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Dental implants and ADA acceptance.
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[Dental implants. Indications and contraindications].
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Dental implants: a proven success.
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Submerged versus non-submerged dental implants: a comparison.
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Symposium: Towards Optimized Treatment Outcomes for Dental Implants. Toronto, Ontario, April 24-25, 1998. Proceedings.
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[Two-cog (pi-shaped) dental implants and preclinical validation of their use].
Based on the results of statistical analyses, the authors validate the need in development of a new optimal design of implants for replacement of removed mandibular molars. Two-cog (P-shaped) dental implants are suggested, which have been patented. Study of their biomechanical characteristics by digital experiments using three-dimensional final element simulation demonstrated the efficiency of this design of implants, particularly for direct and early implantation and confirmed the adequacy and validity of the two-cogs implants.
Clinical applications of synthetic bone in dentistry, Part II: Periodontal and bony defects in conjunction with dental implants.
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The effect of fixture neck design in a realistic model of dental implant: a finite element approach.
The aim of this work is to develop an accurate finite element model able to reproduce a standard experimental set-up for the evaluation of mechanical failure of a dental implant system. The considered system is composed of a fixture, an abutment and a connecting screw. We analysed the behaviour of the implant system considering three different designs of the fixture, in order to establish which one provides the better mechanical behaviour. After the definition of the numerical models, loading conditions were selected in order to reproduce the same stress state found in previous mechanical failure tests. Preloading and functional loading conditions were simulated. The analysis of the numerical results shows that the structure yielding is due to the fixture neck plastic deformation, that increases the load eccentricity and then the bending stress on the connecting screw. Only slight differences were found between the three implant systems in the amount and distribution of stress. The model reproduces properly the implant systems and the experimental set-up. The goodness of the model can be summarised as: realistic geometrical structure, elastoplastic model for the material description, correct definition of the contacts and the existing tolerance among the different system components, reproduction of the preloading stress condition. The present study permitted to define a valid procedure for the realization of numerical models of implant systems.
Medico-legal aspect of dental implants.
The practising environment in health care is ever changing in both clinical and management areas. Within dentistry, two major changes have occurred with the development of implantology into a sound treatment approach and a burgeoning of dental litigation. There are medico-legal issues that relate to dental implant treatment with which clinicians must become familiar and there are medico-legal implications that impact on risk management by Medical Indemnity Organizations (MDOs) and the indemnity premiums they set for their members. The aim of this paper is to discuss these issues and highlight those areas of significance to clinicians.
Dental implants in periodontal therapy.
Over the past 30 years, research has validated the success of osseointegrated implants as a viable alternative to fixed or removable prosthetic restorations. Periodontists are extensively trained in surgical procedures to treat and maintain patients with edentulous and partially edentulous arches. They also have a primary role in treatment planning and maintenance therapy. Thus, periodontists routinely integrate endosseous implants into periodontal therapy. This paper was prepared by the Research, Science and Therapy Committee of the American Academy of Periodontology and is intended to inform the dental profession regarding the utility of endosseous dental implants in the treatment of full and partial edentulism.
An approach to the diagnostic imaging of jaw lesions, dental implants, and the temporomandibular joint.
This article is an overview of three complex and often confusing areas of diagnostic imaging. It provides the reader with a starting point and a frame of reference from which to proceed when confronted with either an unknown jaw lesion, evaluating a potential dental implant patient, or a patient with TMJ internal derangement.
Computed tomography in dental implantation surgery.
High-resolution thin section CT with cross-sectional oblique and panoramic CT reconstructions has been shown to be an excellent tool for the preoperative evaluation of the mandible and maxilla for dental implant surgery. Oblique cross-sections throughout the entire surgical field allow visualization of osseous topography as well as related internal anatomic structures such as the inferior alveolar canal, the mental foramina, the incisive canal, and the maxillary sinuses. Armed with this knowledge, the surgeon-restorative dentist team can plan fixture positioning more effectively, thereby minimizing surprises in the operating room. Cases with inadequate buccolingual bone dimension are not attempted, whereas many other cases that do not appear to have adequate bone, as seen on conventional x-ray films, can be successfully implanted. The ultimate prosthesis is optimized because the surgeon can take full advantage of the available bone to achieve proper fixture alignment. It is quite likely that as future experience is obtained with maxillofacial CT, it may also be useful in diagnosis and treatment for a wide variety of other disorders of the jaw.
Peripheral giant cell granuloma associated with a dental implant.
A 56-year-old woman was referred for the treatment of a mandibular lesion that had been slowly increasing in size over a 6-month period. Intraoral examination revealed a reddish-purple nodule involving the attached vestibular gingiva around a machined-surface dental implant that had been placed 2 years earlier in the mandibular left second premolar region. Another implant had been placed in the mandibular left second molar region. The lesion was tender and bled easily upon tooth brushing. Radiographs showed inadequate abutment angulation. The healing caps on these 2 implants were loose and in contact with each other, preventing optimal oral hygiene. An excisional biopsy of the mass resulted in the diagnosis of peripheral giant cell granuloma. After the implants were gently curetted and scaled, they were cleaned using abrasive paste. At the last follow-up, 3 years later, there was no recurrence.
Bone cell attachment to dental implants of different surface characteristics.
Previous studies to compare the influence of surface characteristics of dental implants on cell behavior have used model systems to simulate the implant surface. In this study, bone cell interactions with smooth titanium, titanium dioxide-blasted, titanium plasma-sprayed, and hydroxyapatite plasma-sprayed implants, as manufactured for clinical use, were compared. Implants were exposed to neonatal rat osteoblast cells in suspension for a 20-minute period and, by means of scanning electron microscopy, attached cells were classified according to stage of attachment. Quantitative analysis showed that cells spread most quickly on the titanium plasma-sprayed implants. Fully spread cells on the smooth titanium implants were closely adherent to the surface, while on the titanium dioxide-blasted surface they showed no adaptation to surface irregularities. On the hydroxyapatite-coated implants, cells adhered closely only to smooth areas. To avoid the use of proteolytic enzymes for cell derivation, the authors developed a novel organ culture system in which the implant was contained in a nylon pocket surrounded by bone fragments, permitting cells to migrate onto the implant surface. Cultures were maintained for up to 4 weeks, allowing comparison of cell migration, proliferation, and differentiation on the implant surfaces.
The Tenax Dental Implant System. Rationalized implant treatment using conventional prosthodontics.
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The effect of combination of recombinant human bone morphogenetic protein-2 and basic fibroblast growth factor or insulin-like growth factor-I on dental implant osseointegration by confocal laser scanning microscopy.
BACKGROUND: The healing period of bone-implant osseointegration usually varies from 3 to 6 months or even longer. Failure may occur during this time. This study aimed to investigate whether osseointegration of dental implants can be enhanced by the combination of growth factors. METHODS: Sixty-four implants were coated with polylactic acid and divided into four groups. Group I was applied with 1.0 mg recombinant human bone morphogenetic protein-2 (rhBMP-2) and 200 microg recombinant human basic fibroblast growth factor (rhbFGF), group II with 1.0 mg rhBMP-2 and 250 mug recombinant human insulin-like growth factor-I (rhIGF-I), group III with 1.0 mg rhBMP-2, and group IV without growth factors as control. In total, 16 rabbits were used, and two osteotomies were drilled on each side of the femur, in which four different groups were randomly placed. Four weeks after implanting, 20 mg calcein green/kg body weight was administered intravenously, and 8 weeks after implanting, 20 mg alizarin/kg body weight was administered intravenously. Twelve weeks after implanting, the animals were sacrificed. The block of bone with implants was embedded in methylmethacrylate and sectioned, and the percentage of new bone surrounding the implant was analyzed by confocal laser scanning microscopy. RESULTS: There was a statistical difference in bone formation between rhBMP-2-applied groups and the non-applied group at 4 or 8 weeks, and no significant difference between groups I and II (although bone formation in group II was greater than that in group I at 4 weeks). The bone formation in group II was greater than that in group III at 4 or 8 weeks. The formed bone in group I was also greater than the one in group III at 8 weeks, but there was no difference at 4 weeks. CONCLUSIONS: rhBMP-2 could increase new bone formation, and it acted synergistically with rhbFGF and rhIGF-I to improve bone-implant osseointegration. The combination of rhBMP-2 and rhbFGF (group 1) showed faster growth of new bone than other groups at 8 months.
Achieving the wow factor in a dental implant practice.
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