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PubMed1993

Stress and strain distribution in the bone surrounding a new design of dental implant: a comparison with a threaded Branemark type implant.

The stress and strain distributions in the bone surrounding a new dental implant, designed specifically for use with a bioactive porous coating and thus having a fully bonded interface to the bone, have been analysed. The new implant geometry was slightly tapered, with deep concentric grooves to allow bone ingrowth and load transfer, and had a parallel cylindrical section at the neck. The results have been compared with stress and strain predictions in the bone surrounding a 'Branemark type' threaded implant with a fully bonded interface. Under axial loading both implant types produced similar stress and strain distributions with a higher level of stress in the cortical bone surrounding the neck of the implant. Under lateral loading a high stress concentration was found in the neck region of both implants, but this was lower around the neck of the new design compared with the threaded implant. When the new implant was surrounded by cancellous bone, the reduction in the stress concentration was up to 50 per cent. This reduction should help to reduce fatigue failure and bone resorption in this area under lateral loading.

Bone Density↗
PubMed2000

Role of the finite element model in dental implants.

Computer-aided design and finite element methods (FEM) have interested dental researchers because of its use in the computer simulation and design of dental implants, a process greatly facilitated by the development of new computer technology and more accurate modeling technologies. FEM allows for a better understanding of stresses along the surfaces of an implant and in surrounding bone. This will aid in the optimization of implant design and placement of the implant into the bone; it will also help when designing the final prostheses to minimize stresses. The purpose of this review is to elucidate the role of FEM and the impact of this technology in clinical dentistry in the new millennium.

Dental Implantation, Endosseous↗
PubMed2002

Early functional loading using Brånemark dental implants.

The present review article discusses the one- and two-stage surgical protocol for dental implant placement as well as the critical amount of micromotion at the bone-implant interface to obtain proper osseointegration. The relevant literature supporting the hypothesis that "splinting of individual implants as soon as possible following installation via a rigid fixed device will most likely decrease the micromotion at the bone-implant interface thus facilitating proper bone healing (osseointegration)" is reported. As a consequence of this approach, the treatment period can be significantly reduced. Finally, the importance of an objective evaluation of the bone quality and initial implant stability is highlighted. The information thus obtained via tools already available will facilitate the decision as to whether to load implants immediately, early, or late, and the term "individual functional loading" is coined.

Dental Implantation, Endosseous↗
PubMed2003

Clinical classification of bone defects concerning the placement of dental implants.

The goal of this classification of bone defects related to dental implant placement is to help clinicians accurately discuss proposed treatment regimens and organize treatment for clinical correction. A further goal of this effort to categorize bone defects requiring bone augmentation for implant placement is to standardize terminology to allow for more accurate dental communication. The five most encountered categories of bony defects are described.

Alveolar Bone Loss↗
PubMed2001

[Dental implantation at the maxilla with autologous bone transplantation].

In the Department of Maxillofacial and Oral Surgery of County Hospital of Szentes, different types of bone losses of the maxillary alveolar ridge have been treated since 1 March, 1990. The applied surgical procedures were the following: 1. 394 patients were treated with GBR technique and 567 DenTi implants were inserted for these patients. 2. In 47 cases autogenous bone grafts were harvested from mandibular cortica and 78 DenTi implants were placed. Altogether 14 implants were lost; the success rate was 97.81% in the period between 1 March, 1990 and 31 January, 2001. 3. The severely resorbed maxillary alveolar ridge was replaced by rigid autogenous bone graft harvested from the ilium or from tibia. The bone graft was fixed with implants to the recipient surface. This method was applied in 36 cases from 1 February, 1992 until 31 January, 2001. 147 DenTi implants were inserted and 7 of them were lost. The success rate was 97.28%. Our results have indicated that the dental implants had accelerated the remodelling process of the transplanted autogenous bone and the success rate of the simultaneously performed dental implants were comparable to that of the two stage procedures in which dental implants were inserted several weeks following bone grafting. Based on our long-term favourable clinical experience this technique has been proven to be an excellent method for correcting and replacing the lost maxillary alveolar ridges as well as the circumscribed alveolar bony defects.

Bone Remodeling↗
PubMed2004

Early and immediately restored and loaded dental implants for single-tooth and partial-arch applications.

PURPOSE: The objective of this consensus committee report was to review the available literature published predominantly in refereed journals to summarize findings, data, and conclusions as they related to reduced healing times and protocols for single-tooth and partial-arch clinical situations. Early loading of dental implants has been defined as restoration of implants in or out of occlusion at least 48 hours after implant placement, but at a shorter time interval than conventional healing. Immediate loading or restoration has been defined as attachment of a restoration in or out of direct occlusal function within 48 hours of surgical placement. MATERIALS AND METHODS: Six articles addressing early loading, with a mixture of single-tooth and partial-arch clinical conditions and including some controlled cohort studies, were reviewed. Immediate loading or restoration of dental implants in single-tooth and partial-arch applications, was extensively reviewed. An attempt was made to isolate and categorize similar case types to discern trends and relevant factors. Variables that were considered included single- or multiple-tooth conditions, immediate or delayed placement in extraction sockets, effect of implant surface and geometry, bone quality, implant stability, surgical technique, occlusal design, effect of cigarette smoking, and stability of results. RESULTS: Combined data from 6 early loading studies on single-tooth and partial-arch applications revealed 1,046 implants with a survival rate of 98.2%. Long-term data for most of the early loading studies were not yet available. Most of the publications on immediate loading or restoration of dental implants were written as case series rather than scientific studies. DISCUSSION AND CONCLUSIONS: In general, most publications indicated that with attention to appropriate factors, implant survival with immediate restoration was comparable to the results with conventional and early loading protocols. It should be recognized that, with few exceptions, these conclusions may be misleading statistical phenomena of the authors, as most publications were written by exceptionally experienced, highly skilled practitioners working under tightly controlled clinical conditions on a relatively small, statistically inconclusive number of implants and patients.

Crowns↗
PubMed2002

Fracture mechanisms of retrieved titanium screw thread in dental implant.

Titanium and its alloy are increasingly attracting attention for use as biomaterials. However, delayed fracture of titanium dental implants has been reported, and factors affecting the acceleration of corrosion and fatigue have to be determined. The fractured surface of a retrieved titanium screw and metallurgical structures of a dental implant system were analyzed. The outer surface of the retrieved screw had a structure different from that of the as-received screw. It was confirmed that a shear crack initiated at the root of the thread and propagated into the inner section of the screw. Gas chromatography revealed that the retrieved screw had absorbed a higher amount of hydrogen than the as-received sample. The grain structure of a titanium screw, immersed in a solution known to induce hydrogen absorption, showed features similar to those of the retrieved screw. It was concluded that titanium in a biological environment absorbs hydrogen and this may be the reason for delayed fracture of a titanium implant.

Biocompatible Materials↗
PubMed1999

Improvement of osseointegration of titanium dental implants by a modified sandblasting surface treatment: an in vivo interfacial biomechanics study.

To study the effects of a modified sandblasting surface treatment on the osseointegration of dental implants at the level of interfacial biomechanics, an in vivo pullout test was conducted using bone-interfacial shear strength as a criterion. Titanium implants were inserted into the medialis condyli of dogs and harvested 2, 4, and 12 weeks after insertion. Shear strength was determined with an Instron pullout tester. Observation and analysis of the surface of modified sandblasted implants after pullout at 12 weeks were performed with scanning electron microscopy and x-ray spectroscopy. Results showed that the shear strength of implants with a modified sandblasted surface was about five times as high as that of implants with a smooth surface. We concluded that the rough surface of titanium dental implants created by the modified sandblasting treatment can greatly enhance the shear strength at the dental implant-bone interface and that, with this enhancement, the secondary micropores play a much more important role in implant-bone bonding.

Animals↗
PubMedDate not supplied

Immediate versus delayed loading of dental implants in the maxillae of minipigs: follow-up of implant stability and implant failures.

PURPOSE: To assess the course of the stability and the failure rate of dental implants placed in the partially edentulous maxillae of minipigs. MATERIALS AND METHODS: Three months after tooth removal, implants were placed in 9 minipigs. Six implants (XiVE; Friadent, Mannheim, Germany) were placed on each side of the posterior maxilla after preparation of the implant sites either by an osteotome technique or with spiral drills. Implant stability was assessed by resonance frequency analysis (RFA) at the time of placement, at second-stage surgery (which took place after a healing periods of 1, 2, 3, 4, or 5 months), and after a loading period of 6 months. RESULTS: Implant stability was significantly influenced by the healing period (P = .007). Implant stability decreased after 1 to 3 months of healing for both of the placement techniques and increased after a healing period of 4 months. After implant site preparation by an osteotome technique, 6 of 12 immediately loaded implants, 18 of 24 implants loaded after healing periods of 1 to 3 months, and 1 of 18 implants loaded after a healing period of 4 or 5 months were lost. After implant site preparation using spiral drills, 7 of 12 immediately loaded implants, 12 of 24 implants loaded after healing periods of 1 to 3 months, and 2 of 18 implants loaded after healing periods of 4 or 5 months were lost. Broad overlapping of confidence intervals for the number of implant failures revealed that there was no relevant difference between immediate and early functional loading for either of the 2 techniques. DISCUSSION AND CONCLUSION: Implant loading after healing periods of 1 to 3 months did not improve implant survival compared to immediate loading in the posterior maxillae of minipigs. Not until a healing period of 4 months was reached did implant stability begin to increase. Only when functional loading was started at this point in time was maximal implant survival achieved.

Analysis of Variance↗
PubMed2004

Private practice results of dental implants. Part I: survival and evaluation of risk factors--Part II: surgical and prosthetic complications.

The aim of this study is to present the clinical data from the use of implants that were placed and restored in four independent private dental offices. In part I, the survival rate was calculated and the failure causes were associated with some potential risk factors. In part II, the surgical and prosthetic complications were also recorded and associated both with failures and clinical factors. During 1990-2002 (mean observation 4.6 years), 1692 dental implants were placed and restored in 405 patients in 4 private clinics following the same treatment protocol. The prosthetic restorations included fixed partial dentures, single crowns, and overdentures. The results were statistically analyzed and survival rate probability curves were calculated according to Kaplan-Meier analysis. Part I: Seventy-four implants (4.4%) in a total of 1692 implants failed. The mean of time elapsed before removal of the failed implants was 40 months. The failure rate was higher in the maxilla in patients with metabolic diseases, in D4 bone quality, in smokers, and in patients with insufficient oral hygiene. Part II: Surgical complications happened to 65 implants (3.8%). Prosthetic complications appeared in 152 implants (9%). The overall survival rate (95.6%) in a period of 1 to 12 years is comparable to other studies. The early failures represented a high percentage of failures. Peri-implantitis was the main cause of late failures. The results of this study indicate that the use of implants in private clinics is a safe and predictable method for the treatment of partially or completely edentulous patients, if the proper clinical protocol is followed. The need of a severe recall program must also be emphasized.

Adolescent↗
PubMed2005

Endpoints and survival analysis for successful osseointegration of dental implants.

We review and adapt modern survival analysis adapted for evaluating the success of dental implants is reviewed. A defined composite success criterion is a valuable tool for assessing new developments of dental implants. However, several inaccuracies are detected in the relevant dental literature. The Kaplan-Meier estimator is distinguished from ad-hoc life table methods and crude cumulative percentages, and generally, the usage of confidence intervals is emphasized. This article reviews the definition of implant success also. For the example of longitudinal measurements of the peri-implant bone level, it is shown how to derive success probabilities by time-to-event analysis. It is concluded that advanced statistical methods and well-defined endpoints are needed to achieve meaningful and comparable results. The article is illustrated using the data of a familiar implant system (TPS-SteriOss).

Bone Resorption↗
PubMed1995

In vivo evaluation of a CSTi dental implant: a healing time course study.

The in vivo interface attachment strength and histology of CSTi (cancellous-structured titanium)-coated cylindrical dental implants were compared with those of solid HA-coated dental implants of the same dimensions and geometry. The implants were placed in healed extraction sites in the mandibles and prepared unicortical sites in the femurs of canines. The mandibular implants were evaluated at two, four, eight, and 12 weeks post-implantation, and the femoral implants were evaluated at two, four, eight, 12, 16, 24, and 34 weeks post-implantation. The interface attachment strength of the CSTi implants placed in the mandible at two, four, eight, and 12 weeks was not significantly different from that of the control HA-coated implants. In the femurs, the CSTi implants were significantly stronger than the HA-coated implants at all time periods except 12 weeks (two, four, eight, 16, 24, and 34 weeks). The CSTi implants were able to achieve high percentages of bone ingrowth in the mandible and femur of up to 92% at the later time periods, thus providing a sound interface bond.

Analysis of Variance↗
PubMed2004

Treatment of midfacial defects using prostheses supported by ITI dental implants.

The purpose of this study was to evaluate retrospectively the use of ITI dental implants used for anchoring facial prostheses in the restorative treatment of midface defects. The authors analyzed the clinical data of 26 patients with orbital defects (n = 11), orbitonasal defects (n = 4), orbitonasomaxillary defects (n = 3), and nasal defects (n = 8). Data included age, sex, primary disease, implant position, implant length, implant failure, prosthetic attachment, radiation therapy, and peri-implant skin reactions. Follow-up was at 1, 3, 6, and 12 months and then on a yearly basis. The authors noted the status of healing and complications, if any. In total, 62 implants were placed as follows: 27 (43.5 percent) for orbital prostheses, 12 (19.4 percent) for orbitonasal prostheses, 14 (22.6 percent) for orbitonasomaxillary prostheses, and nine (14.5 percent) for nasal prostheses. Thirty-eight implants (61.3 percent) were placed in previously irradiated areas in 18 patients (69.2 percent). Mild skin reactions together with mild accumulation of sebaceous crusting around implants were recorded in 14.2 percent of the skin observations. No patient experienced severe inflammation requiring administration of systemic antibiotics or surgical revision. Implant success was 100 percent in both irradiated and nonirradiated patients. In conclusion, ITI dental implants result in a high rate of success in retaining midface prostheses and offer good stability and aesthetic satisfaction.

Adult↗
PubMed1998

[A biomechanical study of dental implants using a method for 3-dimensional volumetric mathematical modelling].

Biomechanics of the dental implants introduced into alveoli immediately after tooth extraction has been investigated. The programme ANSYS has been used. Three-dimension volume mathematical models were calculated, with the help of which the tense-deformed state of the supportive biological tissues has been investigated in the area of direct implantation. On the grounds of the results obtained a conclusion has been made that there is an essential improvement of the load distribution under investigation of the inner bone modified biologically designed implants for direct implantation.

Alveolar Process↗