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At least 163 records · Page 9Linked to original sources
PubMed2004

Surrogate markers of health after titanium dental implant placement.

PURPOSE: We investigated the effects of dental implants on patient health, as measured by commonly used surrogates of human homeostasis, including hepatic metabolic and synthetic ability, renal regulatory functions, bone turnover, clotting, infection, and inflammation. MATERIALS AND METHODS: Patients enrolled had 1 to 3 mandibular uncoated, endosseous titanium dental implants placed and restored. Patients were evaluated serially over 6 months. Blood and urine tests were collected immediately before and 6 months after implant placement. Paired student t tests were used to compare quantified laboratory values. Nonquantified values were evaluated using the McNamara chi square analysis to assess patterns of change. RESULTS: Thirty-one patients met the inclusion criteria. A total of 53 dental implants were placed. Three values were found to be significantly different between the 2 time periods: total protein (P < .008), lactate dehydrogenase (P < .002), and hematocrit (P < .017). Total protein and lactate dehydrogenase were within the laboratory range of normal and judged to be clinically nonsignificant. On reevaluation, the significant change in hematocrit was entirely accounted for by a single outlier. This was attributed to laboratory error. CONCLUSION: No clinically significant effects on surrogate markers of health were found 6 months after placement of titanium dental implants. This series is the only one in the dental, craniomaxillofacial, and orthopedic literature showing a lack of adverse human health effects after dental implant placement, as measured by accepted surrogate measures of human homeostasis.

Adult↗
PubMed2006

Comparative evaluation of the peri-implant bone tissue mineral density around unloaded titanium dental implants.

OBJECTIVE: The mechanical properties of bone are greatly influenced by the percentages of organic and mineral constituents. Nevertheless, the information about the mineral content on a microscopic scale in peri-implant bone is scarce. The aim of this work was to analyze the bone mineral density of peri-implant bone under different techniques. DESIGN: Five unloaded titanium dental implants with a micro-structured surface (three XiVE plus and two Frialit 2, DENTSPLY-Friadent, Mannheim, Germany) were retrieved from the mandible of five patients after a 6-month period. scanning electron microscopy with backscattered electron signal (BSE), light microscopy (LM) with a double staining technique, fluorescence microscopy and confocal laser microscopy were used for measuring microscopic mineral content variations in peri-implant bone. Histomorphometry and image intensity (grey level) were evaluated using a software package for image analysis. RESULTS: The low mineral density index (LMDI) for LM was of 29.2+/-3.1 (mean+/-S.D.), while the high mineral density index (HMDI) was of 88.2+/-3.6 (mean+/-S.D.). The one-way ANOVA analysis showed a significant difference (P<0.001) among the groups. The pairwise Holm-Sidak test identified the differences among HMDI indexes for both LM and SEM values and also for cross-evaluation of the LMDI and HMDI values. The comparison between LMDI indexes for both SEM and LM did not show any significance. The fluorescence microscopy analysis showed clearly the difference between old (high mineralized) and new (low mineralized) bone tissue near the implant surface. Under confocal laser microscopy the same sections showed the area of bone modelling closest to implant surface. CONCLUSION: In this study it was found that bone around unloaded implants showed a low mineral density index under all the investigation methods used. It was also found that the conventional LM technique with the double staining method was able to intensely stain the bone area with a low mineral content.

Analysis of Variance↗
PubMed2003

Current trends in immediate osseous dental implant case selection criteria.

As endosseous dental implant therapy rapidly becomes the prosthetic standard of care for a vast array of clinical applications, we are faced with the challenge of developing dynamic treatment planning protocols. This paper will discuss the clinical benefits of immediate implants and outline a synthesis of case selection criteria garnered from amongst current immediate implant trends. Our immediate findings are that although implants have become widely accepted despite controversial beginnings and the available literature consistently cites high levels of success (ranging from 94 to 100 percent on average), there is no universally agreed upon case selection criteria. Our principal conclusion is that the high success rate of endosseous implant therapy has yet to achieve wide public acceptance and utilization. Overcoming barriers to public utilization will greatly depend on our ability as dentists to appropriately select cases and deliver treatment in a timely and cost-effective manner. Further, developing case selection criteria for immediate dental implants will help to overcome these barriers by increasing treatment success rates and minimizing treatment cost and time.

Alveolar Process↗
PubMed2006

Predictors of dental implant survival.

PURPOSE: To summarize dental implant survival rates under a variety of clinical conditions and identify prognostic variables associated with implant survival. MATERIALS/METHODS: The articles reviewed in this paper were designed as retrospective cohort studies and composed of three subject cohorts having implants placed between 1992 and 2003. The prognostic variables were categorized as demographic/health status, anatomic, implant-specific, prosthetic, and perioperative/operative. The primary outcome variable was duration of implant survival. Kaplan-Meier methods were used to estimate implant survival rates. Multivariate Cox proportional hazards models were used to identify prognostic variables. RESULTS-During the study interval, 921 subjects had 2996 implants placed. Implant survival rates at one year ranged from 90.3 percent for immediate-load implants to 96.2 percent for implants inserted into grafted sinuses. The five-year survivals ranged from 87.9 percent (sinus graft cases) to 91.2 percent (all implants). Frequently cited prognostic variables included tobacco use and implant staging. Other prognostic variables identified included implant length, well size, implant coating, and timing of implant placement relative to tooth extraction. CONCLUSION: Using implants to replace missing teeth is a predictable procedure with five-year survival rates approximating 90 percent. Some of the prognostic variables identified in these studies are under the control, at least to some degree, of the clinician and may be manipulated to enhance implant survival.

Age Factors↗
PubMedDate not supplied

[An automated system for the collection and processing of clinico-diagnostic information in developing methods for treating dental defects by using dental implants].

A dialogue medical information system "Dental Implant" is described, intended for the collection and analysis of clinico-diagnostic information with the aim of developing methods for the treatment of patients with dentition defects, making use of dental implants. This automated system permits a rapid and effective analysis of surgical and orthodontic complications and is intended for operation by a non-programmer.

Computer Systems↗
PubMed2004

Immediate loading with mini dental implants in the fully edentulous mandible.

The use of immediate loaded prostheses is not recommended for at least 2 weeks to prevent implants from premature loading. In addition, immediate removable prostheses are negated for at least 4 weeks at the site of guided bone regeneration or bone graft. However, patients are often not pleased with limited diets and the unaesthetic appearance during the healing period without a denture between implant placement and final prosthesis. Mini dental implants provide stable and esthetic temporary prostheses immediately after implant placement and bone grafts. The use of mini dental implants is simple and cost effective because the patient's old denture is used as a provisional prosthesis. This article shows the success of 27 mini dental implants that were placed for 11 mandibular fully edentulous patients.

Adult↗
PubMed1992

FDA and ADA evaluation of dental implants.

The FDA classification of endosseous dental implants (EDI) is reviewed. Factors impacting the long-term efficacy of dental implants and the guidelines for development of EDI are enumerated. The role of the ADA in evaluation of EDIs is also discussed. Recommendations for development of performance criteria and reporting format are made.

American Dental Association↗
PubMed2006

Parallel screw cylinder implants: comparative analysis between immediate loading and two-stage healing of 1,005 dental implants with a 2-year follow up.

BACKGROUND: Recently, several authors have focused on the possibility of an immediate functional loading of dental implants to minimize the delay between surgical and prosthetic phases. PURPOSE: The aim of this study was a reevaluation of the XiVE dental implant (Dentsply-Friadent, Mannheim, Germany) with: (1) a longer follow-up period; (2) a higher number of fixture; and (3) a proper statistical method. MATERIALS AND METHODS: In July 2001 and December 2002, 371 patients (180 males and 191 females; ages ranging from 17 to 83; mean age, 53 years) were consecutively enrolled in this study. In 371 patients, a total of 1,005 XiVE dental implants were distributed as follows: 484 immediately loaded implants (test group) were inserted in 130 patients, whereas 521 unloaded implants were inserted in 241 patients (control group). RESULTS: The implant survival was 98.7 and 99.4% in immediate loading and control group, respectively. Univariate analysis showed no statistically significant difference between the two groups. CONCLUSION: In a previous report, we showed that immediate loading offered a predictable and reliable procedure also for XiVE implants, at least in the short period. In this study, we confirmed the results of the previous study and added information regarding the survival rate and marginal bone level stability with a 2-year follow up.

Adolescent↗
PubMed2005

Dental implant use in New Zealand in 2004.

OBJECTIVE: To investigate the characteristics of dental implant providers in New Zealand, to evaluate providers' dental implant treatment strategies, and to determine the nature of barriers to implant usage in New Zealand. DESIGN: A postal survey questionnaire was sent to all registered dentists in New Zealand (N=1590). METHOD: Data were analyzed with the SPSS statistical package. RESULTS: Replies were received from 1005 (63.2 percent) of the surveyed dentists. The majority of dentists (76.2 percent) are interested in dental implants and promote them in their practices. Implant dentistry is performed by 49.5 percent of the respondents, with the prosthodontic aspects of implant dentistry are performed by 79.5 percent of these dentists, while the surgical stage is referred to specialists in 89.0 percent of the cases. The greatest barrier to dental implant treatment is cost. Implant dentistry is most often provided when there is financial support from ACC. CONCLUSIONS: The extent of dental implant use in New Zealand is still relatively limited. Dentists understand the benefits of dental implant therapy, but the perceived expense of treatment prevents optimal utilization.

Chi-Square Distribution↗
PubMed2003

Long-term functional loading of dental implants in rhBMP-2 induced bone. A histologic study in the canine ridge augmentation model.

Osseointegration [direct bone-implant contact (BIC)] is a primary goal following installation of endosseous dental implants. Such bone contact provides stability for the dental implant over time. The objective of this study was to evaluate bone formation and BIC at long-term, functionally loaded, endosseous dental implants placed into bone induced by recombinant human bone morphogenetic protein-2 (rhBMP-2) in an absorbable collagen sponge (ACS) carrier. Mandibular, saddle-type, alveolar ridge defects (approximately 15 x 10 x 10 mm), two per jaw quadrant, were surgically induced in each of six young adult American fox hounds. The defects were immediately implanted with rhBMP-2/ACS. Two defects per animal additionally received a nonresorbable expanded polytetrafluoroethylene (ePTFE) membrane or a bioresorbable polyglycolide fiber membrane. Healing was allowed to progress for 3 months, when the ePTFE membrane was removed, and machined, threaded, titanium dental implants were installed into the rhBMP-2/ACS induced bone and into the adjacent resident bone. At 4 months of osseointegration, the implants were exposed to receive abutments and prosthetic treatment (two- or three-unit bridges). Some implants were removed for histologic analysis. The remainder of implants were exposed to functional loading for 12 months at which time the animals were killed for histometric analysis. One animal died prematurely due to kidney failure unrelated to the experimental protocol and was not included in the analysis. The 12-month block sections from a second animal were lost in the histological processing. Four sites receiving rhBMP-2/ACS and ePTFE or resorbable membranes experienced wound failure and membrane exposure, and subsequently exhibited limited bone formation. Defects without wound failure filled to contour with the adjacent alveolar bone. The newly formed bone exhibited features of the resident bone with a re-established cortex; however, it commonly included radiolucent areas that resolved over time. Dental implants block biopsied at 4 months exhibited limited, if any, crestal resorption, whereas those exposed to functional loading for 12 months exhibited some crestal resorption. Implants biopsied at 4 months exhibited a mean (+/- SD) BIC of 40.6 +/- 8.2% in rhBMP-2/ACS induced bone vs. 52.7 +/- 11.4% in resident bone. Dental implants exposed to 12 months of functional loading exhibited a mean BIC of 51.7 +/- 7.1% in rhBMP-2/ACS induced bone vs. 74.7 +/- 7.0% in resident bone. There were no significant differences between dental implants placed into rhBMP-2/ACS induced bone and resident bone for any parameter at any observation interval. In conclusion, rhBMP-2/ACS-induced bone allows installation, osseointegration, and long-term functional loading of machined, threaded, titanium dental implants in dogs.

Alveolar Bone Loss↗
PubMed2006

Risk factors for endosseous dental implant failure.

Failures of endosseous dental implants are rare and tend to cluster in patients with common profiles or risk factors. Clinical trials indicate that factors related to implant devices, anatomy, occlusion,systemic health or exposures, microbial biofilm, host immuno-inflammatory responses, and genetics may increase the risk for im-plant complications or loss. In general, factors associated with the patient appear more critical in determining risk for implant failure than those associated with the implant itself. Several risk factors can be modified. For example, the patient can modify smoking and the clinician can modify implant selection, site preparation,and loading strategy. In identifying these factors and making appropriate interventions, clinicians can enhance success rates while improving oral function, esthetics, and patient well-being.

Dental Implantation, Endosseous↗
PubMed1995

[Dental implants: one or two stages?].

Dental implants can be inserted in one or two stages. The promoters of the two stages implant systems believe that submersion is essential for osseointegration. Animal and human studies, however, have shown that implants can also be successful when the one stage procedure is used. In this article the principles and the (dis)advantages of both procedures are discussed.

Animals↗
PubMed1999

Controlled subperiosteal tissue expansion to facilitate GBR for the placement of endosseous dental implants.

The success of endosseous dental implants is enhanced when sufficient bone is present to stabilize the implant. If adequate bone for full coverage of the implant is not possible, then the use of guided bone regeneration to regenerate the missing bone has been shown to be a predictable solution. Defect size can often limit the amount of soft tissue available for coverage of the membrane, which is essential in obtaining an optimal result when using regenerative and osseointegrative principles. The treatment philosophy demonstrated in this case report uses controlled subperiosteal tissue expansion to facilitate the incorporation of guided bone regeneration with the subsequent placement of endosseous dental implants. This treatment modality provided a successful treatment for an otherwise compromised case.

Adult↗
PubMed2003

External and occlusal trauma to dental implants and a case report.

Dental implants subjected to traumatic forces can survive. Cortical bone seems to provide a protective energy-absorbing mechanism in the collagen polymer that helps to prevent microcracking and fracture of bone. The collagen polymer has cross-linking bonds that break and absorb the energy of a traumatic impact so as not to cause damage to the main polymer chain. A case reported demonstrates that a traumatic force damaged the implant prosthetic crown, but not the bone encasing the implant or the integration of the implant.

Adult↗
PubMed1982

The influence of implant geometry on the stress distribution around dental implants.

A three-dimensional finite element stress analysis has been used to investigate the influence that variations in the infrastructural geometry of a blade-type dental implant have on the stress distribution around LTI carbon and aluminum oxide implants. The finite element model was constructed based upon an analysis of serial sections of a retrieved implant specimen. In addition to the implant, the finite element model contained a three-unit fixed bridge connected to a natural molar with periodontal membrane. The removal of the bridge allowed for the study of freestanding implants and molar. Variations of the implant blade geometry were found to produce significant changes in the stress distributions around bridged and freestanding aluminum oxide implants. Very little effect, however, was observed around the LTI carbon implants. A comparison of the stresses around the freestanding molar and the stresses around the bridged and freestanding implants was made to determine the implant design that came closest to reproducing the stress state around the modeled molar. The LTI carbon system that best achieved this stress state was found to be a full-blade implant used in conjunction with a tooth as an abutment in a fixed bridge. The aluminum oxide system that best achieved this stress state was found to be of the post or short-blade design used as a freestanding implant.

Aluminum Oxide↗
PubMed2003

Interventions for replacing missing teeth: dental implants in zygomatic bone for the rehabilitation of the severely deficient edentulous maxilla.

BACKGROUND: Dental implants are used for replacing missing teeth. However, the possibility of placing dental implants is limited by the presence of adequate bone volume permitting their anchorage. Several bone grafting procedures have been developed to solve this problem. The missing bone can be taken from a donor site, transplanted where needed and then implants are placed. Major bone grafting operations have to be undertaken under general anaesthesia and patients have to be hospitalized for a few days. Some degree of morbidity related to the donor site must be expected and two to three surgical interventions are needed before the implants can be functionally used. Often patients have to wait more than 1 year before a denture can be fixed to the implants and the total cost of the treatment is high. However, the major problem is that about 25% of the implants placed in grafted bone fail. Zygomatic implants are long screw-shaped implants developed as an alternative to bone grafting. Zygomatic implants are inserted into the body of the zygomatic bone. Their main advantages are that bone grafting may not be needed and patients may be fitted with a fixed denture much sooner. OBJECTIVES: To test the hypothesis of no difference in outcomes between zygomatic implants without bone augmenting procedures in comparison with conventional dental implants in augmented bone for severely resorbed maxillae. SEARCH STRATEGY: We searched the Cochrane Oral Health Group's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE. We handsearched several dental journals. No language restrictions were applied. Personal contacts and manufacturers of dental implants were contacted to identify unpublished trials. Most recent search: February 2003. SELECTION CRITERIA: Randomised controlled clinical trials (RCTs) on patients with severely resorbed maxillae who could not be rehabilitated with conventional dental implants, treated with zygomatic implants without bone grafts versus conventional dental implants with bone grafts or other procedures for bone augmentation with a follow up of at least 1 year. Outcome measures considered were: prosthesis and implant failures, side effects, patient satisfaction and cost effectiveness. DATA COLLECTION AND ANALYSIS: Screening of eligible studies, assessment of the methodological quality of the trials and data extraction were to be conducted in duplicate and independently by two reviewers. Results were to be expressed as random effects models using weighted mean differences for continuous outcomes and relative risk for dichotomous outcomes with 95% confidence interval. Heterogeneity was to be investigated including both clinical and methodological factors. MAIN RESULTS: No RCTs or controlled clinical trials (CCTs) were identified. REVIEWER'S CONCLUSIONS: There is an urgent need for RCTs in this area, since zygomatic implants, if found to be at least as effective as other augmentation procedures, may involve major advantages for both patients and society.

Alveolar Ridge Augmentation↗
PubMed2004

A targeted review of study outcomes with short (< or = 7 mm) endosseous dental implants placed in partially edentulous patients.

BACKGROUND: Generally, threaded root-form endosseous dental implants are thought to perform poorly in short lengths (i.e., < 10 mm). However, whether modifications in implant surface geometry will improve performance of short threaded implants is less clear. METHODS: The relationship between dental implant failure rates and their surface geometry, length, and location (maxilla versus mandible) was explored in the published literature. Using a MEDLINE search (1985 through 2001), studies were sought with the following criteria: 1) data suitable to calculate failure rates of implant lengths < or = 7 mm versus > 7 mm; 2) data separable into maxillary versus mandibular results; 3) criteria for "failure" clearly defined; and 4) minimal functional period of 2 years. RESULTS: Twelve papers were identified as follows: eight with machined threaded implants, two with acid-treated threaded implants, and two with sintered porous-surfaced press-fit implants. The following results were found: 1) machined surface implants experienced greater failure rates than textured surface implants; 2) with the exception of sintered porous-surfaced implants, 7 mm long dental implants appear to have higher failure rates than those > 7 mm length; and 3) with textured surface implants, higher failure rates were more likely in the maxilla than in the mandible, but with machined surface implants there were no differences in failure rates between maxilla and mandible. CONCLUSIONS: Dental implant surface geometry is a major determinant in how well these implants perform in short lengths, defined here as lengths of < or = 7 mm. While threaded implants show higher failure rates in short versus longer lengths, sintered porous-surfaced implants perform well in the defined "short" lengths. More studies are needed to better assess the performance of short, acid-washed threaded implants.

Analysis of Variance↗