Clinical studies of endosseous dental implants: the good, the bad and the ugly.
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Cannon burs with only one cutting surface and round burs with multiple cutting surfaces were evaluated in preparing bone sites for root form implant placement in five Macaca fascicularis monkeys. The cannon burs did not appear to produce a bone surface more conducive to osseointegration than the round burs. Bone cutting bur designs utilized in implant dentistry should be extensively evaluated and compared.
PURPOSE: The influence of the osteotome technique on the interface reaction of cylinder implants (SLA, ITI) was compared with the interface reaction of conventional implant insertion in an animal model. MATERIAL AND METHODS: A total of 64 implants were placed in the cranial and caudal tibia of 8 Göttinger minipigs. The implant site was prepared either by a conventional technique with drills (control group A) or by the osteotome technique (experimental group B). Bone tissue responses were evaluated by histomorphometry, fluorescence microscopy and scanning electron microscopy after 7 and 28 days of osseointegration. RESULTS: The average initial (7 days) bone-to-implant contact ratio was not statistically significantly different for the osteotome technique (35.88+/-2.94%) than for the control group (43.78+/-3.39%, P<0.095). After 28 days, the bone-to-implant contact ratio became statistically significantly higher when implants were inserted by conventional preparation (44.81+/-3.07% (group B), 63.47+/-4.87% (group A), P=0.003). Whereas fluorescence and immunhistologic examination revealed new bone formation with osteocalcin deposition directly at the implant surface in both groups, the extent of direct bone/implant contact was enhanced in conventionally prepared implant sites. SEM analysis confirmed an intimate bone to implant bond without fibrous tissue formation in places of direct contact at an ultrastructured level. CONCLUSION: Implant placement in conventionally prepared implantation sites is accompanied by an improved interface formation at an early stage of implantation.
Osseointegration's documented success allowing bone and mucosal tissue to tolerate a titanium implant has dramatically expanded the possibilities of dental care. We can now replace extracted teeth. Maintaining implants is different, but simpler than tooth maintenance. There is much interest in quicker procedures, shorter healing times or other materials to see if they can be as successful as CP titanium. Some may prove to be so. In any case, osseointegration has had as much impact on 20th century dentistry as local anesthetics, fluorides and the air rotor. Our practices and curricula, are changing to remain contemporary and ready for the 21st century.
The purpose of this study is to analyze the bone remodeling process after the placement of threaded implants with rough (RBM) and hydroxyapatite coated surfaces (HA) in rabbit tibias using polyfluorochrome sequential labeling. Histomorphometry was performed in order to quantify the amount of each label deposited during the healing period. This work demonstrates the possibility of periodic identification of apatite deposition during bone remodeling around titanium and ceramic implants. It has been concluded that the polyfluorochrome sequential labeling is an important tool for identification of bone remodeling after the insertion of titanium and ceramic implants inside rabbit tibias.
Endosseous oral implants have been used as orthodontic anchorage in subjects with multiple tooth agenesis, and their application under orthodontic loading has been demonstrated clinically and experimentally. The aim of this investigation was to examine three-dimensional (3D) bone and implant finite element (FE) models. The first model assumed that there was no osseointegration and the second that full osseointegration had occurred. These models were used to determine the pattern and distribution of stresses within the ITI-Bonefit endosseous implant and its supporting tissues when used as an orthodontic anchorage unit. The study examined a threaded implant placed in an edentulous segment of a human mandible with cortical and cancellous bone. The results, using both models, indicated that the maximum stresses were always located around the neck of the implant, in the marginal bone. Thus, this area should be preserved clinically in order to maintain the bone-implant interface structurally and functionally.
A model based on a continuously bonded interface predicts high punching stresses at the apex of the implant and low stresses in the cortical plates. A model based on a continuously bonded interface predicts high stiffness and a resultant low implant displacement-load ratio. A model based on a tissue ingrowth-bonded interface predicts uniform distribution of stresses around the implant through the cortical plates. A model based on a tissue ingrowth-bonded interface predicts an implant displacement-load ratio close to the ratio measured with actual implant specimens.
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Single tooth implant systems have been shown to offer a safe and highly predictable option for the replacement of anterior teeth. There is however, a paucity of evidence on the result of trauma to single tooth implant systems, particularly in the vulnerable anterior maxillary area. This article presents a report on the outcome of a traumatic incident to an osseointegrated single tooth implant.
There are many controversies about the long-term prognosis of hydroxyapatite (HA)-coated implants. Failure may be related to compositional and structural changes of the coating occurring during implantation. Two retrieved and two unused HA-coated blade-type implants were examined by stereomicroscopy, secondary electron microscopy, Fourier transform infrared spectroscopy, X-ray diffraction, and electron probe microanalysis. The objective was to investigate the HA morphology, composition, and structure, and to characterize the changes that occurred in the retrieved implant coatings. Retrieved implants presented partial loss of the coating, especially at the apical and mesiodistal edges. Remaining HA was thick and flattened in the cervical and central areas and gradually thinner and rougher towards the apical and mesiodistal edges. Increase of Cl and Mg, decrease of OH, and X-ray diffraction peak broadening were found in the retrieved implant coatings, in comparison with the unused implants. Morphological changes of the retrieved implants seem to depend on stress values in the surrounding bone and on implant mobility. Compositional changes and increased amount of lattice imperfections appeared in the retrieved implant coatings, as a result of ion substitutions in the apatite lattice. However, the present study could not confirm the influence of these changes on implant failure.
This study compared the effect of diameter and length on the pullout force required to extract hydroxylapatite-coated implants from dog alveolar bone. After 15 weeks for integration, implants of 3.0, 3.3, and 4.0 mm diameter and 4, 8, and 15 mm length were pulled. The results showed that the ultimate pullout force correlated strongly to implant length, but not diameter. Cortical bone contributed more to implant retention than cancellous bone.
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