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PubMedDate not supplied

A comparison of characteristics of implant failure and survival in periodontally compromised and periodontally healthy patients: a clinical report.

PURPOSE: This study compares implant survival and patterns of implant failure in periodontally compromised and periodontally healthy patients. MATERIALS AND METHODS: In a private periodontal practice, over a 13-year period, implants were placed in both periodontally compromised and periodontally healthy patients. Implants were classified in 5 different groups according to surface texture. Survival rates in each group were compared according to implant location, diameter, length, and phase of treatment. RESULTS: A total of 1,511 implants were placed in 334 patients. One hundred fifty-one of these patients, classified as periodontally compromised patients (PCP), received 923 implants. The remaining 183 patients, classified as periodontally healthy patients (PHP), received 588 implants. The overall survival rate for implants placed in the PHP group was 93.7%, compared to 90.6% in the PCP group. The survival rate of hydroxyapatite-coated implants was 92.6% in the PHP group and 81% in the PCP group. The survival rate of the turned-surface implants was similar in both groups. DISCUSSION: Two types of implant failure were identified. The first was failure of the implant to osseointegrate. This type of failure occurred early in treatment and appeared to be related to smooth-surface implants placed in bone of low density. Failures of this type were distributed equally between the PHP and PCP groups. The second type of failure was related to peri-implantitis. It was observed most often with implants with hydroxyapatite surfaces, occurred as the result of a progressive condition, and was most prevalent in the PCP group. CONCLUSION: Further long-term controlled investigations are needed to determine the influences of implant suface and host susceptibility on implant failure in both PHP and PCP.

Coated Materials, Biocompatible↗
PubMed2004

Immediate or early placement of implants following tooth extraction: review of biologic basis, clinical procedures, and outcomes.

PURPOSE: The aim of this article was to review the current literature with regard to survival and success rates, along with the clinical procedures and outcomes associated with immediate and delayed implant placement. MATERIALS AND METHODS: A MEDLINE search was conducted of studies published between 1990 and June 2003. Randomized and nonrandomized clinical trials, cohort studies, case-control studies, and case reports with a minimum of 10 cases were included. Studies reporting on success and survival rates were required to have follow-up periods of at least 12 months. RESULTS: Thirty-one articles were identified. Most were short-term reports and were not randomized with respect to timing of placement and augmentation methods used. All studies reported implant survival data; there were no reports on clinical success. Peri-implant defects had a high potential for healing by regeneration of bone, irrespective of healing protocol and bone augmentation method. Sites with horizontal defects (HD) of 2 mm or less healed by spontaneous bone fill when implants with rough surfaces were used. In the presence of HDs larger than 2 mm, or when socket walls were damaged, concomitant augmentation procedures with barrier membranes and bone grafts were required. Delayed implant placement allowed for resolution of local infection and an increase in the area and volume of soft tissue for flap adaptation. However, these advantages were diminished by simultaneous buccolingual ridge resorption and increased requirements for tissue augmentation. DISCUSSION: Immediate and delayed immediate implants appear to be predictable treatment modalities, with survival rates comparable to implants in healed ridges. Relatively few long-term studies were found. Successful clinical outcomes in terms of bone fill of the peri-implant defect were well established. However, there was a paucity of data on long-term success as measured by peri-implant tissue health, prosthesis stability, and esthetic outcomes. CONCLUSIONS: Short-term survival rates and clinical outcomes of immediate and delayed implants were similar and were comparable to those of implants placed in healed alveolar ridges.

Alveolar Ridge Augmentation↗
PubMed2004

Outcome analysis of implant restorations located in the anterior maxilla: a review of the recent literature.

PURPOSE: To document the literature regarding outcomes of implant restorations in the anterior maxilla to formulate consensus statements with regard to esthetics in implant dentistry, to provide guidelines to clinicians, and to articulate remaining questions in this area to be addressed by future research. MATERIALS AND METHODS: The following areas of the recent literature were scrutinized: treatment outcomes of implant therapy for partial edentulism (including maxillary anterior tooth replacement); anterior maxillary single-tooth replacement; effect of implant design, diameter, and surface characteristics; soft tissue stability/contours around anterior implant restorations; ceramic abutments; influence of surgical techniques; and finally, evaluation of patient satisfaction. RESULTS: The use of dental implants in the esthetic zone is well documented in the literature, and numerous controlled clinical trials show that the respective overall implant survival and success rates are similar to those reported for other segments of the jaws. However, most of the published studies do not include well-defined esthetic parameters. Currently, the literature regarding esthetic outcome is inconclusive for the routine implementation of certain surgical approaches, such as flapless surgery and immediate implant placement with or without immediate loading/restoration in the anterior maxilla. Considering anterior single-tooth replacement in sites without tissue deficiencies, predictable treatment outcomes, including esthetics, can be achieved because of tissue support provided by adjacent teeth. The replacement of multiple adjacent missing teeth in the anterior maxilla with fixed implant restorations is poorly documented. In this context, esthetic restoration is not predictable, particularly regarding the contours of the interimplant soft tissue. DISCUSSION AND CONCLUSIONS: This review has demonstrated that scientific documentation of esthetically relevant and reproducible parameters is rather scarce. Most of the reported outcome analyses primarily focus on implant survival. Elements of anterior implant success such as maintenance or reestablishment of harmoniously scalloped soft tissue lines and natural contours should be included in future studies.

Dental Abutments↗
PubMed2004

Diagnostic parameters for monitoring peri-implant conditions.

PURPOSE: To review the literature on clinical, radiographic, and biochemical parameters used for monitoring peri-implant conditions. MATERIALS AND METHODS: A MEDLINE search was conducted that included articles published in English until the end of August 2003. Results from human and experimental animal studies are presented. RESULTS: The parameters that may be used to assess the presence of peri-implant health and the severity of peri-implant disease include plaque assessment, mucosal conditions, peri-implant probing depth, width of the peri-implant keratinized mucosa, periimplant sulcus fluid analysis, suppuration, implant mobility and discomfort, resonance frequency analysis, and radiographic evaluation. DISCUSSION: Based on the analysis of the available evidence, it appears reasonable to use a number of clinical and radiographic parameters to discriminate between peri-implant health and disease. CONCLUSIONS: Systematic and continuous monitoring of peri-implant tissues during maintenance care is recommended for the early diagnosis of peri-implant disease.

Alveolar Bone Loss↗
PubMed2004

A modified copy technique for obturator prostheses.

Prosthodontic rehabilitation of patients following intra-oral surgical resection is often challenging for both the clinician and patient. With a general increase in life expectancy, it is reasonable that a definitive obturator prosthesis will need to be replaced at least once in the lifetime of a patient. The ability of a patient to become accustomed to such a new prosthesis is often limited by their increased age, and diminished neuromuscular skills and limited tissue support following surgical resection. The purpose of this paper is to describe a duplicating technique for obturator prostheses that has been adapted from conventional complete denture prosthodontics.

Aged↗
PubMed2004

Bone reformation with sinus membrane elevation: a new surgical technique for maxillary sinus floor augmentation.

BACKGROUND: Various maxillary sinus floor augmentation techniques using bone grafts and bone substitutes are frequently used to enable placement of dental implants in the posterior maxilla. A previous case report demonstrated the possibility of promoting bone formation in the sinus by lifting the membrane without using a grafting material. However, the predictability of the technique is not known. PURPOSE: The aim of this study was to investigate whether sinus membrane elevation and the simultaneous insertion of titanium implants without additional grafting material constitute a valid technique for bone augmentation of the maxillary sinus floor. MATERIALS AND METHODS: The study group comprised 10 patients in whom a total of 12 maxillary sinus floor augmentations were performed. A replaceable bone window was prepared in the lateral sinus wall with a reciprocating saw. The sinus membrane was dissected, elevated superiorly, and sutured to the sinus wall to create and maintain a compartment for blood clot formation. One to three dental implants were inserted through the residual bone and protruded at least 5 mm into the maxillary sinus. The bone window was replaced and secured with the overlying mucosa. Bone height was measured directly at each implant site at the time of insertion. Resonance frequency analysis (RFA) was performed on each implant at the time of initial placement, at abutment surgery, and after 12 months of functional loading. Computed tomography (CT) was performed in the immediate postoperative period and 6 months later, prior to exposure of the implants. RESULTS: A total of 19 implants (Brånemark System, TiUnite, Nobel Biocare AB, Gothenburg, Sweden) in lengths of 10 to 15 mm were placed, with an average residual bone height of 7 mm (range, 4-10 mm). All implants remained clinically stable during the study period. Comparisons of pre- and postoperative CT radiography clearly demonstrated new bone formation within the compartment created by the sinus membrane elevation procedure. RFA measurements showed mean implant stability quotient values of 65, 66, and 64 at placement, at abutment connection, and after 12 months of loading, respectively. CONCLUSIONS: The study showed that there is great potential for healing and bone formation in the maxillary sinus without the use of additional bone grafts or bone substitutes. The secluded compartment created by the elevated sinus membrane, implants, and replaceable bone window allowed bone formation according to the principle of guided tissue regeneration. The precise mechanisms are not known, and further histologic studies are needed. Sinus membrane elevation without the use of additional graft material was found to be a predictable technique for bone augmentation of the maxillary sinus floor.

Blood Coagulation↗
PubMed2005

Choice of a dental implant system.

Many dentists are bewildered by the intricacies and complexities of dental implants. They are constantly besieged by product advertisements and can find it difficult to choose which systems to work with. Some dentists are so intimidated by the subject that they choose to avoid getting involved with implants and instead stick to traditional tooth replacement systems. By breaking implants down into 4 main components, the body, collar, connection, and restorative post, it is easier to understand the structure and function of dental implants. Each portion should be designed to achieve certain objectives. Once these structural components are understood, it is easier to compare and contrast differing implant systems.

Bone Remodeling↗
PubMed2005

Effect of cavity form on adhesion to cavity floor.

PURPOSE: To investigate the influence of cavity form, namely the C-factor, on adhesion at the interface on the cavity floor using light-cured resin-based composite. METHODS: Black ABS resin molds were used and were formed into five types of cavities having configuration factors that ranged from 0.5 to 5.0. The cavity size was standardized to cubes of 5 x 5 x 5 mm. Each cavity was treated using a bonding system (Clearfil SE Bond) and was filled with resin-based composite (Clearfil Photo Core). The composite was irradiated in the cavity and then cured for 40 seconds using a halogen light unit. Specimens were subjected to the microtensile test at a cross-head speed of 1 mm/minute. RESULTS: There was no significant difference in bond strength among the five different cavity forms. It was concluded that the difference of cavity forms had little effect on the adhesion to the cavity floor when using light-cured composites.

Acrylic Resins↗
PubMed2005

Effect of adhesive volume on the bond strength of bonded complex amalgam restorations.

PURPOSE: To evaluate in vitro the effect of adhesive volume on the bond strength of bonded complex amalgam restorations using Amalgambond Plus with HPA powder. METHODS: Standardized 6 mm-diameter dentin cylinders were prepared from 30 extracted human molar teeth. Specimens were divided into two groups (n=15). Group 1 received a minimal volume (5 microl) of Amalgambond Plus with HPA powder and Group 2 received a surplus volume (10 microl) of Amalgambond Plus with HPA powder. Amalgam restorations were placed, and loaded at 45 degrees to the long axis of the tooth using an Instron testing machine. RESULTS: Group 1: 14.71 (+/- 3.41) MPa, Group 2: 15.67 (+/- 3.72) MPa. A Student's t-test indicated no significant difference between the groups (P> 0.05).

Adhesiveness↗
PubMedDate not supplied

A randomized controlled clinical trial of conventional and immediately loaded tapered implants with screw-retained crowns.

PURPOSE: Surgical, prosthodontic, and esthetic outcomes of conventional and immediately loaded, single, tapered, roughened-surface Southern implants in the anterior maxilla that were restored with screw-retained crowns were compared over 1 year. MATERIALS AND METHODS: Standardized surgical and prosthodontic procedures were followed and accepted criteria were used for assessment. RESULTS: There were no significant differences within or between the control and test groups for age, gender, bone quality or quantity, implant stability measurements at surgery, or implant length. CONCLUSION: After 1 year, the implants that had been immediately loaded with single provisional crowns at surgery and definitive crowns 8 weeks later were as successful as conventionally loaded 2-stage implants.

Adult↗
PubMedDate not supplied

Resonance frequency analysis measurements of implants at placement surgery.

PURPOSE: The knowledge of what levels of primary stability can be obtained in different jawbone regions and of what factors influence primary stability is limited. The objective of this study was to evaluate primary stability by resonance frequency analysis (RFA) measurements of implants placed according to a surgical protocol that aimed for high primary stability. The aim was also to correlate RFA measurements with factors related to the surgical technique, the patient, and implant design. MATERIALS AND METHODS: A total of 905 Brånemark dental implants used in 267 consecutive patients were measured with RFA at the time of placement surgery. RESULTS: A mean ISQ value of 67.4 (SD 8.6) was obtained for all implants. Univariate analyses with the implant or patient as unit showed higher ISQ values in men compared with women, in mandibles compared with maxillae, in posterior compared with anterior sites, and for wide-platform implants in comparison with regular/narrow-platform implants. There was a correlation between bone quality and primary stability, with lower ISQ values obtained for implants placed in softer bone. A lower stability was seen with increased implant length. A stepwise multiple regression analysis using the patient as unit showed that jaw type and gender had independent effects on primary stability. CONCLUSION: The results suggest that factors related to bone density and implant diameter/length may affect the level of primary implant stability. Furthermore, greater stability was observed in male than in female patients. High primary implant stability was achieved in all jaw regions, although the use of thinner drills and/or tapered implants cannot fully compensate for the effect of soft bone. The research design does not permit conclusions regarding long-term treatment outcome with implants.

Aged↗
PubMed2006

Predictors of dental implant survival.

PURPOSE: To summarize dental implant survival rates under a variety of clinical conditions and identify prognostic variables associated with implant survival. MATERIALS/METHODS: The articles reviewed in this paper were designed as retrospective cohort studies and composed of three subject cohorts having implants placed between 1992 and 2003. The prognostic variables were categorized as demographic/health status, anatomic, implant-specific, prosthetic, and perioperative/operative. The primary outcome variable was duration of implant survival. Kaplan-Meier methods were used to estimate implant survival rates. Multivariate Cox proportional hazards models were used to identify prognostic variables. RESULTS-During the study interval, 921 subjects had 2996 implants placed. Implant survival rates at one year ranged from 90.3 percent for immediate-load implants to 96.2 percent for implants inserted into grafted sinuses. The five-year survivals ranged from 87.9 percent (sinus graft cases) to 91.2 percent (all implants). Frequently cited prognostic variables included tobacco use and implant staging. Other prognostic variables identified included implant length, well size, implant coating, and timing of implant placement relative to tooth extraction. CONCLUSION: Using implants to replace missing teeth is a predictable procedure with five-year survival rates approximating 90 percent. Some of the prognostic variables identified in these studies are under the control, at least to some degree, of the clinician and may be manipulated to enhance implant survival.

Age Factors↗
PubMed2006

Survival rates of IPS empress 2 all-ceramic crowns and fixed partial dentures: results of a 5-year prospective clinical study.

OBJECTIVE: The aim of this prospective clinical study was to evaluate the survival rates of IPS Empress 2 (Ivoclar Vivadent) all-ceramic crowns and fixed partial dentures (FPDs) after an observation period of up to 5 years. METHOD AND MATERIALS: Forty-three patients (19 women and 24 men) were included in this study. The patients were treated with a total of 58 adhesive bonded IPS Empress 2 restorations. A total of 27 single crowns were placed on molars and premolars, and 31 three-unit FPDs were placed in the anterior and premolar regions. Clinical follow-up examinations took place at 6, 12, 24, 36, 48, and 60 months after insertion. Statistical analysis of the data was calculated using the Kaplan-Meier method. RESULTS: Results of the 50-month analysis (interquartile range, 33 to 61 months) showed that the survival rate was 100% for crowns and 70% for FPDs. Six failures that occurred exclusively in the three-unit FPDs were observed. Framework fractures were recorded in three FPD units where the connector dimensions did not meet the manufacturer specifications. Only one FPD exhibited an irreparable partial veneer fracture, and 2 FPDs showed evidence of biologic failures. The accuracy of fit and esthetic parameters were clinically satisfactory for crowns and FPDs. CONCLUSION: The results of this 5-year clinical evaluation suggest that IPS Empress 2 ceramic is an appropriate material for the fabrication of single crowns. Because of the reduced survival rates, strict conditions should be considered before the use of IPS Empress 2 material for the fabrication of three-unit FPDs.

Adult↗