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At least 595 records · Page 33Linked to original sources
PubMed2006

Bone microvascular pattern around loaded dental implants in a canine model.

The vascularity of the implant bed is a very important parameter in both bone formation and maintenance after dental implants insertion. The relationship between bone and vessels network organization is still unknown. The aim of this study was to investigate the three-dimensional bone vascular canals of the peri-implant bone after loading. A total of ten implants with sandblasted and acid-etched surface were placed in the mandible of a beagle dog. Three months later, the implants were connected and loaded. The dog was killed after 12 months. The specimens were embedded and processed for scanning electron microscopy (SEM) analysis. After a 1-year loading period, a very intricate vessel network could be seen around the implants. The vessels, with neighbouring soft tissues, were round in shape and showed a lot of anastomoses with a mesh-like appearance. They ran circularly around the dental implant. In the bone, the majority of the vessels appeared to ran parallel to the mandibular canal. After a 1-year loading period, the peri-implant bone vasculature looked like a mesh that surrounded the implants. Nevertheless, the presence of many thick vessels inside the peri-implant crestal bone indicates a high metabolic need and also a different bone organization, as no osteons were noted. The crater-like bone loss around the marginal part of the implant could be related to the microvasculature "strain". A high strain level could continuously activate the osteocyte-vessel syncytium, producing a net bone loss.

Alveolar Bone Loss↗
PubMedDate not supplied

Effect of Nd:YAG, Ho:YAG, Er:YAG, CO2, and GaAIAs laser irradiation on surface properties of endosseous dental implants.

PURPOSE: To analyze potential surface alterations in endosseous dental implants induced by irradiation with common dental lasers. MATERIALS AND METHODS: Sandblasted and acid-etched, plasma-sprayed, hydroxyapatite-coated, and smooth titanium discs were irradiated using Nd:YAG, Ho:YAG, Er:YAG, CO2, and GaAIAs lasers at various power settings. The specimens were examined by scanning electron microscopy and energy dispersive spectroscopy. RESULTS: In an energy-dependent manner, the pulsed YAG lasers induced partial melting, cracking, and crater formation on all 4 surfaces. Within the energy range applied, the CO2 laser caused surface alterations on the hydroxyapatite and plasma coatings as well as in the acid-etched surface. GaAIAs laser irradiation did not damage any of the surfaces. Energy dispersive spectroscopy revealed an altered chemical compound of the surfaces with regard to titanium, oxygen, and silicon. DISCUSSION: The clinical application of most common dental laser systems can induce implant surface alterations. Relevant factors are not only the laser system and power setting, but also the application system. CONCLUSION: The results of the study indicate that Nd:YAG and Ho:YAG lasers are not suitable for use in decontamination of implant surfaces, irrespective of the power output. With the Er:YAG and CO2 laser, the power output must be limited so as to avoid surface damage. The GaAIAs laser seems to be safe as far as possible surface alterations are concerned.

Carbon Dioxide↗
PubMed2003

Immediate loading of dental implants in the edentulous maxilla: case study of a unique protocol.

Although immediate loading of dental implants is increasingly gaining recognition as an important option for certain categories of implant patients, the maxillary arch has historically posed difficulties that have limited the number of immediate loading applications. To address the needs of patients who cannot tolerate maxillary removable complete dentures, an immediate loading protocol we call "Teeth in a Day" uses a conversion prosthesis that has been expanded to include complete-arch maxillary reconstruction. Use of a large number of implants to prevent micromotion at the bone-to-implant interface is a critical element in this protocol. A patient treatment is reported.

Clinical Protocols↗
PubMed2002

Dental implant treatment in diabetic patients.

The purpose of the present study was twofold: (1) to investigate how many diabetic patients and types of cases that are treated with dental implants in our clinic; and (2) assess the outcome of such treatment. Medical records from 782 patients were examined in patients treated by the Brånemark method for partial or total edentulism with implant supported bridges. From these records, 25 patients (3.2%) with diabetes before implant treatment (136 implants) were identified and further studied with respect to age, gender, type of diabetes, treated jaw, degree of edentulism, bone graft, implant survival, periimplant inflammation, bleeding on probing, and radiographic bone loss. Furthermore, the patients' opinion about the outcome of the treatment was registered. The implant success rate was 96.3% during the healing period and 94.1% 1 year after surgery. Of all 38 bridges, one was lost. Few complications occurred and all patients, except for one, were satisfied with the treatment. Today, diabetic patients are being treated successfully for all types of edentulism, including bone-grafting treatment. Diabetics that undergo dental implant treatment do not encounter a higher failure rate than the normal population, if the diabetics' plasma glucose level is normal or close to normal as assessed by personal interviews.

Aged↗
PubMed1998

A 2-year report on maxillary and mandibular fixed partial dentures supported by Astra Tech dental implants. A comparison of 2 implants with different surface textures.

In 50 partially edentulous patients, 133 (48 maxillary; 85 mandibular) Astra Tech dental implants of 2 different surface textures (machined; TiO-blasted) were alternately installed, supporting 52 fixed partial dentures (FPDs). Before abutment connection 2 machined implants (1 mandibular; 1 maxillary) were found to be non-osseointegrated and were replaced. Another implant could not be restored due to a technical complication. Two FPDs were remade because of technical complications, both because of abutment fractures. Thus, after 2 years in function, the cumulative survival rates were 97.7% and 95.7% for implants and prostheses, respectively. There was no statistically significant difference in survival rate between the 2 types of implants, 100% (TiO-blasted) vs 95.3% (machined), P = 0.24. After 2 years in function, when both jaw and type of implants were combined, the mean (SD) marginal bone loss was 0.24 (0.69) mm. No statistically significant difference in bone loss was found between the 2 types of implant after 2 years of loading, 0.04 (0.82) mm, P > 0.30.

Alveolar Bone Loss↗
PubMedDate not supplied

Immediate versus delayed loading of dental implants in the maxillae of minipigs. Part II: histomorphometric analysis.

PURPOSE: To assess histomorphometric parameters of dental implants placed in partially edentulous maxillae of minipigs. MATERIALS AND METHODS: In 9 minipigs, 6 XiVE implants were placed on each side of the maxilla, either after implant site preparation by an osteotome technique or by spiral drills. The implants were restored with fixed provisional restorations and loaded either immediately or after healing periods of up to 5 months. After a loading period of 6 months, the animals were sacrificed and the implants were retrieved together with the adjacent bone. Histologic specimens were prepared and bone-to-implant contact (BIC) ratio, interthread bone area, and peri-implant bone area were determined. RESULTS: An analysis of variance revealed that the BIC ratio on the palatal side was significantly influenced by the preparation technique of the implant site (P = .001) and by the healing period (P = .02). After implant site preparation by an osteotome technique, higher BIC values were achieved for implants that were loaded either immediately or after healing periods of 1 to 3 months. After healing periods of 4 to 5 months, implant site preparation with spiral drills showed slightly better results in regard to BIC. Interthread bone area and peri-implant bone area did not differ significantly statistically for the 2 implant placement techniques and the 3 healing periods. DISCUSSION AND CONCLUSION: After 6 months of functional loading in the maxilla, successful immediately loaded implants performed the same as implants subjected to an unloaded healing period prior to loading as far as histomorphometric data were concerned. Prospective randomized clinical studies should be carried out in humans to compare immediate loading to loading after an unloaded healing phase.

Analysis of Variance↗
PubMed2006

Focal adhesion contact formation by fibroblasts cultured on surface-modified dental implants: an in vitro study.

A major consideration in designing dental implants is to create a surface that provides strong attachment of the implant to bone, connective tissue and epithelium. The aim of the present study was to examine the influence of different treatments of titanium (Ti) implant surfaces on focal adhesion contact (FAC) formation in fibroblast cultures. Human gingival fibroblasts were cultured on glass sheets and polished Ti discs with different surface coatings (applied by physical vapor deposition (PVD): Ti, titanium nitride (TiN), zirconium nitride (ZrN)) or on Ti discs with different surface topographies. For characterization of all surfaces, modified estimation of surface roughness and spacing parameter was carried out using a contact stylus profilometer. Contact angle measurements were carried out to calculate surface energy. Fibroblasts were prepared for transmission electron microscopy at day 3 after seeding, and the number of FACs and the ratio FAC/cellular cross-sections was determined at a length of 300 microm in ultrathin sections. To visualize the extracellular fibronectin and vitronectin molecules and the intracellular actin and vinculin in FAC areas, immunogold labeling was performed. The results revealed a strong correlation between the number of FACs and the surface roughness. The highest number of FACs and the majority of the immunogold-labeled intra- and extracellular matrix molecules were counted on surfaces with the lowest surface roughness: glass sheets coated with either Ti, TiN or ZrN (roughness average=0.03-0.1 microm). These surfaces appear to favor cellular attachment of human gingival fibroblasts and moreover in previous studies the hard coatings have been shown to reduce bacterial adhesion.

Analysis of Variance↗
PubMed2005

Radiographic evaluation of dental implants placed using an osteotome technique.

BACKGROUND: The osteotome technique has been successfully used for implant placement when a limited vertical height is available at posterior maxilla. However, it is not clear if new bone is formed at the apical portion of the implant placed by this technique without any bone graft. The aim of this study was to radiographically evaluate bone formation around dental implant surfaces exposed to the space created at the sinus floor without the presence of any graft material. METHODS: Forty patients (21 male, 19 female; mean age 46.7 years) who received a total of 75 dental implants together with indirect sinus lifting procedure were included. Initial and 6-month postoperative panoramic films were scanned and analyzed using a commercially available software program. Implants were divided into two groups: initial alveolar bone height <9 mm or > or =9 mm. This helped determine the effect of available bone and exposed implant surface on bone formation in a system where the shortest implant was 8 mm. RESULTS: The mean implant length placed at locations with <9 mm initial bone height (mean 7 +/- 1.3 mm, N = 29 implants) was 11 +/- 1.7 mm; gain in bone height was 3.9 +/- 1.9 mm. At locations where minimum bone height was 9 mm (mean 10.4 +/- 0.7 mm), 44 implants were placed with a 13.5 +/- 1.06 mm mean length. Mean gain in bone height was 2.9 +/- 1.2 mm at these sites. Two implants were lost at stage 2 surgery. The success rate after 25 months of loading was 97.3%. CONCLUSIONS: It is possible to radiographically observe a gain of approximately 3 to 4 mm of bone from the sinus floor to the implant apex. The amount of initial alveolar bone height, presence of sinus membrane perforation, and the amount of exposed implant surface appear to play a role in the presence or absence of radiopacity within the elevated sinus floor, following 6 months of healing.

Alveolar Process↗
PubMedDate not supplied

Flapless approach for removal of bone graft fixing screws and placement of dental implants using computerized navigation: a technique and case report.

This article presents a technique for the removal of the screws used to fix a bone graft and for the placement of dental implants in a flapless approach that utilizes the tracking technology of a computerized navigation system. A 24-year-old female patient injured in a terrorist bombing suffered from tooth loss and a bone defect in the maxilla. The area was grafted with bone from the chin in preparation for the placement of dental implants. Four months following the grafting procedure, the fixing screws were removed and the dental implants were placed in a flapless approach by the application of a specialized computerized navigation system. This technique emphasizes the potential of computerized navigation approaches in the facilitation of minimally invasive oral surgery.

Adult↗
PubMed2000

Stress distribution in the single-unit osseointegrated dental implant: finite element analyses of axial and off-axial loading.

Occlusal overload may contribute to the extensive crestal bone loss often noted around late-failure dental implants. A particularly high risk of traumatic overload occurs with the posterior single-unit implant restoration because the restoration itself is usually wider than the implant, creating the potential for a cantilever effect with high bending moments. The objective of this study was to evaluate the simulated effects of axial and off-axial vertical loads on stress gradients at the implant/bone interface of a single-unit osseointegrated root-form endosseous dental implant. A two-dimensional finite element model was generated. A 490-N load was applied at 0, 2, 4, and 6 mm from the vertical axis of the implant. Off-axis loading resulted in greatly increased compressive stresses within the crestal cortical bone on the side to which the load was applied and similarly increased tensile stresses on the side opposite the load. These stresses increased considerably with each mm increase off axis of the applied load. These data suggest that off-axis loading of single-unit implant restorations provides a significant contribution to increased stresses at the implant/cortical bone interface. The distance off axis at which the load is applied is also significant.

Bite Force↗
PubMed1998

Reassessment of long-term use of dense HA as dental implant: case report.

Dense hydroxyapatite (HA) is widely believed to be unsuitable for clinical use as dental implants due to its poor mechanical properties, although it has excellent biocompatibility and is chemically stable and nonresorbable in vivo. However, the case in this article is one in which the patient's dense HA implants are still stable and in good functional condition 16.5 years after he received four pieces of a one-piece dense HA implant in both sides of his lower molar regions. Furthermore, almost no radiolucency is evident along the root portions of the implant sites in the bone. These findings imply that dense HA can be clinically useful and should be reevaluated as a dental implant material.

Adult↗
PubMed1995

Evaluation of recombinant human osteogenic protein-1 (rhOP-1) placed with dental implants in fresh extraction sites.

This study used the canine mandibular model to evaluate the efficacy of recombinant human osteogenic protein-1 (rhOP-1) for accelerating the healing of fresh dental extraction defects and in encouraging osseointegration of dental implants. Eight implants, four hydroxylapatite (HA)-coated and four non-coated, were placed in each mandible of four adult male mongrel dogs immediately after extraction of the eight premolars. The rhOP-1 was placed in all extraction sites with and without implants on the left side of the mandible. All animals were killed at 12 weeks postoperatively; histologic analysis was performed, including measurement of the new bone formation within the extraction defects, implant incorporation, and implant-bone interface characteristics, including percent bone and fibrous tissue apposition. Extraction sites treated with rhOP-1 were completely filled with new bone and were well incorporated with the host bone at 12 weeks post-operative. New bone had filled the untreated defect sites; however, the amount, density, and degree of remodeling were less than was observed in rhOP-1 sites. Small increases in osseointegration and adjacent new bone formation were apparent surrounding implants placed with rhOP-1. However, good initial implant fit and the small amount of rhOP-1 delivered to the site in this model may have mitigated any large differences. The results of this study demonstrate that new bone formation can be induced around and adjacent to a dental implant placed in a fresh extraction site with a recombinantly produced bone inductive protein.

Alveolar Process↗
PubMed2006

Saliva and dental implants.

This is a review and update of the: (1) interaction of dental implants with the environment, and (2) effects of salivary contamination on the load of implant prostheses.

Biomechanical Phenomena↗
PubMed2002

[The influence of the screw thread and the height of constraints on the stress distribution around dental implants by using three-dimensional finite element analysis].

OBJECTIVE: To study the influence of the screw thread and the height of constraints on the stress distribution of the implants. METHODS: The three-dimensional emulational models of the implants with different screw-pitch were constructed by a CAD/CAM package. The Von Mises stress of the models was analyzed by three-dimensional finite element method. RESULTS: The constraints of the long implant were high. When the constraint height reduced, the change of the stress value of the implants without screw thread was much less than that of the implants with screw thread. The difference of screw-pitch had little influence on the stress value and the stress concentration of the implants. CONCLUSION: The strength requirement of screw implant was high. Stress distribution of the long dental implants was more reasonable than the other, which will contribute to the success of dental implants.

English Abstract↗
PubMed1993

Clinical case report: an improved technique for using dental implants as orthodontic anchorage.

The use of endosseous implants as intra-oral anchorage to facilitate orthodontic treatment has been reported in the literature for some years, first in rabbits and dogs, and then in adult human patients. The implants were generally used solely for the purpose of anchorage. This paper reports the successful application of orthodontic forces utilizing dental implants to achieve tooth movement. The implants were subsequently used as fixtures in a pre-determined plan to support a fixed prosthesis. A clinical example demonstrates how implants may serve dual roles, for anchorage and then for fixed prosthetic support. The principles involved in using dental implants as part of a multi-disciplinary approach to dental treatment are illustrated.

Adult↗
PubMed1997

Distribution of bone quality in patients receiving endosseous dental implants.

Knowledge of the distribution of bone quality in the various jaw regions assists the clinician in dental implant treatment planning. Bone quality was assessed with radiographs and tactile sensation for 2,839 implants at the time of placement into four anatomic regions of the jaw. The Lekholm-Zarb classification system was used. Overall, bone quality types 1 and 4 were found much less frequently than types 2 and 3. Although variations in density existed in each region, quality 2 bone dominated the mandible, and quality 3 bone was more prevalent in the maxilla. For both anterior and posterior jaw regions, types 2 and 3 bone predominated. The anterior mandible had the densest bone, followed by the posterior mandible, anterior maxilla, and posterior maxilla.

Adult↗
PubMed2006

Comparative study of axial and femoral bone mineral density and parameters of mandibular bone quality in patients receiving dental implants.

INTRODUCTION: In view of the increase in the life expectancy of humans and in edentulism of the population above 50 years of age, in which the prevalence of osteoporosis is also higher, it is fundamental to better understand the effects of systemic bone mass loss on the healing process of dental implants and to determine the quality of the bone that surrounds them. The objective of the present study was to compare systemic osteoporosis (axial and femoral) and parameters of mandibular bone quality, and to evaluate osseointegration in postmenopausal women receiving dental implants. METHODS: The sample consisted of 39 women aged 48-70 years, 19 with a densitometric diagnosis of osteoporosis in the lumbar spine and femoral neck and 20 controls with a normal densitometric diagnosis. Bone mineral density was measured in the patients and controls by dual-energy X-ray absorptiometry. Eighty-two osseointegrated dental implants were placed in the mandible, 39 of them in the osteoporosis group and 43 in the control group. Mandibular bone quality was evaluated by classifying mandibular inferior cortical and trabecular bone on panoramic radiographs and by histomorphometric analysis of a mandibular bone biopsy. Osseointegration was analyzed after 9 months. RESULTS: No significant difference was observed between patients with osteoporosis and controls when comparing individuals with a normal cortex and those with a severely or moderately eroded cortex determined on panoramic radiographs. Histomorphometric analysis also revealed no difference in the parameters of bone formation or resorption between the two groups. Implant failure was observed in only one case. CONCLUSION: We conclude that there is no association between systemic osteoporosis (axial and femur) and parameters of poor mandibular bone quality. The loss of one implant (1.2%) is compatible with the literature and cannot be attributed to systemic osteoporosis.

Aged↗
PubMed2003

Enhancement of the fibula free flap by alveolar distraction for dental implant restoration: report of a case.

We describe the utilization of distraction osteogenesis in the free fibular microvascular bone graft to the mandible for increasing bone height for future osseointegrated dental implants. Successful reconstruction of a resected mandible requires restoration of both function and esthetic form. Although current reconstructive techniques restore anterior-posterior and lateral projection, often the graft's vertical height is not sufficient for the placement of osseointegrated dental implants and subsequent oral prosthesis. The patient was a sixteen-year-old male who was found to have a large desmoplastic fibroma of the left mandible, which was resected. The defect was successfully restored with a free fibular microvascular bone graft and reconstruction plate. Nevertheless, the patient had persistent problems with mastication and it was decided to perform a segmental osteotomy of the neomandible. Two internal vertical distraction devices were then placed in the mandible. The appliances were then activated five days postoperative, twice a day, for a total of 14 days. At that time 1.5 cm of distraction had occurred and the patient was placed in a consolidation phase for four months. The patient then had sufficient bone height and was restored with 8 osseointegrated dental implants.

Adolescent↗