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PubMed1993

Clinical evaluation data from a comparative dental implant investigation in dogs.

This report presents one-year clinical evaluation data from 120 ceramic and titanium cylindrical and titanium blade-type implants placed in the mandibles of 30 adult dogs. Ninety-six of the implants supported fixed bridges. The bone and gingival health was evaluated by the following indices: crevicular fluid volume index; gingival bleeding index; plaque accumulation index; clinical mobility index; and a quantitative mobility index utilizing the Periotest instrument. Results from this investigation suggest that, overall, the ceramic implants exhibited more fractures and had more mobile implants than did the titanium implant systems. Overall, complete one-year clinical evaluation data demonstrate healthy tissue responses to 112 of the 120 implants. Further, the Periotest instrument appears to offer a more quantitative assessment of clinical mobility. Also, it appears that the clinical evaluation protocol utilized in this study is a valid procedure to use for the assessment of clinical serviceability.

Analysis of Variance↗
PubMed2005

Satisfaction with dental implants: a literature review.

Recent years have witnessed a consistent trend toward the introduction of patient assessment of different treatment outcomes in dental practice. Patient satisfaction with dental implants was considered among these treatment modalities. Few literature reviews have been published on this topic. This article critically analyzes the concerned topics related to patient satisfaction with dental implant. A MEDLINE search was completed from 1983 to 2004, along with a manual search, to locate related articles on the topic. Dental implants provided promising and predictable results regarding patient satisfaction and various aspects of life assessment.

Age Factors↗
PubMed1979

Carbon-coated subperiosteal dental implants for fixed and movable prostheses.

Subperiosteal dental implants are not intended to replace conventional dentistry but provide an alternative method of treatment for the patient who cannot otherwise tolerate a dental prosthesis. Success can be achieved in the maxillae and in the mandible without the risk of serious complications. There are good prospects for a long-term favorable prognosis when appropriate surgical and prosthodontic criteria are observed.

Carbon↗
PubMed1989

[Histological investigation of improvement of jaw-bone structure for application of hydroxyapatite dental implant].

UNLABELLED: The purpose of this study was to investigate the possibility of applying the hydroxyapatite dental implant to the jaw-bone with atrophic structure. The lower P3, P4 and the mesial root of M1 of 6 mongrel dogs were extracted. At 4 months, the trabeculae were taken out and porous hydroxyapatite granules were filled in the vacant spongiosa. At 8 months, hydroxyapatite dental implants were placed into this area. After 1 week and after 2 months, specimens were taken out and fixed by 10% formalin alcohol. They were embedded in polyester resin and undecalcified thin sections were prepared. The sections were stained with toluidine blue and observed under light microscopy. RESULTS: 1) A larger amount of bone compared with that of the peripheral spongiosa was observed among the granules. 2) One week after implantation, differentiation around the implant was rather slow in the area of the granules. But in the area of the granules next to the spongiosa, differentiation was normal. 3) Two months after implantation, a new bone was observed, which filled the implantation space and united the implant to the bone among the granules. But on some implant surface, a fibrous connective tissue was seen. These results suggest that this method is able to improve the jaw-bone structure sufficiently to apply the hydroxyapatite dental implant.

Animals↗
PubMed2002

Do interleukin-1 polymorphisms predict the development of periodontitis or the success of dental implants?

Factors which increase the risk of severe adult periodontitis (AP) may also contribute to the success of dental implants. To determine which cytokines may be relevant, levels of interleukin-1alpha (IL-1alpha), interleukin-1beta (IL-1beta), interleukin-1 receptor antagonist (IL-1ra), interleukin-6 (IL-6) and interferon-gamma (IFN-gamma) mRNA were quantitated in gingival tissue from periodontitis patients and healthy controls. Periodontitis significantly increased levels of IL-1alpha, IL-1beta, IL-6 and IFN-gamma mRNA relative to healthy tissues. IL-1 was selected for further study, as it has inflammatory and bone resorbing properties. We examined IL-1A(-889) and IL-1B(+3953) alleles in Caucasian patients with AP and early-onset periodontitis (EOP), patients with dental implants and healthy individuals. The IL-1B(+3953) polymorphism was associated with AP. This was evident from an increased homozygosity for allele 2 in patients with AP and a decreased heterozygosity in advanced AP patients. IL-1A(-889) and a composite genotype [IL-1A(-889)2 plus IL-1B(+3953)2] showed no association with the incidence of periodontitis, disease onset or disease severity. IL-1A(-889), IL-1B(+3953) and the composite genotype also showed no association with failure of dental implants.

Adult↗
PubMed1989

Patient evaluation and treatment planning for dental implants.

By supplying additional abutment support, dental implants provide an alternative to removable partial dentures, and offer edentulous patients an enhanced quality of life. However, predictability of success must be the determining factor when considering implants as the treatment of choice. Systematic evaluation of the regional anatomy and the condition of the natural teeth is mandatory. A new caliper technique for measuring the available bone makes predictability of success now even more attainable.

Dental Abutments↗
PubMed1996

Non-submerged osseointegrated dental implants with ball attachments supporting overdentures in patients with mandibular alveolar ridge atrophy. A short-term follow-up.

Non-submerged, hollow screw ITI-Bonefit dental implants with ball attachments supporting overdentures were used as alternative treatment to combined vestibulo-lingual-plasty with free split-thickness skin graft and removable dentures in 40 consecutive patients with mandibular alveolar ridge atrophy. One hundred and fifty-six non-sub-merged fixtures were installed. Ball attachments were mounted on the fixtures and implant-supported overdentures inserted 3-4 months after fixture installation. The observation period after implant activation and prosthesis insertion varied from 1 to 3 years with a median observation period of 2 years. The overall success rate of individual implants was 99%(155/156). The prosthesis function rate was 100%(40/40). The 1-year success rate of individual implants was 99%(155/156) with a prosthesis function rate of 100%(40/40). No persistent surgical, periodontic or prosthodontic complications were observed. The results indicate that non-submerged osseointegrated ITI-Bonefit dental implants with ball attachments supporting overdentures can be a successful alternative to combined vestibulo-lingual-plasty with free split-thickness skin graft and removable dentures, and as successful as the use of submerged dental implants.

Aged↗
PubMed1998

Overview of surface variability of metallic endosseous dental implants: textured and porous surface-structured designs.

A variety of successful endosseous dental implants with different surface forms are currently available for clinical use. These all achieve implant-to-bone fixation primarily (if not totally) through mechanical interlock of bone with implant surface features introduced by design or chance during implant fabrication. Equally important to establishment of rigid fixation is the rate at which it is achieved, because faster rates allow earlier implant loading and less chance of inadvertent early loading that might prevent implant "osseointegration." Investigations of surface modification to favorably affect osteoconductivity and bone bonding represent an active area of research in the field of dental implant development. This article presents a review of available surface designs and future research directions for improved devices.

Coated Materials, Biocompatible↗
PubMed2001

Patient selection for dental implants. Part 2: Contraindications.

In today's dentistry, dental implants have become an excellent choice of treatment for multiple situations. The prognosis of this treatment modality, like any other in dentistry, is highly dependent on appropriate case selection. A multi-stepped data-gathering process, while lengthy, is very important. This process should include a patient interview to gather personal information, the chief complaint, medical history, and dental history. Extra-oral and intra-oral clinical examinations and a radiographic examination should be included.

Contraindications↗
PubMedDate not supplied

Using a diode laser to uncover dental implants in second-stage surgery.

A soft tissue diode laser offers an alternative technique for uncovering dental implants. This article presents two cases in which four dental implants were uncovered using a soft tissue laser. This technique provides an efficient and patient-friendly method to perform second-stage implant surgery, safely allowing a faster rehabilitative phase.

Dental Abutments↗
PubMed2004

Immediate Dental Implant Placement in Sockets Augmented With HTR Synthetic Bone.

PURPOSE: The purpose of this article is to present the results of using immediate implant placement in combination with HTR synthetic bone socket grafting to achieve a predictable restorative result. MATERIAL AND METHODS: Twenty-three hydroxylapatite-coated cylinder implants (Spline, CenterPulse Dental, Carlsbad, CA) were placed into fresh extraction sockets in 19 patients. In each case, HTR synthetic bone (Bioplant, Inc., South Norwalk, CT) was used to fill any voids remaining in the sockets and to augment the facial aspect of the ridge. The restorative phase was initiated approximately 6 months after implant placement. Conventional impression techniques were used and porcelain-fused-to-metal crowns were selected as the final restorations. RESULTS: The prosthetic outcome was evaluated as generally favorable. Only 4 (17%) of the dental implants required an angled abutment. The gingival contour was excellent in 61% and good in 35% of the cases. The emergence profile was evaluated as class I (full papilla) in 37% and class II, III, and IV in 21% each. CONCLUSIONS: The clinical results of this study demonstrate that immediate implant placement in combination with HTR synthetic bone grafting of residual socket voids and crestal deformities is a predictable procedure and provides a good base for successful prosthetic reconstruction. Adequate gingival contour and favorable emergence profile can be expected when combining immediate implant placement and HTR grafting material.

Alveolar Ridge Augmentation↗
PubMed1999

Effect of washers on reverse torque displacement of dental implant gold retaining screws.

STATEMENT OF THE PROBLEM: Gold screw loosening is a frequent problem that affects dental implants. PURPOSE: This study determined the effect of spring washers on gold screw displacements during applied removal torque in dental implants. MATERIAL AND METHODS: A 3-unit fixed partial denture was cast in semiprecious alloy and fixed to 2 dental implants with gold-retaining screws. Implants were embedded in acrylic resin and restrained from movement. A miniature load sensor was attached to a torque controller handpiece to accurately measure the time and torque needed to completely loosen the gold screws. Rotational displacements were calculated for 4 experimental setups, involving washers placed on (a) both, (b) the mesial, (c) the distal, and (d) no implants. Screw displacement data were compared between implants in all 4 combinations by means of paired t tests. RESULTS: Gold screws with underlying conical spring washers underwent on average up to 35% (14.1 microm) more rotational displacement during applied removal torque than those without washers. CONCLUSION: Inclusion of a conical spring washer significantly increased the amount of rotational displacement needed to completely loosen an implant gold retaining screw.

Dental Prosthesis, Implant-Supported↗
PubMed2002

Fracture of dental implants: literature review and report of a case.

Fracture of dental implants is a rare phenomenon with severe clinical results. In this article, the literature is reviewed and various causative factors that may lead to fracture are presented. Galvanic activity has not been mentioned before as a possible cause for implant fracture, yet, it can occur at the level of contact with the superstructure. This is illustrated by the case of a titanium implant restored with a non-precious porcelain-fused-to-metal cemented crown that fractured 4 years after loading. The radiographs show alveolar bone resorption around the fixture. Metallurgical analysis of the implant indicated that the fracture was caused by metal fatigue and that the crown metal, a nickel-chromium-molybdenum alloy, exhibited corrosion. These findings suggest a new explanation for implant fractures; cytotoxic nickel ions, leaching from the base metal alloy may cause bone resorption. This in turn leads to increased mobility, facilitating washout of the luting cement. Contact of the base metal with titanium in the presence of oral fluids produces galvanic currents that hasten corrosion and leaching out of nickel ions, thus leading to further bone resorption. Loss of bone support allows lateral bending moments that cause metal fatigue, eventually leading to fracture. Therefore, good treatment planning and appropriate case selection might have prevented this fracture. Furthermore, the use of nonprecious metal alloy for the crown's infrastructure had further contribution to the chain of events that led to the implant's fracture.

Aged↗
PubMedDate not supplied

Porous hydroxyapatite for grafting the maxillary sinus in sheep: comparative pullout study of dental implants.

PURPOSE: In this experimental study, dental implants placed after maxillary sinus grafting with either porous hydroxyapatite (HA) (Interpore 200) or autogenous bone were examined for their mechanical stress tolerance. MATERIALS AND METHODS: A total of 54 titanium plasma flame-sprayed cylindric implants were placed in the lateral sinus wall bilaterally of 27 mountain sheep. The bony sinuses were opened through an extraoral approach. Eighteen sinuses were grafted with porous HA, and another 18 were grafted with cancellous bone from the iliac crest. Eighteen non-grafted sinuses were used as controls. In the same operation, 2 cylindric implants were placed in each of the sinuses. One implant of each sinus was tested for mechanical strength of the bone-implant interface at 12, 16, and 26 weeks using pullout force. RESULTS: The mean pullout force was 259.3 N in the control group, 356.7 N in the autogenous bone group, and 376 N in the HA group. Pooled data for the grafted sites showed the pullout force to be significantly higher than in the empty control sites (P = .02). The pullout force increased significantly with ongoing healing time (P = .02), but there was considerable variation within the groups. While the force remained more or less constant throughout the follow-up time in the controls (248 N at week 12 to 276 N at week 26), it increased dramatically in the group augmented with autogenous bone (223.8 N at week 12 to 523.16 N at week 26). The pullout force was initially highest in the HA group (302.3 N at week 12) and increased to 423.5 N at 26 weeks, but it did not reach the levels recorded in the autografted group. DISCUSSION AND CONCLUSION: Mechanical tests of bone-to-implant contact in a sheep model showed that HA for 1-stage sinus floor elevation significantly increased the pullout force versus ungrafted sinuses, although it was less than that found with autogenous bone after 26 weeks.

Animals↗
PubMed1990

A clinical study of the Brånemark dental implant system.

A clinical study using the Brånemark dental implant system was carried out on 13 patients aged 41 to 68 years. Clinical and psychological effects of treatment were assessed at 6-monthly intervals over a period of 3 years by means of a clinical examination, a personality assessment using Cattell's 16 PF Questionnaire and a general subjective questionnaire. Six per cent of implants failed to osseointegrate. Fifty per cent of bridges became loose, but remained stable after retightening. A similar percentage of fractures occurred, mainly teeth separating from acrylic gumwork. There was some soreness of peri-implant mucosa, particularly on cleaning. Despite these problems, there was considerable evidence of improved well-being of patients, who felt more secure following treatment and, as a result, their personal and social relationships improved.

Adult↗
PubMed2007

Thermal-mechanical study of functionally graded dental implants with the finite element method.

This article investigates the thermal-mechanical performance of hydroxyapatite/titanium (HA/Ti) functionally graded (FG) dental implants with the three-dimensional finite element method. The stresses induced by occlusal force for the present HA/Ti FG implant are calculated to compare with the corresponding stresses for the titanium dental implant. Thermal-mechanical effect of temperature variation due to daily oral activity is also studied. The HA/Ti FG dental implant performance is evaluated against the maximum von Mises stress, which is the general performance indicator, the first principal/tensile stress for mechanical failure of implant-bone-bond and the third principal/compressive stress for bone absorption. Simulation results indicate that under the influence of occlusal force only, the FG implants with different HA fraction along the implant length perform almost equally well, while the titanium implant sustains much higher von Mises stress. However, when thermal stress is also considered, the FG implant having HA fraction exponential index of m = 2 with temperature decrease of 20 degrees C yields the highest first principal and von Mises stresses among all the FG and titanium implants.

Coated Materials, Biocompatible↗
PubMed2004

Treatment options of untreatable traumatized anterior maxillary teeth for future use of dental implantation.

The anterior maxilla is the most traumatized region during childhood. Posttraumatic complications occasionally lead to tooth loss as well as the need for future implants. Unfortunately, it is contraindicated to place dental implants during childhood. A waiting period of approximately 8 to 10 years before completion of growth is required. For this patient to become a candidate for future dental implants, it is necessary to ensure the continuous growth and to preserve the dimensions of the alveolar process until growth has ceased from time of injury until joint maturation. To achieve these goals, it is essential to coordinate the treatment sequence at the time of trauma. After loss of a traumatized anterior permanent maxillary incisor in young adults, treatment options are limited: orthodontic closure of the gap and reshaping the adjacent teeth, or tooth extraction and maintaining the gap with a temporary restoration. Orthodontic space closure has limited indications and requires prosthetic restoration of at least 2 teeth. Extraction and temporary restoration will usually lead to bone augmentation before implantation. Other possible treatment options include orthodontic extrusion of the root remnant (in cases of untreatable root fracture or complicated crown-root fracture) and a temporary crown to serve the patient until the completion of growth and development, autogenous tooth transplantation, intentional extraction and immediate tooth replantation, distraction osteogenesis, and decoronation. Because general rules do not apply, individual treatment plans are necessary.

Adult↗
PubMed2004

Treatment options of untreatable traumatized anterior maxillary teeth for future use of dental implantation.

The anterior maxilla is the most traumatized region during childhood. Posttraumatic complications occasionally lead to tooth loss as well as the need for future implants. Unfortunately, it is contraindicated to place dental implants during childhood. A waiting period of approximately 8 to 10 years before completion of growth is required. For this patient to become a candidate for future dental implants, it is necessary to ensure the continuous growth and to preserve the dimensions of the alveolar process until growth has ceased from time of injury until joint maturation. To achieve these goals, it is essential to coordinate the treatment sequence at the time of trauma. After loss of a traumatized anterior permanent maxillary incisor in young adults, treatment options are limited: orthodontic closure of the gap and reshaping the adjacent teeth, or tooth extraction and maintaining the gap with a temporary restoration. Orthdontic space closure has limited indications and requires prosthetic restoration of at least 2 teeth. Extraction and temporary restoration will usually lead to bone augmentation before implantation. Other possible treatment options include orthodontic extrusion of the root remnant (in cases of untreatable root fracture or complicated crown-root fracture) and a temporary crown to serve the patient until the completion of growth and development, autogenous tooth transplantation, intentional extraction and immediate tooth replantation, distraction osteogenesis, and decoronation. Because general rules do not apply, individual treatment plans are necessary.

Adolescent↗