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Endoscopic removal of a dental implant through a middle meatal antrostomy.

Ear nose and throat surgeons use endoscopic operations on the sinuses not only for chronic paranasal sinusitis but also for other operations. We report the case of a 52-year-old woman in whom we used an endoscopic technique to remove a dental implant that had been displaced into the maxillary sinus. We approached the sinus through the natural ostium, and the foreign body was removed through the widened ostium.

Dental Implants↗

A histologic evaluation of eight cases of failed dental implants: is bone overheating the most probable cause?

Biomechanical overloading has been stated to be, overall, the major cause of implant failures. Very important can be, however, in the etiopathogenesis of early implant failure, the overheating of the surgical site. The authors present eight cases of implant loss most probably due to bone overheating, even if other causes cannot be excluded. The microscopical picture, in all cases, was composed by the same features: (1) presence of bone sequestra; (2) no regeneration of the peri-implant bone; (3) presence of an inflammatory infiltrate in the gap between bone and implant; (4) no organization of the peri-implant bone clot; (5) presence of a compact and mature bone around the implant; (6) presence of bacteria around the implant and the necrotic bone.

Biomechanical Phenomena↗

Evaluation of accuracy of insertion of dental implants and prosthetic treatment by computer-aided navigation in minipigs.

The survival of loaded implants is critically dependent on their biomechanical stability. We have used a computer-guided navigation technique to evaluate the accuracy of computer-assisted insertion for immediately-loaded implants in minipigs. On the basis of computed tomographical data, the Robodent system was used for preoperative planning and guidance of inserting the implant. An optical tracking system allowed positioning of the implant and immediate prosthetic rehabilitation by inserting it in a plaster model and during the operation. Postoperative computed tomograms (CT) showed that the implants were placed precisely in the preoperatively planned position. The accuracy achieved corresponded well with the spatial resolution of the CT used. Immediate placement of the prefabricated crowns resulted in favourable occlusal positioning. Histological cross-sections showed that the implants were biomechanically stable. The accuracy of insertion of oral implants illustrated here suggests that insertion and prosthetic modelling of implants may benefit from computer-assisted navigation.

Animals↗

Is osteoporosis a risk factor for osseointegration of dental implants?

The success of osseointegration depends in part on the state of the host bed. Concerns have therefore been raised about osteoporosis, a condition believed to be associated with a decrease in bone quality and quantity. However, the orthopedic literature indicates that osteoporotic fractures heal readily and that the level of bone mass and estimates of the parameters associated with bone remodeling present considerable overlap between patients with osteoporosis and control subjects. It also appears that osteoporosis, as diagnosed at one particular site of the skeleton, is not necessarily seen at another distant site. Although the prevalence of osteoporosis increases among the elderly and after menopause, the results of this study indicate that implant failure rate is not correlated with age and sex. A review of the literature and of results of a series of patients treated does not provide a compelling theoretical or practical basis to expect osteoporosis to be a risk factor for osseointegrated dental implants.

Adult↗

Nifedipine-induced gingival enlargement around dental implants: a clinical report.

Calcium channel-blocking agents are used extensively for the management of cardiovascular conditions, including angina pectoris, coronary artery spasm, cardiac arrhythmias, and hypertension. Gingival overgrowth around natural teeth has been previously reported in the literature with patients taking calcium channel-blocking agents. This clinical report describes hyperplasia of tissues around titanium dental implants in a patient taking Nifedipine along with the multiphasic approach to treating this medication-induced hyperplasia of the peri-implant tissues.

Animals↗

Influences of some background factors on the subjective need for dental implants in a Swedish population.

On the basis of a questionnaire sent to 3000 randomly sampled individuals aged 45-69 years and living in an average Swedish county (response rate, 79.4%), the influences of some demographic socioeconomic, and attitude variables on the subjective need for treatment with dental implants were studied in stepwise logistic regression models. The overall influence of these background factors was rather limited. Instead, the most important single factor seemed to be dental status. For the subjects wearing removable partial dentures, low education was significantly related to a low subjective need for implant treatment. For the totally edentulous group of subjects, low income was most significantly associated with a low subjective need for implant therapy.

Aged↗

ICP-MS multielemental determination of metals potentially released from dental implants and articular prostheses in human biological fluids.

A sector field high-resolution (HR)-ICP-MS and an octapole reaction system (ORS)-ICP-MS have been compared for the simultaneous determination of traces of metals (Ti, V, Cr, Co, Ni, and Mo) released from dental implants and articular prostheses in human biological fluids. Optimum sample treatments were evaluated to minimize matrix effects in urine and whole blood. Urine samples were diluted tenfold with ultrapure water, whereas whole blood samples were digested with high-purity nitric acid and hydrogen peroxide and finally diluted tenfold with ultrapure water. In both matrices, internal standardization (Ga and Y) was employed to avoid potential matrix interferences and ICP-MS signal drift. Spectral interferences arising from the plasma gases or the major components of urine and whole blood were identified by (HR)-ICP-MS at 3,000 resolving power. The capabilities of (HR)-ICP-MS and (ORS)-ICP-MS for the removal of such spectral interferences were evaluated and compared. Results indicate that polyatomic interferences, which hamper the determination of such metallic elements in these biological samples, could be overcome by using a resolving power of 3,000. Using (ORS)-ICP-MS, all those elements could be quantified except Ti and V (due to the polyatomic ions 31P16O and 35Cl16O, respectively). The accuracy of the proposed methodologies by (HR)- and (ORS)-ICP-MS was checked against two reference materials. Good agreement between the given values and the concentrations obtained for all the analytes under scrutiny was found except for Ti and V when analyzed by (ORS)-ICP-MS.

Cartilage, Articular↗

Immediate loading of dental implants placed in distracted bone: a case report.

A 40-year-old female patient presented for rehabilitation of an edentulous mandible with endosseous implants. Radiologic examination showed evidence of moderate atrophy in the intraforaminal area and an even more pronounced level of bone resorption in the posterior mandible. The patient desired a fixed rehabilitation with re-establishment of the posterior occlusal plane. From an esthetic standpoint, it was necessary to provide a restoration with crowns the same height as the original teeth while avoiding an unfavorable biomechanical situation. Vertical distraction of the complete mandible was performed using a Martin distractor according to the Hoffmeister technique. At the end of the period of activation and consolidation, the distractor was removed and 8 Frialit-2 Synchro-type implants were placed in predetermined sites and immediately loaded with a cemented transitional prosthesis. Ten months later the definitive restoration was delivered. The absence of any pathologic symptoms or negative radiologic findings 12 months after the surgery suggests a satisfactory result in the short term.

Adult↗

Radiation absorbed from dental implant radiography: a comparison of linear tomography, CT scan, and panoramic and intra-oral techniques.

Absorbed radiation dose in bone marrow, thyroid, salivary gland, eye, and skin entrance was determined by placement of lithium fluoride thermoluminescent dosimeters (TLD's) at selected anatomical sites within and on a human-like x-ray phantom. The phantom was exposed to radiation from linear tomographic and computer-assisted tomographic (CT) simulated dental implant radiographic examinations. The mean dose was determined for each anatomical site. Resulting dose measurements from linear tomography and computer-assisted tomography are compared with reported panoramic and intra-oral doses. CT examination delivered the greatest dose, while linear tomography was generally lowest. Panoramic and intra-oral doses were similar to those of linear tomography.

Dental Implantation, Endosseous↗

Guided bone regeneration for dental implants.

The application of barrier membranes to promote bone regeneration was first described by Hurley et al. (J Bone Joint Surg 1959, 41A:1243-1254) in orthopedic research. However, the clinical potential of this membrane technique was recognized in the early 1980s for periodontal regeneration. Based on promising results in periodontology, researchers started to evaluate the potential of this technique--often called guided bone regeneration (GBR)--to regenerate bone defects in the alveolar process. This review describes the current knowledge of GBR in implant dentistry. Emphasis is placed on the scientific basis of GBR and the various surgical factors necessary to achieve predictable results with GBR procedures. In addition, unanswered questions that require future research are addressed including long-term success rates of dental implants placed in combination with barrier membranes, evaluation of resorbable membranes, and use of bone substitutes or growth factors to enhance bone regeneration in membrane-protected defects.

Alveolar Bone Loss↗