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PubMedDate not supplied

Predictable peri-implant gingival aesthetics: surgical and prosthodontic rationales.

Bone resorption following maxillary anterior tooth extraction is common and often compromises gingival tissue levels for the implant restoration. The creation of predictable peri-implant aesthetics requires proper understanding and preservation of the osseous and gingival tissue surrounding the failing tooth. This article addresses the various factors that affect the predictability of peri-implant gingival aesthetics in anterior single-tooth replacement. The surgical and prosthodontic procedures for maintenance of peri-implant aesthetics are also presented using an ovate pontic tooth on a removable partial denture following immediate extraction and implant placement.

Adult↗
PubMed1999

Modular transitional implants to support the interim maxillary overdenture.

It has been reported that for implants to become osseointegrated, they must heal in the absence of functional loads for 4 to 6 months. To address the need for undisturbed healing and patient demand for uninterrupted immediate function and esthetics, the Modular Transitional Implant and Prosthetic System has been developed. This case report describes the use of transitional implants to support a removable maxillary overdenture, including methodology and the advantages and disadvantages of the system. The histomorphometric analysis of one of these transitional implants and its surrounding osseous tissue showed a 45% bone-to-implant interface after 6 months of functional loading. The transitional implant system is a sound and economical method of immediate patient restoration that allows for the protected healing of submerged implants.

Bite Force↗
PubMed2000

Use of immediately loaded press-fit cylinder implants in oral reconstruction.

Press-fit implants can be used to meet the prosthetic needs of patients who require immediate loading of their implants. This procedure may be necessary because of a patient's unwillingness and/or inability to tolerate a removable prosthesis. The implants reported in this study had a similar success rate to those immediately loaded screw-type implants previously reported by others. The lack of large numbers of long-term immediately loaded implants dictates the need for detailed informed consent when using immediately loaded cylinder implants for dental reconstruction.

Aged↗
PubMed2005

Clinical and radiographic performance of delayed-immediate single-tooth implant placement associated with peri-implant bone defects. A 2-year prospective, controlled, randomized follow-up report.

OBJECTIVES: The aim of the present study was to compare the delayed-immediate (Im) and the delayed (De) protocols for placement of single-tooth implants. MATERIAL AND METHODS: After allocation to the Im and De groups by random, 46 patients were treated with a single-tooth implant with acid etched surfaces (Osseotite) in the anterior or pre-molar region of the maxilla or the mandible on average 10 days (Im) or 3 months (De) following tooth extraction, respectively. Forty-one patients attended a follow-up visit 2 years after implant placement corresponding to 1(1/2) years of loading of the implant restorations. Peri-implant and prosthetic parameters were evaluated clinically and marginal bone levels measured on radiographs. RESULTS: Three implants were lost, all before mounting of the crown. None of the implant restorations had failed after 1(1/2) years of function. Probing pocket depths were reduced by up to 1.4 mm on average from the time of loading to the 2-year follow-up and at that time, no significant difference between the Im and De groups was found (4.2 versus 4.1 mm). A statistically significant radiographic marginal bone loss had occurred in the Im group (mean=0.8 mm) as well as in the De group (mean=0.7 mm) in the follow-up period. However, a mean marginal bone level of approx. 1.5 mm in both groups measured from the implant-abutment junction was found to be acceptable. It was demonstrated that probing pocket depths and marginal bone levels after 1(1/2) years of loading of the implant-retained crowns were not influenced by the presence of peri-implant bone defects immediately after implant placement. Furthermore, no severe prosthodontic complications, such as screw loosening or porcelain fractures, arose in this study material. CONCLUSION: High success rates of single-tooth implants after 1(1/2) years of function were achieved using the delayed-immediate and delayed implant placement techniques.

Alveolar Bone Loss↗
PubMed1999

The efficacy of modular transitional implants placed simultaneously with implant fixtures.

After the placement of implants in areas in which several teeth have been lost, both the clinician and the patient face many difficulties, particularly during healing. If no prosthesis is provided, the patient's quality of life suffers. If a removable prosthesis is provided for optimum mastication and speech, many complicated adjustments of the denture may become necessary during healing, and the possibility of osseointegration failure increases. This case report describes simultaneous placement of implant fixtures and modular transitional implants, providing occlusal function immediately after placement. The use of modular transitional implants is very effective in maintaining good oral function for the patient.

Dental Implantation, Endosseous↗
PubMed2004

Rationale for the application of immediate load in implant dentistry: part II.

Immediate loading of an implant interface has been used for completely and partially edentulous patients. A biomechanical rationale to decrease the initial risk of overload is reasonable, because implant failure and overload has been well established. This article addresses methods to decrease stress to the transitional restoration. Forces may be influenced by patient factors, implant position, cantilever forces, occlusal load direction, occlusal contact intensity, and diet. The surface area of load distribution may be increased by implant size, implant design, and surface condition of the implant body. A blend of these factors affects the amount of stress to the developing implant interface and hence may affect the risk of immediate occlusal loading for implant prostheses.

Alveolar Process↗
PubMed2000

The clinical effectiveness of implants placed immediately into fresh extraction sites of molar teeth.

BACKGROUND: Studies concerning immediate implantation describe its use in the anterior and premolar regions. However, its clinical effectiveness in immediately replacing molar teeth has rarely been challenged. The purpose of this study was to evaluate the survival rate of implants placed immediately after extraction of molar teeth to support a fixed ceramo-metal prosthesis. METHODS: From 1989 to 1996, 56 immediate implants were placed in 43 patients following extraction of 51 molars; 46 molars were replaced by 1 implant and 5 molars replaced by 2 implants. All implants were restored with fixed prostheses (4 single crowns and 52 splinted). Mean follow-up period was 15 months (range, 4 to 60 months). The influence of the following parameters on implant failure was evaluated: gender, arch, smoking, pre-extraction vertical bone loss, implant length, and severity of complications between the two stages of surgery. RESULTS: The 5-year cumulative survival rate (5-year CSR) was 89%. The 5-year CSR among men was 84% compared to 93.5% among women. The maxillary 5-year CSR was 82% and the mandibular 92%. Among non-smokers (50 implants), the 5-year CSR was 90% compared to 83% among smokers (6 implants). Complications were evident in 8 (6 minor, 2 major) out of 50 non-failing implants compared to 2 (minor) of the 6 failing implants. No differences were evident in the other study variables. CONCLUSIONS: Immediate implantation in the molar region is an alternative, predictable surgical treatment. Immediate implantation in the posterior mandible has a better prognosis than in the posterior maxilla.

Adolescent↗
PubMed2003

[A new tricortical implant].

We wish to introduce a new type of implant intended for use in the posterior maxilla when only 8 mm or less of the resorbed alveolar ridge is present, without the need for sinus lift procedures or ridge augmentation. The implant is called "Excalibur" and will be available in varying lengths with either an internal or external hex. The implant is supported at three points in the cortical bone due to the use of an apically positioned screw, which passes through the implant and the buccal and palatal cortices at 90 degrees to the long axis of the implant. The bicortical screw is inserted via a minimal full thickness flap or through a small incision in the gingiva at the proposed point of placement. The additional stability provided by this screw allows for immediate loading at the time of implant placement. In comparative tests with regular implants, the "Excalibur" was found to be far more resistant to forces applied to the implant resulting in far less stress on the neck of the implant, which was shown on the finite element modeling. Two clinical cases are presented: 1) Excalibur implants were placed in the posterior maxilla and four months after the surgical procedure the permanent prosthetic rehabilitation was completed. 2) Excalibur implants were placed at the time of extraction, with an immediate temporary acrylic bridge. Permanent prosthetic rehabilitation was begun four months later.

Alveolar Bone Loss↗
PubMedDate not supplied

Immediate versus delayed loading of dental implants in the maxillae of minipigs. Part II: histomorphometric analysis.

PURPOSE: To assess histomorphometric parameters of dental implants placed in partially edentulous maxillae of minipigs. MATERIALS AND METHODS: In 9 minipigs, 6 XiVE implants were placed on each side of the maxilla, either after implant site preparation by an osteotome technique or by spiral drills. The implants were restored with fixed provisional restorations and loaded either immediately or after healing periods of up to 5 months. After a loading period of 6 months, the animals were sacrificed and the implants were retrieved together with the adjacent bone. Histologic specimens were prepared and bone-to-implant contact (BIC) ratio, interthread bone area, and peri-implant bone area were determined. RESULTS: An analysis of variance revealed that the BIC ratio on the palatal side was significantly influenced by the preparation technique of the implant site (P = .001) and by the healing period (P = .02). After implant site preparation by an osteotome technique, higher BIC values were achieved for implants that were loaded either immediately or after healing periods of 1 to 3 months. After healing periods of 4 to 5 months, implant site preparation with spiral drills showed slightly better results in regard to BIC. Interthread bone area and peri-implant bone area did not differ significantly statistically for the 2 implant placement techniques and the 3 healing periods. DISCUSSION AND CONCLUSION: After 6 months of functional loading in the maxilla, successful immediately loaded implants performed the same as implants subjected to an unloaded healing period prior to loading as far as histomorphometric data were concerned. Prospective randomized clinical studies should be carried out in humans to compare immediate loading to loading after an unloaded healing phase.

Analysis of Variance↗
PubMed1998

Immediate implant placement: a procedure without incisions.

Primary socket closure in immediate implantation may be difficult, due to the opening left by the extracted tooth. The absolute need for bone augmentation and primary flap closure for implants placed into fresh extraction sites has never been proven. The hypothesis of the present study was that immediate implants can succeed without primary flap closure. A technique that does not require any incisions during immediate implant placement is described. No barrier membranes were used and the sole grafting material used were autogenous bone chips. Full soft tissue coverage was achieved 1 week to 2 months postimplantation. Clinical osseointegration was achieved with minimal gingival recession and papillae preservation. Immediate implant placement in the anterior maxilla can be successful for replacing a single tooth even without primary closure.

Adult↗
PubMed2004

[Combined method for preventing alveolar process deformation after tooth extraction].

This paper presents a combined method for prevention of deformation of the alveolar process of the jaws after tooth extraction. This method was used in 26 patients of different age. Use of colapol in the KP-3l modification and laser coagulation method in combination with immediate orthodontic treatment led to reduction of the incidence of inflammatory complications. The method is recommended for practical use.

Adult↗
PubMed2002

Immediate loading of osseotite implants: two-year results.

The high success rate of dental implants has changed the quality of life for many patients. Immediate loading finds its application in some clinical cases and certainly adds another modality of treatment for the implant patient. Starting with a couple of implants placed in the mandible and immediately loaded within 72 hours after surgical placement with an overdenture, this concept evolved to immediately loading multiple implants in both the maxilla and the mandible. In this investigation, 11 consecutive patients were treated with 87 screw-shaped endosteal acid-etched, Osseotite implants (3i, Implant Innovations, Inc., Palm Beach Gardens, FL) between June 1998 and June 1999. Two mandibular and two maxillary cases received screw-retained provisional prostheses the day of surgery. Three mandibular and four maxillary cases were loaded 48 hours after surgery with the final screw-retained, porcelain-fused-to-metal prostheses. All implants were followed for 2 to 3 years. Follow-up consisted of clinical as well as radiographic examination. All implants were successful. There was no implant mobility or periimplant radiolucency. The bone level was measured at the 12th and 24th months. The average radiographic bone level from the implant platform to the first bone-to-implant contact was 0.654 mm at the 12th month and 0.946 mm at the 24th month. We conclude that a high success rate can be achieved when implants with a hybrid surface, machined/acid-etched, are immediately loaded within 48 hours after surgical placement in the maxilla and the mandible.

Acid Etching, Dental↗
PubMed2001

Immediate provisional for single-tooth implant replacement with Brånemark system: preliminary report.

BACKGROUND: The success of osseointegrated implants ad modum Brånemark for single-tooth restorations is documented. Future developments should aim at improving the benefits to patients by decreasing treatment time, minimizing surgical stages, and maximizing esthetic outcomes. Using knowledge from studies of immediate implant placement, one-stage, immediate loading protocols, the authors developed the immediate provisional. PURPOSE: The purpose of this study was to develop a protocol to provide an immediate solution for restoring a single missing tooth in the esthetic zone. The protocol should be simple, predictable, cost effective, and allow the use of other techniques to improve esthetic outcome. MATERIALS AND METHOD: This prospective clinical study included 24 patients treated from August 1999 to October 2000. Single-tooth implant replacement was done according to immediate provisional protocol. Thirteen of the 24 patients had immediate implant placement after tooth extraction. All implants were placed in the esthetic zone. During surgery, emphasis was placed on obtaining primary stability by achieving bicortical anchorage and maximum insertion torque of at least 40 Ncm. CeraOne (Nobel Biocare) abutments were used, and provisional crowns were fabricated immediately before wound closure. The occlusion was protected by adjacent teeth. RESULTS: Within the follow-up period of between 1 month and 15 months, all fixtures in the 24 patients were stable. Crestal bone loss greater than one thread-width was not detected. The esthetic result was considered satisfactory by all patients. CONCLUSIONS: The implant placement and restoration protocol used in this study showed promising initial results for both the immediate implant and healed extraction site groups. The desirable goals of patient satisfaction, excellent esthetic outcomes, and no increase in treatment cost were achieved in this protocol. Further studies to elucidate the potential of the immediate provisional protocol are justified.

Adolescent↗
PubMed2004

Immediate resin-bonded bridgework: results of a medium-term clinical follow-up study.

A total of 21 immediate resin-bonded bridges were inserted under controlled and standardized clinical conditions and evaluated over a period of 35 months. During the evaluation period, two bridges debonded (9.5%). The debonded bridges were re-cemented successfully. This low incidence of debonding indicates that this simple alternative procedure for the immediate replacement of a single unsaveable tooth was satisfactory. The subjects included in this study expressed their satisfaction with this form of treatment.

Adult↗
PubMedDate not supplied

An immediate-extraction anterior single-tooth replacement utilizing a fiber-reinforced dual-component bridge.

Replacement of a single anterior tooth is an extremely challenging procedure. Numerous objective and subjective factors must be evaluated by the interdisciplinary team in the determination of the appropriate restorative method. This article reviews the restorative options and describes an emerging treatment modality--the fiber-reinforced dual-component bridge--as the option selected in a case requiring an immediate extraction of the maxillary right central incisor. The pertinent technology, indications, contraindications, and current clinical technique of dual-component nonmetallic prostheses are examined.

Adult↗
PubMed2003

Immediately loaded bar-connected implants with an anodized surface inserted in the anterior mandible in a patient treated with diphosphonates for osteoporosis: a case report with a 12-month follow-up.

BACKGROUND: It has been suggested that tooth loss is greater in the osteoporotic patient population. Only a few cases have been reported in the literature about the use of dental implants in patients with osteoporosis. Diphosphonates are stable analogs of pyrophosphate, a physiologic regulator of calcification and bone resorption. Multiple implant failures have been reported in a patient undergoing treatment with diphosphonates. Recently, several clinical and experimental reports have shown that immediate loading of dental implants is possible in selected situations. PURPOSE: The aim of this case report was to present the clinical outcome of immediate loading of implants in a patient undergoing diphosphonate treatment for osteoporosis. MATERIALS AND METHODS: In a 65-year-old patient undergoing diphosphonate treatment for osteoporosis, four implants were inserted in the anterior mandible. The implants were connected with a bar supporting an overdenture and were then loaded the same day. RESULTS: No problems occurred in the postoperative period. At 1-year follow-up, all four of the implants appeared to be clinically osseointegrated, and no mobility was present. Minimal bone resorption was present around all implants. CONCLUSIONS: Our case report points to the fact that, contrary to what has been reported in the literature, it is possible to successfully insert and load immediately after surgery dental implants in a patient undergoing diphosphonate treatment for osteoporosis.

Aged↗