the oral environment and the attachment to bone as related to stress distribution. The materials that were under study were ceramic bonded to base metals and Dacron.

Aluminum↗
PubMedDate not supplied

[Current status of therapy with dental implants].

The objective of the present article was to review the literature concerning the use of dental implants during the last decades. It is based on the excellent paper published by Dr. Roland Meffert in the Proceedings of the World Workshop in Clinical Periodontics of 1989. The following points were analyzed: 1) The current criteria of success for dental implants. 2) The histology of the perimucosal or transgingival area surrounding the dental implants. 3) The means of retention of the different types of dental implants. 4) Four basic forms of dental implants: a) Blade-Vent implants, b) Transosteal Implants, c) Osseointegrated Implants, and d) Subperiosteal Implants. 5) The steps for the construction of an osseointegrated prosthesis. 6) The maintenance of the case. 7) Indications and contraindications of the different types of implants. 8) Conclusions. 9) Bibliography.

Dental Implantation↗
PubMed1993

Immediate placement of dental implants into extraction sockets: surgically-related difficulties.

Osseointegrated dental implants have proven predictably successful when appropriate guidelines are followed. The Branemark Technique includes a period of up to 12 months for post-extraction bone healing. This delay, combined with the inevitable ridge resorption following extraction may contribute to several problems. The two common difficulties are: insufficient available bone for ideal implant placement and, prolonged treatment time. Recently several investigators have reported on the immediate placement of osseointegrated dental implants into extraction sockets. This technique was developed in order to eliminate or minimize the problems associated with delayed implant placement. Readers are referred to: Oral Health, pg. 19, July 1992, which discusses the technique and advantages of immediate placement of dental implants into extraction sockets. This paper discusses some of the difficulties associated with immediate implant placement. Several types of complications that may occur are summarized in Table I and expanded in the text of the article.

Alveolar Bone Loss↗
PubMed2004

Immediate restoration and loading of dental implants: clinical considerations and protocols.

The use of dental implants to assist in the treatment of partial and complete edentulism is well documented. Most of the implant literature, however, reports results associated with implant survival and success when there has been adherence to rigid placement and loading protocols. Conventionally, these protocols call for the undisturbed healing of the implant-3 months in the mandible and 4 to 6 months in the maxilla. This article evaluates the literature and develops protocols for clinical procedures for the early or immediate restoration or loading of dental implants. Criteria are established for defining immediate loading, immediate restoration, early loading, and early restoration as compared to conventional protocols. The review assesses factors that influence accelerated loading and restoration decisions, including bone quality and quantity, implant design, splinting of implants, and prosthetic design. Conclusions and recommendations are made based on the experience of the consensus group charged with considering these procedures and on the current literature published on these protocols.

Bone Density↗
PubMed2005

A six-year study of hydroxyapatite-coated root-form dental implants.

BACKGROUND: The effect of hydroxyapatite coating of dental implants is controversial. The long-term fate of hydroxyapatite-coated implants has been the subject of some criticism. PURPOSE: The aim of this retrospective study was to assess the clinical outcome of hydroxyapatite-coated cylindrical root-form endosseous Impladent dental implants (LASAK Ltd, Prague, Czech Republic) during a six-year course. METHODS: Three-hundred and ninety-one consecutively placed implants were used in 169 patients and followed for four to six years. Interval and cumulative success of implants and prostheses survival was tabulated. Marginal bone loss was measured RESULTS: Of the total number of implants, 98.5% achieved initial osseointegration. The cumulative success was 98.3% after one year, 97.0% after three years, 92.8% after five years and 90.4% after six years. The prostheses survival at the end of the study was 100% for fixed bridges totally supported by implants, 96.5% for fixed bridges with combined implant and tooth support, 94.2% for single crowns, 90.9% for mandibular overdentures and 81.3% for maxillary overdentures. Marginal bone loss averaged 2.4 +/- 0.8 mm at the end of five years. CONCLUSION: The success rate of the investigated hydroxyapatite-coated implants was comparable with the data presented in the literature and with the results of the similar implants without hydroxyapatite-coating. However, the marginal bone loss was of interest. Longer monitoring of the implants is necessary.

Alveolar Bone Loss↗
PubMed2005

[Morphologic analysis of reparative osteogenesis in cases of immediate dental implantation in experiments on rabbits].

In experiments on 24 rabbits it was found out that in the period from 2 to 6 weeks after the tooth had been extracted regenerative tissue in alveola went through the series of successive stages of maturation, beginning from indifferent areolar tissue and finishing with porous fibroreticular bone. Similar process of reparative osteogenesis took place around the implant after immediate dental implantation and young bone tissue had been formed during 2 months. In the area of artificial osseous defect under the membrane of allogenic lyophilic dura mater the adequate osteointegration of implants was observed, while without this membrane transgression of regeneration of the jaw-bone took place.

Alveolar Process↗
PubMed2005

Factors affecting soft tissue around dental implants: a review of the literature.

Much of the focus in the early dental implant literature is on the bone-to-titanium interface because a successful osseointegrated implant requires direct bone contact to the implant surface. The research on soft tissue around dental implants has focused on the partially edentulous patient and, in particular, on the maxillary anterior dentition. Few studies have evaluated soft tissue around dental implants in completely edentulous patients over time. This paper reviews the pertinent literature on soft-tissue healing in both partially and completely edentulous dental implant patients from a Medline search of the English peer-reviewed literature from 1980 to 2004.

Animals↗
PubMed2005

An in-vitro study of the sterilization of titanium dental implants using low intensity UV-radiation.

OBJECTIVES: Commercial titanium dental implants are coated with nanostructured TiO2. The aim of the research reported in this paper was to assess whether the TiO2 at the surface of a dental implant is sufficiently photoactive to eradicate bacteria when illuminated with low intensity light. METHODS: The photoactivity of dental implants was established by studies of the photoenhanced decomposition of Rhodamine B. In vitro studies to establish the influence of irradiating with UV light an implant that is immersed in a solution containing Escherichia Coli were performed. RESULTS: It was demonstrated that under low UV intensity irradiation, 49 microW cm(-2), bacteria are killed at a rate of approximately 650 million per cm2 of implant per minute. SIGNIFICANCE: The results indicate that illumination of dental implants with UV light may be a suitable treatment for periimplantitis.

Dental Implants↗
PubMed2004

[Risk factors for dental implant inflammation--a literature review].

Replacing missing teeth with osseointegrated dental implants is a predictable technique as evidanced by overall 5-years survival rate that range between 93% to 97%. Few studies, however have adressed the history and frequency of inflammatory complication associated with dental implant. Inflammatory complications are the main cause of failure of dental implants. In this review we classified the inflammatory complications to acute and chronic and to those limited to the hard tissue, to the soft tissue or both. The incidence of the complications is discussed with an emphasis on their risk factors.

Dental Implantation, Endosseous↗
PubMed1990

Dental implants: materials and design.

The use of endosseous dental implants represents one of the most rapidly expanding areas of dentistry. This article attempts to summarize the current understanding of factors affecting dental implant success. The need continues for further fundamental studies to provide a base for future improvements in the design and use of dental implants.

Aluminum Oxide↗
PubMed2000

The relationship between cigarette smoking and dental implant failure.

This paper examines the effect of tobacco use on the failure rates of dental implants. A review of 56 dental implant patients with a total of 187 endosseous dental implants, placed over a four year period, demonstrated a significant association between increased implant failure rates and cigarette smoking with failure rates of 16.6% in smokers compared to 6.9% in non-smokers. Also implant length was shown to be a significant factor with shorter implants (< or = 10 mm) being more susceptible to failure in smokers. A chi-square test was used for data analysis. Current recommendations that should be given to implant patients who smoke are included.

Chi-Square Distribution↗
PubMed2003

Implant materials, design, and surface topographies: their influence on osseointegration of dental implants.

The purpose of this review is to describe commonly used dental implants with reference to their material composition, design factors, and surface topographies. The review includes a discussion of the biological principle of osseointegration and how this process of bone-implant interaction is influenced by different implant materials, designs, and surface characteristics

Dental Implantation, Endosseous↗
PubMed1999

The barrier between the keratinized mucosa and the dental implant. An experimental study in the dog.

The present study was performed in order to examine the composition of the connective tissue that forms an attachment to a dental implant. 6 beagle dogs were used. All mandibular premolars were extracted. After 3 months of healing, 6 fixtures--3 in each side of the mandible--(Astra Tech Implants, Dental System TiO blast; Astra Tech AB, Mölndal, Sweden) were installed. After another 3 months of healing, abutment (Uni-abutment 45; Astra Tech AB, Mölndal, Sweden) connection was performed and a plaque control program was initiated. The animals were sacrificed and perfused with a fixative through the carotid arteries. Each implant site, including the implant and the soft and hard peri-implant tissues, was dissected, decalcified in EDTA and further processed using a "fracture technique". The specimens were subsequently embedded in EPON, cut with the microtome set at 3 microm and the sections stained in PAS and toluidine blue. From the EPON-embedded blocks, ultra-thin sections were cut and electron micrographs were prepared. The detailed histologic and morphometrical examinations were restricted to a 200 microm wide zone of connective tissue interposed between the apical border of the junctional epithelium and the bone tissue. In the analysis, this zone was further subdivided into 2 different units; (i) one central, 40 microm wide unit (zone A) located immediately next to the implant surface, and (ii) one lateral, 160 microm wide unit (zone B) that was continuous with the central unit. The implant surface apical of the junctional epithelium and coronal of the bone crest appeared to be in direct contact with a connective tissue. Zone A of this connective tissue was characterized by its (i) absence of blood vessels and (ii) abundance of fibroblasts which were interposed between thin collagen fibers. The more lateral zone B contained comparatively fewer fibroblasts, but more collagen fibers and blood vessels. There are reasons to assume that the fibroblast rich barrier tissue next to the titanium surface plays a rôle in the maintenance of a proper seal between the oral environment and the peri-implant bone.

Alveolar Process↗
PubMed2005

Anchoring dental implant in tissue-engineered bone using composite scaffold: a preliminary study in nude mouse model.

PURPOSE: The purpose of this study was to fabricate a tissue-engineered bone graft anchoring dental implant with bone marrow stromal cell (bMSC) seeded coral-implant composite scaffold. MATERIALS AND METHODS: Titanium dental implants (3 mm in diameter) were inserted into the cylinder coral scaffolds (5 mm in diameter and 1 mm in wall thickness). bMSCs were isolated from iliac bone marrow of adult New Zealand White rabbits, induced by dexamethasone and seeded into the composite scaffold at the density of 2 x 10 8 /mL in 200 muL medium. Nine cell coral-implant complexes were incubated in vitro for 5 days. One complex was processed for scanning electronic microscopy. The other 8 complexes, together with 4 coral scaffold without cell acting as control, were implanted subcutaneously into nude mice back. At 1 and 2 months after implantation, 4 specimens from the experiment group and 2 specimens from the control group were harvested respectively. New bone restoration and new bone integration with dental implant were evaluated by gross inspection, manual handling test, radiographic examination, and histologic observation. RESULTS: Specimens harvested at 2 months after implantation were red and similar to native bone. Manual handling test showed that dental implants were fixed in the newly formed bone. Radiographic examination showed that most of the coral scaffold had been absorbed. Bone density x-ray shadow could be observed around the dental implant. Histologic examination showed that large amount of new bone formed around the dental implants and integrated well with the implants in some area. In the control group no bone formation was observed both macroscopically and microscopically. CONCLUSION: The results of the study suggested that the tissue-engineered bone of bMSCs seeded natural coral-implant composite scaffold is promising for dental implant anchoring, which has positive implication for clinical jaw reconstruction.

Animals↗
PubMed2000

Pulsed electromagnetic fields promote bone formation around dental implants inserted into the femur of rabbits.

The present study examined the effect of applying a pulsed electromagnetic field (PEMF) on bone formation around a rough-surfaced dental implant. A dental implant was inserted into the femur of Japanese white rabbits bilaterally. A PEMF with a pulse width of 25 microseconds and a pulse frequency of 100 Hz was applied. PEMF stimulation was applied for 4 h or 8 h per day, at a magnetic intensity of 0.2 mT, 0.3 mT or 0.8 mT. The animals were sacrificed 1, 2 or 4 weeks after implantation. After staining the resin sections with 2% basic fuchsin and 0.1% methylene blue, newly formed bone around the implant on tissue sections was evaluated by computer image analysis. The bone contact ratios of the PEMF-treated femurs were significantly larger than those of the control groups. Both the bone contact ratio and bone area ratio of the 0.2 mT- and 0.3 mT-treated femurs were significantly larger than the respective value of the 0.8 mT-treated femurs (P < 0.001). No significant difference in bone contact ratio or bone area ratio was observed whether PEMF was applied for 4 h/day or 8 h/day. Although a significantly greater amount of bone had formed around the implant of the 2-week treated femurs than the 1-week treated femurs, no significant difference was observed between the 2-week and 4-week treated femurs. These results suggest that PEMF stimulation may be useful for promoting bone formation around rough-surfaced dental implants. It is important to select the proper magnetic intensity, duration per day, and length of treatment.

Alloys↗
PubMed2001

Mini-dental implant insertion with the auto-advance technique for ongoing applications.

The clinical and histological results of two cases demonstrating retrieved Sendax mini-dental implants in two different patients is the focus of this report. The mini-dental implants were inserted using the auto-advance technique and loaded immediately. The implants were retrieved at 4 months following insertion and at 5 months following insertion and were prepared and reviewed histologically. Clinically, the implants had no mobility, with no apparent exudate or bleeding upon probing, prior to removal. At the time explant procedures were performed, the mini-dental implants had provided immediate support for prostheses during the integration of traditional root-form endosteal implants. Upon explantation, the mini-dental implants were in a state of health and functioning in their intended purpose. Histologically, the bone appeared to be integrated to the surface of the implant at the light microscope level, and the bone appeared to be relatively mature and healthy in the areas observed, more so than one would expect in this amount of time from insertion of mini-dental implants with immediate loading. A discussion of the purposes and technique used for insertion and removal of these mini-dental implants is discussed. This is the first human histological report on the auto-advance technique with immediate loading of mini-dental implants, demonstrating feasibility in ongoing applications.

Aged↗