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Hamilton A, Gonzaga L, Amorim K, Wittneben JG, Martig L, Morton D, Martin W, Gallucci GO, Wismeijer D. Selection criteria for immediate implant placement and immediate loading for single tooth replacement in the maxillary esthetic zone: A systematic review and meta-analysis. Clin Oral Implants Res 2023; 34 Suppl 26:304-348. [PMID: 37750515 DOI: 10.1111/clr.14109] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 05/20/2023] [Accepted: 05/31/2023] [Indexed: 09/27/2023]
Abstract
OBJECTIVES The aim of this study was to review available evidence for Type 1A (immediate implant placement and immediate loading) of single tooth replacement in the maxillary esthetic zone. MATERIALS AND METHODS An electronic search was conducted utilizing the databases of MEDLINE, Embase, and Cochrane to identify publications reporting on the outcomes of Type 1A for single tooth replacement in the maxillary esthetic zone. The success and survival rates of the included articles were reported, which were further categorized according to the clinical criteria reported in Type 1A. Mean survival rates were univariately compared between risk groups and additionally between studies published before and since 2012 using bias-corrected and study size-weighed bootstrap tests. A study time-correcting meta-analysis was then performed to obtain an overall effect for the study pool. RESULTS A total of 3118 publications were identified in the search, with a total of 68 articles included. A mean number of implants per study were 37.2 and mean follow-up was 2.8 years. All the included studies utilizing Type 1A report highly selective inclusion and exclusion criteria. Univariate risk group comparison determined that studies before 2012 report a significantly lower mean survival rate (difference of -1.9 percentage points [PP], 95% CI: [-0.3, -4.0], p = .02), facial gap dimension had an impact on survival rates (+3.1 PP [0.2, 5.3] for width >2 mm, p = .04), as well as presence of endodontic infection (+2.6 PP [0.9, 5.1], p = .004). CONCLUSIONS Type 1A has a high survival rate in studies reporting strict patient and site selection criteria. Further research is required to assess esthetic and functional success with Type 1A treatments.
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Affiliation(s)
- Adam Hamilton
- Division of Oral Restorative and Rehabilitative Sciences, University of Western Australia, Perth, Western Australia, Australia
- Division of Regenerative and Implant Sciences, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Luiz Gonzaga
- Center for Implant Dentistry, Department of Oral and Maxillofacial Surgery, College of Dentistry, University of Florida, Gainesville, Florida, USA
| | - Karina Amorim
- Center for Implant Dentistry, Department of Oral and Maxillofacial Surgery, College of Dentistry, University of Florida, Gainesville, Florida, USA
| | | | | | - Dean Morton
- Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, Indiana, USA
| | - William Martin
- Center for Implant Dentistry, Department of Oral and Maxillofacial Surgery, College of Dentistry, University of Florida, Gainesville, Florida, USA
| | - German O Gallucci
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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Rai S, Rai A, Kumar T, Kumari M, Somanna MK, Bandgar S. Immediately Loaded Single Unit Dental Implants: A Clinical Study. J Pharm Bioallied Sci 2020; 12:S245-S253. [PMID: 33149465 PMCID: PMC7595488 DOI: 10.4103/jpbs.jpbs_72_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 02/02/2020] [Accepted: 03/02/2020] [Indexed: 11/04/2022] Open
Abstract
Background: Immediate loading of dental implants is an obvious advantage. A long treatment period that involves the wearing of a temporary prosthesis may be of great inconvenience, and is sometimes the reason for not choosing implant-supported restorations at all. Aim: In our study, an attempt was made to immediately load single tooth implants in the aesthetic zone of the dentition. Materials and Methods: Patients were selected from Government Dental College, Patna. Twenty-four single tooth implants were placed in 24 patients; 12 male and 12 female patients desiring replacement of one or more missing teeth in anterior region were selected. Surgery for the placement of the implant was carried out, and implants of the Uniti Implant System were placed. The abutment was then attached and the flap was sutured. A temporary acrylic resin crown was fabricated and cemented on the same day. Permanent prosthesis was inserted on sixth month after implant placement. Results: A clinical study was performed to evaluate the treatment outcomes of dental implants installed according to a one-stage surgical procedure followed by immediate loading with prosthesis. Of the 24 implants, 23 showed signs of successful osseointegration over a 1-year follow-up. Conclusion: Within limits of the evaluated data, it was observed that immediately loaded implants osseointegrate, so this alternative was used over conventional procedures that take 6 months for osseointegration. This has advantages, both for patient and practitioner.
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Affiliation(s)
- Shweta Rai
- Department of Oral and Maxillofacial Surgery, Buddha Institute of Dental Sciences and Hospital, Patna, Bihar, India
| | - Anurag Rai
- Department of Orthodontics, Patna Dental College and Hospital, Patna, Bihar, India
| | - Tanoj Kumar
- Department of Oral Pathology and Microbiology, Patna Dental College and Hospital, Patna, Bihar, India
| | - Minti Kumari
- Public Health Dentistry, Patna Dental College and Hospital, Patna, Bihar, India
| | - Muthyalu Kumar Somanna
- Department of Prosthodontics, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Subhash Bandgar
- Department of Prosthodontics, Nair Hospital Dental College, Mumbai, Maharashtra, India
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Ohyama H, Hamilton A, Forman MS, Weber HP. Comparative Observation of Immediate and Late Placement of Dental Implants With Immediate Loading: A 14-Year Follow-Up Case Report. J ORAL IMPLANTOL 2019; 45:313-318. [PMID: 31008685 DOI: 10.1563/aaid-joi-d-18-00290] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Hiroe Ohyama
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Mass
| | - Adam Hamilton
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Mass
| | - Michael S Forman
- Division of Oral and Maxillofacial Surgery, Columbia University College of Dental Medicine, New York, NY
| | - Hans-Peter Weber
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Mass
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Bukhari SA, Proussaefs P, AlHelal A, Garbacea A, AlBader B, Kattadiyil MT. Use of Implant-Supported Custom Milled Impression Copings to Capture Soft-Tissue Contours and Incisal Guidance. J Prosthodont 2019; 28:473-479. [PMID: 30730087 DOI: 10.1111/jopr.13034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2019] [Indexed: 11/30/2022] Open
Abstract
A technique is presented where a custom milled impression coping is used to replicate the clinically established anterior incisal guidance to the definitive prosthesis when multiple implants are restored in the esthetic zone. A conventional impression is initially made, then the stone cast is scanned, and a digitally designed custom screw-retained, implant-supported interim prosthesis is milled from a polymethylmethacrylate (PMMA) billet. This is aimed to digitally design the pontic areas, contour the gingival soft tissue, and establish an anterior incisal guidance. A custom milled impression coping (CMIC) is then fabricated. The CMIC has contours similar to the contours of the interim prosthesis and is fabricated from a PMMA billet. Titanium inserts are placed in the interim prosthesis and the CMIC. The CMIC is inserted intraorally and used for the final impression by using a custom tray and by following the open tray impression protocol. With the proposed technique, the exact contours of the digitally designed and clinically verified interim prosthesis are used to fabricate the definitive restoration.
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Affiliation(s)
- Sarah A Bukhari
- Division of General Dentistry, Loma Linda University School of Dentistry, Loma Linda, CA
| | - Periklis Proussaefs
- Advanced Specialty Education Program in Implant Dentistry, Loma Linda University School of Dentistry, Loma Linda, CA.,Private prosthodontic practice, Ventura, CA
| | - Abdulaziz AlHelal
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Antoanela Garbacea
- Advanced Specialty Education Program in Prosthodontics and Implant Dentistry, Loma Linda University School of Dentistry, Loma Linda, CA
| | - Bader AlBader
- Division of General Dentistry, Loma Linda University School of Dentistry, Loma Linda, CA.,College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Mathew T Kattadiyil
- Advanced Specialty Education Program in Prosthodontics, Loma Linda University School of Dentistry, Loma Linda, CA
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Bukhari SA, AlHelal A, Proussaefs P, Garbacea A, Kattadiyil MT. Use of Patient's Own Natural Teeth as Part of the Interim Prosthesis on Immediately Placed Single Implants in a Staged Surgical Approach: A Clinical Report. J ORAL IMPLANTOL 2018; 44:351-357. [PMID: 29870306 DOI: 10.1563/aaid-joi-d-17-00292] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
A technique is described where the tooth's natural crown is used as part of the interim implant supported prosthesis in clinical situations where a tooth with poor prognosis is extracted and an implant is placed immediately after tooth extraction. A preliminary impression is made before tooth extraction, and the exact tooth positioning is assessed in the laboratory as part of the treatment plan. An acrylic resin repositioning jig is fabricated that will guide the clinician in seating and orienting the crown intraorally after implant placement is completed. After the natural tooth is extracted and an implant is immediately placed via guided approach, the extracted natural crown is hollowed and placed on top of an interim abutment. The natural crown is positioned intraorally by using the acrylic resin repositioning jig. The crown is then internally relined and placed as part of the interim implant supported prosthesis. After osseointegration has been confirmed, a definitive prosthesis is placed.
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Affiliation(s)
- Sarah A Bukhari
- 1 Advanced Specialty Education Program in Prosthodontics, Loma Linda University School of Dentistry, Loma Linda, Calif
| | - Abdulaziz AlHelal
- 2 Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Periklis Proussaefs
- 3 Advanced Specialty Education Program in Implant Dentistry, Loma Linda University School of Dentistry, Loma Linda, Calif, and private prosthodontic practice, Ventura, Calif
| | - Antoanela Garbacea
- 1 Advanced Specialty Education Program in Prosthodontics, Loma Linda University School of Dentistry, Loma Linda, Calif.,3 Advanced Specialty Education Program in Implant Dentistry, Loma Linda University School of Dentistry, Loma Linda, Calif, and private prosthodontic practice, Ventura, Calif
| | - Mathew T Kattadiyil
- 1 Advanced Specialty Education Program in Prosthodontics, Loma Linda University School of Dentistry, Loma Linda, Calif
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Proussaefs P, AlHelal A. A technique for immediately restoring single dental implants with a CAD-CAM implant-supported crown milled from a poly(methyl methacrylate) block. J Prosthet Dent 2018; 119:339-344. [DOI: 10.1016/j.prosdent.2017.03.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 03/29/2017] [Accepted: 03/29/2017] [Indexed: 02/04/2023]
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A Technique for Duplicating the Contours of an Interim Implant Supported Crown to Fabricate a Custom Impression Coping and the Definitive Prosthesis. IMPLANT DENT 2016; 25:861-865. [DOI: 10.1097/id.0000000000000495] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kattimani VS, Kondaka S, Lingamaneni KP. Hydroxyapatite–-Past, Present, and Future in Bone Regeneration. ACTA ACUST UNITED AC 2016. [DOI: 10.4137/btri.s36138] [Citation(s) in RCA: 122] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Hydroxyapatite (HA) is an essential element required for bone regeneration. Different forms of HA have been used for a long time. The essence of bone regeneration always revolves around the healthy underlying bone or it may be the surroundings that give enough strength. HA is well known for bone regeneration through conduction or by acting as a scaffold for filling of defects from ancient times, but emerging trends of osteoinductive property of HA are much promising for new bone regeneration. Emerging technology has made the dreams of clinicians to realize the use of HA in different forms for various regenerative purposes both in vivo and in vitro. The nanostructured calcium apatite plays an important role in the construction of calcified tissues. The nanostructured material has the ability to attach biological molecules such as proteins, which can be used as functional materials in many aspects, and the capability of synthesizing controlled structures of apatite to simulate the basic structure of bone and other calcified tissues. The process of regeneration requires a biomimetic and biocompatible nanostructured novel material. The nanostructured bioceramic particles are of interest in synthetic bone grafts and bone cements both injectable and controlled setting, so that such composites will reinforce the strength of bioceramics. Extensive research is being carried out for bone regeneration using nanotechnology. Artificial bone formation is not far from now. Nanotechnology has made many dreams come true. This paper gives comprehensive insights into the history and evolution with changing trends in the use of HA for various regenerative purposes.
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Affiliation(s)
| | - Sudheer Kondaka
- Department of Prosthodontics, Lenora Institute of Dental Sciences, Rajahmundry, Andhra Pradesh, India
| | - Krishna Prasad Lingamaneni
- Department of Oral and Maxillofacial Surgery, SIBAR Institute of Dental Sciences, Guntur, Andhra Pradesh, India
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Vasconcellos F, Proussaefs P. A Novel Technique for Replicating the Profile of an Interim Implant-Supported Single Crown on the Definitive Prosthesis. J ORAL IMPLANTOL 2016; 42:437-441. [PMID: 27168404 DOI: 10.1563/aaid-joi-d-16-00032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Frederico Vasconcellos
- 1 Advanced Education Program in Prosthodontics, Department of Prosthodontic, Instituto Nacional de Ciencias Odontologicas, Rio de Janeiro, Brazil.,2 Private practice, Rio de Janeiro, Brazil
| | - Periklis Proussaefs
- 3 Advanced Education Program in Implant Dentistry, Department of Restorative Dentistry, Loma Linda University, Loma Linda, Calif.,4 Private prosthodontic practice, Ventura, Calif
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Proussaefs P. A Novel Technique for Immediate Loading Single Root Form Implants With an Interim CAD/CAM Milled Screw-Retained Crown. J ORAL IMPLANTOL 2016; 42:327-32. [PMID: 26928766 DOI: 10.1563/aaid-joi-d-15-00087] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
A technique is described where an interim abutment and crown are fabricated in the laboratory by utilizing computer-aided design/computer-aided manufacturing (CAD/CAM) technology and placed the day of dental implant surgery. The design and contours of the interim crown are designed by the computer software to be identical to the contours of the tentatively designed definitive prosthesis. The interim crown satisfies esthetics immediately after dental implant surgery while allowing the tissue to heal and obtain contours similar to the contours of the definitive prosthesis. The interim crown can be either cement retained or screw retained. The presented technique describes fabrication of a screw-retentive interim crown. After osseointegration is confirmed, a definitive impression is made with a CAD/CAM impression coping. The definitive prosthesis is then fabricated.
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Affiliation(s)
- Periklis Proussaefs
- Advanced Education Program in Implant Dentistry, Loma Linda University, Loma Linda, Calif, and private prosthodontic practice, Ventura, Calif
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11
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Proussaefs P. Immediate provisionalization with a CAD/CAM interim abutment and crown: A guided soft tissue healing technique. J Prosthet Dent 2015; 113:91-5. [DOI: 10.1016/j.prosdent.2014.09.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Revised: 08/29/2014] [Accepted: 09/02/2014] [Indexed: 11/25/2022]
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12
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Aguilar-Salvatierra A, Calvo-Guirado JL, González-Jaranay M, Moreu G, Delgado-Ruiz RA, Gómez-Moreno G. Peri-implant evaluation of immediately loaded implants placed in esthetic zone in patients with diabetes mellitus type 2: a two-year study. Clin Oral Implants Res 2015; 27:156-61. [PMID: 25623884 DOI: 10.1111/clr.12552] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/26/2014] [Indexed: 01/22/2023]
Abstract
OBJECTIVES The aim of this study was to evaluate implant survival and primary stability parameters in patients with diabetes with different levels of glycosylated hemoglobin Alc (HbA1c) treated with immediate placement and provisionalization of implant-supported, single-tooth replacements over 2 years. MATERIALS AND METHODS Eighty-five patients were divided into three groups according to their HbA1c levels: 33 patients in Group 1 (<6, control group); 30 patients in Group 2 (6.1-8); and 22 patients in Group 3 (8.1-10). Each patient received one-one-piece implant in the anterior zone of the upper maxillary. The implant survival rate was analyzed for each group, together with three variables to evaluate the general state of peri-implant health: probe depth, bleeding on probing, marginal bone loss. RESULTS Marginal bone loss increased in relation with higher HbA1c levels. For marginal bone loss in Group 1, mean resorption values ranged from 0.51 after 6 months to 0.72 after 2 years in comparison with respective values of 1.33 and 1.92 in Group 3. This pattern was repeated for bleeding on probing, both parameters showing significant differences between groups. For bleeding on probing, mean bleeding levels varied from 0.36 in Group I at 6 months after implant placement, to 0.59 in Group 3 (P = 0.041 between the three groups). Peri-implant pocket depth showed the same tendency to increase in relation to HbA1C but differences between groups did not reach statistical significance. CONCLUSIONS Patients with diabetes can receive implant-based treatments with immediate loading safely, providing they present moderate HbA1c values.
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Affiliation(s)
- Antonio Aguilar-Salvatierra
- Department of Pharmacological Research in Dentistry, Faculty of Dentistry, University of Granada, Granada, Spain
| | - José Luis Calvo-Guirado
- Department of Implant Dentistry, Master of Implant Dentistry and Biomaterials, School of Medicine and Dentistry, University of Murcia, Murcia, Spain
| | - Maximino González-Jaranay
- Department of Periodontology, Master of Periodontology and Implant Dentistry, Faculty of Dentistry, University of Granada, Granada, Spain
| | - Gerardo Moreu
- Department of Periodontology, Master of Periodontology and Implant Dentistry, Faculty of Dentistry, University of Granada, Granada, Spain
| | | | - Gerardo Gómez-Moreno
- Department of Special Care in Dentistry, Pharmacological Research in Dentistry, Master of Periodontology and Implant Dentistry, Faculty of Dentistry, University of Granada, Granada, Spain
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De Bruyn H, Raes S, Östman PO, Cosyn J. Immediate loading in partially and completely edentulous jaws: a review of the literature with clinical guidelines. Periodontol 2000 2014; 66:153-87. [DOI: 10.1111/prd.12040] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2013] [Indexed: 11/29/2022]
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Engelhardt S, Papacosta P, Rathe F, Özen J, Jansen JA, Junker R. Annual failure rates and marginal bone-level changes of immediate compared to conventional loading of dental implants. A systematic review of the literature and meta-analysis. Clin Oral Implants Res 2014; 26:671-87. [DOI: 10.1111/clr.12363] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2014] [Indexed: 11/29/2022]
Affiliation(s)
| | - Petros Papacosta
- Department of Implantology and Periodontology; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
| | - Florian Rathe
- Department of Prosthodontics and Biomaterials; Danube Private University; Krems Austria
- Private Practice; Forchheim Germany
| | - Jülide Özen
- Department of Prosthetic Dentistry; Private Dental Clinic; Aachen Germany
| | - John A. Jansen
- Department of Biomaterials; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
| | - Rüdiger Junker
- Department of Prosthodontics and Biomaterials; Danube Private University; Krems Austria
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Kohal RJ, Patzelt SBM, Butz F, Sahlin H. One-piece zirconia oral implants: one-year results from a prospective case series. 2. Three-unit fixed dental prosthesis (FDP) reconstruction. J Clin Periodontol 2013; 40:553-62. [DOI: 10.1111/jcpe.12093] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2013] [Indexed: 11/26/2022]
Affiliation(s)
- Ralf-Joachim Kohal
- Department of Prosthodontics; School of Dentistry; Albert-Ludwigs University; Freiburg Germany
| | - Sebastian B. M. Patzelt
- Department of Periodontics; School of Dentistry; University of Maryland; Baltimore USA
- Department of Prosthodontics; School of Dentistry; Albert-Ludwigs University; Freiburg Germany
| | - Frank Butz
- Department of Prosthodontics; School of Dentistry; Albert-Ludwigs University; Freiburg Germany
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Rismanchian M, Attar BM, Razavi SM, Shamsabad AN, Rezaei M. Dental Implants Immediate Loading Versus the Standard 2-Staged Protocol: An Experimental Study in Dogs. J ORAL IMPLANTOL 2012; 38:3-10. [DOI: 10.1563/aaid-joi-d-09-00104.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The endeavors to shorten implant treatment time have led to the concept of immediate loading. This research was designed to compare the immediate loading and the 2-staged methods on implant placement from a clinical, histological, and histomorphometric standpoint. Three months postextraction of 12 premolars of 3 dogs, 12 implants were inserted. Bone-implant contact (BIC), implant stability quotient (ISQ), the bone type in a 2-mm periphery around the implant, and the marginal bone loss (MBL) were recorded for unloaded implants (n = 6) and immediately loaded ones (n = 6). BIC, ISQ, MBL in the mesial, and the bone types around the implants were not significantly different in the 2 groups. The distal MBL was higher in the immediately loaded group. Immediate loading does not appear to be perilous for osseointegration, BIC, or new bone type around implants.
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Affiliation(s)
- Mansour Rismanchian
- Department of Oral and Maxillofacial Prosthodontics, Isfahan University of Medical Sciences and Torabinejad Dental Research Center, Isfahan, Iran
| | - Bijan Movahedian Attar
- Department of Oral and Maxillofacial Surgery, Isfahan University of Medical Sciences and Torabinejad Dental Research Center, Isfahan, Iran
| | - Sayed Mohammad Razavi
- Department of Oral and Maxillofacial Pathology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ali Nasir Shamsabad
- Department of Oral and Maxillofacial Prosthodontics, Ahvaz University of Medical Sciences, Isfahan, Iran
| | - Majid Rezaei
- Department of Oral and Maxillofacial Surgery, Isfahan University of Medical Sciences, Isfahan, Iran
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Lang NP, Pun L, Lau KY, Li KY, Wong MCM. A systematic review on survival and success rates of implants placed immediately into fresh extraction sockets after at least 1 year. Clin Oral Implants Res 2011; 23 Suppl 5:39-66. [PMID: 22211305 DOI: 10.1111/j.1600-0501.2011.02372.x] [Citation(s) in RCA: 238] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Niklaus P. Lang
- The University of Hong Kong; Faculty of Dentistry; Prince Philip Dental Hospital; Hong Kong; SAR; China
| | - Lui Pun
- The University of Hong Kong; Faculty of Dentistry; Prince Philip Dental Hospital; Hong Kong; SAR; China
| | - Ka Yee Lau
- The University of Hong Kong; Faculty of Dentistry; Prince Philip Dental Hospital; Hong Kong; SAR; China
| | - Ka Yan Li
- The University of Hong Kong; Faculty of Dentistry; Prince Philip Dental Hospital; Hong Kong; SAR; China
| | - May CM Wong
- The University of Hong Kong; Faculty of Dentistry; Prince Philip Dental Hospital; Hong Kong; SAR; China
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18
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Response of osteoblasts to low fluid shear stress is time dependent. Tissue Cell 2011; 43:311-7. [DOI: 10.1016/j.tice.2011.06.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2010] [Revised: 05/30/2011] [Accepted: 06/06/2011] [Indexed: 01/09/2023]
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Zembić A, Johannesen LH, Schou S, Malo P, Reichert T, Farella M, Hämmerle CHF. Immediately restored one-piece single-tooth implants with reduced diameter: one-year results of a multi-center study. Clin Oral Implants Res 2011; 23:49-54. [DOI: 10.1111/j.1600-0501.2011.02174.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Bahat O, Sullivan RM. Parameters for successful implant integration revisited part I: immediate loading considered in light of the original prerequisites for osseointegration. Clin Implant Dent Relat Res 2010; 12 Suppl 1:e2-12. [PMID: 20455902 DOI: 10.1111/j.1708-8208.2010.00279.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE With the increasing popularity and publication of loading implants at the time of placement, including at time of dental extraction and simultaneous with reconstructive procedures, the objective was to evaluate known variables identified for a traditional unloaded healing period and determine the applicability of these variables to immediate loading. MATERIALS A total of 124 published reports available as of January 2008 that contained information about loading from the time of surgery up to 3 months postsurgically were examined in light of published variables affecting osseointegration based on a 2 stage surgical approach. METHODS The articles were examined to differentiate between immediate loading (within the initial 48 hours) and early/delayed loading of implants. Success or survival criteria were noted, and where reasons for failure were available, categorized according to six variables considered as determinants for maintaining a long-term bone-to-implant contact. RESULTS Approximately 60 of the 124 reports described immediately loading implants within 48 with single-tooth, partial, and full-arch restorations, as well as implant overdentures. The implant success or survival rates ranged from 70.8% to 100%. Most studies considered implant survival to be the only criterion for success. CONCLUSIONS Of six parameters identified in 1981 as influencing osseointegration, two parameters (the status of the bone/implant site and implant loading conditions) appear to have diagnostic implications, whereas three (implant design, surgical technique, and implant finish) may affect immediate loading positively or adversely.
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Degidi M, Iezzi G, Perrotti V, Piattelli A. Comparative Analysis of Immediate Functional Loading and Immediate Nonfunctional Loading to Traditional Healing Periods: A 5-Year Follow-Up of 550 Dental Implants. Clin Implant Dent Relat Res 2009; 11:257-66. [DOI: 10.1111/j.1708-8208.2008.00117.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Histologic and histomorphometric report of three immediately loaded screw implants retrieved from man after a three-year loading period. IMPLANT DENT 2008; 17:192-9. [PMID: 18545051 DOI: 10.1097/id.0b013e318166d654] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of the present study, in man, was an histologic and histomorphometric analysis of the peri-implant tissues in 3 immediately loaded screw implants retrieved, because of fracture, after a 3 year loading period. RESULTS Mineralized tissue was present at the interface of all implants. The mean bone to implant contact percentage for the 3 implants was 56.3% +/- 5%. The histologic and histomorphometric data showed that mineralized tissues can be obtained in immediately loaded screw implants and that these mineralized tissues are maintained over a period of 3 years. The response of the osseous tissue was not disturbed by the stresses and strains transmitted at the interface. CONCLUSION A high primary stability, obtained by the large threads of the screw-shaped implant, was probably a key factor in the long-term maintenance of a mineralized bone interface. The primary stability helps to resist micromotion, i.e., the relative movements between the implant surface and surrounding bone during functional loading.
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Siddiqui AA, O'Neal R, Nummikoski P, Pituch D, Ochs M, Huber H, Chung W, Phillips K, Wang IC. Immediate Loading of Single-Tooth Restorations: One-Year Prospective Results. J ORAL IMPLANTOL 2008; 34:208-18. [DOI: 10.1563/0.926.1] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Abstract
Immediate loading of splinted implant restorations is a growing trend, but limited clinical documentation hampers evidence-based treatment planning for single-tooth applications. This study prospectively evaluated the clinical efficacy of placing implant-supported, single-tooth restorations into immediate, full-occlusal loading. Sixty consecutive patients (intent-to-treat group) with 1 missing tooth between 2 intact teeth were treated with a total of 69 implants. At placement, final impressions were made and implants were provisionalized with nonoccluding prostheses. Definitive prostheses were delivered 2 weeks later. A claim of noninferiority was made with a 95% confidence interval (Mann-Whitney U test) if the success rates between the experimental group and a 97% historical control was >7%. Standardized radiographs taken at placement and bimonthly intervals were analyzed for crestal bone changes at a type I (alpha) error level of .05; significance levels were not adjusted for multiplicity (Fisher exact tests and Student t tests). Sixteen patients (18 implants) were withdrawn for protocol deviations. The resulting treated-per-protocol group consisted of 44 subjects with 51 implants. Cumulative implant success rates were 98.55% (n = 68/69) for the intent-to-treat group and 98.04% (n = 50/51) for the treated-per-protocol group. There were no significant adverse events or statistically significant differences between the experimental and historical control groups. At 12 months mean crestal bone loss was 1.05 mm, and ranged from 0.38 to 1.5 mm (77%) and 1.6 to 2.69 mm (23%). Immediate full-occlusal loading of single-tooth restorations was safely performed in selected subjects when good primary implant stability and an appropriate occlusal load were achieved.
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Kim H, Choi SH, Ryu JJ, Koh SY, Park JH, Lee IS. The biocompatibility of SLA-treated titanium implants. Biomed Mater 2008; 3:025011. [DOI: 10.1088/1748-6041/3/2/025011] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Degidi M, Perrotti V, Piattelli A. Immediately Loaded Titanium Implants with a Porous Anodized Surface with at Least 36 Months of Follow-Up. Clin Implant Dent Relat Res 2006; 8:169-77. [PMID: 17100742 DOI: 10.1111/j.1708-8208.2006.00008.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Results from some studies clearly suggest that immediate loading can achieve equal success rates as those found in delayed or unloaded implants. There is still a lack of knowledge about the role of surface oxide properties during the peri-implant bone healing processes. PURPOSE The aim of this study was a clinical follow-up study of immediately loaded implants with a porous anodized surface. MATERIALS AND METHODS A total of 142 TiUnite (Nobel Biocare, Göteborg, Sweden) implants were inserted from January to September 2001. All implants have been used in fixed restorations. Fifty implants were inserted in completely edentulous mandibles, and 69 implants were inserted in completely edentulous maxillae. All 119 implants were subjected to immediate functional loading (IFL) (immediate restoration with full occlusal contact). The other 23 implants, inserted in 12 patients, underwent immediate nonfunctional loading (INFL) (immediate restoration without occlusal contact) in different anatomical configurations (single tooth, small bridges in the anterior mandible, anterior maxilla, and posterior maxilla). All 142 implants have been followed for at least 3 years. RESULTS All implants appeared to be osseointegrated from a clinical and radiographic point of view. No failures were observed in the IFL and INFL groups. The implant success was 100%. The mean marginal bone loss was 0.8 and 1.0 mm at 12 and 36 months, respectively. CONCLUSION Implants with a porous anodized surface appear to work well under an immediate loading state in the long term.
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Affiliation(s)
- Marco Degidi
- Dental School, University of Chieti, Pescara, Italy
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Di Stefano D, Iezzi G, Scarano A, Perrotti V, Piattelli A. Immediately loaded blade implant retrieved from a after a 20-year loading period: a histologic and histomorphometric case report. J ORAL IMPLANTOL 2006; 32:171-6. [PMID: 17009561 DOI: 10.1563/765.1] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Immediate loading of root-form dental implants has shown promising results and offers treatment cost and convenience advantages to patients. Although blade implants have been immediately loaded for over 2 decades, the ability of this implant design to achieve osseointegration has been debated. The aim of the present study was to histologically evaluate the peri-implant tissues of an immediately loaded blade implant retrieved for abutment fracture after a 20-year loading period. Histologic samples were prepared and examined by light microscope. Compact, cortical, mature bone with well-formed osteons was present at the interface of the implant. Bone-to-implant contact was 51% +/- 6%. The histologic data showed that osseointegration was obtained in an immediately loaded blade implant inserted into the mandible, and that mineralized tissues were maintained at the interface over a long period (20 years).
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Hoffmann O, Beaumont C, Zafiropoulos GG. Immediate implant placement: a case series. J ORAL IMPLANTOL 2006; 32:182-9. [PMID: 17009563 DOI: 10.1563/801.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
A major drawback of implant therapy is the comparatively long healing period involved. Early and immediate loading of dental implants can significantly decrease the treatment time and thus result in an increase in patients' comfort. In this report, 3 cases of placement and immediate loading of the final implants are presented. In 2 of these cases, where preliminary augmentation was necessary, provisional implants were placed after the procedure and immediate provisional dentures were delivered. With the exception of 1 case, in which 1 implant failed, no adverse events were observed. All cases are in function now for 3 to 5 years after implant placement. The observations from this limited number of cases confirm that immediate loading of implants could be a viable treatment option.
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Affiliation(s)
- Oliver Hoffmann
- Department of Periodontics, Loma Linda University, School of Dentistry, CA 92350, USA.
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Abstract
It was the aim of this review to compare the survival and success rates of immediately loaded dental implants with those of conventionally loaded dental implants, based on prospective controlled studies and prospective studies without controls. Studies on immediate loading were identified in the current literature by electronic and hand searches. Only clinical data on root-form or cylindrical threaded oral implants were included. For immediate loading of oral implants in the edentulous and partially dentate, mandible and maxilla controlled studies could be found. All of these studies were based on limited patient numbers. Therefore, definitive conclusions could not be drawn concerning survival and success rates of immediately loaded implants compared with conventionally loaded implants. The compilation of the current literature shows that prospective controlled studies as well as prospective studies without controls using several different approaches to immediate loading have demonstrated high implant survival and success rates. However, more high-level evidence-based studies are needed to demonstrate the relative merits of immediate loading compared with conventional loading in all potential applications.
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Affiliation(s)
- Emeka Nkenke
- Department of Oral and Maxillofacial Surgery, University of Erlangen-Nuremberg, Erlangen, Germany.
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Glauser R, Zembic A, Hämmerle CHF. A systematic review of marginal soft tissue at implants subjected to immediate loading or immediate restoration. Clin Oral Implants Res 2006; 17 Suppl 2:82-92. [PMID: 16968384 DOI: 10.1111/j.1600-0501.2006.01355.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The objective of this systematic review was to critically evaluate marginal soft-tissue aspects at implants subjected to immediate loading or immediate restoration. METHODS An electronic Medline search from 1966 up to August 2005 was conducted to identify prospective and retrospective studies on immediate implant loading. The search strategy was complemented by hand searching in peer-reviewed journals. Studies reporting on soft-tissue aspects at implants subjected to immediate loading or immediate restoration and with a follow-up time of at least 1 year were included. Assessment of identified studies and data extraction was performed independently by two reviewers. An attempt was made to isolate and categorize studies with similar protocols in order to identify trends and relevant factors. Variables that were considered included marginal and interproximal soft-tissue stability, marginal plaque accumulation, probing depth, bleeding on probing, peri-implant mucositis and peri-implantitis. RESULTS From an initial yield of 581 titles, 240 articles were selected for text analysis, finally resulting in 17 studies that met the inclusion criteria. Six studies on immediate implant loading or restoration were controlled studies, whereas the remainder was prospective case series. Seven studies reported on a 1-year data, and the longest follow-up within the included studies was 4 years. The total number of patients treated within the 17 studies was 432 including a total 706 implants studied. Overall, the articles reported on many different procedures and follow-up times, time points and evaluated soft-tissue parameters varied considerably between the different articles. CONCLUSION Within the limits of the evaluated data it can be cautiously concluded that once immediately loaded or restored implants integrate successfully, they appear to show a soft-tissue reaction with regard to periodontal as well as morphologic aspects comparable with those of conventionally loaded implants. However, follow-up periods are generally short, number of patients and/or implants per study are few, and most studies present only limited data on peri-implant soft-tissue evaluation. More accurate long-term studies with a stronger study design (i.e., RCT) reporting more detailed on treatment and follow-up protocols are required to allow for proper comparisons and conclusions.
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Ertugrul HZ, Pipko DJ. Measuring mobility of 2 dental implant fixtures of different configurations: an in vitro study. IMPLANT DENT 2006; 15:290-7. [PMID: 16966903 DOI: 10.1097/01.id.0000226817.39036.97] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To our knowledge, it has not as yet been determined if mini-dental implants can be used as a long-term treatment method compared to endosseous standard root-form dental implant fixtures. This in vitro study investigates the stability of 2 different implants, 1 mini-dental implant and 1 endosseous standard root form dental implant, under lateral forces. METHODS There were 2 different screw-type dental implants with the O-ring/ball attachment prosthetic heads used. A mini-dental implant (Sendax MDI MAX; IMTEC, Corp., Ardmore, OK) 13 mm in length and 2.2 mm in diameter, and root form implant (Brånemark; Nobel Biocare AB, Goteborg, Sweden) 13 mm in length and 4 mm in diameter. These implants were then embedded into a matrix mixture of pumice, two-fifths BaSO4 powder and one-fifth plaster. Parallel periapical radiographs were taken pretest and after lateral forces were applied. The implants were vibrated using electric toothbrushes. They were attached to O-rings on the implants. Periapical radiographs were secured periodically every 5 minutes. The first discrepancy was observed at the 35th minute. Mobility and discrepancy values were recorded at the instances of 35th, 60th, 90th, and 120th minutes. Stability was measured and recorded using a manual stress and tension gauge. Radiographic discrepancy values were measured using a stereomicroscope. RESULTS The Brånemark implant showed less mobility and discrepancy values than the mini-dental implant. The discrepancies were observed mostly at the cervical region of the 2 implants. CONCLUSIONS According to the experimental results of this study, the Brånemark implant was more stable than the mini-dental implant at the end of 2 minutes.
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Affiliation(s)
- H Zeynep Ertugrul
- Prosthodontics, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA 15261-1920, USA
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Wang HL, Ormianer Z, Palti A, Perel ML, Trisi P, Sammartino G. Consensus Conference on Immediate Loading: The Single Tooth and Partial Edentulous Areas. IMPLANT DENT 2006; 15:324-33. [PMID: 17172948 DOI: 10.1097/01.id.0000246248.55038.3a] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE A consensus conference was held to determine what the parameters should be for the immediate functional loading of the single-tooth implant restoration and short-span fixed implant-supported bridgework. MATERIALS Forty-one clinicians and researchers presented cases and situations relating to the topic. A panel then distilled questions that were presented to the audience (430) at large. Answers were gleaned to formulate a consensus. RESULTS Ten distinct answers evolved that constituted the essence of guidelines for clinicians to be aware of when undertaking immediate loading. These guidelines are contained within the body of the text. CONCLUSIONS Extreme caution and adherence to a universal generic protocol are suggested for clinicians who are involved with single-tooth and short-span multiple-teeth implant replacements as related to immediate loading as defined within this text.
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Affiliation(s)
- Hom-Lay Wang
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
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Attard NJ, Zarb GA. Immediate and early implant loading protocols: a literature review of clinical studies. J Prosthet Dent 2005; 94:242-58. [PMID: 16126077 DOI: 10.1016/j.prosdent.2005.04.015] [Citation(s) in RCA: 177] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The purpose of this literature review is to present the outcomes of clinical studies on immediate and early loading protocols, identify shortcomings, and suggest a number of questions that still require exploration. English language clinical studies, limited to peer-reviewed journals between 1975 and 2004, were reviewed to identify treatment outcomes with these loading protocols. The data were tabulated from studies reporting on patients treated with fixed and overdenture prostheses. The former included partially edentulous patients treated with single or multi-unit prostheses. Within the limitations of this review, it can be concluded that these treatment protocols are predictable in the anterior mandible, irrespective of implant type, surface topography, and prosthesis design (success rates 90%-100%). Limited evidence for the edentulous maxilla (success rates 90%-100%) and the partially edentulous patient (success rates 93%-100%) are available, underscoring the need for further research. Studies suggest that to achieve predictable results in extraction sites, implant placement should be restricted to sites without a history of periodontal involvement (success rates 61%-100%). A number of questions require further exploration. There is a need to thoroughly investigate clinical outcomes to measure the economic benefit of these protocols and the impact of treatment on a patient's quality of life. Furthermore, more accurate long-term studies reporting on treatment protocols for separate clinical situations are required to allow meaningful comparisons.
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Affiliation(s)
- Nikolai J Attard
- Department of Restorative Dentistry, Faculty of Dental Surgery, University of Malta, The Medical School, G'Mangia, MSD 08 Malta.
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Degidi M, Scarano A, Iezzi G, Piattelli A. Histologic Analysis of an Immediately Loaded Implant Retrieved After 2 Months. J ORAL IMPLANTOL 2005; 31:247-54. [PMID: 16265855 DOI: 10.1563/1548-1336(2005)31[247:haoail]2.0.co;2] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Human biopsy of immediately loaded implants is the most important way to determine the occurrence of osseointegration. Implants inserted in sites with poor bone quality have been associated with lower success rates. The aim of this study is to document the early healing processes in a man around an immediately loaded implant retrieved after a 2-month loading period. An implant was inserted in the mandible of a 32-year-old patient and was loaded into a nonfunctional loading mode with a fixed provisional prosthesis the same day of the implant surgery. After 2 months, because the patient had difficulty accepting the implant, the implant was retrieved with a 5-mm trephine drill. Before retrieval, the implant appeared to be clinically osseointegrated, and no mobility was present. The preexisting bone quality was type D4. The implant was surrounded by newly formed bone lamellae with a width of 200 to 400 microm. In many areas it was possible to observe osteoblasts producing osteoid matrix directly on the implant surface. Bone-to-implant contact percentage was 71% +/- 3.2%. Even in a poor bone site and after a healing period of only 2 months, we observed a high bone-to-implant contact percentage. We can confirm that immediately loaded implants placed in soft spongy bone after a 2-month healing period can present mineralized tissue at the interface.
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Affiliation(s)
- Marco Degidi
- Dental School, University of Chieti-Pescara, Chieti, Italy
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