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PubMed1994

Second-stage failures related to bone quality in patients receiving endosseous dental implants: DICRG Interim Report No. 7. Dental Implant Clinical Research Group.

The quality of bone plays an important role in the long-term clinical success of dental implant treatment. An interim evaluation of the relationship between bone quality and the incidence of failure at second-stage surgery is presented. The data include 2,131 root form implants placed by the Dental Implant Clinical Research Group over the past three years. Trends to date suggest differences in the rates of osseointegration among the various bone qualities. Quality 1 bone experienced the greatest failure rate, whereas quality 2 and quality 3 bone had the lowest failure rates.

Alveolar Bone Loss↗

PubMed2002

Interventions for replacing missing teeth: different types of dental implants.

BACKGROUND: Dental implants are available in different materials, shapes and with different surface characteristics. In particular, numerous implant surface modifications have been developed for enhancing clinical performances. OBJECTIVES: To test the null hypothesis of no difference in clinical performance between various root-formed osseointegrated implant types. SEARCH STRATEGY: The Cochrane Oral Health Group Specialised Trials Register, The Cochrane Controlled Trials Register, MEDLINE and EMBASE were searched. Hand searching included several dental journals. Bibliographies of relevant clinical trials and review articles were checked for studies outside the handsearched journals. In addition, authors of all identified trials and fifty-five oral implant manufacturers were contacted to find unpublished or ongoing RCTs. Two extensive personal libraries (ME and AJ) were consulted. The last electronic search was conducted 8th May 2002. SELECTION CRITERIA: All randomised controlled trials of oral implants comparing implants with different materials, shapes and surface properties having a follow-up of at least one year. DATA COLLECTION AND ANALYSIS: Data were independently extracted, in duplicate, by two reviewers (ME & HW). Authors were contacted for details of randomisation and withdrawals and a quality assessment was carried out. The Cochrane Oral Health Group's statistical guidelines were followed. MAIN RESULTS: Thirty publications, representing 13 different RCTs, were identified. Five of these RCTs (seven publications), which reported results from a total of 326 patients, were suitable for inclusion in the review. Six implant systems were compared: Astra, Branemark, IMZ, ITI, Steri-Oss and Southern with a follow-up ranging from one to three years. All implants were made in commercially pure titanium and had different shapes and surface preparations. On a patient rather than per implant basis there were no statistically significant differences for failures and marginal bone level changes on intra-oral radiographs between various implant systems. REVIEWER'S CONCLUSIONS: There was no evidence that any of the implant systems evaluated was superior to the other. However, these findings are based on a few RCTs all having short follow-up periods and few participants. More RCTs should be conducted, with follow-up of at least five years and including a sufficient number of patients, to detect a true difference if any exists. Such trials should be reported according to the CONSORT guidelines (http://www.consort-statement.org/).

Dental Implantation, Endosseous↗

PubMedDate not supplied

Immediate implantation of endosseous dental implants in the posterior maxilla and anatomic advantages for this region: a case report.

A procedure is presented whereby treatment planning for the long-term restoration of imminent loss of well-rooted posterior maxillary teeth by immediate endosseous dental implant placement may aid the patient in avoiding major surgical reconstruction. The clinical case report presented illustrates the advantages of an immediate dental implant placement technique that is especially relevant and unique to the posterior maxilla. Anatomic advantages are discussed.

Adult↗

PubMed2002

Interventions for replacing missing teeth: hyperbaric oxygen therapy for irradiated patients who require dental implants.

BACKGROUND: Dental implants offer one way to replace missing teeth and associated tissues. Patients who have undergone radiotherapy and those that have also undergone surgery for cancer may benefit particularly from reconstruction with implants. Hyperbaric oxygen therapy (HBO) has been advocated to improve the success of implant treatment in patients who have undergone radiotherapy but this remains a controversial issue. OBJECTIVES: This review aims to compare success, morbidity, patient satisfaction and cost effectiveness of dental implant treatment carried out with and without HBO in irradiated patients. SEARCH STRATEGY: The Cochrane Oral Health Group Specialised Register, the Cochrane Controlled Trials Register, MEDLINE and EMBASE were searched. In addition, the bibliographies of review articles were checked for studies outside the handsearched journals and personal references were searched. We also wrote to implant manufacturers and experts in the field. SELECTION CRITERIA: Randomised controlled trials of HBO therapy for irradiated patients requiring dental implants. DATA COLLECTION AND ANALYSIS: No randomised trials were identified. MAIN RESULTS: No data were available. REVIEWER'S CONCLUSIONS: Clinicians ought to make patients aware of the lack of reliable clinical evidence for or against the clinical effectiveness of HBO in irradiated patients requiring dental implants. There is a definite need for RCTs to ascertain the effectiveness of HBO in irradiated patients requiring dental implants. These trials ought to be of a high quality and reported as recommended by the CONSORT statement (http://www.consort-statement.org/). Each clinical centre may have limited numbers of patients and it is likely that trials will need to be multi-centred.

Dental Implants↗

PubMed1995

Curriculum Guidelines in Implant Dentistry for Dental Hygiene Programs. Consensus Conference sponsored by the International Congress of Oral Implantologists, the American College of Oral Implantology, the American Society of Osseointegration, and the Association of Dental Implant Auxiliaries & Practice Management. Monterey, California, June 16, 1995.

A consensus conference to develop curriculum guidelines in implant dentistry for dental hygiene programs was held on June 16, 1995 in Monterey, California. The conference was sponsored by the International Congress of Oral Implantologists, the American College of Oral Implantology, the American Society of Osseointegration, and the Association of Dental Implant Auxiliaries & Practice Management. The guidelines, which will be distributed to dental hygiene program directors, are printed in their entirety.

Curriculum↗

PubMed2003

An illustrative study of the role of tomograms for the placement of dental implants.

Before dental implants are placed, an evaluation of a presurgical bone site with tomograms will reveal information not available from panoramic or periapical radiographs. This article illustrates the importance of making tomograms before the placement of dental implants to determine the actual height, width, inclination, and undercut of alveolar bone; the shape, cortication, and irregularities of crestal alveolar bone; the density of alveolar bone; the relative location of anatomical landmarks, such as mandibular canal, maxillary sinus, nasal fossa, incisive canal, submandibular gland fossa, etc.; the bucco-lingual view of dental pathosis; the bucco-lingual evaluation of sinus graft following sinus-lift surgery; and the evaluation of surgically placed dental implants.

Alveolar Process↗

PubMed2001

Detection of platelet-activating factor in gingival tissue surrounding failed dental implants.

BACKGROUND: Dental implant therapy has entered routine clinical practice. However, the failure rate of implants at 5 years, due to biological factors, is still around 7%. The pathogenesis of implant loss involves a complex network of cells and inflammatory mediators. This study evaluated platelet-activating factor (PAF), a potent phospholipid mediator of inflammation, in soft tissue surrounding failed dental implants versus healthy implants. METHODS: PAF was estimated on extracted lipids by bioassay on washed rabbit platelets; inflammatory cell populations were assessed semiquantitatively after staining, and microvessel density was evaluated after immunohistochemical staining. RESULTS: Biologically active PAF was detected in the lipid extracts of samples excised from gingival tissue of patients with failed implants, but not in samples from patients with osseointegrated implants or from healthy edentulous subjects. The amount of PAF detected in failed implants was significantly higher than in healthy implants, suggesting a local production of this mediator. CONCLUSIONS: The presence of PAF was associated with histopathological findings of local inflammation and increased blood vessel density.

Adult↗

PubMed2005

Interventions for replacing missing teeth: different types of dental implants.

BACKGROUND: Dental implants are available in different materials, shapes and with different surface characteristics. In particular, numerous implant surface modifications have been developed for enhancing clinical performances. OBJECTIVES: To test the null hypothesis of no difference in clinical performance between various root-formed osseointegrated dental implant types. SEARCH STRATEGY: We searched the Cochrane Oral Health Group's Trials Register, The Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE. Handsearching included several dental journals. We checked the bibliographies of relevant clinical trials and review articles for studies outside the handsearched journals. We wrote to authors of the identified randomised controlled trials (RCTs), to more than 55 oral implant manufacturers; we used personal contacts and we asked on an internet discussion group in an attempt to identify unpublished or ongoing RCTs. No language restriction was applied. The last electronic search was conducted on 28 June 2004. SELECTION CRITERIA: All RCTs of oral implants comparing osseointegrated implants with different materials, shapes and surface properties having a follow up of at least 1 year. DATA COLLECTION AND ANALYSIS: Screening of eligible studies, assessment of the methodological quality of the trials and data extraction were conducted in duplicate and independently by two reviewers. Results were expressed as random effects models using weighted mean differences for continuous outcomes and relative risk for dichotomous outcomes with 95% confidence intervals. MAIN RESULTS: Thirty-one different RCTs were identified. Twelve of these RCTs, reporting results from a total of 512 patients, were suitable for inclusion in the review. Twelve different implant types were compared with a follow up ranging from 1 to 5 years. All implants were made in commercially pure titanium and had different shapes and surface preparations. On a 'per patient ' rather than 'per implant' basis no significant differences were observed between various implant types for implant failures. There were statistically significant differences for peri-implant bone level changes on intraoral radiographs in three comparisons in two trials. In one trial there was more bone loss only at 1 year for IMZ implants compared to Branemark (mean difference 0.60 mm; 95% CI 0.01 to 1.10) and to ITI implants (mean difference 0.50 mm; 95% CI 0.01 to 0.99). In the other trial Southern implants displayed more bone loss at 5 years than Steri-Oss implants (mean difference -0.35 mm; 95% CI -0.70 to -0.01). However this difference disappeared in the meta-analysis. More implants with rough surfaces were affected by perimplantitis (RR 0.80; 95% CI 0.67 to 0.96) meaning that turned implant surfaces had a 20% reduction in risk of being affected by perimplantitis over a 3-year period. AUTHORS' CONCLUSIONS: Based on the available results of RCTs, there is limited evidence showing that implants with relatively smooth (turned) surfaces are less prone to loose bone due to chronic infection (perimplantitis) than implants with rougher surfaces. On the other hand, there is no evidence showing that any particular type of dental implant has superior long-term success. These findings are based on a few RCTs, often at high risk of bias, with few participants and relatively short follow-up periods. More RCTs should be conducted, with follow up of at least 5 years including a sufficient number of patients to detect a true difference if any exists. Such trials should be reported according to the CONSORT recommendations (http://www.consort-statement.org/).

Dental Implantation, Endosseous↗

PubMed2002

The effects of an immediately pre-surgical chlorhexidine oral rinse on the bacterial contaminants of bone debris collected during dental implant surgery.

Dental implant surgery produces bone debris that can be used in the "simultaneous augmentation" technique. Although this debris is contaminated with oral bacteria, a stringent aspiration protocol has been shown to reduce the levels of contamination. Chlorhexidine mouthrinse is a well-proven antibacterial rinse that has been shown to reduce infectious complications associated with dental implants. This study examined the effect of pre-operative rinsing with a 0.1% chlorhexidine digluconate mouthrinse on the bacterial contaminants present in collected bone debris bone (CBD). Twenty partially edentate patients were randomly allocated into equal groups and underwent bone collection using the Frios Bone Collector (FBC) during the insertion of two dental implants. In group T a pre-operative chlorhexidine rinse was used, whilst in group C sterile water was used. For both groups, a stringent bone collection protocol was used. Bone samples were immediately transported for microbial analysis. Colonial and microscopic morphology, gaseous requirements and identification kits were utilised for identification of the isolated microbes. Thirty-nine species were identified including a number associated with disease, in particular Actinomyces odontolyticus, Clostridium bifermentans, Prevotella intermedia, and Propionibacterium propionicum. Samples from group T (chlorhexidine mouthrinse) yielded significantly fewer organisms (P < 0.001) than in group C (sterile water mouthrinse). Gram-positive cocci dominated the isolates from both groups. It is concluded that if bone debris is to be used for the purpose of immediate simultaneous augmentation, a preoperative chlorhexidine mouthrinse should be utilised in conjunction with a stringent aspiration protocol to reduce further the bacterial contamination of CBD.

Actinomyces↗

PubMed2006

Oral hygiene and maintenance of dental implants.

When dental implants were first introduced, the emphasis for long-term success was on the surgical phase of treatment. Subsequently, the emphasis changed from a focus on the surgical technique to proper fixture placement, which would be dictated by the prosthetic and aesthetic needs of each patient. In more recent years, implant maintenance and effective patient home care have been emphasized as two critical factors needed for long-term success of dental implants.

Dental Implants↗

PubMed1992

The use of a new form of allograft bone in implantation or osseointegrated dental implants--a preliminary report.

The use of and early results with a new form of demineralized allograft bone tissue with the immediate placement of a dental implant are described. No occlusive membranes were utilized. GRAFTON Allogeneic Bone Matrix (ABM) is processed from human cortical bone into a thick gel consistency and packaged sterile in disposable syringes. The material was utilized in seven patients with seven implants. New bone formation was noted and, with the exception of two implants with a small amount of thread exposure, complete. It appears that treatment with the bone-grafting material produced clinical results similar to those reported with the use of barrier membranes and may provide an alternative to guided tissue regeneration. Further investigation appears warranted.

Bone Matrix↗

PubMed2005

Evaluation of 31 zygomatic implants and 74 regular dental implants used in 16 patients for prosthetic reconstruction of the atrophic maxilla with cross-arch fixed bridges.

BACKGROUND: The use of a specially designed implant to be anchored in the zygomatic body has been proposed as an alternative to bone grafting in the prosthetic rehabilitation of the severely resorbed maxilla. However, few studies have evaluated the long-term stability and soft tissue conditions of zygomatic implants. PURPOSE: The aim of this retrospective study was to evaluate the clinical performance of zygomatic implants when used for prosthetic reconstruction of atrophic maxillae. MATERIALS AND METHODS: Sixteen patients consecutively treated with 31 zygomatic implants and 74 additional dental implants from 1998 to 2002 were retrospectively evaluated and prospectively followed using a standardized clinical and radiographic study design. Data were collected from the time of implant treatment until the last follow-up RESULTS: The follow-up period ranged from 9 to 69 months from the day of implant treatment, with a mean of 46.4 months (3 years, 10 months). Three (9.7%) of the 31 zygomatic implants were surgically removed because of recurrent sinusitis. Three (4.1%) of the 71 additional dental implants failed to integrate. Poor oral hygiene and gingivitis were seen at most zygomatic implant sites (10/16). Local infections were observed in 9 of 16 patients. Sinusitis occurred in 6 patients. All patients (16/16) eventually received fixed bridges, which were stable throughout the observation period. CONCLUSIONS: The results showed an acceptable outcome with regard to implant and prosthetic survival rates. However, postoperative complications not related to implant and prosthesis stability were frequent. Further investigations of the long-term performance of zygomatic implants and with a focus on soft tissue and maxillary sinus health are needed.

Adult↗

PubMed1988