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At least 523 records · Page 29Linked to original sources
PubMed1997

Effects of guided bone regeneration around commercially pure titanium and hydroxyapatite-coated dental implants. II. Histologic analysis.

The purpose of this study was to determine which treatment of a large osseous defect adjacent to an endosseous dental implant would produce the greatest regeneration of bone and degree of osseointegration: barrier membrane therapy plus demineralized freeze-dried bone allograft (DFDBA), membrane therapy alone, or no treatment. The current study histologically assessed changes in bone within the healed peri-implant osseous defect. In a split-mouth design, 6 implants were placed in edentulous mandibular ridges of 10 mongrel dogs after preparation of 6 cylindrical mid-crestal defects, 5 mm in depth, and 9.525 mm in diameter. An implant site was then prepared in the center of each defect to a depth of 5 mm beyond the apical extent of the defect. One mandibular quadrant received three commercially pure titanium (Ti) screw implants (3.75 x 10 mm), while the contralateral side received three hydroxyapatite (HA) coated root-form implants (3.3 x 10 mm). Consequently, the coronal 5 mm of each implant was surrounded by a circumferential defect approximately 3 mm wide and 5 mm deep. The three dental implants in each quadrant received either DFDBA (canine source) and an expanded polytetrafluoroethylene membrane (ePTFE), ePTFE membrane alone, or no treatment which served as the control. Clinically, the greatest increase in ridge height and width was seen with DFDBA/ePTFE. Histologically, statistically significant differences in defect osseointegration were seen between treatment groups (P < 0.0001: DFDBA/ePTFE > ePTFE alone > control). HA-coated implants had significantly greater osseointegration within the defect than Ti implants (P < 0.0001). Average trabeculation of newly formed bone in the defect after healing was significantly greater for HA-coated implants than for titanium (P < 0.0001), while the effect on trabeculation between treatments was not significantly different (P = 0.14). Finally, there were significantly less residual allograft particles in defect areas adjacent to HA-coated implants than Ti implants (P = 0.0355). The use of HA-coated implants in large size defects with DFDBA and ePTFE membranes produced significantly more osseointegration histologically than other treatment options and more than Ti implants with the same treatment combinations. The results of this study indicate that, although the implants appeared osseointegrated clinically after 4 months of healing, histologic data suggest that selection of both the implant type and the treatment modality is important in obtaining optimum osseointegration in large size defects.

Alveolar Bone Loss↗
PubMed2004

Replacement of missing maxillary canines with dental implants: prosthesis design considerations.

Replacing a missing canine with a dental implant is the optimal treatment plan. The strategic roles canines play in maintaining normal function and the high visibility of these teeth, especially in the maxilla, require a restoration that provides uncompromised function and aesthetics. Eliminating lateral forces on the implant can minimize implant complications, but in young patients (ie, with steep canine guidance) achieving such a goal presents a restorative challenge. This article discusses several considerations (ie, ease of maintenance, retrievability) that will affect the design of the definitive restoration.

Adult↗
PubMed2005

The effect of cigarette smoking on dental implants and related surgery.

Cigarette smoking is still considered a common habit. Of smokers, increased plaque accumulation, higher incidence of gingivitis and periodontitis, higher rate of tooth loss, and increased resorption of the alveolar ridge have been found in the oral cavity. Cigarette smoking may adversely affect wound healing, and, thus, jeopardize the success of bone grafting and dental implantation. Bone grafts and sinus lift operations are both common and well-documented procedures before dental implant placement. Heat as well as toxic by-products of cigarette smoking, such as nicotine, carbon monoxide, and hydrogen cyanide, have been implicated as risk factors for impaired healing, and, thus, may affect the success and complications of those surgical procedures. An association among dental implants, grafting procedures (i.e., bone grafts, maxillary sinuses augmentation), and history of smoking has been reported. A higher degree of complication, or implant failure rates, were found in smokers with and without bone grafts. The relationship between cigarette smoking and implant-related surgical procedures, including the incidence of complications associated with these procedures, will be described and discussed based on relevant literature and results of our recent studies.

Alveolar Bone Loss↗
PubMed1996

[Dental implants--indications and long-term outcome].

Osteo-integratable dental implant systems were developed 25 years ago. The mean life of such implants is about 20 years when they are properly inserted for the right indications. The most important indication is the edentulous mandible, but also the toothless maxilla, the free-end situation in the case of bridges, and single-tooth replacement. Effective procedures have since been developed for eliminating bone deficits that once excluded the use of implants.

Contraindications↗
PubMed2000

[Experimental study of Ti-75(AlMoZrTi alloy) dental implants in dog mandible].

OBJECTIVE: The purpose of this study was to investigate the biocompatibility of Ti-75(AlMoZrTi Alloy) dental implants. METHODS: Four 6.5 to 16 kg dogs were used,after mandibular cuspids and premolar extraction, 16 implants were placed and left for six or twelve months. All of the dental implants were made of Ti-75 (AlMoZrTi Alloy) and they were manufactured in two types-nonsubmerged and submerged threaded implants. RESULTS: The survival rate of the implants was 100% (submerged implants) and 91.7% (nonsubmerged implants). Histologically,all survival implants showed some degree of intimate bone to implant contact, but one of the nonsubmerged implants showed periimplantitis. No implants were observed to be mobile. The periotest values of the dental implants were near the periotest values of the nature teeth. CONCLUSION: This study demonstrated Ti-75 is a biocompatible material and periotest is worthy of detection of osseointegration.

English Abstract↗
PubMedDate not supplied

Restoration of partially edentulous patients using dental implants with a microtextured surface: a prospective comparison of delayed and immediate full occlusal loading.

PURPOSE: The aim of this study was to determine the clinical effectiveness of placing dental implants with microtextured surfaces into full occlusal loading at the time of placement in partially edentulous patients. MATERIALS AND METHODS: Two demographically similar groups of 14 patients each were treated with a total of 92 Spline Twist Implants (Centerpulse Dental, Carlsbad, CA). Test implants were placed into immediate full occlusal loading, and control implants were restored using a conventional delayed loading procedure. Otherwise, both groups of patients received similar therapy from the same treatment team. Radiographs, periodontal indices, and Periotest values were recorded every 6 months during routine clinical follow-up appointments. The mean loading time for all prostheses was 24 months at the time of this report. RESULTS: No implants failed in the test group, and 1 implant failed before loading in the control group. Cumulative implant success was 98.9% for all implants placed (test group = 100%; control group = 92.9%). Periodontal measurements indicated no significant clinical differences between implants placed into immediate full occlusal loading and those loaded via a conventional delayed protocol. DISCUSSION: Immediate full occlusal loading of partial prostheses supported by microtextured implants in partially edentulous patients demonstrated excellent clinical results, with no adverse periodontal effects after 24 months of function. Additional follow-up will provide invaluable information on the long-term effects of this technique. CONCLUSION: Immediate full occlusal loading of partial prostheses supported by microtextured implants can be successfully achieved for 24 months in highly motivated patients with excellent oral hygiene.

Adolescent↗
PubMedDate not supplied

Evaluation of sleep bruxism by polysomnographic analysis in patients with dental implants.

PURPOSE: The aims of the present study were to use polysomnographic analysis to confirm sleep bruxism (SB) and to evaluate clinical findings of dental implant treatment in SB patients. MATERIALS AND METHODS: The present study comprised the retrospective analysis of 368 patients with a total of 838 endosseous implants. Nineteen patients who experienced mechanical complications, such as implant or abutment fractures, loosened gold screws, or occlusal surface wear or damage, were selected for polysomnographic analysis to monitor sleep symptoms. Six patients in the study group were identified as having SB, and this was confirmed by polysomnographic analysis. RESULTS: The SB electromyographic episodes were at least 20% of the patients' maximum voluntary contractions while awake and were scored. Most of the bruxism episodes (80%) were seen in light sleep stages. Only 5% of bruxism episodes were detected during rapid-eye-movement sleep. Sleep stage recordings were similar in all individuals. Bruxism episodes did not cause arousals. Patients were unaware of their nocturnal parafunctional habits. Despite protection with night guards, all patients were reported to have continued bruxism. DISCUSSION: Since possible occlusal parafunctional habits may be evident in any stage of dental treatment, treatment outcome risks must be considered. CONCLUSIONS: Polysomnographic study was evaluated as an effective, low-cost method to confirm occlusal parafunctional habits during sleep. Precautions against SB in patients having dental implant treatment have not been properly clarified. However, night guard protection appears to have some validity in patients having sleep bruxism.

Dental Implantation, Endosseous↗
PubMed2001

Comparison of patient dose from imaging protocols for dental implant planning using conventional radiography and computed tomography.

OBJECTIVES: To compare the radiation doses from imaging protocols for dental implant planning either using conventional radiography only (dental panoramic radiography (DPR), cephalometry and linear cross-sectional tomography) or involving computed tomography (CT). METHODS: Organ absorbed doses were measured using a female Rando anthropomorphic phantom loaded with lithium fluoride thermoluminescent dosemeters (TLD). Standard mandibular protocols for dental implant planning were followed using either a conventional dental radiographic unit (PM 2002 CC Planmeca, Helsinki, Finland) or CT scanner (Excel Twin Elscint, Haifa, Israel). Organ absorbed and effective doses were calculated. Effective dose was calculated using two approaches, one based on the ICRP method which excludes the salivary tissue from the remainder organs (designated E(exc)), and the other with its inclusion (E(inc)). RESULTS: The greatest individual organ doses for any examination were measured in the salivary tissue. E(exc) for panoramic, cephalometric and cross-sectional tomography using DPR was 0.004 mSv, 0.002 mSv and 0.002 mSv, respectively, whereas with CT it was 0.314 mSv. The value of E(inc) calculated using these data was between two and five times E(exc). CONCLUSIONS: E(inc) greatly increases the apparent radiation burden, especially with high dose procedures. CT techniques can provide excellent images, but at the cost of increased radiation detriment. DPR with a cross-sectional tomography facility may give adequate clinical information at a greatly reduced dose.

Absorption↗
PubMed2005

Analysis of failed commercially pure titanium dental implants: a scanning electron microscopy and energy-dispersive spectrometer x-ray study.

BACKGROUND: The failure of osseointegration in oral rehabilitation has gained importance in current literature and in clinical practice. The integration of titanium dental implants in alveolar bone has been partly ascribed to the biocompatibility of the implant surface oxide layer. The aim of this investigation was to analyze the surface topography and composition of failed titanium dental implants in order to determine possible causes of failure. METHODS: Twenty-one commercially pure titanium (cpTi) implants were retrieved from 16 patients (mean age of 50.33 +/- 11.81 years). Fourteen implants were retrieved before loading (early failures), six after loading (late failures), and one because of mandibular canal damage. The failure criterion was lack of osseointegration characterized as dental implant mobility. Two unused implants were used as a control group. All implant surfaces were examined by scanning electron microscopy (SEM) and energy-dispersive spectrometer x-ray (EDS) to element analysis. Evaluations were performed on several locations of the same implant. RESULTS: SEM showed that the surface of all retrieved implants consisted of different degrees of organic residues, appearing mainly as dark stains. The surface topography presented as grooves and ridges along the machined surface similar to control group. Overall, foreign elements such as carbon, oxygen, sodium, calcium, silicon, and aluminum were detected in failed implants. The implants from control group presented no macroscopic contamination and clear signs of titanium. CONCLUSION: These preliminary results do not suggest any material-related cause for implant failures, although different element composition was assessed between failed implants and control implants.

Biocompatible Materials↗
PubMed1993

Osteogenesis at the dental implant interface: high-voltage electron microscopic and conventional transmission electron microscopic observations.

The osteogenesis of mandibular bone to endosteal dental implants was examined using an in vivo dog model. One half of the implants examined were unloaded implants, with the remaining one half prosthodontically loaded for 6 months. Undecalcified mandibular implant samples were examined with both high-voltage electron microscopy (HVEM) stereology and routine transmission electron microscopy. The osseous interface to integrated implants was shown to vary in its morphology. Mineralized bone was observed directly apposing the implant, often separated from the implant by an electron-dense deposit of approximately 50 nm. Within this densely mineralized matrix, osteocytes were routinely observed. Adjacent areas were shown to contain slightly wider zones of either a less dense mineralized matrix or, alternatively, unmineralized tissue. Other zones consisted of wider unmineralized matrices containing collagen fibers and osteoblasts. These latter zones were consistent with the appearance of an appositional type of bone growth. Because bone is a dynamic, actively remodeling tissue, a varied morphology of the support tissues to dental implant is not unexpected. Areas of mature bone interfacing with successfully integrated implants were demonstrated, as well as areas adjacent to the mature bone that were undergoing remodeling or mineralization. This study has also shown that HVEM stereology is a valuable research tool to investigate the oral tissue interface with dental implants.

Aluminum Oxide↗
PubMed2000

Stability of the bone-implant complex. Results of longitudinal testing to 60 months with the Periotest device on endosseous dental implants.

BACKGROUND: Maintenance of the health and integrity of the bone-implant complex (osseointegration) has been shown to be essential for long term success of root-form, endosseous dental implants. If reliable clinical indicators of adequacy of the bone-implant complex existed, they could stimulate new and innovative early intervention research to arrest of reverse early deterioration of the bone-implant complex. In the absence of such indicators, this has been problematic. The Periotest may have the potential to provide this information by indirectly assessing the status of the bone-implant complex. However, little information is available that documents either the capability of the Periotest to reliably assess changes of the bone-implant complex or the "normal variations" in Periotest values (PTVs) for both HA-coated and non-coated implants. METHODS: The purpose of this paper was to document changes in PTVs as influenced by various implant surfaces, implant designs, and bone densities. The mean PTVs recorded for each visit, for all implant types and bone densities, were combined to provide an overall average PTV (A-PTV). The changes in stability (PTVs) were analyzed using a generalized linear model (GLM) with repeated measures (Hotelling's Trace). RESULTS: The A-PTV for all implants over all visits was -3.5. The mean PTVs ranged from -4.2 (SD = 2.4) at uncovering to -3.9 (SD = 2.9) at 60 months. All implants in bone qualities 1 and 2 (BQ-1 and BQ-2) became more stable over time, while those in bone quality 3 or 4 (BQ-3 and BQ-4) showed a slight decrease in stability. In BQ-1, the mean PTVs increased from -4.7 at uncovering to -4.9 at 60 months. A similar increase in stability occurred in BQ-2 (-4.1 at uncovering to -4.4 at 60 months). In BQ-3, the stability of the implants decreased over time (-3.6 at uncovering to -2.9 at 60 months), with similar changes recorded for BQ-4 (-2.5 at uncovering to -1.0 at 60 months). When comparing the stability of all HA-coated with all non-coated implants, the HA implants became less stable (-4.4 to -3.4) over time, while non-coated implants showed an improvement in stability (-3.5 to -4.5). The changes in stability found in BQ-1, BQ-2, and BQ-3 were similar, with HA implants becoming less stable and non-coated more stable. HA- and non-coated comparisons were not possible in BQ-4 since there were too few non-coated implants placed in this type of bone. The HA-coated screw showed a decrease in stability when compared to the non-coated screw. CONCLUSIONS: Conclusions of the study are as follows: 1) PTVs are influenced by bone quality and surface coating of the implant; 2) the PTVs at the time of uncovering provide the best estimate of a clinically acceptable PTV for that bone-implant complex; 3) while the PTVs for any bone-implant complex may fluctuate +/- 1.0 around the uncovering PTV during routine healing and loading of the implant, a consistent shift toward a positive PTV that approaches "0" should be cause for concern that the bone-implant complex may be at risk of failure; 4) HA-coated implants became slightly less stable (more positive PTVs) over time, while the non-coated implants became more stable (more negative PTVs); and 5) until a "critical PTV" can be accurately identified, it is suggested that a consistent shift in recorded PTVs that exceeds the +3.0 value on the PTV scale should be viewed with concern for possible deterioration at the bone-implant complex.

Alloys↗
PubMed2004

Microstructured dental implants and palatal mucosal grafts in cleft patients: a retrospective analysis.

BACKGROUND: In cleft patients, implant dentistry has become an integral part of oral rehabilitation. However, a lack of keratinized mucosa is found in many cases which may have adverse effects on the long-term success of dental implants with microstructured surfaces. Therefore, the aim of this study was to evaluate whether mucogingival surgery is of value in the treatment of these patients. PATIENTS: Between 1991 and 2002, a total of 35 microstructured dental implants were inserted in 32 cleft patients. In 18 patients, vestibular scars extended to the rim of the marginal mucosa of the implants and the gingiva of the adjacent teeth. To enhance the soft tissue condition, mucogingival surgery was performed using palatal mucosal grafts. METHODS: In May 2002, 29 implants and 16 mucosal grafts were evaluated. Assessment included radiological and clinical parameters. RESULTS: Three implants were lost. Most mucosal grafts showed shrinkage of up to 30%. Clinical and radiological parameters, however, showed results that were very similar to those from non-cleft patients. CONCLUSION: These results support the hypothesis that keratinized mucosal grafts show long-term success in the cleft region as well. Moreover, it may be concluded that a combination of dental implants with a rough surface and palatal mucosal grafts can be recommended for oral rehabilitation of cleft patients.

Adolescent↗
PubMed2005

Automatic noise robust registration of radiographs for subtraction using strategic local correlation: an application to radiographs of dental implants.

Most of digital subtraction methods in dental radiography are based on registration using manual landmarks. We have developed an automatic registration method without using the manual selection of landmarks. By restricting a geometrical matching of images to a region of interest (ROI), we compare the cross-correlation coefficient only between the ROIs. The affine or perspective transform parameters satisfying maximum of cross-correlation between the local regions are searched iteratively by a fast searching strategy. The parameters are searched on the 14 scale image coarsely and then, the fine registration is performed on the original scale image. The developed method can match the images corrupted by Gaussian noise with the same accuracy for the images without any transform simulation. The registration accuracy of the perspective method shows a 17% improvement over the manual method. The application of the developed method to radiographs of dental implants provides an automatic noise robust registration with high accuracy in almost real time.

Dental Implants↗
PubMed2004

Post-traumatic use of dental implants to rehabilitate anterior maxillary teeth.

The treatment sequel of post-traumatic teeth for the use of dental implants in the anterior maxillary region to rehabilitate anterior maxillary missing teeth was evaluated. Files of 53 healthy patients reporting anterior dental trauma were reviewed. All patients had an anterior maxillary dental implant because of tooth loss after trauma. At initial examination, 18 patients (34%) had root canal treatment and an inflammatory lesion, 15 (28.3%) had a missing tooth on admission, 12 (22.6%) had a prior operation (i.e. root-end surgery or crown lengthening), 4 (7.5%) presented an ankylotic root, and 4 (7.5%) had a root remnant not suitable for rehabilitation, with no inflammatory periapical lesion. Treatment sequences and complications were recorded. Augmentation procedure (i.e. onlay bone graft or guided bone regeneration) was performed in 43 patients (81.1%), and 2 patients (3.8%) had orthodontic extrusion prior to tooth extraction and implantation. Implants were placed immediately in 25 patients (47.2%) and 4 (7.5%) had immediate loading at the time of implantation. Complications and postoperative incidents (fistula, inflammation, swelling hematoma, etc.) were observed in 24 patients (45.3%). There was no difference in complication and postoperative incident rates with regards to the implantation technique. Complications were found at the prosthetic phase in seven patients (13.2%; six fistula and one implant failure). When patients were divided into two groups, with and without an inflammatory lesion, a significantly lower complication and postoperative incident rate were found in the non-inflammatory group (P = 0.057). This study reaffirmed the necessity for scrupulous diagnosis of teeth and alveolar bone after a traumatic injury. Treatment is multidisciplinary, requiring surgical, orthodontic, endodontic, operative, and prosthetic compliance. A specially designed treatment plan for each patient is necessary. General rules do not apply.

Alveolar Ridge Augmentation↗
PubMed1992

Analysis of surface cleanliness of three commercial dental implants.

Six routinely packaged commercially pure titanium dental implants (three commercial brands) were analysed using secondary ion mass spectrometry to examine the outermost surface layer. The aim of the analysis was to compare the surface purity (99.95%) of the implants with the substrate metal, common to all three brands. The use of a low primary ion current density provided a nominal protection limit of 0.01% or 100 p.p.m. All the implants examined had extremely pure surfaces. However, only one brand of implant had an ultraclean oxide surface in relation to the substrate.

Dental Implants↗
PubMed1992

Dental implants and chemotherapy complications.

The cancer patient receiving chemotherapy often suffers severe oral complications related to the administration of antineoplastic drugs. Cancer patients who also have transmucosal or endosseous dental implants pose special problems for medical oncologists and dentists, both when planning for chemotherapy and when providing supportive care during the course of treatment. The relationship between dental implants and cancer chemotherapy is described and complications experienced by implant patients treated with chemotherapy at The University of Texas M.D. Anderson Cancer Center are reviewed. Recommendations on various aspects of management involving implant evaluation and the removal or retention of dental implants are discussed.

Antineoplastic Agents↗
PubMed1996

A clinical trial of a new dental implant.

This paper presents the results of a clinical trial of a new dental implant after two years of loading. The design and the technical details of the surgical and prosthodontic phases of treatment are discussed. The implant's success was measured using Health Canada (Health Protection Branch) criteria. Patients with less than optimal clinical situations were not excluded from the study. The study shows survival rates in the lower jaw of 85.6 per cent and in the upper jaw of 86.7 per cent. Bleeding and oral hygiene indices and bone loss (less than 0.2 mm/yr) all fall within generally accepted limits.

Adult↗