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PubMed2005

[Junctional epithelialization of dental implants in animals].

OBJECTIVE: To detect the histological changes and the expression of proliferating cell nuclear antigen (PCNA) in junctional epithelialization of dental implants. METHODS: The junctional epithelium was detected by HE staining and the PCNA expression was observed by immunohistochemical staining on the st, 3rd, 6th, 9th, 12th, 15th, 20th and 30th day after implantation in Beagle dogs. RESULTS: The junctional epithelium began to form and PCNA was expressed positively 12 days after implantation. The epithelial hyperplasia tended to stabilization and the expression of PCNA weakened drastically 15 days after implantation. The epithelial attachment showed to be similar to that of natural teeth 20 days later. CONCLUSION: The gingiva epithelium can attach to titanium implants forming junctional epithelium which is similar to the natural teeth.

Animals↗
PubMed1997

The influence of bone quality on Periotest values of endosseous dental implants at stage II surgery.

Periotest values (Periotest, Siemens AG, Bensheim, Germany) were recorded as a baseline variable at surgical uncovering in the ongoing multicenter, prospective clinical studies of the Dental Implant Clinical Research Group, which uses implants from the Spectra-System (Core-Vent Corporation, Las Vegas, NV). For 2,212 osseointegrated implants, the mean Periotest value (PTV) of mandibular implants was -4.14 (anterior, -4.22; posterior, -4.06) versus -3.24 for maxillary implants (anterior, -2.91; posterior, -3.91). Implants in the densest bone (quality 1) had the lowest mean PTV (-4.13), followed by quality 2 (-4.00), quality 3 (-3.58), and quality 4 (-2.64).

Adult↗
PubMed2002

RhBMP-2/alphaBSM induces significant vertical alveolar ridge augmentation and dental implant osseointegration.

BACKGROUND: Recombinant human bone morphogenetic protein 2 (rhBMP-2) in a carrier has been shown to induce significant bone formation. Several candidate carriers, however, lack structural integrity to offset compressive forces that may compromise rhBMP-2 bone induction, in particular, for challenging onlay indications such as alveolar ridge augmentation. PURPOSE: The objective of this study was to evaluate rhBMP-2 in a calcium-phosphate cement carrier, alphaBSM, for vertical alveolar ridge augmentation and immediate dental implant osseointegration. MATERIALS AND METHODS: Six adult Hound Labrador mongrels with 5 mm critical size supra-alveolar peri-implant defects were used. Three animals received rhBMP-2/alphaBSM (rhBMP-2 at 0.40 and 0.75 mg/mL) in contralateral jaw quadrants (total implant volume/defect approximately 1.5 mL). Three animals received alphaBSM without rhBMP-2 (control group). The animals were euthanized at 16 weeks post surgery, and block biopsies were processed for histologic and histometric analysis. RESULTS: rhBMP-2/alphaBSM induced substantial augmentation of the alveolar ridge. Control sites exhibited limited new bone formation. Vertical bone augmentation averaged (+/- SD) 4.9 +/- 1.0 mm (rhBMP-2 at 0.40 mg/mL), 5.3 +/- 0.3 mm (rhBMP-2 at 0.75 mg/mL), and 0.4 +/- 0.4 mm (control); new bone area 8.5 +/- 4.2 mm2, 9.0 +/- 1.9 mm2, and 0.5 +/- 0.4 mm2; new bone density 55.1 +/- 6.4%, 61.1 +/- 6.0%, and 67.7 +/- 9.5%; and new bone-implant contact 26.9 +/- 17.5%, 28.5 +/- 1.4%, and 24.6 +/- 16.1%, respectively. Residual alphaBSM comprised < 1% of the new bone. Bone density for the contiguous resident bone ranged from 65 to 71%, and bone-implant contact ranged from 49 to 64%. CONCLUSIONS: Surgical implantation of rhBMP-2/alphaBSM appears an effective protocol for vertical alveolar ridge augmentation procedures and immediate dental implant osseointegration and for onlay indications of lesser complexity.

Alveolar Ridge Augmentation↗
PubMed1999

Dental implants in the diabetic patient: a retrospective study.

It has become increasingly common for controlled diabetic patients to be considered as candidates for dental implants. This study reports on the results of placing implants in 34 patients with diabetes who were treated with 227 Brånemark implants. At the time of second-stage surgery, 214 of the implants had osseointegrated, a survival rate of 94.3%. Only one failure was identified among the 177 implants followed through final restoration, a clinical survival rate of 99.9%. Screening for diabetes and trying to ensure that implant candidates are in metabolic control are recommended to increase the chances of successful osseointegration. Antibiotic protection and avoidance of smoking should also be considered.

Adult↗
PubMedDate not supplied

Morphologic studies on the biologic seal of titanium dental implants. Report II. In vivo study on the defending mechanism of epithelial adhesions/attachment against invasive factors.

Clinical measurements on gingival indices and morphologic observations were performed in this study to verify the defending mechanism of gingival soft tissue against foreign invasions from the perspective of epithelial adhesion/attachment to implant surfaces in the monkey mandible. The following zones were observed using scanning electron microscopy: (1) plaque zone, suggesting susceptibility of the gingival tissue to bacterial invasion; (2) nude zone, demonstrating indirect adhesion of epithelial cells to the implant surface through the mucous layer and preventing bacterial invasion; and (3) epithelial cell attached zone, having greater bond strength of epithelial cells at the cell-implant interface as compared to cell-cell bonding within the epithelial cell layer. This study suggested that epithelial cell attachment/adhesion may play a dominant role in retaining the successful condition of a dental implant.

Animals↗
PubMed2000

The development of the ITI DENTAL IMPLANT SYSTEM. Part 1: A review of the literature.

In a short trip through more than twenty years, the development of the ITI DENTAL IMPLANT SYSTEM is described. The systematic unfolding and continuous advancement of the system, permanently supported and accompanied by scientific work in clinical and general practice, is outlined in short paragraphs. Some major milestones are emphasized and characterized.

Dental Abutments↗
PubMed1997

Postmortem histologic evaluation of hydroxyapatite-coated cylinder and titanium alloy basket implants in situ for 37 months in the posterior mandible. Dental Implant Clinical Research Group.

Histologic examination of the tissues surrounding a titanium alloy basket implant and a hydroxyapatite-coated titanium cylinder implant from the mandible of a cadaver were examined. The 67-year-old man died 37 months after first-stage surgery from cardiovascular failure. Clinical and radiographic examinations indicated that the implants were functional, immobile, and integrated. Light microscopy revealed that the gingival tissues adjacent to the implants were healthy and, in general, free of inflammatory cells. The transmucosal area demonstrated a tight connective tissue apposition to the implants. The sulcular epithelial appearance was similar to that of a natural tooth. Histomorphometric analysis revealed that 72.2 percent of the basket implant and 75.3 percent of the hydroxyapatite-coated implant were in direct contact with bone. Generally, the bone along the surface of the basket implant was thicker than the bone along the surface of the hydroxyapatite-coated cylinder. Bone grew through the vent hole areas of both implants.

Aged↗
PubMed1983

Three-dimensional stress distribution around a dental implant at different stages of interface development.

An anchor-type ceramic dental implant contained in a section of the mandibular molar region was modeled for finite element stress analysis. The distributions of stresses in the bone around the implant due to axial and transverse loading were calculated for different stages of normal and pathological development of the implant-bone interface. Highest stress concentrations are observed in the crestal region with transverse loading when spongy bone surrounds the implant immediately after surgery. Development of a lamina dura around the implant slightly reduces severe stress peaks, whereas ingrowth of connective tissue almost eliminates them.

Aluminum Oxide↗
PubMed1996

Periodontal parameters around porous-coated dental implants after 3 to 4 years supporting overdentures.

In this study, an assessment using modified periodontal indices was done on a group of 48 fully edentulous patients who had each been treated with 3 porous-coated (EndoPore) dental implants and a mandibular overdenture. Parameters assessed included plaque index (PI), sulcular bleeding index (SBI), pocket probing depth (PD), probing attachment level (PAL) and mobility (M) using a Periotest device. At the time of the assessment, all of the patients had passed 3 years of continuous function while 26 had passed 4 years. Approximately 50% of implant surfaces were plaque-free while 79% of surfaces showed no bleeding upon probing. There was no correlation between PI and SBI. The mean PD was 3.1 mm with 64% of sites < or = 3.5 mm. Mobility measurements taken with the Periotest device gave a mean PTV of (-4.35) with 96% of measurements (-0.5). No significant correlations were found between mobility and either PAL or implant length.

Analysis of Variance↗
PubMed1997

Guided tissue regeneration around dental implants in immediate extraction sockets: comparison of resorbable and nonresorbable membranes.

This study was performed to compare the efficacy of guided tissue regeneration (GTR) around dental implants immediately placed into extraction sockets by resorbable of nonresorbable membranes. Mandibular P2, P3, and P4 of four adult beagle dogs were extracted bilaterally, and buccal standard defects were created and measured. Eighteen commercially pure titanium Steri-Oss implant fixtures were placed into the fresh extraction sockets. Four implants were untreated controls, four implants received polytetrafluoroethylene (e-PTFE, Gore-Tex) membranes, five implants received collagen membranes (ParaGuide), and five implants received polyglactin 910 mesh (Vicryl). After 14 weeks, clinical measurements were taken and the dogs were sacrificed and all specimens retrieved for histologic and histomorphometric evaluation. The average gain in bone height was 2.1 mm for untreated control sites, 3.3 mm for Gore-Tex sites, 3.8 mm for collagen sites, and 1.3 mm for polyglactin 910 sites. The greatest gain in bone height and volume was seen for two sites that received Gore-Tex membranes and remained covered for the entire evaluation interval. The results of this study indicate that Gore-Tex and collagen membrane produced good results for GTR around implants immediately placed into extraction sockets. Since collagen membrane does not cause obvious infection and does not need the surgical reentry for membrane removal, it can be a valid alternative to Gore-Tex membrane to improve bone regeneration around dental implants, while polyglactin 910 mesh seems not suitable to be used as GTR membrane in immediate implantation for its high infection rate.

Animals↗
PubMed2004

A three-year follow-up report of a comparative study of ITI Dental Implants and Brånemark System implants in the treatment of the partially edentulous maxilla.

BACKGROUND: Many longitudinal studies of different implant systems have been published but few controlled randomized investigations have been reported. A 1-year report of a comparative study of ITI Dental Implant System implants (Straumann AG, Waldenburg, Switzerland) and Brånemark System implants (Nobel Biocare AB, Gothenburg, Sweden) has been published by the present authors. This paper is a 3-year follow-up of that randomized study. PURPOSE: The aim of the study was to compare the outcome of fixed partial prostheses supported by ITI or Brånemark implants. The outcome was evaluated primarily in terms of survival rates and changes in marginal bone level. MATERIAL AND METHODS: The study group comprised 28 patients with anterior residual dentition in the maxilla. The patients were provided with two to four implants on each side of the dentition and were randomly allocated to Brånemark implants or ITI implants; 77 ITI implants and 73 Brånemark implants were inserted. After 6 months abutment connections were made to both ITI and Brånemark implants. All patients were provided with fixed partial prostheses of gold-ceramic. The patients were followed up annually with clinical and radiographic examinations for 3 years RESULTS: Two Brånemark implants and two ITI implants were lost. The Brånemark implants were lost before loading whereas the ITI implants were lost because of periimplantitis. The survival rate for both groups was 97.3%. The mean marginal bone level of the Brånemark implants was situated 1.8 mm from the reference point at both the baseline and the 3-year examinations. The corresponding values for the ITI implants were 1.4 mm at baseline and 1.3 mm after 3 years. There was no significant difference between the implant systems with regard to bone level or bone level change. A steady state of the marginal bone level was calculated to have been reached after 3 years for 95.5% of the Brånemark implants and 87.1% of the ITI implants. Periimplantitis (infection including pus and bone loss) was observed with seven ITI implants but with none of the Brånemark implants. This difference was statistically significant. CONCLUSIONS: No statistically significant differences were found between the implants studied, except for the frequency of periimplantitis, which was higher for the ITI implants. The survival rates were high, and the marginal bone loss was small for both systems.

Adult↗
PubMed2002

An anatomical study of vascularized iliac bone grafts for dental implantation.

PURPOSE: The purpose of this study was to clarify the anatomical features of vascularized iliac bone grafts used for mandibular reconstruction and dental implantation. MATERIAL AND METHOD: Twenty-six cadavers were dissected to examine vessels and areas of iliac bone that could be used as pedicles and grafts. The length and diameter of vessels of the vascular pedicle were determined, and the length and depths of the iliac bone were measured with respect to points determined by the relative dimensions of the bone. RESULTS: The deep circumflex iliac arteries were classified as double nutrient type (75%), iliac-crest type (19%), or iliacus-muscle type (6%). The mean arterial length was 64+/-15 mm in the double nutrient type. The mean internal diameters at the origin of the deep circumflex iliac artery and vein that could be used for anastomosis were 1.7+/-0.4 mm and 2.1+/-0.7 mm respectively. The greatest mean cross-sectional width and height were 18+/-3 and 42+/-5 mm respectively. The greatest mean cross-sectional cortical thickness at the intermediate line of the iliac crest was 3.4+/-0.8 mm. CONCLUSION: These results should be useful in designing bone grafts for mandibular reconstruction followed by dental implantation.

Anastomosis, Surgical↗
PubMedDate not supplied

A comparative clinical investigation of 2 early loaded ITI dental implants supporting an overdenture in the mandible.

The purpose of this prospective clinical study was to evaluate the efficacy of early loading of implants and to provide evidence to support simplified treatment of mandibular edentulism by using an implant designed for 1-stage surgery, combined with ball abutments to circumvent the need for a fixed prosthodontic superstructure. Historically, the recommended time between the placement and functional loading of dental implants has been 3 months in the mandible. This recommendation is the result of a systematically chosen healing time during development of implant treatment. In recent years, histologic and experimental studies have shown that specially designed implants can result in increased bone-to-implant contact at earlier healing times. Accordingly, these implants can be placed into function faster than previously recommended. In this study, 21 patients aged between 61 and 85 years with edentulous mandibles were included. All received 2 titanium plasma-sprayed, solid-screw dental implants in the interforaminal region. Ten patients had the implants loaded with an overdenture connected with ball abutments after 3 months (control group). The other 11 patients (test group) had prostheses connected to the ball abutments after a maximum of 3 weeks. Marginal bone resorption, Periotest values, and patient satisfaction were evaluated. The cumulative post-loading implant survival rate was 100% for both groups after 24 months. Marginal bone resorption after 1 year around all implants ranged from 0 to 2 mm (no significant differences between groups; P < .05). Periotest values for all implants 1 year after loading were below zero (range -1 to -6). The results of this clinical trial suggest that successful early loading of 2 implants is possible provided there is uncomplicated implant placement.

Aged↗
PubMed1994

The use of the subepithelial connective tissue graft to enhance both the aesthetics and periodontal contours surrounding dental implants.

The subepithelial connective tissue graft is a gingival grafting plastic surgery procedure that can be used to enhance the aesthetic and gingival contour of the periodontium around dental implants. This technique is described and illustrated to create a soft-tissue root prominence and mask the grey color penetrating the thin labial attached gingival tissues over dental implants.

Adult↗
PubMed1990

Clinical application of dental implant with root of coated bioglass: short-term results.

During the last 4 years 73 dental implants with root-coated bioglass to replace one to three teeth in the premolar and molar sites of the mandible were inserted. The bonding ratio between implant and bone was observed clinically 1 year after implantation and installation of the superior structure. This ratio measured 52.4% to 63.3%. An acoustoelectric tester was developed that advanced our skills. The emphasis was placed on a tight fit between implant and surrounding bone.

Adolescent↗
PubMed1992

Dental implant treatment in a severely compromised (irradiated) patient.

When faced with a patient with relative medical or psychological contra-indications, the practitioner may be tempted to withhold dental implant treatment because of the risks. Yet, for some highly motivated but compromised patients, the potential benefits of implant treatment can be an overriding consideration. In the case presented here, a 56-year-old patient who had undergone two series of radiation therapy and surgery for recurring cancer of the tongue was treated first with a subperiosteal, and, when the subperiosteal was removed after six years, the patient was treated with endosseous implants. This treatment significantly improved the patient's life without further negative effect on her medical condition.

Contraindications↗
PubMedDate not supplied

Sinus augmentation bone grafts for the provision of dental implants: report of clinical outcome.

PURPOSE: The aim of this study was to report the outcome of sinus augmentation surgery with autogenous bone grafting in routine dental implant practice. MATERIALS AND METHODS: Twenty-seven sinus augmentation procedures were undertaken on 18 consecutive patients (mean age 43.7 years). The mandibular symphysis was used as the donor site for 11 patients. The iliac crest was used as a donor site for 7 bilateral cases. RESULTS: Six patients had implants placed at the time of grafting: the other 13 had a mean bone graft consolidation period of 24.7 weeks (range 9 to 39 weeks) before implants were placed. One patient who had a repeat procedure had both immediate and delayed techniques. A total of 79 Brånemark System Mk II implants were placed in grafted bone (and 2 Mk IV implants were placed in a patient who had to have a repeat procedure) and proceeded to occlusal loading. After a mean follow-up period of 162 weeks (range 76 to 288 weeks), 16 implants failed to integrate in grafted bone, representing an 80.25% survival rate. Fourteen patients proceeded to the planned prosthesis, 3 patients had a compromised treatment plan, and 1 patient was restored conventionally. This represents 94% of patients who were rehabilitated. DISCUSSION AND CONCLUSION: The sinus augmentation procedure using autogenous bone grafting can Increase bone volume to allow implant placement where there is insufficient bone. The survival of implants in the grafted bone, as measured by integration and successful loading, was reduced compared to implants placed in normal maxillary bone. Infection during the healing of the grafted site reduces the success of subsequent implant osseointegration.

Adolescent↗