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At least 91 records · Page 5Linked to original sources
PubMed2005

Determination of the pH of peri-implant crevicular fluid in successful and failing dental implant sites: a pilot study.

The aims of this pilot study were to assess if a standard technique which is used to determine the pH of dental plaque around natural teeth (the 'touch electrode' technique) could be modified for use to determine the pH of crevicular fluid around dental implants, and to evaluate any possible changes in the peri-implant crevicular fluid pH in successful and failing implants. pH measurements of a sample of subjects' (n=17) peri-implant crevicular fluid of both successful and failing dental implants present in the same oral cavities were performed using iridium/iridium oxide (Beetrode) electrodes with 100 microm sensing tips, connected to an Orion 720 A pH meter. The technique appeared to be satisfactory for the purpose intended. The mean pH of the successful implants was 6.80 [STD+/-0.4; 95% confidence intervals (CI), 6.50-7.0], and that for the failing dental implants was 7.20 (STD+/-0.6; 95% CI, 6.90-7.50). The results showed that the technique described could be satisfactorily used to determine the pH of peri-implant crevicular fluid at dental implant sites, and that there was a significant difference between the pH of successful and failing dental implants (P<0.05). However, the results obtained should be interpreted with caution in view of the small sample size used in this pilot study.

Adult↗
PubMed2006

Interventions for replacing missing teeth: bone augmentation techniques for dental implant treatment.

BACKGROUND: Dental implants require sufficient bone to be adequately stabilised. For some patients implant treatment would not be an option without bone augmentation. A variety of materials and surgical techniques are available for bone augmentation. OBJECTIVES: General objectives: To test the null hypothesis of no difference in the success, function, morbidity and patient satisfaction between different bone augmentation techniques for dental implant treatment. SPECIFIC OBJECTIVES: (A) to test whether and when augmentation procedures are necessary; (B) to test which is the most effective augmentation technique for specific clinical indications. Trials were divided into three broad categories according to different indications for the bone augmentation techniques: (1) major vertical or horizontal bone augmentation or both; (2) implants placed in extraction sockets; (3) fenestrated implants. SEARCH STRATEGY: The Cochrane Oral Health Group's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE were searched. Several dental journals were handsearched. The bibliographies of review articles were checked, and personal references were searched. More than 55 implant manufacturing companies were also contacted. Last electronic search was conducted on 1 October 2005. SELECTION CRITERIA: Randomised controlled trials (RCTs) of different techniques and materials for augmenting bone for implant treatment reporting the outcome of implant therapy at least to abutment connection. DATA COLLECTION AND ANALYSIS: Screening of eligible studies, assessment of the methodological quality of the trials and data extraction were conducted independently and in duplicate. Authors were contacted for any missing information. Results were expressed as random-effects models using weighted mean differences for continuous outcomes and odd ratios for dichotomous outcomes with 95% confidence intervals. The statistical unit of the analysis was the patient. MAIN RESULTS: Thirteen RCTs out of 29 potentially eligible trials reporting the outcome of 330 patients were suitable for inclusion. Since different techniques were evaluated in different trials, no meta-analysis could be performed. Six trials evaluated different techniques for vertical or horizontal bone augmentation or both. Four trials evaluated different techniques of bone grafting for implants placed in extraction sockets and three trials evaluated different techniques to treat bone dehiscence or fenestrations around implants. AUTHORS' CONCLUSIONS: Major bone grafting procedures of extremely resorbed mandibles may not be justified. Bone substitutes (Bio-Oss or Cerasorb) may replace autogenous bone for sinus lift procedures of extremely atrophic sinuses. Both guided bone regeneration (GBR) procedures and distraction osteogenesis can augment bone vertically, but it is unclear which is the most efficient technique. It is unclear whether augmentation procedures at immediate single implants placed in fresh extraction sockets are needed, and which is the most effective augmentation procedure, however, sites treated with barrier + Bio-Oss showed a higher position of the gingival margin, when compared to sites treated with barriers alone. Non-resorbable barriers at fenestrated implants regenerated more bone than no barriers, however it remains unclear whether such bone is of benefit to the patient. It is unclear which is the most effective technique for augmenting bone around fenestrated implants. No bone promoting molecule has been shown to be effective or necessary in conjunction with dental implant treatment. The use of particulated autogenous bone from intraoral locations, also taken with dedicated aspirators, might be associated with an increased risk of infective complications. These findings are based on few trials including few patients, having sometimes short follow up, and being often judged to be at high risk of bias.

Animals↗
PubMed2003

Interventions for replacing missing teeth: bone augmentation techniques for dental implant treatment.

BACKGROUND: Dental implants require sufficient bone to adequately stabilise. For some patients implant treatment would not be an option without bone augmentation. A variety of materials and surgical techniques are available for use in bone augmentation. OBJECTIVES: To test the null hypothesis of no difference in the success, function, morbidity and patient satisfaction between different bone augmentation techniques for dental implant treatment. SEARCH STRATEGY: The Cochrane Oral Health Group's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE were searched. Several dental journals were handsearched. The bibliographies of review articles were checked, and personal references were searched. Implant manufacturing companies were also contacted. SELECTION CRITERIA: Randomised controlled trials (RCTs) of different techniques and materials for augmenting bone for implant treatment. DATA COLLECTION AND ANALYSIS: Quality assessment was carried out and authors were contacted for any missing information. Data were independently extracted in duplicate. MAIN RESULTS: Four RCTs (n = 95) were suitable for inclusion in this review, assessing three different aspects of bone augmentation techniques: onlay grafting with and without a barrier membrane, grafting with a resorbable and non-resorbable membrane, and membranes for guided bone regeneration (GBR). Trials reported on augmentation procedures up to abutment connection only. At the patient level there were no statistically significant differences for the alternative techniques for onlay grafting with respect to the degree of bone graft resorption and wound dehiscence. One trial showed statistically significantly more infections in the non-resorbable group compared to the resorbable group, relative risk 0.05 (95% confidence interval (CI): 0.00 to 0.74). One study of GBR with a resorbable versus non-resorbable membrane indicated no statistically significant difference in early implant failure, reduction in bone defect or wound dehiscence. The other GBR study compared a non-resorbable membrane with no membrane and reported no statistically significant difference in wound infection or dehiscence but a significant increase in per cent bone gain for the test group compared to control, mean difference = 70 (95% CI: 36 to 104, p = 0.002). REVIEWER'S CONCLUSIONS: There is no evidence from available RCTs supporting superior success with one or other of the alternative techniques examined. There was weak evidence that a non-resorbable membrane was better than no membrane for permitting bone growth about dental implants, and that a resorbable membrane over a bone graft may allow healing with fewer infections than a non-resorbable membrane.

Animals↗
PubMed2006

Simultaneous implant placement and bone regeneration around dental implants using tissue-engineered bone with fibrin glue, mesenchymal stem cells and platelet-rich plasma.

This study was undertaken to evaluate the use of tissue-engineered bone as grafting material for alveolar augmentation with simultaneous implant placement. Twelve adult hybrid dogs were used in this study. One month after the extraction of teeth in the mandible region, bone defects on both sides of the mandible were induced using a trephine bar with a diameter of 10 mm. Dog mesenchymal stem cells (dMSCs) were obtained via iliac bone biopsy and cultured for 4 weeks before implantation. After installing the dental implants, the defects were simultaneously implanted with the following graft materials: (i) fibrin, (ii) dMSCs and fibrin (dMSCs/fibrin), (iii) dMSCs, platelet-rich plasma (PRP) and fibrin (dMSCs/PRP/fibrin) and (iv) control (defect only). The implants were assessed by histological and histomorphometric analysis, 2, 4 and 8 weeks after implantation. The implants exhibited varying degrees of bone-implant contact (BIC). The BIC was 17%, 19% and 29% (control), 20%, 22% and 25% (fibrin), 22%, 32% and 42% (dMSCs/fibrin) and 25%, 49% and 53% (dMSCs/PRP/fibrin) after 2, 4 and 8 weeks, respectively. This study suggests that tissue-engineered bone may be of sufficient quality for predictable enhancement of bone regeneration around dental implants when used simultaneous by with implant placement.

Alkaline Phosphatase↗
PubMed1999

A comparison of endosseous dental implant surfaces.

Endosseous dental implants are available with various surface characteristics ranging from relatively smooth machined surfaces to more roughened surfaces created by coatings, blasting by various substances, by acid treatments, or by combinations of the treatments. Studies characterizing these implants and surfaces include in vitro experimentation, animal studies, and human clinical trials. Both descriptive and functional testing of the bone-implant interface includes histomorphometrics and biomechanical testing such as torque removal values and push out/pull out strength. Using these assays to evaluate and compare different surfaces, the data demonstrate that rough implant surfaces have increased bone-to-implant contact and require greater forces to break the bone-implant interface compared to more smooth surfaces. The objective of this report was to evaluate publications of human clinical experiences evaluating implant use in patients and to determine if differences existed in success rates of implants with relatively smooth surfaces compared to implants having roughened implant surfaces. Human trials were reviewed to determine the clinical efficacy of implants under various clinical indications. Synopsis tables were constructed and the experiences segregated by implant surface characteristics. Meta-analyses were performed on all implants in all locations, on implants placed only in the maxilla or the mandible, and, finally, on implants placed in the maxilla compared to implants placed in the mandible. Evaluation of the data revealed that predictably high success rates can be achieved for implants with both rough and smooth titanium surfaces and for hydroxyapatite-coated implants. When studies were clustered by specific indications or patient populations, rough surfaced implants had significantly higher success rates compared to implants with more smooth surfaces except in the case of single tooth replacements where the success rates were comparable. In general, implants placed in the mandible had significantly higher success rates than implants placed in the maxilla. However, in the partially edentulous patient group, titanium implants with a rough surface had significantly higher success rates in the maxilla compared to the mandible and, in cases of single tooth replacement, success rates were similar in the maxilla and in the mandible as was the case for hydroxyapatite-coated implants. The documented advantage of implants with a roughened surface in animal and in vitro experiments has been demonstrated in clinical cases when studies were compared in which specific indications or patients were treated. Additionally, implants placed in the mandible have, in general, higher success rates than implants placed in the maxilla, with only a few exceptions noted. These data from human clinical experiences support the documented advantage of implants with a roughened surface in animal and in vitro experimentation and indicate that the magnitude of the advantage is significant for patient care.

Animals↗
PubMedDate not supplied

Experimental peri-implant tissue breakdown around different dental implant surfaces: clinical and radiographic evaluation in dogs.

PURPOSE: Tissue reactions to 4 different implant surfaces were evaluated in regard to the development and progression of ligature-induced peri-implantitis. MATERIALS AND METHODS: In 6 male mongrel dogs, a total of 36 dental implants with different surfaces (9 titanium plasma-sprayed, 9 hydroxyapatite-coated, 9 acid-etched, and 9 commercially pure titanium) were placed 3 months after mandibular premolar extraction. After 3 months with optimal plaque control, abutment connection was performed. Forty-five days later, cotton ligatures were placed around the implants to induce peri-implantitis. At baseline and 20, 40, and 60 days after placement, the presence of plaque, peri-implant mucosal redness, bleeding on probing, probing depth, clinical attachment loss, mobility, vertical bone loss, and horizontal bone loss were assessed. RESULTS: The results did not show significant differences among the surfaces for any parameter during the study (P > .05). All surfaces were equally susceptible to ligature-induced peri-implantitis over time (P < .001). Correlation analysis revealed a statistically significant relationship between width of keratinized tissue and vertical bone loss (r2 = 0.81; P = .014) and between mobility and vertical bone loss (r2 = 0.66; P = .04), both for the titanium plasma-sprayed surface. DISCUSSION AND CONCLUSIONS: The present data suggest that all surfaces were equally susceptible to experimental peri-implantitis after a 60-day period.

Alveolar Bone Loss↗
PubMedDate not supplied

Quantitative histomorphometric description of implant anchorage for three types of dental implants following 3 months of healing in baboons.

Important to the understanding of the dynamics associated with dental implant anchorage over time is a knowledge of the supporting anatomy for common endosseous implants prior to being placed into function. This study followed 20 screw-shaped dental implants placed in edentulated (2 months' healing time) posterior jaws of five adult female baboons. Implants made of three biomaterials were placed and allowed to heal for 3 months prior to processing for evaluation. Percentage integration and bone area data from six horizontal sections along the entire length of each implant were collected and analyzed for differences between jaws, implant biomaterials, jaw/biomaterial, and sections of the implants (ANOVA, pairwise comparison using LSM with Bonferroni adjustment). The results indicated that overall mean percentage integration was 46.5 and mean percentage bone area was 39.9. Maxillary and mandibular differences for both parameters were statistically different (integration: maxillary = 38.1%, mandibular = 56.7%; bone area: maxillary = 35.8%, mandibular = 44.9%; both were significant at the P < .05 level). The biomaterial analyses revealed significant differences for percentage integration between the metal implants and the hydroxyapatite-coated implant (commercially pure titanium = 39.1%, titanium-aluminum-vanadium = 40.0%, hydroxyapatite-coated = 61.5%), but no such difference was noted for percentage bone area (commercially pure titanium = 38.8%, titanium-aluminum-vanadium = 38.9%, hydroxyapatite-coated = 42.3%). Discussion of the relative importance of the two parameters highlights the fact that resistance to functional loads requires establishing and then maintaining an adequate volume of bone, which may have a functionally specific structure based on the mechanical properties of the local jaw environment.

Alloys↗
PubMed2002

Effect of over- and underexposure on the sharpness of the image of a marker in computer-assisted dental implant tomography.

In dental implant tomography, a clinician typically makes several tomograms of cross-sectional and sagittal slices at and near the intended implantation site. The slice with the sharpest image of the metal marker is deemed to be the correct implantation site; the other slices with blurred images of the marker are those made either mesially or distally to the marker. However, if the images were over- or underexposed, the marker will be blurred on all the slices and a dentist may be wrongly accused of having placed a dental implant at an improper site with possible medico-legal ramifications.

Dental Implantation, Endosseous↗
PubMed1988

The scientific basis for dental implant therapy.

Dental and oral implantology have rapidly moved into the mainstream of dentistry in the last ten years with a phenomenal growth based on rapidly expanding technology, increasing public interest, and the reporting of sound scientific data. This paper reviews current knowledge about implant tissue reactions and identifies areas where additional scientific inquiry is needed. Bone- and soft-tissue healing around dental implants varies greatly depending upon the form of the implant, biomaterial used, and surgical approach. Controversy exists as to whether a direct bony-biomaterial interface is preferable over a bone-connective tissue-biomaterial interface. Scientific data are required to document whether intervening molecular layers of glycoproteins exist between implant and bone, and what role is played by these structures relative to the implant-bone interface. The adaptation of regenerated gingival epithelium to an implant is critical for the development of a perimucosal seal. Many scientific questions remain unanswered about this seal and its role in maintenance of implant longevity. Controlled clinical trials must be carried out to determine clinical serviceability standards for patients. Resolving these areas of concern and understanding the biological reactions involved will require in-depth scientific inquiry by clinician and scientist alike to make dental implantology a highly acceptable and predictable treatment modality. Even with these controversies and lack of comprehensive comparison studies, dental implantology is an exciting treatment concept that makes considerable demands upon the surgical, prosthetic, periodontal, and restorative skills of today's practitioners, and on their scientific understanding as well.

Biocompatible Materials↗
PubMed1994

Survey of dental implant practice.

Research advances in oral implantology have led to the development of several implant systems and to an increasing utilization of oral implants by dental practitioners. The purpose of this study was to conduct a survey of dental practitioners using implants in their practices, in order to determine their educational qualifications, to profile their practice in implants, and to evaluate the outcomes of implant therapy. The typical general practitioner in this study received dental implant training mainly from continuing education courses sponsored by a dentist experienced in implantology, spent 12 months or more in receiving formal instruction/training in implant dentistry, practiced state-of-the-art dental implantology, provided both surgical and restorative phases, used an endosseous implant system most of the time, and presented 5- and 10-year success rates of more than 90% for dental implant therapy. No clinically significant correlations were found between the 5- and 10-year success rates and the nature of the dental implant training, the amount of time spent for instruction and training in implant dentistry, or the type of dental implant system used.

Adult↗
PubMed2005

[Needs and current research directions of biological regenerative medicine in prosthodontic practice--to attain reliable and sophisticated dental implant therapy].

Appropriate dental implants are known to improve the quality of life in totally and partially edentulous patients, as well as to prevent future tooth loss, and so prosthetic treatment modalities have drastically changed recently with reconstruction therapy. However, dental implant therapy did not win the confidence of the dental community in the early developmental stage, until osseointegration between titanium and surrounding bone tissue was discovered and the modality utilizing osseointegration became reliable and produced durable treatment outcomes for long-term function. On the other hand, the biological mechanism of osseointegration has not been clarified yet and the time required for osseointegration is still long, e.g. three to four months. As well, when the implant is applied in the upper posterior region, the acquisition of osseointegration and the long-term survival of the implant are still not clinically adequate. Therefore, to reduce the time required for osseointegration and to regenerate enough alveolar bone mass in the target implantation site, the oral implant modality must be made more useful and potent as one of the treatment options for partial and total edentulism. With this background, we have studied biological strategies for reducing the time required for osseointegration and for regenerating enough alveolar bone mass, e.g., investigation of the specific genes for osseointegration between titanium and bone, nano-level surface modification of the titanium, biodegradable apatite foam for alveolar bone regeneration, application of bone formation-related growth factors with biological scaffold, and autologous cell transplantation of bone marrow derived mesenchymal stem cells. In this article, we review the current status of regenerative medicine being applied in prosthodontics and discuss our future research direction.

Alveolar Process↗
PubMed2005

Treatment outcomes for adolescent ectodermal dysplasia patients treated with dental implants.

UNLABELLED: To evaluate dental implant survival in patients with ectodermal dysplasia (ED). To assess patterns of hypodontia in this patient group. METHOD: . A retrospective analysis of the use of dental implants in ED patients treated at the Royal Children's Hospital, Melbourne. RESULTS: Sixty-one implants were placed into 14 patients (nine male and five female). The mean age of patients receiving maxillary implants was 18 years 6 months (range 17 years 9 months-20 years 0 months) and mandibular implants was 17 years 5 months (range 12 years 2 months-21 years 11 months). The mean follow-up period was 3 years 4 months (range 1 year 18 months-5 years 1 month). Forty-three implants were placed in the anterior mandible, three in the posterior mandible and the remaining 15 in the anterior maxilla. Of the 61 implants placed, 54 [88.5%] successfully integrated and were able to be restored. Three of the 15 implants placed into the anterior maxilla [20%] failed, while four of the 46 in the anterior mandible failed [8.7%]. Five of the 14 patients [35.7%] had at least one implant fail prior to abutment connection. At the 12-month review appointments, 41 of the integrated 54 implants [76%] were reviewed and classed as successful, giving an overall success at follow up of 67.2%. Thirteen implants [21.3%] were unable to be reviewed owing to geographical reasons. Teeth most likely to be present in the maxilla were the central incisors [71%], first molars [54%] and canines [43%], whereas in the mandible they were the canines [53%] and the first premolars and first molars [40%]. CONCLUSIONS: Dental implants can be placed, restored and loaded in ED patients. Maxillary teeth most likely to be present are the central incisors, canines and first molars, whereas in the mandible the canines, first premolars and molars are most likely to be present. Prior to cessation of growth, implant placement in the symphyseal region of the anterior mandible may be performed with caution. Despite the limited numbers and with due consideration to jaw development, the results support the continual use of endosseous dental implants in this group of patients for optimal clinical outcomes.

Adolescent↗
PubMedDate not supplied

In vivo performance of a modified CSTi dental implant coating.

Cylindrical dental implants coated with cancellous structured titanium (CSTi) were studied in a dog model. CSTi-2-coated and hydroxyapatite-coated (HA) implants were placed in 8 mongrel dogs. The porosity of the CSTi-2 coating was 9% less than that of the previously studied CSTi-1, resulting in greatly improved mechanical strength and cosmetic appearance. A slightly lower level of bone ingrowth was observed for CSTi-2 than for CSTi-1. However, the in vivo attachment strength of the CSTi-2 coating was comparable both to CSTi-1 and to an HA-coated control after 8 weeks. Measured porosity is technique dependent; digital analysis of in vitro samples yielded higher porosity values than in vivo histology cross sections.

Animals↗
PubMed2002

[Implant fracture: a complication of treatment with dental implants--review of the literature].

Dental implants are a functional and esthetic solution to partial and total edentulism. The initial success rate of this treatment modality is 90-95%. But, that treatment modality is not free of complications. One of the rare complications yet, with severe clinical results is fracture of dental implants. The current literature review presents the various causative factors that may lead to implant fracture. Implant failures may be sorted into groups by the timing of their appearance, or by the origin of failure. Fractures belong to the group of late complications, caused by a biomechanical overload. Overload may be caused by inappropriate seat of the superstructure, in-line arrangement of the implants, leverage, heavy occlusal forces (bruxing, clenching), location of the implant and the size of the implant or metal fatigue. Good clinical examinations and correct treatment plans may reduce the risk of implant fracture.

Biomechanical Phenomena↗
PubMedDate not supplied

Long-term results after placement of dental implants: longitudinal study of 1,964 implants over 16 years.

In a retrospective study, Kaplan-Meier implant survival analyses were conducted on 883 patients with 1,964 implants of various systems placed, followed up, documented, and statistically evaluated at an oral surgery and dentistry practice between January 1981 and January 1997. The goal of this study was to evaluate the success of osseointegrated implants of the Brånemark, Frialit-1 (Tübinger Implant), Frialit-2, and IMZ systems and Linkow blade implants. For all systems, mandibular implants were generally more successful than maxillary implants. The preprosthetic loss rate was 1.9%, and 4.3% of implants were lost after prosthetic treatment. The lowest loss rates were seen with implants in intermediate and distal extension spaces and with single-tooth replacements using IMZ, Frialit-2, and Brånemark implants. In edentulous arches, implants of the IMZ and Brånemark systems had the lowest failure rates.

Adolescent↗
PubMed2000

The Procera abutment--the fifth generation abutment for dental implants.

The Brånemark dental implant has undergone progressive development in terms of both the implant body itself and the components connecting the implant to the prosthesis. Many screw and abutment designs have been developed, with various degrees of success. About 15 years ago, CAD (computer-assisted design)-CAM (computer-assisted manufacture) technology was introduced to dentists. More recently CAD-CAM has been used in the manufacture of abutments for implants. This article reviews currently available techniques for creating the Procera custom abutment (Nobel Biocare, Göteborg, Sweden) and outlines appropriate applications for this type of implant.

Computer-Aided Design↗
PubMed1984

Implant-tissue interface of endosseous dental implants in dogs. validity of clinical evaluation methods.

Plaque and gingival bleeding were scored and probing, radiography, and histologic methods were used to evaluate clinical methods for estimating alterations of supporting structures at functioning endosseous dental implants. Twelve implant abutment posts in three Labrador retriever dogs were assessed. The observation period was 3 months of submerged healing followed by 6 months in function. In the presence of daily gingival cleaning, both plaque and gingival bleeding scores were reduced on implant abutments. No correlation was found between gingival scores and the degree of bone resorption. The correlation between probing and radiographic measurements was studied by comparing 136 parallel measurements. The average difference was 0.4 mm. Discrepancies were observed when evaluating bone loss that reached the shoulder area. Better accordance was obtained when moderate (2 to 4 mm) or extensive (6 to 8 mm) resorption was assessed. Histologic evaluation indicated alternating regions of implant-bone contact and fibrous encapsulation. Progressive infiltrates were observed in the permucosal area, sometimes extending into the deeper parts of the supporting bone. A combination of probing and radiographic measurements seems to give the most reliable information about the level of bone support and is recommended to be included in routine control of implant abutments.

Alveolar Process↗