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At least 1,423 records · Page 79Linked to original sources
PubMed2004

Sinus floor augmentation with simultaneous placement of dental implants in the presence of platelet-rich plasma or recombinant human bone morphogenetic protein-7.

The aim of the present study was to evaluate the possible benefit of platelet-rich plasma (PRP) in sinus grafting as compared with recombinant human bone morphogenetic protein-7 (rhBMP-7). For this purpose, we performed a bilateral sinus augmentation with anorganic bovine bone and simultaneous insertion of a titanium screw implant in five miniature pigs. Six hundred microliters of PRP and 15%-vol. autologous bone, which was collected with a trap during preparation of the implant recipient site, were added to the right sinus and 420 microl rhBMP-7 to the left sinus. A polychrome sequential labeling was performed. The animals were sacrificed 6 weeks after surgery. Undecalcified ground sections were evaluated by microradiography, digitized histomorphometry and under fluorescent light. The mean bone-implant contact using rhBMP-7 was 45.8% and 5.7% under PRP (P=0.002). The mean height of newly mineralized bone in the augmented area using rhBMP-7 amounted to 8.3 mm as opposed to 3.6 mm under PRP (P=0.013). Using PRP, the mean area of the newly formed bone was enhanced (51.3%) as compared with rhBMP-7 (33.1%); however, this difference was not statistically significant (P=0.081). In conclusion, under the selected experimental conditions the use of rhBMP-7 led to superior outcomes with regard to the osseointegration of dental implants and the height of new bone as compared with the use of PRP.

Animals↗
PubMed2000

Factors affecting late fixture loss and marginal bone loss around teeth and dental implants.

BACKGROUND: The predictability and high success rate of implant treatment have averted attention from factors affecting fixture loss and bone loss around implants. PURPOSE: The goal of this study was to retrospectively evaluate late fixture loss and marginal bone loss around implants that have been in function for 5 years and to relate these findings to bone loss in the natural dentition. MATERIALS AND METHODS: One hundred and forty-three consecutively treated patients who had received an implant-anchored fixed prosthesis and completed a 5-year follow-up were selected. Intraoral and panoramic radiographs were used to assess bone loss. RESULTS: The bone loss was greater around remaining implants in patients who had lost implants after loading. No correlation was found between bone loss around implants and that around teeth. Only 2% of the fixtures were lost during 5 years of functional load. Most fixtures losses occurred in the edentulous maxilla. Seven of the nine patients who lost fixtures were smokers. CONCLUSION: These findings show that patients who lost implants also lost more bone around the remaining implants. There was no correlation between bone loss around implants and that around teeth, indicating that different interacting mechanisms are involved.

Aged↗
PubMed1996

Aesthetic and functional reconstruction with the trapezius osseomyocutaneous flap and dental implants in oral cavity cancer patients.

The trapezius osseomyocutaneous flap is the only pedicled flap that is able to transfer vascularized bone for mandibular reconstruction as well as skin for intra-extra oral reconstruction. The trapezius muscle also helps to fill the defect created by the neck dissection and covers the vessels of the neck. This flap has been used in our maxillofacial surgery service during the past 14 years. In spite of having incorporated microvascular flaps in our reconstructive techniques it continues to be one of the flaps we use in selected patients for bone and soft tissue compound defects of the oral cavity. We describe in this article our experience using this flap with dental implants in order to achieve a functional reconstruction. We also discuss when we use this flap for mandibular reconstruction and when a free vascularized flap is used.

Acromion↗
PubMedDate not supplied

Reconstruction of severely resorbed alveolar ridge crests with dental implants using a bovine bone mineral for augmentation.

This study reviews the outcome of implant placement in 61 patients after augmentation of severely atrophic alveolar bone with a bovine bone mineral, Bio-Oss. Bone augmentation was performed at 4 different sites: alveolar crest width, alveolar crest height, antral cavity, or nasal cavity. After a mean healing time of 11.9 months, 231 implants were placed in Bio-Oss bone. The time of loading of the implants varied between 12 and 113 months. Calculated from the time of implant placement and irrespective of loading time, a survival rate of 80.5% for the individual implants was estimated. In most patients (73%), Bio-Oss was mixed with autogenous bone from the chin. However, the results indicated that autogenous bone may be excluded from the Bio-Oss graft.

Adult↗
PubMed1997

Clinical evaluation of hydroxyapatite-coated titanium plasma-sprayed and titanium plasma-sprayed cylinder dental implants: a preliminary report.

OBJECTIVE: The purpose of this article was to present the preliminary results of a prospective clinical trial comparing titanium plasma-sprayed versus hydroxyapatite-coated titanium plasma-sprayed cylinder (press fit) implants in different regions of the mouth. STUDY DESIGN: Sixty-five subjects met the inclusion requirements. Surgery was done in two phases by four experienced surgeons. Implant placement and abutment connection were separated by 3 to 4 months in the mandible, 6 to 7 months in the maxilla. Patients were assigned to either titanium plasma-sprayed or hydroxyapatite-coated implants on the day of surgery. Implant placement was not stratified for the region of the jaws. Outcome assessment was failure (loss) of an implant before or within 3 months of second phase surgery. RESULTS: Three hundred fifty-two implants equally distributed between titanium plasma-sprayed and hydroxyapatite-coated titanium plasma-sprayed implants were placed in four different sites; anterior maxilla, posterior maxilla, anterior mandible, and posterior mandible. There were a total of 15 failures (4.26%). Overall, titanium plasma-sprayed implants showed a higher but not significant failure rate compared with hydroxyapatite-coated implants (p = 0.06). Although not statistically significant, we believe that a smoking history played an important role in the failure of implants. CONCLUSION: This study suggests that an hydroxyapatite-coating of an implant allows superior initial integration when compared with a titanium plasma-sprayed surface.

Adult↗
PubMed2004

An instrument for the optimal guiding of osseointegrated dental implants.

The purpose of this study was to design an instrument for the optimal guiding of osseointegrated implants intraoperatively to achieve parallelism or desired angulations. Seven patients (4 males and 3 females) were enrolled in the investigation. They ranged in age from 44 to 61 years. Using an instrument designed by the senior author that permitted optimal guiding of the osteotomy instruments (33 Osteofix Oy, Oulu, Finland) we placed in these patients, root form, single stage implants. The difference in angulations between the first and the remaining implants was measured using the abutment replicas on the working models. It was found that the mean deviation angle between the first and the adjacent implant replicas was 2.2 degrees (SD = 0.4 degrees). The largest deviation angles were 2.3 degrees (SD = 0.5 degrees) and 3.1 degrees (SD = 0.8 degrees). The study indicated that the instrument had been designed in a functional manner and that all implants in such relationships can be inserted into their desired positions, either parallel to one another or with the desired angle for the planned prostheses.

Adult↗
PubMed1991

Controlled longitudinal study on the psychological effects of osseointegrated dental implants.

Forty-seven patients participated in a longitudinal study on the psychological effects of the Brånemark implant technique. They were asked to complete questionnaires measuring their psychological well-being and symptom level on two occasions. The first occasion was shortly after the initial prosthetic assessment. Although 29 patients were subsequently accepted for implant treatment, 18 were found to be unsuitable at the later surgical assessment. Both groups of patients were again given the questionnaires approximately 2 years later. The implants were associated with a clinically significant improvement on measures of symptoms and psychological distress, but there was no change in self-esteem. By contrast, the only change in the untreated comparison group was that their level of distress had risen.

Adult↗
PubMedDate not supplied

Evaluation of three different dental implants in ligature-induced peri-implantitis in the beagle dog. Part I. Clinical evaluation.

The purpose of this study was to clinically evaluate experimental peri-implant breakdown. Hydroxyapatite-coated, titanium plasma-sprayed, and machined titanium-alloy surfaces were investigated. Eighty-four implants were placed in 14 beagle dogs. Pocket probing depths and clinical attachment level and mobility measurements were made. Dogs were sacrificed at 3 and 6 months. All experimental implants showed a significant loss in clinical attachment level (P < .05). Increased pocket probing depths for experimental implants occurred during the first 2 months, after which a plateau was reached. At the 3- and 6-month evaluation, pocket probing depths at experimental implants were significantly increased (P < .05). No differences among the three implant types were noted for clinical attachment levels and pocket probing depths. In general, greater mobility was found with the titanium-alloy implants than with hydroxyapatite-coated and titanium plasma-sprayed implants (P < .025). In addition, mobility measurements were significantly greater for experimental titanium-alloy implants during the first 3 months (P < .05). Clinical attachment level measurements were most sensitive to peri-implant status. All implants were equally susceptible to ligature-induced peri-implant breakdown. Consequently, meticulous oral hygiene and regular maintenance care are prerequisites for successful implantology.

Alloys↗
PubMed1997

Flexible (Polyactive) versus rigid (hydroxyapatite) dental implants.

In a beagle dog study, the peri-implant bone changes around flexible (Polyactive) and rigid hydroxyapatite (HA) implants were investigated radiographically by quantitative digital subtraction analysis and by assessment of marginal bone height, with the aid of a computerized method. A loss of approximately 1 mm of marginal bone height was observed for both the dense Polyactive and the HA implants, after 6 months of loading. This value appeared to be stable from 12 weeks of loading onward. Along the total length of the implant during the first 6 weeks of loading, both the flexible (dense Polyactive) and the rigid (HA) implants showed a decrease in density. However, after this 6-week period, the bone density around the implants increased, and after 18 weeks the original bone density was reached. The flexible Polyactive implants provoked less decrease in density than the rigid HA implants, although not to a statistically significant level. This finding sustains the hypothesis that flexible implant materials may transfer stresses to the surrounding bone more favorably.

Alveolar Bone Loss↗
PubMed2000

Fatigue properties of hydroxyapatite-coated dental implants after exposure to a periodontal pathogen.

We studied the fatigue properties of rods (4 mm diameter) of hydroxyapatite-coated, titanium alloy implant material after it was exposed to a periodontal pathogen, Actinobacillus actinomycetemcomitans (Aa). We varied the crystallinity of the hydroxyapatite (HA) coating in these rods to the levels of, 60.5%, 52.8%, and 47.8%. Each rod was first inoculated with Aa in the log phase of its growth cycle. After 48 h, we counted the adhered cells. We measured the dissolution of HA coating due to bacterial exposure alone by determining the calcium and phosphate concentrations in the bacterial growth media. Once the adherent bacteria were removed from these rods, we subjected them to 5 million cycles of fatigue testing after immersion in Lactated Ringer's solution. We then determined the calcium and phosphate concentrations in the fatigue media. We found additional coating loss after fatiguing of the samples. This coating loss was a cumulative effect of bacterial exposure and fatigue loading of the hydroxyapatite-coated dental implant alloy. The lower crystallinity sample showed a higher loss of coating within the range of crystallinity studied here. The HA coating in implants during clinical use may undergo such changes, because they are exposed to the same bacteria.

Aggregatibacter actinomycetemcomitans↗
PubMed1989

A comparison of the stress transfer characteristics of a dental implant with a rigid or a resilient internal element.

It has been suggested that there is a unique set of problems associated with joining an implant and a natural tooth with a fixed partial denture. The manufacturer of the IMZ implant system claims that this procedure can be accomplished successfully because of the planned stress-distributing characteristics of their resin internal (intramobile) element. This study compared the difference in the stress patterns generated in photoelastic plastic by an IMZ implant with a resilient or a rigid internal element. Under a standardized cantilever load, the stress patterns were photographed in the field of a circular polariscope. The total stress areas were calculated and a statistical comparison performed. The static load conditions of the model demonstrated no statistical difference between the area of stress pattern generated by an IMZ implant with or without a resilient internal element. Moreover, a single load produced the same deflection of the cantilever beam regardless of which element was interposed.

Alveolar Process↗
PubMedDate not supplied

Immediate loading of dental implants in the completely edentulous maxilla: a clinical report.

PURPOSE: The purpose of this article was to determine whether clinical success can be achieved with immediate loading in the completely edentulous maxilla with endosseous screw-type implants. MATERIALS AND METHODS: The study sample consisted of 34 patients who were edentulous or about to lose all remaining maxillary teeth. The patients underwent an extensive presurgical and prosthetic workup to determine whether they qualified for the study. Sufficient osseous structure to place 6 to 8 implants with a minimum length of 8 mm was required. Provisional prostheses were fabricated either chairside on the day of implant placement or in a laboratory from an impression. The abutments and temporary restorations were placed 48 to 72 hours postsurgery. RESULTS: A total of 236 implants were placed in 34 patients. Sixteen implants were lost in 11 patients; thus the survival rate was 93%. All patients subsequently received definitive maxillary restorations. DISCUSSION: The major cause of implant failure appeared to be micromotion during healing. This was the result of either a non-passively fitting restoration or noncompliance (eg, eating chewing hard foods before the implants had integrated). CONCLUSIONS: This clinical report suggests that immediate loading of implant-supported restorations in the completely edentulous maxilla was a viable treatment alternative for this patient population.

Adult↗
PubMedDate not supplied

Effect of occlusal wear on bone loss and Periotest value of dental implants.

PURPOSE: Occlusal overload may contribute to the loss of osseointegration of oral implants, so some clinicians are reluctant to place implants in patients with signs of bruxism. This study evaluated the effect of occlusal wear as a probable sign of bruxism on bone loss and implant stability. MATERIALS AND METHODS: The study investigated 379 patients who had worn implant-retained or implant-supported restorations for many years. Occlusal wear, patient age and gender, time of prosthetic loading, jaw, location in the dental arch, implant diameter, prosthesis construction, occlusal material, periimplantitis, and loosening of the prosthetic construction were recorded. One implant from each patient was selected for radiographic and Periotest measurements. The implant with the highest bone resorption was chosen. A forward stepwise multiple linear regression analysis was performed to analyze the effect of the explanatory variables on Periotest value and radiographic bone loss. RESULTS: The statistical models could account for part of the variation in bone loss rate and Periotest value. Some influence of time of loading, jaw, and implant diameter on bone loss or Periotest value was formally established. Occlusal wear failed to have any statistical impact on vertical annual bone loss rate or Periotest value. CONCLUSION: This study gave no indication that implants in patients with occlusal wear have an increased bone loss rate or Periotest value.

Adult↗
PubMed2002

A prospective multicenter clinical investigation of a bone quality-based dental implant system.

This article reports the 5-year interim results of an independently monitored, prospective, multicenter clinical trial of a bone quality-based implant design. At six study centers, 495 implants were placed in 151 cases with an average follow-up period of 1.6 years (range: 1.0-3.6 years) after prosthesis delivery. The majority of the implants were placed in D2 or D3 bone to support fixed partial dentures or implant-supported overdentures. Using strict success criteria, there were three implant failures, resulting in a cumulative 99.5% success rate according to Kaplan-Meier survival analysis. Radiographic analysis revealed a mean bone loss of 0.06 mm at 1 year and a bone gain of 0.04 mm at 2 years after prosthesis loading. There were no statistical differences in the results by center, implant type, bone density, area of the mouth, or prosthesis type. The results of this 5-year study revealed a high success rate and limited crestal bone loss in all bone densities by the use of an implant specifically designed for the varying biomechanical conditions and bone quality associated with the human maxilla and mandible.

Alveolar Bone Loss↗
PubMedDate not supplied

Treatment planning for dental implants: considerations, indications, and contraindications.

During the last 10 years the initial concept of osseointegrated implant dentistry as essentially treatment of the heavily resorbed edentulous mandible in older patients has expanded to encompass almost every combination of prosthetic problem. Many factors must be taken into account when planning treatment to ensure a flexible approach which is necessary given the uncertainty in predicting the outcome of difficult cases. The complex, and therefore inherently costly, nature of implant dentistry will inevitably lead the patient to have very high expectations of treatment. It is extremely important for the operator to determine these expectations at an early stage, and if there is any doubt about being able to satisfy them then he or she may be wiser not to proceed (as in all other areas of dentistry, skillful case selection is the key to success). In any event, the patient must be fully appraised of the complications, the potential risks and the benefits of treatment so that they can proceed on the basis of informed consent.

Contraindications↗
PubMedDate not supplied

Dental implants in edentulous adults with cognitive disabilities: report of a pilot project.

Individuals with cognitive disabilities face many barriers to oral care, often suffering from partial or complete edentulism. While the use of implant reconstruction is becoming more common in the general population, such care is still being used infrequently in individuals with intellectual impairment. A pilot project in 1995 surgically placed and restored implant-supported prostheses in six edentulous adults who had varying degrees of cognitive impairment. This report presents the dentists' reconstruction experiences and the patients' follow-up care, and discusses the results in relationship to current literature. Experiences from these patients suggest that behavior during the restorative process, prosthetic complications post placement, and patients' oral hygiene practices should influence patient selection and prosthetic design. Anteriorly placed fixtures and removable designs, which make self-care and repair easier, can be used to treat an edentulous population.

Adult↗