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At least 865 records · Page 48Linked to original sources
PubMed2002

Distraction osteogenesis: a treatment tool to improve baseline conditions for esthetic restorations on immediately placed dental implants--a case report.

Replacement of two adjacent teeth in an anterior maxilla with deficient hard and soft tissues appears to be the utmost challenge in implant dentistry in the esthetic zone. In this case report, baseline conditions for implant placement were improved by alveolar distraction to enhance hard and soft tissues around the maxillary central incisors. Three months after the active phase of distraction, the roots of the central incisors were extracted and two screw-type dental implants were immediately placed into the extraction sockets. For immediate provisionalization, acrylic resin crowns were fabricated on UCLA abutments, providing the ideal emergence profile to support the periimplant soft tissue. Six months after implant placement, the prosthetic restoration of the case was finished with ceramic crowns cemented to individually fabricated zirconium oxide abutments. The described treatment strategy appears to have a great potential to restore natural esthetics in cases with major tissue deficiencies in the esthetic zone.

Acrylic Resins↗
PubMed2004

Retrospective clinical review of dental implants placed in a university training program.

Many dental schools offer implant clinical training at the pre- and postdoctoral levels, but little has been published on the clinical outcomes of implants placed in those programs. A post-entry chart review was conducted of all Branemark and Taper-Lock implants placed in a university clinic by faculty-student teams. Case information was gathered on data reporting forms and entered into a computer spreadsheet program. Survival rates were calculated as percentages. Cumulative implant survival was 96% for all 303 implants placed. Eight of the 12 implants that failed were placed by 2 operators, only 1 of whom was in the early stages of implant training. Branemark implant survival was 94.9% (n = 198) at 36 months; failures occurred between stage 2 and 3 months (n = 8) in mandibles and after 12 months (n = 2) in maxillae. Taper-Lock implant survival was 98.1% (n = 105) at 24 months; no mandibular failures occurred, but maxillary failures occurred before stage 2 (n = 1) and after 12 months of loading (n = 1). Taper-Lock implants exhibited a slightly higher (3.2%) cumulative survival rate at 24 months compared to Branemark implants. Differences in the numbers of implants placed (105 vs 198) and follow-up times (24 months vs 36 months) may have skewed the comparative results of Taper-Lock and Branemark implants, respectively, in this study. Implant survival for both systems was similar at 24 months of follow-up, and clinician experience did not appear to be an influencing variable on implant survival.

Adolescent↗
PubMedDate not supplied

Mechanical response of bone under short-term loading of a dental implant with an internal layer simulating the nonlinear behaviour of the periodontal ligament.

We consider a non-standard design for a fixed dental implant, incorporating a soft layer which simulates the presence of the periodontal ligament (PDL). Instead of being aimed at causing an a priori defined stress/strain field within the surrounding bone, upon loading, such a design simply tries to better reproduce the natural tooth-PDL configuration. To do this, the mechanical properties of the internal layer match those of the PDL, determined experimentally to be strongly nonlinear. Three-dimensional finite element analyses show that the presence of such a layer produces (i) a prosthesis mobility very similar to that of a healthy tooth, for several loading conditions, and (ii) a stress/strain distribution substantially different from that arising, upon loading, around a conventional implant. The lack of knowledge of the real mechanical fields existing, under loading, in the bone around a healthy tooth makes it very difficult to state that the stress distribution produced by the modified implant is "better" than that produced by the standard one. Nevertheless, the comparison of the results obtained here, with those of previous refined analyses of the tooth-PDL-bone system, indicates that the modified implant tends to produce a stress distribution in the bone, upon loading, closer to "natural" than that given by the standard one, within the limits imposed by the presence of threads coupling the implant with the bone.

Biomimetic Materials↗
PubMed1975

The epithelium contiguous with the neck of intraosseous dental implants.

There are three distinct regions with which a wedge shaped dental implant is in contact; the intraoral, transitional and intraosseous portions. The environment of each of these is different and will require special consideration. This investigation compares the epithelium found associated with a natural tooth to that which is found contiguous with the transitional region of an implant. The possibility of a pseudojunctional epithelium being formed in association with a glass collar processed onto the neck of a wedge shaped implant is examined. The histological appearance of a specimen in situ for 11 months shows an altered epithelial structure compared to that found adjacent to the neck of an unmodified titanium wedge shaped implant. Because the implant and glass must be mechanically separated from the tissue being examined, the value of demeneralized histological sections is limited. However, examination by a Scanning Electron Microscope of the surface of the glass after removal reveals an area of clear glass in the deeper region of the collar. Above this there is a deposit, the exact nature of which is unknown, but which migth be interpreted as the contents of the gingival crevice. Although this might be interpreted as a type of epithelial attachment, other factors are necessary to ensure close gingival adaptation and limitation on epithelial downgrowth.

Animals↗
PubMed1993

Tissue response of apatite-filled resin cement and titanium-reinforced apatite dental implants in dogs.

Abutment and root portion divided two-piece dental implants were designed to modify the one-piece dense hydroxyapatite (D-HAP) implant. The initial placement of the root portion endosseously ensured an aseptic environment and physical stability for the implant during the bone healing period. The outer D-HAP shell of the root portion was fortified by an inner titanium cylinder and cemented with an adhesive resin cement containing 4-methacryloyoxyethyl trimellitate anhydride (4-META) and reinforced by fine apatite filler. Upon attaining integration of the bone and implant, the abutment was screwed and fixed into the screw hole of the root portion. The tissue response of both the apatite-filled resin cement and root portion of the two-piece implant was studied by animal canine experiments. Light and electron microscopic examination of specimens taken from experimental animal tissue showed bone contacted directly not only the exposed apatite filler at the surface of the apatite-filled resin cement, but also the resin portion. These findings of direct bone contact suggested that the tissue response of apatite-filled resin cement was approximately similar to the usual D-HAP. Because most of the surface of the outer D-HAP shell of the root portion came in contact with bone, it prevented the deposition of contamination on the D-HAP surface during the manufacturing procedures of the root portion.

Animals↗
PubMed2001

Plaque formation on surface modified dental implants. An in vitro study.

Bacterial adhesion on titanium implant surfaces has a strong influence on healing and long-term outcome of dental implants. Parameters like surface roughness and chemical composition of the implant surface were found to have a significant impact on plaque formation. The purpose of this study was to evaluate the influence of two physical hard coatings on bacterial adhesion in comparison with control surfaces of equivalent roughness. Two members of the oral microflora, Streptococcus mutans and Streptococcus sanguis were used. Commercially pure titanium discs were modified using four different surface treatments: physical vapour deposition (PVD) with either titanium nitride (TiN) or zirconium nitride (ZrN), thermal oxidation and structuring with laser radiation. Polished titanium surfaces were used as controls. Surface topography was examined by SEM and estimation of surface roughness was done using a contact stylus profilometer. Contact angle measurements were carried out to calculate surface energy. Titanium discs were incubated in the respective bacterial cell suspension for one hour and single colonies formed by adhering bacteria were counted by fluorescence microscopy. Contact angle measurements showed no significant differences between the surface modifications. The surface roughness (Ra) of all surfaces examined was between 0.14 and 1.00 microm. A significant reduction of the number of adherent bacteria was observed on inherently stable titanium hard materials such as TiN and ZrN and thermically oxidated titanium surfaces compared to polished titanium. In conclusion, physical modification of titanium implant surfaces such as coating with TiN or ZrN may reduce bacterial adherence and hence improve clinical results.

Bacterial Adhesion↗
PubMed1990

Dental implants. State of the art, state of the science.

Analysis of epidemiologic studies reveals that even with advances in preventive dentistry, edentulism continues to be a pressing problem especially in a rapidly expanding senior population. As an alternative to traditional removable dentures, dental implants can provide fixed support for crowns and bridges. A recent National Institutes of Health Consensus Development Conference revealed significant growth in implant technology and established that, although a complex treatment alternative, implants can function for 10 years or more. Continued development in basic and clinical research, federal regulations, professional education, public awareness, insurance, and marketing will shape the future of the field.

Biocompatible Materials↗
PubMed1997

Influences of smoking on the periodontium and dental implants.

The purpose of this article is to review current information on the role of smoking in destructive periodontal disease and in increasing the likelihood of failure of endosseous dental implants. Practical recommendations are made on the role of the dental health professional in everyday dealings with patients who smoke.

Age Factors↗
PubMedDate not supplied

Biomimetic coatings functionalized with adhesion peptides for dental implants.

A complete biological integration into the surrounding tissues (bone, gingiva) is a critical step for clinical success of a dental implant. In this work biomimetic coatings consisting either of collagen type I (for the gingiva region) and hydroxyapatite (HAP) or mineralized collagen (for the bone interface) have been developed as suitable surfaces regarding the interfaces. Additionally, using these biomimetic coatings as a matrix, adhesion peptides were bound to further increase the specificity of titanium implant surfaces. To enhance cell attachment in the gingiva region, a linear adhesion peptide developed from a laminin sequence (TWYKIAFQRNRK) was bound to collagen, whereas for the bone interface, a cyclic RGD peptide was bound to HAP and mineralized collagen using adequate anchor systems. The biological potential of these coatings deduced from cell attachment experiments with HaCaT human keratinocytes and MC3T3-E1 mouse osteoblasts showed the best results for collagen and laminin sequence coating for the gingiva region and mineralized collagen and RGD peptide coatings for regions with bone contact. Our concept opens promising approaches to improve the biological integration of dental implants.

Journal Article↗
PubMedDate not supplied

Clinical and microbiological findings on newly inserted hydroxyapatite-coated and pure titanium human dental implants.

The clinical and microbiologic features of 30 hydroxyapatite-coated root-form endosseous dental implants (Tri-Stage) were compared to 10 similar pure titanium implants without hydroxyapatite coatings. In 7 of 9 partially edentulous patients studied, pure titanium fixtures were placed adjacent to hydroxyapatite-coated implants. Implants in the maxilla were submerged beneath mucosal tissues after implant placement for a minimum of 6 months, and in the mandible for at least 4 months. All patients were prescribed short-term beta-lactam antibiotic therapy after fixture placement, and 8 of 9 used chlorhexidine mouthrinses after fixture exposure. Clinical and microbiological examination was carried out 7-10 months after fixed prosthetic loading of the implants. Clinical measurements included the gingival index, plaque index, bleeding on probing and peri-implant probing depths determined with the Florida Probe system. Subgingival microbial samples were collected with paper points and transported in VMGA III. Specimens were examined by direct phase-contrast microscopy and were plated onto nonselective and selective culture media for anaerobic and aerobic incubation. No significant mean clinical or microbiological differences were found between the implant types, although one hydroxyapatite-coated implant exhibited deep probing depths, bleeding on probing and marked radiographic crestal bone loss. Streptococcus sanguis and Streptococcus mitis were the most predominant organisms recovered from clinically stable implants, whereas high proportions of Fusobacterium species and Peptostreptococcus prevotii were isolated from the ailing hydroxyapatite-coated implant. One or more implants in 8 of the study subjects yielded enteric rods, pseudomonads, enterococci or staphylococci. The prognosis of implants with varying early microbiotas needs to be established in longitudinal studies.

Aged↗
PubMed1993

The role of a hospital-based dental implant center.

The role of a hospital-based implant center with dental and medical specialists working as a team is discussed. Advantages to the team include the availability of sophisticated hospital equipment and facilities. Referring dentists are encouraged to participate in and/or observe treatment performed at the implant center. Four cases treated by an implant team within a hospital environment are presented.

Adult↗
PubMed2001

Brånemark System and ITI Dental Implant System for treatment of mandibular edentulism. A comparative randomized study: 3-year follow-up.

In a randomized prospective study, two implant systems were compared in forty consecutive patients treated for mandibular edentulism. The patients were randomly allotted for treatment by the Brånemark two-stage (submerged) system (BRS), or the ITI(R) one-stage (non-submerged) system. In all, 102 Brånemark selftapping implants and 106 ITI hollow screw implants were installed and all patients were treated with full bridges. Biological and prosthodontic parameters, complications, success rates, clinical efficacy, patient satisfaction and resource requirements were evaluated. No differences were found in plaque accumulation, bleeding or complications during the follow-up period. The BRS group showed deeper periimplant sulcus, less attached mucosa, larger bridge-mucosa distance and higher Periotest values. Prosthetic complications were not related to the configuration of the implant systems. After 3 years, the cumulative success rates were 97.9% and 96.8% for the Brånemark and ITI systems, respectively (difference not statistically significant). One implant in the BRS group had failed to osseointegrate at the time of abutment connection, and another was lost after 2 years due to progressive breakdown of bone. In the ITI group, three implants showed progressive bone loss after 1-3 years associated with periimplant infection. All 40 bridges were intact and remained stable throughout the study. There was general patient satisfaction, but about half the Brånemark patients reported difficulty in coping with the surgical procedures. Treatment time was similar for the two systems. It is concluded that both systems meet the current requirements for dental implant systems in the treatment of mandibular edentulism.

Adaptation, Psychological↗
PubMed1989

Microstructure and mechanical properties of Ti-Ta/alumina and Ti-Nb/alumina joints for dental implants.

The microstructure of Ti-Ta and Ti-Nb alloys diffusion bonded to a 99.7 wt% Al2O3 ceremic for dental implants is subdivided into a reaction double layer containing the phases TiAl and Ti3Al, a transition region of coarse alpha-Ti plates in beta-Ti, and the unaffected bulk metal, the alpha-Ti/beta-Ti structure of which can be refined by annealing at 800 degrees C for 1 hour after bonding. Optimized joints fabricated by diffusion bonding in a high vacuum at 1,200 degrees C from a 99.7 wt% Al2O3 ceramic and Ti-Ta alloys fitted in their thermal contraction behavior to that of the ceramic by the addition of 30 to 40 wt% Ta showed a fracture resistance of 2.3 MN/m3/2. Approximately 80% of the bend test specimens notched at the Ti-Ta/alumina interface failed by crack extension parallel to the interface within the ceramic, which is typical for a metal-ceramic bond of high to medium interfacial strength.

Aluminum Oxide↗
PubMed2001

Effects of guided bone regeneration with non-resorbable and bioabsorbable barrier membranes on osseointegration around hydroxyapatite-coated and uncoated threaded titanium dental implants placed into a surgically-created dehiscence type defect in rabbit tibia: a pilot study.

The purpose of this study was to evaluate the effects of guided bone regeneration (GBR) with either a non-resorbable (ePTFE) or bioabsorbable barrier membrane (RSLT) on osseointegration and extent of bone formation around hydroxyapatite-coated (HA) and uncoated threaded titanium (Ti) dental implants placed into surgically-created dehiscence type defects in rabbit tibia. A dehiscence type bone defect, approximately 3 mm in width and height was surgically created on the outer surface of the bone in each tibia of 9 rabbits. For the conventional group, either a HA or a Ti implant was then placed at this site. After the same procedure was performed as in the conventional group, the implant site of the GBR group was covered with either an ePTFE or a RSLT. After 4 months, the rabbits were sacrificed. Specimens were prepared and examined histometrically. It was found that the mean percentage of osseointegration tended to increase in HA compared to Ti implants, both with and without membranes. There was a tendency that the extent of newly regenerated bone was higher in the GBR group than that in the conventional group.

Absorbable Implants↗
PubMed2002

Predicting dental implant survival by use of the marginal approach of the semi-parametric survival methods for clustered observations.

The analyses of clustered survival observations within the same subject are challenging. This study's purpose was to compare and contrast predicted dental implant survival estimates assuming the independence or dependence of clustered observations. Using a retrospective cohort composed of 677 patients (2,349 implants), we applied an innovative analytic marginal approach to produce point and variance estimates of survival predictions given the covariates smoking status, implant staging, and timing of placement adjusted for clustered observations (dependence method). We developed a second model assuming independence of the clustered observations (naïve method). The 95% confidence intervals for survival prediction point estimates given the naive method were 5.9% to 14.3% more narrow than the dependence method estimates, resulting in an increased risk for type I error and erroneous rejection of the null hypothesis. To obtain statistically valid confidence intervals for survival prediction of the Aalen-Breslow estimates, we recommend adjusting for dependence among clustered survival observations.

Cluster Analysis↗
PubMed2006

Effects of sinus membrane perforations on the success of dental implants placed in the augmented sinus.

BACKGROUND: Maxillary sinus lifting procedure enables clinicians to place implant-supported prostheses even in cases with very limited vertical bone height of the maxillary sinus. The aim of this study was to evaluate the implant success with regard to effects of the sinus membrane perforations that occurred during sinus lifting surgery. METHODS: The study group consisted of 91 patients (29 females and 54 males) with edentulous posterior maxilla. Implant placement combined with sinus lifting surgery was performed, and 259 implants were inserted. Sinus membrane perforations were detected in 12 sinus sites. After proper treatment of perforations, 26 implants were placed into perforated sinus areas. Baseline panaromic radiographs were taken before the beginning of prosthetic treatment. Panaromic radiographs taken at the last recall were used for evaluation and compared to the baseline panaromic radiographs using image analysis software to reveal the peri-implant resorption rate for the implants placed in perforated and non-perforated sinus area. The modified sulcus bleeding index and plaque index were used for the assessment of soft tissue conditions. RESULTS: Eleven implants were lost during the follow-up period, resulting in an overall survival rate of 95.9%. Two failures occurred in the group with sinus perforations. There was no statistically significant difference regarding peri-implant bone resorption (P = 0.778) and soft tissue conditions for implants placed into perforated-augmented sinus areas and augmented sinus areas. CONCLUSION: Within the limits of this study, perforation of the sinus membrane did not compromise the osseointegration process or the success of dental implants placed in the augmented maxillary sinus.

Adult↗
PubMed1998

Comparative densitometric study of iliac crest and scapula bone in relation to osseous integrated dental implants in microvascular mandibular reconstruction.

The study was designed to compare dimension and density of four frequently used bone donor regions (the iliac crest, the lateral border of the scapula, the radius and the fibula) with regard to placement of endosseous dental implants in microvascular mandibular reconstruction. The first part of the study reports on the results of bone dimension and density findings for iliac crest and scapula bone. Nearly all of the iliac crests had adequate dimensions for the positioning of four 10 mm implants. In 63% of the scapulae, it was possible to place four 10 mm implants. In the case of the scapula, half of the female subjects lacked enough available bone for the insertion of four 10 mm implants because of their inadequate width. Bone density and cortical thickness was found to be similar in the iliac crest and scapula. Age and side do not have an important influence on cortical bone dimensions and density. In contrast to the iliac crest, the lateral margin of the scapula astonishingly showed increasing values for bone density and increasing thickness of the cortex. Analogical advanced biological age works in conformity with the scapula flap. The results could, together with other clinical criteria, contribute to the choice of the best individual alternative in mandibular reconstruction.

Adult↗