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PubMed2001

Mini-dental implant insertion with the auto-advance technique for ongoing applications.

The clinical and histological results of two cases demonstrating retrieved Sendax mini-dental implants in two different patients is the focus of this report. The mini-dental implants were inserted using the auto-advance technique and loaded immediately. The implants were retrieved at 4 months following insertion and at 5 months following insertion and were prepared and reviewed histologically. Clinically, the implants had no mobility, with no apparent exudate or bleeding upon probing, prior to removal. At the time explant procedures were performed, the mini-dental implants had provided immediate support for prostheses during the integration of traditional root-form endosteal implants. Upon explantation, the mini-dental implants were in a state of health and functioning in their intended purpose. Histologically, the bone appeared to be integrated to the surface of the implant at the light microscope level, and the bone appeared to be relatively mature and healthy in the areas observed, more so than one would expect in this amount of time from insertion of mini-dental implants with immediate loading. A discussion of the purposes and technique used for insertion and removal of these mini-dental implants is discussed. This is the first human histological report on the auto-advance technique with immediate loading of mini-dental implants, demonstrating feasibility in ongoing applications.

Aged↗
PubMed2001

A new implant designed to maximize contact with trabecular bone: survival to 18 months.

PROBLEM: A roughened, commercially pure titanium (CP-Ti) implant design has been developed that features a different length and pitch for each screw thread to direct functional stresses away from cortical bone and to the more resilient trabecular bone. Abutment-implant connection is made using a conical taper to provide a seal against invasion by microorganisms. PURPOSE: To assess short-term (18 months) clinical performance of this innovative implant design. METHODS: A total of 1,419 implants were placed in 313 patients to support 419 prostheses in a multidisciplinary, multicentered, prospective clinical study conducted by the Ankylos Implant Clinical Research Group (AICRG). More than 100 dentists at 32 centers in the United States, 1 in Korea, and 1 in Taiwan are involved in the study. Failure was defined as implant removal for any reason. The influence of mobility at placement, implant length and diameter, incision type, augmentation, crestal bone reduction, bone density, and the use of the operating room or dental clinic on survival were evaluated over 18 months. Crestal bone loss between placement and uncovering was also determined. RESULTS: Crestal bone loss ranged from 0.2 to 0.5 mm. The overall success rate from placement to 18 months was 96.6%. Implants mobile at placement failed more frequently (16.9%) compared with stable implants (3.1%). Wide-diameter implants and longer implants exhibited higher survival rates. Incision design and surgery location did not influence survival. Bone density was important to clinical survival.

Adult↗
PubMed2001

A 48-month multicentric clinical investigation: implant design and survival.

This report is based on a total of 2,955 implants of 6 different designs, randomized and placed in 829 patients and followed for 48 months. Implant failure was defined as nonintegration at uncovering or removal due to mobility, persistent pain, infection, and evidence of radiographic bone loss. Failures were reported for 3 phases of treatment: implant placement to uncovering (phase 1), uncovering to loading (phase 2), and postloading (phase 3). Differences in survival were compared with Kaplan-Meier survival curves. The maxillary single tooth application resulted in 95.2% survival for the hydroxyapatite-coated grooved implants. In the maxillary completely edentulous application, survival of hydroxyapatite grooved and screw implants were considerably better compared with the titanium screw implants. The hydroxyapatite-coated cylinder had better survival than the titanium basket and screw designs in the mandibular completely edentulous application. The hydroxyapatite-coated cylinder and grooved implants in the maxillary posterior partially edentulous application had similar survival rates. The survival of the hydroxyapatite-coated cylinder exceeded that of the titanium basket in mandibular posterior partially edentulous applications. Analyses by phase of treatment indicated a pattern of early failure for nonhydroxyapatite-coated implants compared with hydroxyapatite-coated implants. The implant with the highest survival at all phases of treatment was the hydroxyapatite-coated press-fit cylinder. Two hydroxyapatite-coated implant designs performed well in the challenging posterior maxillary region.

Adult↗
PubMed2001

Stability of implants and natural teeth as determined by the Periotest over 60 months of function.

Various methods for evaluating tooth mobility have been developed throughout the years, but their acceptance has been limited because of the subjectivity associated with their use. In recent years, the Periotest has been studied and used to evaluate the mobility of natural teeth and is claimed to b e potentially reliable in assessing the stability of the implant-bone interface. Few clinical implant studies have used natural teeth as controls to monitor changes in mobility associated with dental implants. The Dental Implant Clinical Research Group initiated a long-term clinical study in 1991 to assess the influence of design, application, and site of placement on clinical success and crestal bone height. As part of the study, Periotest values (PTVs) were recorded for 2,623 of the 2,998 implants placed and uncovered. For the statistical analysis, 2,623 implants were tested at second-stage surgery, with the number of implants tested varying at each follow-up visit. Data were collected from investigators at 32 study centers for periods ranging up to 60 months. A total of 975 natural teeth from 409 partially edentulous study subjects served as controls. FPVs on natural teeth and implants were combined, and the overall average Periotest values (OA-PTVs) were compared with values for individual subjects. The effect of implant and natural tooth locations on mobility were evaluated and compared with each other. The combined OA-PTV for all natural teeth was +1.8 and the OA-PTV for all implants was -3.4 PTVs. Compared with those in the maxillae, mandibular teeth and implants were found to be more stable Implants were found to be significantly more stable as compared with natural teeth. The recorded variations in PTVs for natural teeth and implants over the entire evaluation period were not found to be significantly different. This study developed the following conclusions: (1) implants were found to be significantly less mobile as compared with natural teeth for individual subjects; (2) the PTVs for natural teeth and implants did not exhibit significant variation over the evaluation period; (3) the Periotest can provide reproducible assessment of stability in a long-term clinical study; and (4) changes in PTVs may be helpful in evaluating improvement or degradation of the implant-bone complex.

Dental Implantation, Endosseous↗
PubMed2003

Analysis of HA-coated subperiosteal implants.

Bone atrophy is often encountered in the endentulous patient. With many clinicians performing bone grafting and augmentation techniques, there appears to be a decreased use of the subperiosteal implant modality for prosthetic stabilization. In recent years, there seems to be a decreasing number of literature reports and fewer academic presentations about the subperiosteal implant technique. Additionally, the American Academy of Implant Dentistry deleted this requirement for fellowship in its bylaws at its 1999 annual meeting. The purpose of this paper is to present the success and complication rates of 22 hydroxyapatite-coated subperiosteal implants placed over a 10-year period. Correlations between arch type and full vs unilateral subperiosteal implant cases are analyzed.

Adult↗
PubMed2003

Bone density: its influence on implant stability after uncovering.

Primary implant stability and bone density are variables that have long been considered to be essential to achieving predictable osseointegration and long-term clinical survival. Although the dentist can control most factors associated with implant survival, bone density is the one factor that cannot be controlled. Measuring implant stability would assist in determining if an implant has integrated and is ready for the fabrication of the final prosthesis. Changes in implant stability in each type of Bone Quality (BQ-1, -2, -3, and -4), which may occur with time, have not been studied. Such information could help identify well-integrated implants and identify changes associated with impending implant failure. Several studies have used the Periotest instrument to study implant stability. Use of the Periotest implant stability will be studied during each phase of implant treatment for each bone density, and a range for clinically satisfactory integration will be suggested. Implant stability changes over time, and the changes are different for each bone density as the bone surrounding the nonhydroxyapatite implant becomes denser. This is clearly demonstrated in a postmortem histological specimen. The changes in implant stability (Periotest Values [PTVs]) are more apparent in BQ-1 and BQ-2 bone and less apparent in BQ-3 and BQ-4 bone. The Periotest is capable of providing valuable information concerning favorable or unfavorable changes in the bone-implant interface after uncovering. In addition, it can help identify when an implant is ready to be loaded. A new range of PTVs (-5 to -2) is suggested for monitoring the status of implants. Implants with PTVs more positive than -2 would indicate a bone-implant complex that may be marginal.

Bone Density↗
PubMed2004

AICRG, Part I: A 6-year multicentered, multidisciplinary clinical study of a new and innovative implant design.

PROBLEM: Repetitive microstrains, which occur at the bone-implant interface during function, can lead to implant loss. In an attempt to improve survival by directing the stresses during function away from the dense cortical bone and toward the resilient trabecular bone, the Ankylos implant was developed with a roughened, progressive thread and a smooth cervical collar. The highly polished collar reduces the stresses in areas of the crestal bone. A precisely machined Morse taper prevents rotation of the abutment on the implant and eliminates the microgap present in many 2-stage implant systems. Clinical studies of other implants at different clinical research centers have demonstrated varying degrees of survival. PURPOSE: The purpose of this paper was (1) to assess the overall clinical survival of this new implant design and (2) to compare implant stability (ie, Periotest values [PTVs]) over time with other implants. METHOD: The investigation represented a comprehensive, multicentered, international clinical study conducted over a period of 6 years. It was conducted under an Investigational Device Exemption (IDE) protocol that was reviewed and accepted in the United States by the Food and Drug Administration (FDA). Over 1500 implants were placed and restored, and follow-up data were gathered for a period of up to 3 to 5 years. RESULTS: Over 44% of the clinical research centers reported no failures (100% survival). A total of 63% of the centers had none or only 1 failure during the study. One center reported 6 failures in 1 patient, which were not related to the implant design. Overall survival for implants in function for 3 to 5 years was 97.5%. Using failure criteria of earlier studies of other implants, 5-year survival was 98.3%. Higher handpiece speeds were associated with an increase in the number of failures. This new design produced a slightly more resilient trabecular bone-implant complex with a difference of about 1 PTV in all bone densities when compared with other implants. CONCLUSIONS: The following conclusions can be made: (1) the implant design was effective under all clinical conditions; (2) no significant and unexpected complications or risk factors were evident; (3) survival was found to be excellent; and (4) this implant is well suited for use in the restoration of masticatory function and esthetics in patients with missing natural teeth.

Adult↗
PubMed2004

AICRG, Part III: The influence of antibiotic use on the survival of a new implant design.

PURPOSE: The American College of Surgeons guidelines suggest that complex oral surgery may benefit from prophylactic antibiotic coverage. The use of preoperative antibiotics, postoperative antibiotics, or both during implant placement is a widely accepted practice in the United States, whereas dentists in other countries rarely use antibiotics. PURPOSE: The purpose of this study was to determine if antibiotic coverage at the time of implant placement improves the survival of the Ankylos implant. METHODS: As part of a comprehensive, multicentered, multidisciplinary, prospective, independent, international clinical study, designed and coordinated in the United States by the Ankylos Implant Clinical Research Group (AICRG), the use of preoperative (several regimens) and postoperative antibiotics (yes/no) were carefully documented to assess their influence on improving survival. A total of 1500 Ankylos implants were placed and followed for a period of 3 to 5 years. The decision to use antibiotics and the regimen to be employed was made by the treating surgeon. Failure was defined as removal of the implant for any reason. All data were entered into a computerized database for analysis. RESULTS: The use of preoperative antibiotics produced no significant improvement (P = .21, Fisher's exact test) in survival compared with those placed without antibiotic coverage. There was no significant difference between the regimens defined as AHA-1990, AHA-1997, and Peterson's recommendations. CONCLUSIONS: The results of this study suggest that there was little or no advantage to providing antibiotic coverage when placing this implant. These findings also suggest that the use of antibiotics for implant placement may not be as beneficial as once believed. If validated by other studies, the elimination of this practice for routine implant placement would represent a small but significant step forward in the reduction of unnecessary antibiotic use.

Anti-Bacterial Agents↗
PubMed2004

AICRG, Part V: Factors influencing implant stability at placement and their influence on survival of Ankylos implants.

PROBLEM: Several factors influence primary stabilization of dental implants at placement surgery. These include implant design, bone quality, implant jaw location, and the use of a bone tap. PURPOSE: This report evaluates clinical data gathered by the Ankylos Implant Clinical Research Group (AICRG) to assess (1) the influence of several variables on primary stability and (2) the potential for an Ankylos implant (Friadent GmbH, Mannheim, Germany) that is mobile at placement to integrate and survive for at least 3 years of clinical function. METHODS: The Ankylos implant is a roughened grade-2 titanium screw. A total of 1554 implants were placed in 478 patients. At both the time of placement and abutment connection, the implants were tested for evidence of clinical mobility by attempting to rotate or move the implant with an application of force. Survival was recorded from placement and up to 36 months following placement. RESULTS: At placement, 2.8% were found to be mobile. In the maxillary posterior quadrant, 6.3% were clinically mobile. Implant mobility was frequent (12.2%) in jaw regions with poor-quality bone (BQ-4) or with short implants (8 mm = 8.3% mobile). Of the implants mobile at placement, 97.7% were stable at uncovering. The 3-year postplacement survival of initially mobile implants was 84.1% compared with 96.8% for implants not mobile at placement (chi2 test, P = .001). CONCLUSIONS: The Ankylos implant predictably promoted primary stability during surgical placement. Poor bone quality, short implants, and maxillary posterior jaw locations were all associated with a slightly higher rate of mobility at placement. Primary implant stability, while highly desirable, is not absolutely necessary for achieving osseointegration of Ankylos

Bone Density↗
PubMed2004

New prosthetic restorative features of Ankylos implant system.

PROBLEM: All oral implant systems rely on the abutment part of the implant to provide stability for the dental prosthetic. The Ankylos implant offers precisely machined, tapered-cone abutment (Morse taper) connection. This tapered abutment connection provides high resistance to bending and rotational torque during clinical function, which significantly reduces the possibilities of screw fracture or loosening. PURPOSE: This report describes the design and mechanical construction characteristics of the Ankylos implant system that make it possible for the system to provide final restorations that are natural looking, esthetically acceptable, durable, and cost effective. METHODS: Review of the clinical literature. RESULTS: The clinical results of singletooth crowns borne on Ankylos implants in the lateral tooth region are excellent after a minimum of 5 years in function (mean = 6.3 years) compared with the high prosthetic complication rate with other systems. Abutment loosening occurred in only 1.3% of the 233 innovative implants restored with crowns that were designed with a physiologically shaped occlusal surface. CONCLUSION: This implant system is exceptionally well suited for use in the restoration of missing natural teeth.

Crowns↗
PubMed2005

Overview of the SwissPlus Implant System.

Although many improvements have been made to implant dentistry during the last quarter of a century, clinical challenges still remain. For the surgeon, achieving implant stability in low-density bone can be difficult. For the restorative dentist, incompatibility between implant systems and the increasing complexity of esthetic restorative options frequently require special training in the selection and use of prosthetic components. This article presents an overview of a 1-stage implant system with a textured surface and osteocompressive surgical protocol designed to achieve stability in soft bone. Self-tapping, double lead threads and a separate surgical protocol also enable the implant to be placed in high-density bone. The implant is packaged on a fixture mount that also functions as a transfer and transitional or definitive abutment for cemented restorations. This implant is designed to help simplify restorative procedures by eliminating many ancillary restorative components. For multiple-unit, screw-retained restorations, the prosthesis can be splinted directly to the top of the implant without an intermediate abutment. Overdenture attachments and straight, angled, screw-receiving, and custom-cast abutments complete the restorative system.

Dental Implantation, Endosseous↗
PubMed2005

A 16-year study of the microgap between 272 human titanium implants and their abutments.

A microgap has been described at the level of the implant-abutment connection. This microgap can be colonized by bacteria, and this fact could have relevance on the remodeling of the peri-implant crestal bone and on the long-term health of the peri-implant tissues. The authors report on 272 implants with screw- or cement-retained abutments retrieved from humans for different causes during a 16-year period. In the implants with screw-retained abutments, a 60-microm microgap was present at the level of implant-abutment connection. In some areas the titanium had sheared off from the surface and from the internal threads. The contact between the threads of the implant and those of the abutment was limited to a few areas. Bacteria were often present in the microgaps between implant and abutment and in the internal portion of the implants. In implants with cement-retained abutments, a 40-microm microgap was found at the level of the implant-abutment connection. No mechanical damage was observed at the level of the implant or of the abutment. All the internal voids were always completely filled by the cement. No bacteria were observed in the internal portion of the implants or at the level of the microgap. The differences in the size of the microgap between the two groups were statistically significant (P < .05). In conclusion, in screw-retained abutments the microgap can be a critical factor for colonization of bacteria, whereas in cement-retained abutments all the internal spaces were filled by cement. In these retrieved implants, the size of the microgap was markedly variable and much larger than that observed in vitro.

Bacteria↗
PubMed2002

The application of fiber core posts in restoring badly destroyed primary incisors.

Early childhood caries (ECC) represents a challenge to pediatric dentists especially, when teeth are badly destroyed. ECC involves the upper anterior teeth early in life and by the time the dentist sees the child, most of the coronal structure is lost. Dentally, this is a very devastating situation for both the dentist and parents, as in many cases, extraction of these teeth is the only option. With the introduction of new adhesive systems and restorative materials, a new approach for treating these teeth is explained and documented by clinical cases, where fiber core posts are introduced into the root canals of primary incisors for a distance of 2 to 3 mm. It is retained in place by flowable composite, then the coronal part is reconstructed by a strip crown to restore the crown form. After a follow up period of one year, only 2 teeth out of 30 had to be extracted. The failure was attributed to failure in pulpal therapy rather than failure in the restorations, which were totally intact. A laboratory testing of the fracture load resistance of the restored teeth proved that this technique significantly improved the fracture load resistance of composite celluloid crowns, making it a valuable procedure to consider when the coronal tooth structure is not enough to support and retain a composite celluloid strip crown.

Cementation↗
PubMed2003

Localized ridge augmentation/preservation. A systematic review.

BACKGROUND: Osseointegrated implants have been documented as efficacious, however, their placement may be contraindicated in some patients due to insufficient bone volume. Techniques such as guided bone regeneration (GBR), immediate implantation, and distraction osteogenesis (DO) have been utilized as ridge enhancement therapies. RATIONALE: This systematic review evaluates dental implant survival rates in patients treated with ridge augmentation or preservation techniques. FOCUSED QUESTION: In patients requiring dental implant placement, what is the effect of localized ridge preservation versus implant placement without augmentation on implant survival and adverse effects? SEARCH PROTOCOL: MEDLINE and Cochrane Oral Health Group Specialized Trial Register were searched. Hand searches were performed on Clinical Oral Implants Research, International Journal of Oral and Maxillofacial Implants, International Journal of Periodontics and Restorative Dentistry, Journal of Clinical Periodontology, Journal of Periodontology, and Journal of Periodontal Research. All searches were performed for articles published through April 2002. SELECTION CRITERIA: Publications reporting survival rate of dental implants following ridge therapy were included in the analysis. Reports describing techniques were excluded. DATA COLLECTION AND ANALYSIS: Due to the absence of controlled studies, a meta-analysis was not performed. Descriptive statistics are used to report the data. MAIN RESULTS: 1. A total of 18 studies were included: 13 reporting on guided bone regeneration (GBR, 1,741 patients) and 5 on distraction osteogenesis (DO, 92 patients). 2. There is a high level of predictable implant survival in sites treated by GBR or DO. 3. These survival rates are similar to those of implants placed in native bone. REVIEWERS' INTERPRETATIONS: Survival rates were similar for both GBR and DO implants. These survival rates were similar to implants placed in native bone.

Alveolar Ridge Augmentation↗
PubMed2003

Effect of maxillary sinus augmentation on the survival of endosseous dental implants. A systematic review.

BACKGROUND: Grafting the floor of the maxillary sinus has become the most common surgical intervention for increasing alveolar bone height prior to the placement of endosseous dental implants in the posterior maxilla. Outcomes of this procedure may be affected by specific surgical techniques, simultaneous versus delayed implant placement, use of barrier membranes over the lateral window, selection of graft material, and the surface characteristics and the length and width of the implants. RATIONALE: The primary objective of this systematic review was to determine the efficacy of the sinus augmentation procedure and compare the results achieved with various surgical techniques, grafting materials, and implants. FOCUSED QUESTION: In patients requiring dental implant placement, what is the effect on implant survival of maxillary sinus augmentation versus implant placement in the non-grafted posterior maxilla? SEARCH PROTOCOL: MEDLINE, the Cochrane Oral Health Group Specialized Trials Register, and the Database of Abstracts and Reviews of Effectiveness were searched for articles published through April 2003. Hand searches were performed on Clinical Oral Implants Research, International Journal of Oral and Maxillofacial Implants, and the International Journal of Periodontics & Restorative Dentistry and the bibliographies of all relevant papers and review articles. In addition, researchers, journal editors, and industry sources were contacted to see if pertinent unpublished data that had been accepted for publication were available. SELECTION CRITERIA INCLUSION CRITERIA: Human studies with a minimum of 20 interventions, a minimum follow-up period of 1-year loading, an outcome measurement of implant survival, and published in English, regardless of the evidence level, were considered. EXCLUSION CRITERIA: Studies involving multiple simultaneous interventions (e.g., simultaneous ridge augmentation) and studies with missing data that could not be supplied by the study authors were excluded. DATA COLLECTION AND ANALYSIS: Where adequate data were available, subgroups of dissimilar interventions (e.g., surgical techniques, graft materials, implant surfaces, membranes) were isolated and subjected to meta-regression, a form of meta-analysis. MAIN RESULTS: 1. Forty-three studies, 3 randomized controlled clinical trials (RCTs), 5 controlled trials (CTs), 12 case series (CS), and 23 retrospective analyses (RA) were identified. Thirty-four were lateral window interventions, 5 were osteotome interventions, 2 were localized management of the sinus floor, and 2 involved the crestal core technique. 2. Meta-regression was performed to determine the effect of the variables of block versus particulate grafting techniques, implant surface, graft material, and the use of a membrane over the lateral window. 3. The survival rate of implants placed in sinuses augmented with the lateral window technique varied between 61.7% and 100%, with an average survival rate of 91.8%. For lateral window technique: 4. Implant survival rates reported in this systematic review compare favorably to reported survival rates for implants placed in the non-grafted posterior maxilla. 5. Rough-surfaced implants have a higher survival rate than machine-surfaced implants when placed in grafted sinuses. 6. Implants placed in sinuses augmented with particulate grafts show a higher survival rate than those placed in sinuses augmented with block grafts. 7. Implant survival rates were higher when a membrane was placed over the lateral window. 8. The utilization of grafts consisting of 100% autogenous bone or the inclusion of autogenous bone as a component of a composite graft did not affect implant survival. 9. There was no statistical difference between the covariates of simultaneous versus delayed implant placement, types of rough-surfaced implants, length of follow-up, year of publication, and the evidence level of the study. REVIEWERS' CONCLUSIONS: Insufficient data were present to statistically evaluate the effects of smoking, residual crestal bone height, screw versus press-fit implant design, or the effect of implant surface micromorphology other than machined versus rough surfaces. There are insufficient data to recommend the use of platelet-rich plasma in sinus graft surgery.

Bone Transplantation↗
PubMed1994

Clinical and microbiological status of osseointegrated implants.

Peri-implantitis, an inflammatory response around implants, has a poorly defined etiology and pathogenesis. To better understand the role of specific microorganisms in this disease process, clinical and microbiological parameters were examined in 24 patients with 98 osseointegrated implants. Sites were evaluated for probing depth (PD), plaque/calculus index (PI), gingival bleeding index (GBI), mobility, and crevicular fluid flow rate (CFFR). Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, and Prevotella intermedia in subgingival plaque were identified by latex agglutination assays. Clinically, a statistically significant correlation (P < 0.001) was observed between probing depth and the length of time an implant was present. Mobility was also significantly greater (P < 0.001) in the maxillary than in the mandibular implants. Subgingival sites harboring one of the three microorganisms had significantly greater PD, GBI, and CFFR than non-colonized sites. Implants in partially edentulous patients more frequently were colonized with P. gingivalis/P. intermedia than edentulous patients. The incidence of these microorganisms also correlated with fixture longevity. Implants present for 3 to 4 years had a significantly greater frequency of test microorganisms than implants present for 1 to 2 years. These findings suggest that microbial pathogens associated with periodontitis occur more commonly around implants exhibiting gingival inflammation (GBI) and may contribute to peri-implantitis.

Adult↗
PubMed1995

The successful use of osseointegrated implants for the treatment of the recalcitrant periodontal patient.

This study reports the successful use of osseointegrated implants to replace teeth in patients whose periodontal disease has been categorized as recalcitrant. It includes partially and totally endentulous jaws. A total of 309 implants placed by two periodontists practicing in traditional office settings were included in the survey. Of the 132 mandibular implants, 4 failed, for a success rate of 97%; and 3 of the 177 maxillary implants failed, for a success rate of 98%. There were 21 implants placed in 1985; 38 in 1986 and 1987; 185 from 1988 to 1990; 42 in 1991; and 23 in 1992. The report includes 42 mandibular and 50 maxillary prostheses, none of which has failed. One female mandibular case was converted from 2 posterior free-standing to a full arch prosthesis when the anterior teeth failed periodontally. These results demonstrate that individuals with a strong susceptibility to periodontal disease can be treated successfully with osseointegrated implants.

Adult↗
PubMed1998

Factors affecting implant mobility at placement and integration of mobile implants at uncovering.

This study examined 1) factors that contributed to implant stability at placement and 2) the likelihood for an implant that was mobile at placement to osseointegrate. Eighty-one (3.1%) of 2,641 implants placed by the Dental Implant Clinical Research Group between 1991 and 1995 were found to be mobile at placement. Seventy-six (93.8%) of the 81 mobile implants were integrated at uncovering compared to 97.5% for the 2,560 immobile implants. Variables that influenced mobility at placement included patient age, implant design and material, anterior-posterior jaw location, bone density, and use of a bone tap. Hydroxyapatite (HA)-coated implants were slightly more likely to be mobile at placement (P = 0.324) than non-hydroxypatite (HA)-coated implants. Of the 54 HA-coated implants that were mobile at placement, all (100%) integrated, while only 17 (81.5%) of the 22 mobile non-HA-coated implants integrated (P = 0.003). Mean electronic mobility testing device values (PTVs) at uncovering for all implants mobile or immobile at placement that integrated were -2.9 and -3.6 respectively. PTVs for HA-coated implants that were mobile (-3.5 PTV) or immobile (-4.0 PTV) at placement differed by 0.5 PTV, whereas non-HA-coated implants exhibited a greater difference of 1.2 PTVs at uncovering. HA-coated implants, regardless of mobility at placement, integrated more frequently and exhibited greater stability than non HA-coated implants.

Adult↗