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PubMed2002

Bone remodeling analysis after placement of dental implants using polyfluorochrome sequential labeling.

Nowadays there is a general consensus related to the stability of dental implants during bone repair. The implant anchorage in the bone is very important for the stability of the element that has to support much pressure when under use. This stability is attained by bone modeling and remodeling processes. As it is known, the implant/bone interface does not present the ideal result expected by every professional. The possibility of stimulation of the bone formation at the interface and around titanium implants is based on the reaction of the bone to trauma due to the surgical procedure. This bone reaction leads to bone repair during healing. The purpose of this study is to analyze the efficiency of bone tissue labeling through polyfluorochrome sequential labeling during remodeling or neo-formation processes after the placement of smooth threaded implants used in dentistry. This work demonstrates the possibility of periodic deposition of bone identification around titanium osseointegrated implants. It was concluded that the polyfluorochrome sequential labeling is an important tool to identify bone modeling and remodeling after the insertion of titanium implants inside rabbit's tibias at different periods of time.

Animals↗
PubMedDate not supplied

A 5-year follow-up comparative analysis of the efficacy of various osseointegrated dental implant systems: a systematic review of randomized controlled clinical trials.

PURPOSE: To test the null hypothesis that there is no difference in failure rates between various root-formed osseointegrated dental implant systems after 5 years of loading. MATERIALS AND METHODS: A search was conducted for all randomized controlled clinical trials (RCTs) comparing different implant systems with a follow-up of 5 years. The Cochrane Oral Health Group's Trials Register, CENTRAL, MEDLINE, and EMBASE were searched. Several dental journals were also searched by hand. Written contacts were established with authors of the identified RCTs and with more than 55 oral implant manufacturers and personal contacts to identify unpublished RCTs. No language restriction was applied. The last electronic search was conducted on February 1, 2005. Screening of eligible studies, quality assessment, and data extraction were conducted in duplicate. Results were expressed as random effect models using weighted mean differences for continuous outcomes and relative risk for dichotomous outcomes with 95% confidence intervals. RESULTS: Ten RCTs were identified. Four of these RCTs, reporting results from a total of 204 patients, were considered suitable for inclusion. Six different implant types were compared. On a per-patient rather than a per-implant basis, there were no statistically significant differences, with the exception of more marginal bone loss around early loaded Southern implants when compared to early loaded Steri-Oss implants (mean difference -0.35 mm; 95% CI -0.70 to -0.01). However, the difference disappeared in the meta-analysis. DISCUSSION AND CONCLUSIONS: There were no clinical differences among implant systems. However, these findings are based on only 4 RCTs with few participants. More RCTs should be conducted with larger patient samples.

Dental Implantation, Endosseous↗
PubMed1992

The surgical management of osseous defects associated with endosteal hydroxyapatite-coated and titanium dental implants.

As more and more patients choose implant therapies it will be incumbent upon the dentists placing, restoring, and maintaining endosseous implants to be armed with the most current information. There is a need for further research to answer the many significant questions in the management of osseous defects associated with dental implants. Some of these questions include: Which grafting materials yield the greatest repair? If resorbable materials (for example, DFDB) are not replaced by bone, are residual defects and peri-implant tissues similar to those which existed prior to osseous grafting procedures? If so, perhaps the combination of a nonresorbable graft like HA with DFDB may yield the wound-healing potential of both materials; for example, osseoinduction by DFDB and the benefits of a radiographic marker and defect filler provided by HA. Can reintegration occur on previously pathologically exposed implant surfaces? Do biodegradable barriers yield significant GTR, and do they resorb predictably? Is complete detoxification of the infected HA-coated surface possible or necessary for regeneration to occur? Which chemotherapeutic modality detoxifies HA-coated surfaces best clinically and at the histologic level? Or should infected HA coatings be removed before attempting implant repair? Are regenerative techniques (for example, GTR) predictable enough to treatment plan for them when we know there will be residual osseous defects after placing fixtures in their most ideal prosthetic position? If so, what defect types resolve most predictably following surgical correction? Should barriers be used in conjunction with grafting when placing 2-stage blade implants to generate bone in the slot preparation coronal to the shoulder of the blade? It is evident from the growing popularity and acceptance of implant therapies that these and other questions will need to be answered to continue the evolution of the science of this discipline. This author would encourage practitioners to keep abreast of the current research and developments in this field as new techniques, materials, and therapies are in a constant state of flux.

Alveolar Bone Loss↗
PubMed1982

Retention characteristics of porous rooted Co-Cr-Mo alloy dental implants.

The interface characteristics of porous rooted cobalt-chromium-molybdenum alloy (Co-Cr-Mo) dental implants which had been in free standing function in canine mandibles for a period of two years were investigated. The displacement of the implants and of points on the adjacent mandibular cortex were determined by mechanical testing. Bone ingrowth was quantified, and the structure of the bone-implant interface and mandibular cortex were characterized using histologic and microradiographic analyses. Displacement characteristics were correlated with determinations of the tissue structure adjacent to and growth within the implant to provide information about the biological attachment. A correlation was found between the thickness of the buccal and lingual cortical plates and implant displacements; implants having the greatest displacement response were in mandibles with the thinnest cortical plates. A relationship could not be established between the implant displacement response and the quantitative tissue structure data. Differences observed in the displacement response of the implant by mechanical testing were not observed by clinical measurements of mobility. It was concluded that implant retention mechanical behavior results from both interfacial displacement and deflection of the adjacent mandibular structures.

Animals↗
PubMed1990

[Individually produced open endosseous dental implants made of Bioverit glass ceramic. First report on experiences].

The glass ceramic "BIOVERIT" is characterised by biocompatibility, bioactivity and distinguished machinable treatment. The single casting in an especially dental technical laboratory pender is possible the individual production of dental implants. Described were the development of the form, the production and operation for these glass ceramic implants and first clinical results.

Biocompatible Materials↗
PubMed1990

Dental implant reconstruction after endodontic failure: report of case.

Avulsion of natural teeth caused by trauma may present an unusual problem for the general practitioner. Endodontic therapy and replantation of the tooth into the socket have a relatively low long-term prognosis because of internal or external root resorption. Dental implants can provide proper support and function for missing teeth with excellent esthetic results without preparation of natural dentition. In this case report, an implant system is used to restore an anterior space created by the loss of endodontically treated central and lateral incisors.

Adult↗
PubMed1999

Use of lyodura for bone augmentation of osseous defects around dental implants.

BACKGROUND: Lyodura has been used in periodontology and maxillofacial surgery to overcome different clinical conditions. The use of lyodura to induce new bone formation in humans has not been widely reported. The purpose of this article is to describe the use of lyodura as a resorbable barrier to promote bone formation in osseous defects around dental implants. METHODS: The study group consisted of 22 healthy patients (12 women and 10 men), with a mean age of 32 (range 20 to 45). A total of 44 implants (9 titanium screw-type and 35 hydroxyapatite-coated cylinder implants) were placed. Of these, 27 implants were placed in the maxilla and 17 in the mandible. At 27 extraction sites bony vertical defects were measured on the buccal, lingual, mesial and distal sides of the implant. In the remaining 17 cases, where either immediate or staged implantation was performed, and a dehiscence was present, its vertical length was measured from the alveolar crest. All bony defects were grafted with autogenous bone harvested from the tuberosity. Each site was covered with lyodura. RESULTS: Healing was uneventful; no inflammation, infection, or soft tissue dehiscence was observed. At all extraction sites and in 76% of the dehiscence defects, hard tissue appearing clinically similar to bone completely filled the defect. Of those defects not completely filled, a mean vertical bone increase of 2.5 mm was recorded. A mean vertical bone increase of 2.6 mm was achieved at extraction sites and a mean increase of 2.79 mm was achieved at dehiscence sites. CONCLUSIONS: Lyodura can safely and effectively be used for guided bone regeneration at both extraction sites and for dehiscence defects.

Absorbable Implants↗
PubMed2002

The effect of bruxism on treatment planning for dental implants.

Bruxism is a potential risk factor for implant failure. Excessive force is the primary cause of late implant complications. An appreciation of the etiology of crestal bone loss, failure of implants, failure to retain implant restorations, and fracture of components will lead the practitioner to develop a treatment plan that reduces force on implants and their restorations. The forces are considered in terms of magnitude, duration, direction, type, and magnification. Once the dentist has identified the source(s) of additional force on the implant system, the treatment plan is altered to contend with and reduce the negative sequelae on the bone, implant, and final restoration. One viable approach is to increase the implant-bone surface area. Additional implants can be placed to decrease stress on any one implant, and implants in molar regions should have an increased width. Use of more and wider implants decreases the strain on the prosthesis and also dissipates stress to the bone, especially at the crest. The additional implants should be positioned with intent to eliminate cantilevers when possible. Greater surface area implant designs made of titanium alloy and with an external hex design can also prove advantageous. Anterior guidance in mandibular excursions further decreases force and eliminates or reduces lateral posterior force. Metal occlusal surfaces decrease the risk of porcelain fracture and do not require as much abutment reduction, which in turn enhances prosthesis retention. The retention of the final prosthesis or super-structure is also improved with additional implant abutments. Night guards designed with specific features also are a benefit to initially diagnose the influence of occlusal factors for the patient, and as importantly, to reduce the influence of extraneous stress on implants and implant-retained restorations.

Bite Force↗
PubMedDate not supplied

Histologic and microradiographic evaluation of textured and nontextured aluminum oxide dental implants.

This paper reports the histological and microradiographical observations of macroscopically textured and nontextured aluminum oxide dental implants. Ion beam bombardment was used to produce a wafflelike pattern of surface undulations approximately 35 microns deep. Twelve nontextured and eight textured implants were placed in the healed extraction sites of the second and forth mandibular premolars of adult mongrel dogs. Eight nontextured and five textured implants remained in situ for six months. Results consistent with previously reported clinical and radiographic findings, indicated a decreased incidence of an interposed fibrous tissue-implant interface associated with the textured implants. Texturing was not found to influence the amount of vertical bone loss. Secondarily, delayed tissue fixation due to post-retrieval mechanical testing procedures resulted in loss of valuable cellular information.

Aluminum↗
PubMed2003

Radiographic evaluation of dental implants with different surface treatments: an experimental study in dogs.

PURPOSE: The aim of the study was to radiographically measure the bone density at the peri-implant region after osseointegration and to compare the relative bone density achieved by different surface-treated implants. MATERIALS AND METHODS: Four different types of implant surfaces were compared, using five young-adult male mongrel dogs. The first, second, third, and fourth lower premolars were extracted. Ninety days after removal, four 3.75-mm diameter and 10-mm long screw implants (Paragon) were placed with different surface treatments in the lower hemiarches. The dogs received two implants each of the following surface treatments: 1) smooth (machined); 2) titanium plasma spray: 3) hydroxyapatite coating; and 4) sandblasting with soluble particles. The implants were maintained unloaded for 90 days. After this period, the animals were killed and the hemimandibles were extracted and radiographed. The grey level of the bone adjacent to implants was measured with a specific software tool (line histogram) and the relative bone density was calculated. RESULTS: The four different surface treatments promote different numeric levels of bone density around the dental implants (sandblasting with soluble particles, 52.45 +/- 2.95; titanium plasma spray, 53.98 +/- 3.67; machined, 55.78 +/- 3.06, and hydroxyapatite coating, 58.2 +/- 2.71). Therefore, the implants can be ranked in terms of relative bone density from high to low as follows: sandblasting with soluble particles, titanium plasma spray, machined, and hydroxyapatite coating. There were no statistically significant differences in bone density among the four groups (P = 0.1130, analysis of variance). CONCLUSION: Surface treatments that add roughness to the implant show numerically higher bone density when compared with machined surfaces. The findings of radiographic density analysis suggest that the soluble blasting media-treated surface provides a greater bone density at the peri-implant region.

Animals↗