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At least 1,189 records · Page 66Linked to original sources
PubMed1987

Veterans Administration Cooperative Dental Implant Study--comparisons between fixed partial dentures supported by blade-vent implants and removable partial dentures. Part I: Methodology and comparisons between treatment groups at baseline.

This study was conducted to determine whether fixed partial dentures supported by dental implants provide an acceptable alternative to conventional removable partial dentures in patients with Kennedy class I or class II edentulous conditions. The acceptability of the new treatment will be based on success rates, impact on the health of the remaining dentition, masticatory performance, patient satisfaction, and maintenance care and cost. The study was planned also to provide comparisons between two designs commonly used by dentists for fabricating removable partial dentures. The designs differed only in terms of the type of the retainer (clasp type) and tooth support (rest location). A total of 272 patients with Kennedy class I and class II edentulous conditions were assigned on a random basis to one of the treatment groups, 134 to receive a removable partial denture and 138 a fixed partial denture supported by a blade-vent implant. All of the patients were medically screened and met prespecified criteria for oral hygiene, bone support for abutment teeth, and size of the residual ridge. Thirty-four patients were eliminated from the study before completion of their treatment. An additional six patients with early implant failures were reentered in the study and followed up as a separate group. The remaining 232 patients received comprehensive dental care, including removable partial dentures for 118 and fixed partial dentures for 114 patients. A series of examinations, radiographs, masticatory performance tests, patient satisfaction, food selection questionnaires, and dietary history were completed before initiation of the treatment, 16 weeks after the insertion of an RPD or an implant, and thereafter at 6-, 18-, 36-, and 60-month intervals. In addition, patients were seen at 6-month intervals for a recall dental examination, oral prophylaxis, plaque instructions, radiographic survey of the implant, and any needed dental treatment. The randomization stratification approach produced two treatment groups with comparable age, number of remaining maxillary and mandibular teeth, type of opposing dentition, and percent of patients with Kennedy class I and class II edentulous conditions. The mean scores of bone support, tooth mobility, and sulcular depths of abutment teeth were also similar. Significant but comparable improvements in oral hygiene and sulcular depth occurred in the two groups after treatment. The periodontal health scores at the 16-week interval serve as the baseline to measure subsequent changes in periodontal health.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1993

Guided tissue regeneration and endosseous dental implants.

This paper presents an evaluation of the use of the principles of guided tissue regeneration to correct the osseous defects associated with the placement of dental implants. The biologic rationale for the use of supplemental materials, such as decalcified freeze-dried bone allograft, is discussed. The results of this investigation suggest that the use of a physical barrier in combination with a bone allograft can produce successful results in 97% of the defects treated.

Alveolar Bone Loss↗
PubMed2005

Comparison of osteoblast spreading on microstructured dental implant surfaces and cell behaviour in an explant model of osseointegration. A scanning electron microscopic study.

OBJECTIVES: To compare interactions between rat calvarial osteoblasts and titanium dental implants with different microstructured surfaces. MATERIAL AND METHODS: Seven commercially available implants were used. Surfaces included plasma-sprayed, grit-blasted and/or acid-etched, smooth-machined and anodised titanium. Two methods were used to compare cell behaviour: (1) A cell-spreading assay in which percentages of cells at four different stages of attachment were identified by scanning electron microscopy and quantified within a 30 min attachment period. (2) Implants were placed in 'pocket culture' within nylon mesh sacs in contact with explanted calvarial bone fragments for 2 and 4 weeks. RESULTS: Surfaces combining grit blasting and acid etching, of microporous topography, showed significantly enhanced rates of cell spreading in comparison with the others. Differential cell morphology was observed in both suspension assays and pocket cultures. In the latter, cells migrated onto all surfaces. Multicellular layers with extracellular matrix (ECM) were present between the layers and on the material surfaces after 2 weeks. After 4 weeks, cell layers were more consolidated, and microstructures were obscured by layers of cells and ECM. Mineralised tissue was seen in association with ECM on grit-blasted surfaces of rough and smooth microtopography. CONCLUSIONS: The two methods provided complementary information: a rough surface of porous microstructure may enhance the rate of cell spreading. Differentiation and calcification occurred on surfaces of both rough and smooth microstructure.

Animals↗
PubMedDate not supplied

Bone resorption around dental implants placed in grafted sinuses: clinical and radiologic follow-up after up to 4 years.

PURPOSE: The long-term results of endosseous implants depend on the maintenance of bone support. The aim of this study was to evaluate radiologically bone resorption around dental implants placed in grafted sinuses after up to 4 years of function. MATERIALS AND METHODS: Between 1997 and 2001, augmentation of the maxillary sinus floor with alloplastic (Biostite) or xenogenic (Bio-Oss) materials was performed in 34 patients. RESULTS: Eighteen patients participated in the study. Twenty-six sinus augmentations were performed on these 18 patients, and they received 37 implants. The change in marginal bone level around the implants at the mesial side was 1 mm during the first year after the abutment connection, followed by an annual loss of 0.1 mm. The change in marginal bone level around the implants at the distal side was 1.1 mm during the first year after the abutment connection followed by an annual loss of 0.2 mm. DISCUSSION: The implant survival rate observed in this study is in line with data previously reported for patients treated with implants in the posterior maxilla without bone atrophy. The results for implants placed into sinuses grafted with Bio-Oss were similar to the results for implants placed in sinuses grafted with Biostite. CONCLUSION: Although this study involved a limited number of procedures, it confirmed that alloplastic and xenogenic materials can be reliable for bone regeneration in subantral cavities. The angular defects present both at the distal and mesial sides of the implants were comparable to those observed at implants placed in native bone.

Adult↗
PubMed2000

A 3-D FEM analysis of single and multiple screw-root dental implant fixed in a mandible.

Replacement of single tooth using a threaded titanium screw root coated with hydroxyapatite (HA) for faster bone apposition to implant site is common. Uncoated pure titanium is also used for osseointegration. Usually bone fixation of implant takes four to six months in either case. Quite often, a good number of teeth in a mandible or maxilla are replaced. Usually it is often said that bones appear to be well designed from the point of view of structural engineering. The "maximum-minimum law" claimed by Roux is a rational concept that states that bone provides maximum strength with a minimum of construction material. According to this proposition, stress distribution in bone will be almost uniform under a set of loading conditions. This was found to be true in the case of normal human mandibular bone as examined by some Japanese scientists. The present authors are interested in examining the stress distribution during multiple single tooth replacements using 3D-FEM technique to ascertain how the stress pattern changes with such implantation of three screws in a row in the human mandible, as we are in the process of clinical trial of hydroxyapatite coated and uncoated titanium implant. This will be of considerable interest to the dental surgeons, who prompted us to address this problem. Our results depicted the mean values of various stress in cortical and cancellous bone while applying the maximum masticatory load of 50 N in each teeth. The generated stress level is within the safe range of stress for bones. However, such screws cannot be applied to osteoporotic or other diseased mandible where bone strength may be quite low.

Bone Screws↗
PubMed2001

[Guided bone regeneration around dental implants using a bioabsorbable membrane. A pilot investigation in experimental animals].

The aim of this experimental investigation was to evaluate the effect of guided bone regeneration around immediately placed implants using different barrier membranes. Five adult fox hounds were used in this investigation. After extraction of all premolars in the lower jaw, implant osteotomies in the regions of the former premolars and additional buccal bone defects (5 mm x 5 mm) were created. Subsequently, the implants were placed. The defects were treated with one of the following three modalities: (a) guided bone regeneration, using a bioinert expanded polytetrafluoroethylene membrane, (b) no membrane application and (c) guided bone regeneration, using a bioabsorbable membrane made from a synthetic copolymer of lactide and glycolide. After a healing period of six months, the animals were sacrificed and the implants with the surrounding tissues processed for histologic evaluation. The clinical pretreatment defects between the different treatment groups were not statistically different (bioinert membrane group: 4.8 mm; control group: 4.3 mm; bioabsorbable membrane group: 4.9 mm). The remaining histological defects after a healing period of 6 months amounted to 3.2 mm for the nonresorbable group, to 5.6 mm for the control and to 6.3 mm for the bioabsorbable group. A significant difference was observed between the bioinert membrane group and the other two groups. The mineralized bone-to-implant contact in the bioinert membrane group was 52%, in the control group 47% and in the bioabsorbable membrane group 43.3%. The values were not statistically significant different. The results of this study indicate that a partial bone regeneration with bioinert e-PTFE membranes around immediately placed implants is possible. The utilized bioabsorbable polylactide/polyglycolide membrane did not show any bone regenerative effect, and the results did not differ from the control group without membrane application.

Absorbable Implants↗
PubMedDate not supplied

Evaluation of the clinical predictability of hydroxyapatite-coated endosseous dental implants: a review of the literature.

Although the use of hydroxyapatite-coated (HA-coated) endosseous implants in the treatment of dental patients has been established, their clinical predictability remains controversial. This study is an analysis of the clinical predictability and indications for use of HA-coated endosseous implants. This study also discusses the biochemical composition of commercial HA coatings in relation to in vivo predictability, potential concerns, and potential advantages of HA coatings. Clinical studies suggest that HA-coated implants have short-term survival rates (ranging from 6 months to 6 years) that are comparable to short-term survival rates of titanium implants. In addition, clinical data suggest that HA-coated implants may be valuable treatment modalities when placing implants (1) in type IV bone, (2) in fresh extraction sites, (3) in grafted maxillary and/or nasal sinuses, or (4) when using shorter implants (less than or equal to 10 mm). However, long-term controlled studies are required to validate these observations.

Alveolar Bone Loss↗
PubMedDate not supplied

Osteotome single-stage dental implant placement with and without sinus elevation: a clinical report.

Forty-three sites in 16 patients were selected for placement of implants using osteotomes in a single-stage surgical technique. Most sites were treated to enhance bone quality. Sixteen sites in the posterior maxilla had sinus elevation performed in conjunction with implant placement. No soft tissue coverage of the implant cover screw was attempted in either the sinus-elevated or the nonelevated sites. Sinus elevation was significant relative to baseline (mean gain 3.25 mm, P < .01). The implant survival rate was 95.3%.

Dental Abutments↗