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PubMed1994

Patient demographics and implant survival at uncovering: Dental Implant Clinical Research Group Interim Report No. 6.

Implant prognoses for healthy elderly patients have been found to be comparable with those reported for younger patients. In 1991, the Dental Implant Clinical Research Group initiated a prospective, randomized clinical study in cooperation with the Department of Veterans Affairs to investigate the influence of implant design, application, and site of placement on long-term clinical performance and crestal bone height. As a result of the large sample size and wide range of patient ages, the study provided an opportunity to determine if age correlates with implant survival. Interim analysis of 2,132 root form implants at uncovering on an implant, case, and patient basis suggests that implant survival does not appear to be influenced by age in the largely white, male sample.

Adult↗
PubMed2003

Ion implantation: surface treatment for improving the bone integration of titanium and Ti6Al4V dental implants.

Dental implants subjected to surface treatment have shown better bone integration than implants which have only been turned (machined). Three main types of treatment are presently available: the addition of material or coating, the removal of material, and surface modification. Ion implantation corresponds to the third approach. A histomorphometric study is made following the rabbit tibial bone placement of 88 commercial dental implants of pure titanium and Ti6AI4V subjected to surface treatment in the form of different ion implants (C+, CO+, N+, Ne+). Light microscopic, scanning electron microscopic (SEM), electron microsonde (EDS) and X-ray photoelectron spectroscopy (XPS) studies were made. The results indicate improved bone integration (expressed as percentage bone-implant contact) in those specimens subjected to ion implantation versus the non-treated controls, the difference being statistically significant for the groups treated with C+ and CO+. In these groups, XPS showed a Ti-O-C junction (bone-implant interface) involving covalent type bonds, these being stronger and more stable than the ion-type bonds usually established between the titanium oxide and bone.

Alloys↗
PubMed2001

[The mandibular molar-area implantation of screw-typed dental implants].

OBJECTIVE: To study molar area implantation with screw-typed implant based on the specific anatomic properties of inferior alveolar nerve. METHODS: Depending on the degree of alveolar atrophy in mandibular molar area, the direct implantation, the buccal-to mandibular-canal implantation, and the repositioning inferior-alveolar-nerve implantation were employed. During the period of 1992 to 1998, a total of 22 cases of this kind with 45 dental implants were restored. The follow-up period was 5 years. RESULTS: 2 dental implants were lost respectively after 3 months of insertion and after 1 year of restoration. All the 43 others, however, still remained complete osseointegration, with no obvious crestal bone rebesorption and with excellent function. The 5-year accumulating survival rate of dental implants was 96%. CONCLUSIONS: These three surgical techniques, to a large extent, can solve the problems of mandibular molar area implantation. The key to success of each technique is the selection of patient and the selection of surgical project.

Adult↗
PubMed2004

Osteogenesis and morphology of the peri-implant bone facing dental implants.

This study investigated the influence of different implant surfaces on peri-implant osteogenesis and implant face morphology of peri-implant tissues during the early (2 weeks) and complete healing period (3 months). Thirty endosseous titanium implants (conic screws) with differently treated surfaces (smooth titanium = SS, titanium plasma sprayed = TPS, sand-blasted zirconium oxide = Zr-SLA) were implanted in femur and tibiae diaphyses of two mongrel sheep. Histological sections of the implants and surrounding tissues obtained by sawing and grinding techniques were observed under light microscopy (LM). The peri-implant tissues of other samples were mechanically detached from the corresponding implants to be processed for SEM observation. Two weeks after implantation, we observed osteogenesis (new bone trabeculae) around all implant surfaces only where a gap was present at the host bone-metal interface. No evident bone deposition was detectable where threads of the screws were in direct contact with the compact host bone. Distance osteogenesis predominated in SS implants, while around rough surfaces (TPS and Zr-SLA), both distance and contact osteogenesis were present. At SEM analysis 2 weeks after implantation, the implant face of SS peri-implant tissue showed few, thin, newly formed, bone trabeculae immersed in large, loose, marrow tissue with blood vessels. Around the TPS screws, the implant face of the peri-implant tissue was rather irregular because of the rougher metal surface. Zr-SLA screws showed more numerous, newly formed bone trabeculae crossing marrow spaces and also needle-like crystals in bone nodules indicating an active mineralising process. After 3 months, all the screws appeared osseointegrated, being almost completely covered by a compact, mature, newly formed bone. However, some marrow spaces rich in blood vessels and undifferentiated cells were in contact with the metal surface. By SEM analysis, the implant face of the peri-implant tissue showed different results. Around the SS screws, the compact bone with areas of different mineralisation rate appeared very smooth, while around the rougher TPS screws, the bone still showed an irregular surface corresponding to the implant macro/microroughness. Around the Zr-SLA screws, a more regular implant-bone surface and sparse, calcified marrow spaces were detectable. Results from this research suggest that 2 weeks after implantation, trabecular bone represents the calcified healing tissue, which supports the early biological fixation of the implants. The peri-implant marrow spaces, rich in undifferentiated cells and blood vasculature, observed both 2 weeks and 3 months after surgery, favour the biological turnover of both early and mature peri-implant bone. The implant surface morphology strongly influences the rate and the modality of peri-implant osteogenesis, as do the morphology and arrangement of the implant face in peri-implant bone both during early healing (after 2 weeks) and when the implant is just osseointegrated; rough surfaces, and in particular Zr-SLA, seem to better favour bone deposition on the metal surface.

Animals↗
PubMedDate not supplied

Characteristics associated with the loss and peri-implant tissue health of endosseous dental implants.

This study investigated the association of patient and provider characteristics on dental implant performance and survival probabilities. The outcomes of interest in this study were implant failures and peri-implant tissue health status. Univariate and bivariate statistics were used to describe the study population and to assess association of outcomes with patient and facility characteristics. Data were gathered from the period 1985 through January 1, 1990, from the Department of Veterans Affairs Dental Implant Registry. Logistic regression models were used to relate the outcomes with independent variables. Results showed that implant survival is associated with (1) the medical status of the patient, (2) the surface coating material of the implant, and (3) implant surgical and healing complications. Peri-implant soft tissue health was associated with (1) patient's use of tobacco, (2) surface coating of implants, and (3) implant provider's experience.

Adult↗
PubMed2003

Antibiotics to prevent complications following dental implant treatment.

BACKGROUND: Some dental implant failures may be due to bacterial contamination at implant insertion. Infections around biomaterials are difficult to treat and almost all infected implants have to be removed. In general, antibiotic prophylaxis in surgery is only indicated for patients at risk of infectious endocarditis, for patients with reduced host-response, when surgery is performed in infected sites, in cases of extensive and prolonged surgical interventions and when large foreign materials are implanted. To minimise infections after dental implant placement various prophylactic systemic antibiotic regimens have been suggested. More recent protocols recommended short term prophylaxis, if antibiotics have to be used. With the administration of antibiotics adverse events may occur, ranging from diarrhoea to life-threatening allergic reactions. Another major concern associated with the widespread use of antibiotics is the selection of antibiotic-resistant bacteria. The use of antibiotics in implant dentistry is controversial. It would be useful to know whether prophylactic antibiotics are effective in reducing failures of dental implants. OBJECTIVES: To assess the beneficial or harmful effects of the administration of prophylactic antibiotics for dental implant placement versus no antibiotic/placebo administration and if antibiotics are of benefit, to find which type, dosage and duration is the most effective. SEARCH STRATEGY: We searched the Cochrane Oral Health Group's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE. We handsearched several dental journals. No language restrictions were applied. Personal contacts and manufacturers of dental implants were contacted to identify unpublished trials. Most recent search: March 2003. SELECTION CRITERIA: Randomised controlled clinical trials (RCTs) with a follow up of at least 3 months comparing the administration of various prophylactic antibiotics regimens and no antibiotics/placebo to patients undergoing dental implant placement. Outcome measures were prosthesis failures, implant failures, postoperative infections and adverse events (gastrointestinal, hypersensitivity). DATA COLLECTION AND ANALYSIS: Screening of eligible studies, assessment of the methodological quality of the trials and data extraction were to be conducted in duplicate and independently by two reviewers. Results were to be expressed as random effects models using weighted mean differences for continuous outcomes and relative risk for dichotomous outcomes with 95% confidence interval. Heterogeneity was to be investigated including both clinical and methodological factors. MAIN RESULTS: No RCTs were identified. REVIEWER'S CONCLUSIONS: There is not appropriate scientific evidence to recommend or discourage the use of prophylactic systemic antibiotics to prevent complications and failures of dental implants. Even though the present review did not assess the effectiveness of prophylactic antibiotics for patients at risk for endocarditis, it seems sensible to recommend the use of prophylactic antibiotics for patients at high and moderate risk for endocarditis, with immunodeficiencies, metabolic diseases, irradiated in the head and neck area and when an extensive or prolonged surgery is anticipated.

Antibiotic Prophylaxis↗
PubMedDate not supplied

Morphologic studies on the biologic seal of titanium dental implants. Report I. In vitro study on the epithelialization mechanism around the dental implant.

To propose a mechanism for apical epithelialization at the implant-tissue interface, cell contact to titanium surfaces and adhesive strength of epithelial-like (HGE) and fibroblastic (HGF) cells derived from human gingiva were investigated under three different media conditions containing plaque extracts: nonfiltered, 5-micron pore filtered, and 0.22-micron pore filtered. The plaque extracts had a greater effect in decreasing the growth rate of the HGF than of the HGE. Similarly, the HGE exhibited greater adhesive strength than the HGF. These differences in the cells' resistance to plaque extracts were also observed using light and electron microscopy. Evidence from this study suggests that the difference in growth, contact, and adhesive strength of the HGE and HGF cells to titanium surfaces may promote apical epithelialization under the pathologic condition.

Adult↗
PubMed1999

Determination of the success and failure of root-form osseointegrated dental implants.

Permucosal osseointegrated dental implants are a highly effective and predictable treatment modality for edentulism. This review discusses some controversial aspects of the definitions for success and failure of root-form dental implants. The discussion will focus on the underlying pathologies that, if untreated, may lead to loss of the implanted device. Few clinical syndromes are described based on human pathological material and clinical presentation. The theoretical chronological relationship between implant loss and the incidence of pathology of the soft- and hard-tissue seal around implants is also discussed. The review also examines the finding that implant failures are not randomly distributed in the treated populations and that implant loss clusters in specific high-risk groups and individuals. Known risk indicators, and possible risk factors, are discussed, taking into account the patient, the reconstruction, the implant, and implant site-specific factors. Particular emphasis is placed on the need for better determination of whether periodontal patients are at higher risk for implant failures as a consequence of their increased susceptibility to infectious, inflammatory-response-driven tissue breakdown.

Dental Implantation, Endosseous↗
PubMedDate not supplied

Histomorphometric analysis of implant anchorage for 3 types of dental implants following 6 months of healing in baboon jaws.

In an effort to better understand the supporting anatomy for unloaded endosseous dental implants, this study focused on the histomorphometric analysis of 3 different types of implants placed into non-human primate jaws and allowed to heal for 6 months. This report describes data from 24 screw-type dental implants placed in edentulated (2 months healing time) posterior arches of 4 adult female baboons. Three different implants were placed and allowed to heal for 6 months prior to processing for evaluation: commercially pure titanium (n = 8), titanium alloy (n = 8), and titanium plasma-sprayed (n = 8). Circumferential bone-implant interface sampling from 6 regions along the entire length of each implant was obtained for evaluation of percent bone-implant contact (%BIC) and percent bone area (%BA), within 3 mm of the implant. Data were collected (reliability of 1.6% for both parameters) and analyzed by an observer blinded to implant material using IMAGE analysis software for differences between jaws, implant biomaterials, and jaw/biomaterial (analysis of variance, pairwise comparison using least squares method with Bonferroni adjustment). The results indicated that the overall mean %BIC was 55.8 and mean %BA was 48.1. Maxillary and mandibular differences for both parameters were statistically significantly different: %BIC in maxilla 50.8, in mandible 60.8; %BA in maxilla 43.6, in mandible 52.6 (both significant at the P < .05 level). The biomaterial analyses revealed no significant differences between the different implants for %BIC or %BA. The trend observed--that mandibular values were greater than maxillary values for the overall jaw comparisons--was found to be consistent at the jaw/biomaterial level, although the small sample size limited statistical power. These data, along with data from a previous 3-month study, provide insight into baseline supporting anatomy for dental implants.

Alloys↗