Comparative evaluation of the stability of two different dental implant designs and surgical protocols-a pilot study

Comparative Evaluation of Two Implant Designs Based on Bone Loss and Stability with Early Loading Method

The study evaluated the implant bone loss and stability of implant changes with diverse designs with early placement at eight weeks and eight months' time. The subjects for the current study had partial tooth loss in the posterior mandibular arch. A total of 30 samples were split into two groups of 15, one with a flared crest module and a buttress thread design, the other with a parallel crest module and a V-shaped thread design. Ostell assessed each subject's implant stability four times, at baseline, eight weeks, four months, and eight months. At intervals of eight weeks, four months, and eight months, intraoral periapical radiographs were examined using ImageJ software to measure crestal bone loss. When Group I and Group II's implant stability quotient (ISQ) values at baseline, eight weeks, four months, and eight months were compared; Group I's ISQ values at each of the four measured time periods were statistically significant. At eight weeks in Group I, the ISQ value was very considerable. At eight weeks, four months, and eight months, there was a statistically significant bone loss in Group II in comparison to Group I. At eight months, Group II's bone loss value was very considerable. In contrast to Group II implant designs, it was found that Group I implants demonstrated enhanced implant-less bone loss and stability.

Clinical study to assess influence of immediate provisionalization and various implant morphologies on implant stability: A prospective clinical study

Introduction

The aim of this study was to evaluate the influence of different implant morphologies and immediate provisionalization options on the change of implant stability.

Methods

94 Patients were randomized to receive implants from Straumann^® BL/Straumann^® BLT/Astra OsseoSpeed^® TX, meanwhile having the same opportunity to receive healing abutment or immediate provisionalization. Implant stability quotient (ISQ) and marginal bone loss (MBL) were recorded at following timepoints. Parametric statistic was used for data analysis.

Results

Data showed that ISQ and MBL values of conical/straight/straight with micro-thread neck implants had no significant difference.

Discussion

Immediate provisionalization options could move the dip point of ISQ values ahead or delayed around one week, which were also relevant to implant systems. MBL values were proved to be unaffected by both two factors mentioned above.

Comparison of nonself-tapping tapered implant and self-tapping hybrid implant in terms of implant stability at initial and second fixation: A prospective randomized clinical trial

BACKGROUND

Various features are provided in dental implants to improve initial fixation.

PURPOSE

To compare the implant stability of the nonself-tapping tapered implant and self-tapping hybrid implant over a 3-month healing period.

MATERIALS AND METHODS

A randomized controlled trial was conducted. Patients were randomly divided into tapered and self-tapping groups. Patients in the tapered group received NobelReplace Tapered (Nobel Biocare, Sweden) implants, while those in the self-tapping group received NobelSpeedy (Nobel Biocare, Sweden) implants. Implant stability was measured by resonance frequency analysis at surgery and 3 months following implant insertion. Data were analyzed using an independent t-test.

RESULTS

Forty-three patients (tapered group: 21, self-tapping group: 22) received a total of 88 implants. Initial stability in the tapered group was significantly higher (mean: 60.14, SD: 12.40) than that in the self-tapping group (mean: 54.72, SD: 7.92). Implant stability significantly increased 3 months after implantation in the tapered group (mean: 66.61, SD: 9.00) and self-tapping group (mean: 64.01, SD: 5.78). No significant intergroup difference in implant stability was noted 3 months after surgery.

CONCLUSIONS

The tapered shape affected initial fixation more than the self-tapping function. However, during the second fixation, both implants showed good stability, and the difference disappeared.

The clinical significance of implant stability quotient (ISQ) measurements: A literature review

Implant stability quotients (ISQ values) are obtained in dental clinical practice on a non-invasive basis by resonance frequency measurement rapidly after surgical placement of implants. The ISQ-values are used as indicator for mechanical implant stability, and are believed to have predictive power for clinical outcome. It is the aim of this review to provide a synopsis of all factors described in the literature that influence ISQ measurements by performing an exhaustive literature review; moreover, this review aims at elucidating the key factors relevant for a rapid clinical predictive assessment. We searched systematically and exhaustively all major databases for publications relating to ISQ measurement methodology and for ISQ-influencing factor analyses. The reports identified were ordered in experimental (preclinical) studies and in clinical publications. We were able to identify 13 basic factors influencing ISQ-measurements. Among these, local bone quality, playing a key role in such measurements, was subdivided in four specific subfactors; thus a total of 17 individual factors was identified and reported to influence ISQ-measurements. A comprehensive list of these factors is provided in Table-form. A critical analysis points out that only 6 of these factors are of a sound predictive power useful for a rapid clinical assessment; and only two of these factors appear to have a well-documented scientific basis.

Evaluation of the implant stability and the marginal bone level changes during the first three months of dental implant healing process: A prospective clinical study

Achievement of adequate implant stability is one of the determinants for long-term successful osseointegration. Resonance frequency analysis was developed to monitor implant stability and is now a well-recognized, non-invasive tool for determining the appropriate time for functional loading. However, there have been few studies with continuous evaluation and comparison of implant stability and marginal bone level changes between two different macro designs and clinical situations during the implant healing process. Thus, the purpose of this clinical trial is to evaluate the implant stability and marginal bone level changes of straight and conical implants during the implant healing process. In this prospective clinical trial, 25 participants were randomized to either straight or conical implants. A total of 32 titanium dental implants with a length of 9 mm or 11 mm were installed in the maxilla and the mandible according to the manufacturer's instructions. A resonance frequency analyzer was used to measure the implant stability quotient (ISQ) at the time of implant placement and after 2 weeks, 4 weeks, 6 weeks, 8 weeks, 10 weeks, and 12 weeks of healing. The changes in the peri-implant marginal bone level were evaluated from digital radiographic films taken at the time of implant placement and after 4 weeks, 8 weeks, and 12 weeks of healing. The preliminary results of this study revealed higher ISQ values and better healing tendency for conical implants in comparison with straight implants in the maxilla. Similar ISQ values and healing tendency were observed for straight and conical implants in the mandible. No significant differences in marginal bone loss were found between the straight and conical implants. However, in the mandible, slightly more marginal bone loss was found with the conical implants than straight implants after 12 weeks of healing. In conclusion, ISQ healing tendency and marginal bone loss are influenced by implant macro-design and jaw regions. Straight implants revealed similar ISQ healing tendency and marginal bone loss in both the mandible and maxilla. Conical implants were confirmed more beneficial for maintenance of implant stability and marginal bone level in the maxilla.

Tapered Versus Cylindrical Implant: Which Shape Inflicts Less Pain After Dental Implant Surgery? A Clinical Trial

PURPOSE

Because no study has evaluated the postoperative pain caused by the shape of dental implants, this study compared the level of postoperative pain between tapered and cylindrical implants inserted in the posterior region of the maxilla.

MATERIALS AND METHODS

The study was designed as a double-blinded randomized clinical trial and conducted in 50 healthy patients 20 to 60 years old who were edentulous in the posterior maxilla and were candidates for single implantation. All patients had the same surgical difficulty with appropriate bone width and height. BioHorizons (Birmingham, AL) implants (tapered vs cylindrical) with 4.5-mm platform diameter were randomly selected for each group. The visual analog scale was used to evaluate the level of pain. Pain severity in each group was measured at 30-minute, 3-hour, 6-hour, 12-hour, 24-hour, 2-day, 3-day, and 1-week intervals. The predictor variable was implant shape and the outcome was postoperative pain severity. Data were statistically analyzed with SPPS 16 (SPSS, Inc, Chicago, IL) at the significance level of a P value less than .05.

RESULTS

Fifty patients (n = 25 per group) with the mean age of 43.7 ± 10.9 years were included in this study. The pain level in the 2 groups reached its maximum at the 6-hour postoperative interval. Pain severity decreased significantly over time in the 2 implant groups (P < .001). Severities of postoperative pain in the tapered group at 3-, 6-, 12-, and 24-hour intervals were statistically lower than those in the cylindrical group (P < .05).

CONCLUSIONS

Implant shape had an impact on postoperative pain. It can be concluded that tapered implants lead to less postoperative pain compared with cylindrical ones.

Systematic review of clinical and patient-reported outcomes following oral rehabilitation on dental implants with a tapered compared to a non-tapered implant design

BACKGROUND

Dental implants are available in different shapes.

AIMS

This systematic review aims to address whether tapered compared to non-tapered implants demonstrate similar clinical and patient-reported outcomes. The review follows the preferred reporting items for systematic reviews and meta-analyses (PRISMA) format.

MATERIALS & METHODS

We searched electronic databases including MEDLINE through PubMed and the Cochrane Central Register of Controlled Trials for randomized clinical trials (RCT) that compare tapered versus non-tapered implants with at least 10 treated participants and a minimum mean follow-up time of 3 years. There were no restrictions to a particular treatment indication or outcome measures. Two authors independently conducted screening, risk of bias assessment, and data extraction of eligible trials in duplicate. We applied the Cochrane risk of bias assessment tool to consider risk of bias.

RESULTS

We identified 18 different RCTs, of which three reported outcomes at 3 years or greater. The three trials described the results of 245 participants with 388 implants at 3 years, from the initially 306 participants with 494 implants at baseline. The three trials compared, respectively, two, two, and three different commercially available implant brands and reported only clinically insignificant differences. We judged all three trials to be at moderate risk of bias. The low number and heterogeneity of RCTs did not allow for meta-analyses.

DISCUSSION AND CONCLUSION

Appropriate professional judgment in clinical decision making must include a comprehensive diagnosis of the patient's jawbone quality and quantity and consideration of osteotomy protocol in accordance with the patient's treatment preferences, where the shape of the dental implant is only one contributory factor.

Impact of a zoledronate coating on early post-surgical implant stability and marginal bone resorption in the maxilla-A split-mouth randomized clinical trial

OBJECTIVES

The objective of this clinical study was to evaluate the effect of a bisphosphonate coating on a titanium implant on the implant stability quotient (ISQ) and the radiographic marginal bone levels at implants during early healing (2-8 weeks).

MATERIALS AND METHODS

In a randomized double-blind trial with internal controls, 16 patients received a dental implant coated with zoledronate and one uncoated implant as a control. The coated and uncoated implants which were visually indistinguishable were bone level titanium implants with a moderately rough surface and a microthreaded neck. ISQ values were obtained at insertion and at 2, 4, 6, and 8 weeks. Radiographs were obtained at insertion and at 8 weeks. The primary outcome was the difference in ISQ values between the coated implants and the control implants at 4 and 6 weeks, corrected for insertion values. The secondary outcome was loss of marginal bone level from insertion to 8 weeks.

RESULTS

Implant stability quotient values remained largely constant over the 8 weeks, and there was no significant difference between coated and uncoated implants at any time point. There was 0.12 (SD 0.10) mm marginal bone loss at the control implants and 0.04 (SD 0.08) mm at the coated implants. The difference was 0.17 mm; SD 0.14; p < 0.006). On blind qualitative scoring, 13 of the 15 control implants and two of 15 coated implants showed small marginal bone defects (p = 0.003).

CONCLUSIONS

There were no statistically significant differences observed in ISQ values between the coated and uncoated implants during the early healing. There was less marginal bone loss at the coated implants.

Stability of tapered and parallel-walled dental implants: A systematic review and meta-analysis

BACKGROUND

Clinical trials have suggested that dental implants with a tapered configuration have improved stability at placement, allowing immediate placement and/or loading. The aim of this systematic review and meta-analysis was to evaluate the implant stability of tapered dental implants compared to standard parallel-walled dental implants.

MATERIALS AND METHODS

Applying the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement, randomized controlled trials (RCTs) were searched for in electronic databases and complemented by hand searching. The risk of bias was assessed using the Cochrane Collaboration's Risk of Bias tool and data were analyzed using statistical software.

RESULTS

A total of 1199 studies were identified, of which, five trials were included with 336 dental implants in 303 participants. Overall meta-analysis showed that tapered dental implants had higher implant stability values than parallel-walled dental implants at insertion and 8 weeks but the difference was not statistically significant. Tapered dental implants had significantly less marginal bone loss compared to parallel-walled dental implants. No significant differences in implant failure rate were found between tapered and parallel-walled dental implants.

CONCLUSIONS

There is limited evidence to demonstrate the effectiveness of tapered dental implants in achieving greater implant stability compared to parallel-walled dental implants. Superior short-term results in maintaining peri-implant marginal bone with tapered dental implants are possible. Further properly designed RCTs are required to endorse the supposed advantages of tapered dental implants in immediate loading protocol and other complex clinical scenarios.