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Patel R, Ucer C, Wright S, Khan RS. Differences in Dental Implant Survival between Immediate vs. Delayed Placement: A Systematic Review and Meta-Analysis. Dent J (Basel) 2023; 11:218. [PMID: 37754338 PMCID: PMC10528222 DOI: 10.3390/dj11090218] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/09/2023] [Accepted: 09/13/2023] [Indexed: 09/28/2023] Open
Abstract
OBJECTIVES To compare the impact of immediate and delayed implant placement upon the survival of implants and to investigate the differences in implant survival between immediate and delayed placement in adults. METHODS A search for the relevant literature was performed using the databases of CENTRAL, MEDLINE and Scopus. The studies found were limited to publications between 2014 and 2022, written in the English language, peer-reviewed, and were randomised trials or comparative studies. The quality of the evidence was assessed using the Cochrane Risk of Bias 2.0 and Risk of Bias in Non-randomised Studies-of Interventions appraisal tools and implant survival, and the primary outcome was meta-analysed using RevMan v.5.3. RESULTS A total of 10 studies were eligible for inclusion, including six randomised controlled trials and four non-randomised comparative studies. Five of the six randomised trials observed a low risk of bias, while the comparative studies had a moderate-to-serious risk of bias. The search strategy resulted in 341 implants placed immediately into fresh extraction sites (332 survived, 97.4%) and 359 implants inserted into delayed sites (350 survived, 97.5%). CONCLUSION The meta-analysis demonstrated that there was no significant difference in the implant survival rates between immediately placed implants and implants placed using a delayed timing protocol (risk ratio 0.99; 95% CI 0.96, 1.02, Z = 0.75, p = 0.45). However, the detailed analysis showed that slightly more implant failures happened in the immediate dental implant placement group, with survival rates in some studies ranging between 90 and 95%, while the delayed placement group had survival rates of more than 95%.
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Affiliation(s)
- Rishi Patel
- ICE Postgraduate Dental Institute and Hospital, University of Salford, 24 Furness Quay, Salford M50 3XZ, UK; (R.P.); (C.U.); (S.W.)
| | - Cemal Ucer
- ICE Postgraduate Dental Institute and Hospital, University of Salford, 24 Furness Quay, Salford M50 3XZ, UK; (R.P.); (C.U.); (S.W.)
| | - Simon Wright
- ICE Postgraduate Dental Institute and Hospital, University of Salford, 24 Furness Quay, Salford M50 3XZ, UK; (R.P.); (C.U.); (S.W.)
| | - Rabia S. Khan
- ICE Postgraduate Dental Institute and Hospital, University of Salford, 24 Furness Quay, Salford M50 3XZ, UK; (R.P.); (C.U.); (S.W.)
- Department of Medicine, University of Lancaster, Lancaster LA1 4YR, UK
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Babayi M, Ashtiani MN, Emamian A, Ramezanpour H, Yousefi H, Mahdavi M. Peri-implant cell differentiation in delayed and immediately-loaded dental implant: A mechanobiological simulation. Arch Oral Biol 2023; 151:105702. [PMID: 37086495 DOI: 10.1016/j.archoralbio.2023.105702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 04/15/2023] [Accepted: 04/15/2023] [Indexed: 04/24/2023]
Abstract
OBJECTIVE This study aimed to investigate the effect of immediate versus delayed dental implant placement strategies on cell differentiation in a dental callus. DESIGN The implant was placed in the mandible with two nearby teeth using an idealized two-dimensional finite element model. Eight weeks after surgery, the mechanobiological modeling of healing was used to estimate cell differentiation. It was assumed that the callus was initially filled by mesenchymal cells. The model then transformed mechanical stimuli received by the callus from loadings in terms of distortional and dilatational strains into predictions of the cellular phenotypes, including fibroblasts, chondrocytes, and osteoblasts, or whether they would remain unchanged or die. RESULTS The results demonstrated that delayed loading led to greater bone formation than immediate loading. Osteoblast colonies were observed in the base of threads in the immediately-loaded implant, whereas the delayed loading caused distant bone formation from the surrounding bone side towards the implant. The osteoblasts were differentiated from both intramembranous and endochondral mechanisms of ossification. After eight weeks, approximately 61 % of the callus was ossified in the delayed placement model compared to 35 % in the immediate placement model, resulting in a greater amount of fibrocartilaginous tissue on the bone side of the callus. CONCLUSIONS Immediate and delayed loading models generated different results. In the delayed strategy, bone cells were supplied appropriately during the first few weeks following surgery, whereas the immediate loading caused fibrocartilaginous tissue differentiation. In the form of distant osseointegration, the secondary stability of the dental implant was higher and faster due to the delayed placement.
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Affiliation(s)
- Masumeh Babayi
- Department of Biomedical Engineering, Sahand University of Technology, Tabriz, Islamic Republic of Iran
| | - Mohammed N Ashtiani
- Faculty of Medical Sciences, Tarbiat Modares Unviersity, Tehran, Islamic Republic of Iran.
| | - Amirhossein Emamian
- Department of Biomedical Engineering, Sahand University of Technology, Tabriz, Islamic Republic of Iran; Research and Development Department, Avita Dental System, Tehran, Islamic Republic of Iran
| | - Hosseinali Ramezanpour
- Research and Development Department, Avita Dental System, Tehran, Islamic Republic of Iran
| | - Hashem Yousefi
- Research and Development Department, Avita Dental System, Tehran, Islamic Republic of Iran
| | - Majid Mahdavi
- Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Islamic Republic of Iran
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Recombinant Proteins-Based Strategies in Bone Tissue Engineering. Biomolecules 2021; 12:biom12010003. [PMID: 35053152 PMCID: PMC8773742 DOI: 10.3390/biom12010003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 12/08/2021] [Accepted: 12/11/2021] [Indexed: 11/29/2022] Open
Abstract
The increase in fracture rates and/or problems associated with missing bones due to accidents or various pathologies generates socio-health problems with a very high impact. Tissue engineering aims to offer some kind of strategy to promote the repair of damaged tissue or its restoration as close as possible to the original tissue. Among the alternatives proposed by this specialty, the development of scaffolds obtained from recombinant proteins is of special importance. Furthermore, science and technology have advanced to obtain recombinant chimera’s proteins. This review aims to offer a synthetic description of the latest and most outstanding advances made with these types of scaffolds, particularly emphasizing the main recombinant proteins that can be used to construct scaffolds in their own right, i.e., not only to impregnate them, but also to make scaffolds from their complex structure, with the purpose of being considered in bone regenerative medicine in the near future.
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Kumar PR, Vikram J, Kher U, Tunkiwala A, Sawhney H. Pink esthetic and radiological scores around immediate implants placed in the esthetic zone - Socket-Shield Technique versus Immediate Conventional Technique: A Pilot Study. J Indian Soc Periodontol 2021; 25:510-517. [PMID: 34898917 PMCID: PMC8603788 DOI: 10.4103/jisp.jisp_278_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 01/26/2021] [Accepted: 03/13/2021] [Indexed: 02/06/2023] Open
Abstract
Objective: It is irrefutable that the extraction of teeth inextricably results in definitive changes in the surrounding hard and soft tissues. Recently, Socket-Shield Technique (SST) has been used to keep the buccal two-third of the root intact in the socket. This buccal shield further preserves the periodontium-bundle bone complex and hence preserves the buccal hard and soft tissue. The purpose of the study was to do a statistical comparative analysis of two different types of flapless and graftless techniques using the esthetic (Pink Esthetic Index) and radiological parameters. Materials and Methods: A total of thirty nonrestorable tooth/root stumps (vital or nonvital) were selected and randomly allocated to two different groups: control group with immediate conventional implant placement (without SST) (Group C, n = 15) and test group with immediate implant placement using SST (Group S, n = 15). All of the sites received immediate chairside temporaries. All implants were restored either with screw- or cement-retained prostheses 4 months postoperative. Each control and test group was analyzed at two different durations: 15 days after placement of provisional and 15 days after placement of definitive prosthesis. Five parameters of Pink Esthetic Score (PES) were used for esthetic analysis, and digital periapical radiographs were used for radiographic analysis. Results: Within the time frame of the study (15 days postplacement of definitive prosthesis), a statistically significant difference (p < 0.05) was observed between PES of the two techniques. Test group S (mean = 9.07) showed better scores than control group C (mean = 6.87). It was observed that buccal bone was maintained in all the cases of test group S while there was loss of buccal bone in almost all the cases of control group C. Conclusion: Within the limitations of this short-term pilot study, better soft-tissue parameters were observed with SST as compared to a conventional graftless technique whenever a restoration on immediate implant placement is considered.
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Affiliation(s)
| | - Jay Vikram
- Professor, Department of Prosthodontics & Crown & Bridge, School of Dental Sciences, Sharda University, Greater Noida, India
| | - Udatta Kher
- MDS, Oral Surgery, Private Practice, Mumbai, Maharashtra, India
| | - Ali Tunkiwala
- MDS, Prosthodontics, Private Practice, Mumbai, Maharashtra, India
| | - Hemant Sawhney
- Professor and Head, Department of Oral Medicine and Radiology, School of Dental Sciences, Sharda University, Greater Noida, India
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Javed F, Sculean A, Romanos GE. Association between age-related macular degeneration and periodontal and peri-implant diseases: a systematic review. Acta Ophthalmol 2021; 99:351-356. [PMID: 32996717 DOI: 10.1111/aos.14629] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 08/28/2020] [Indexed: 12/26/2022]
Abstract
The aim of the present systematic review was to assess the association between age-related macular degeneration (AMD) and periodontal and peri-implant diseases. The focused question was 'Is there a relationship between AMD and periodontal and peri-implant diseases?' Indexed databases were searched up to and including May 2020 to identify pertinent original studies. The Cochrane Collaboration's tool was used to assess the risk of bias. Five observational cohort studies were included that assessed the association between AMD and periodontitis. The number of patients with and without AMD ranged between 54 and 90 and 1697 and 12,171 individuals, respectively. Examiner blinding to the study groups was performed in 1 of the 5 studies. None of the studies were power adjusted. Scrutiny of studies showed that all 5 studies included in the present systematic review had a high risk of bias. Results from all studies reported a direct association between AMD and periodontitis. No studies assessed the association between AMD and peri-implant diseases. The association between AMD and periodontal and peri-implant diseases remains debatable. Further well-designed and power-adjusted studies are needed to determine whether or not a 'true' association exists between AMD and periodontal and peri-implant diseases.
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Affiliation(s)
- Fawad Javed
- Division of Orthodontics and Dentofacial Orthopedics Eastman Institute for Oral HealthUniversity of Rochester Rochester NY USA
| | - Anton Sculean
- Department of Periodontology School of Dental Medicine University of Bern Bern Switzerland
| | - Georgios E. Romanos
- Department of Periodontology Laboratory for Periodontal‐, Implant‐, Phototherapy (LA‐PIP) School of Dental Medicine Stony Brook University Stony Brook NY USA
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Nguyen VG, Flanagan D, Syrbu J, Nguyen TT. Socket Shield Technique Used in Conjunction With Immediate Implant Placement in the Anterior Maxilla: A Case Series. Clin Adv Periodontics 2020; 10:64-68. [DOI: 10.1002/cap.10087] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 06/18/2019] [Indexed: 11/06/2022]
Affiliation(s)
| | | | - John Syrbu
- Department of Family DentistryUniversity of Iowa College of Dentistry and Dental Clinics Iowa City IA
| | - Thomas T. Nguyen
- Division of PeriodontologyDepartment of Oral Medicine, Infection and ImmunityHarvard School of Dental Medicine Boston MA
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Chao D, Crockett R, Wu B, Shah K. Digital workflow for predictable immediate loading in the mandible by using a shape memory dental implant abutment system: A clinical report. J Prosthet Dent 2019; 123:1-5. [PMID: 31153616 DOI: 10.1016/j.prosdent.2019.04.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 04/15/2019] [Accepted: 04/15/2019] [Indexed: 10/26/2022]
Abstract
Digital surgical planning for immediately loaded dental implants can be a predictable and accurate procedure, with the interim prosthesis also designed digitally. If the planning and execution are meticulous, chairside adjustments can be minimized because the outcome should be closely matched to the proposed digital plan. A novel dental implant abutment system made from a shape memory metal could be an answer to the cement versus screw controversy as it uses neither. This new system can provide patients with better esthetics and is biologically favorable.
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Affiliation(s)
- Denny Chao
- Resident, Graduate Prosthodontics, Division of Advanced Prosthodontics, School of Dentistry, University of California, Los Angeles, Los Angeles, Calif
| | - Russell Crockett
- Past Resident, Graduate Prosthodontics, Division of Advanced Prosthodontics, School of Dentistry, University of California, Los Angeles, Los Angeles, Calif
| | - Benjamin Wu
- Chair, Division of Advanced Prosthodontics, School of Dentistry, University of California, Los Angeles, Los Angeles, Calif
| | - Kumar Shah
- Director, Graduate Prosthodontics, Division of Advanced Prosthodontics, School of Dentistry, University of California, Los Angeles, Los Angeles, Calif.
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Alahmari F, Javed F, Ahmed ZU, Romanos GE, Al‐Kheraif AA. Soft tissue status and crestal bone loss around conventionally‐loaded dental implants placed in cigarette‐ and waterpipe (narghile) smokers: 8‐years' follow‐up results. Clin Implant Dent Relat Res 2019; 21:873-878. [DOI: 10.1111/cid.12746] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Revised: 01/20/2019] [Accepted: 02/12/2019] [Indexed: 12/18/2022]
Affiliation(s)
- Fatemah Alahmari
- Department of Periodontics and Community DentistryCollege of Dentistry, King Saud University Riyadh Saudi Arabia
| | - Fawad Javed
- Department of PeriodontologyStony Brook University Stony Brook New York
- Laboratory for Periodontal‐, Implant‐, Phototherapy (LA‐PIP)School of Dental Medicine, Stony Brook University Stony Brook New York
| | | | - Georgios E. Romanos
- Department of PeriodontologyStony Brook University Stony Brook New York
- Laboratory for Periodontal‐, Implant‐, Phototherapy (LA‐PIP)School of Dental Medicine, Stony Brook University Stony Brook New York
| | - Abdulaziz A. Al‐Kheraif
- Dental Health DepartmentCollege of Applied Medical Sciences, King Saud University Riyadh Saudi Arabia
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Garg R, Mishra N, Alexander M, Gupta SK. Implant Survival between Endo-osseous Dental Implants in Immediate Loading, Delayed Loading, and Basal Immediate Loading Dental Implants a 3-Year Follow-up. Ann Maxillofac Surg 2017; 7:237-244. [PMID: 29264292 PMCID: PMC5717901 DOI: 10.4103/ams.ams_87_17] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Introduction: With introduction of the term “ossteointegration of dental implant” by Branemark, advancement in implantology from 1957 to 2017 has come a long way with modification in implant type and in loading time. This study aims to evaluate the survival of endo-osseous immediate loading (IL) implant and basal IL implants in atrophic jaws with objective to compare implant survival in atrophic jaws for full mouth rehabilitation between endo-osseous IL versus endo-osseous delayed loading (DL) versus basal IL during 3-year follow-up. Materials and Methods: Fifty-two (34 endo-osseous and 18 basal) implants were placed in 4 patients requiring full mouth rehabilitation in atrophic jaws. Case 1: Endo-osseous DL implants in upper and lower arch, Case 2: Endo-osseous IL implants in upper and lower arch, Case 3: Basal IL implant in upper and lower arch, and Case 4: Endo-osseous DL in upper arch and basal IL implant in the lower arch. Intraoperative evaluation was done on the basis of pain (visual analog scale [VAS]), operative time, and initial primary implant stability. Postoperative evaluation was done on pain (VAS), infection, radiographically successful implant (orthopantomogram), and patient satisfaction (Grade 0–10). Results: All cases showed satisfactory results but more amount of intra- and post-operative pain was felt with immediate basal implants. Conclusion: We believe that clinicians should comply with patient requests, and for this reason, we agree with some authors to use minimally invasive techniques and to avoid when possible esthetic or functional problems associated with the use of removable prosthesis after teeth extractions.
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Affiliation(s)
- Ritesh Garg
- Department of Oral and Maxillofacial Surgery, Institute of Dental Studies and Technology, Modinagar, Uttar Pradesh, India
| | - Neha Mishra
- Department of Endodontics and Conservative Dentistry, DJ College of Dental Science an Studies, Modinagar, Uttar Pradesh, India
| | - Mohan Alexander
- Department of Oral and Maxillofacial Surgery, MAHSA University, Kuala Lumpur, Malaysia
| | - Sunil Kumar Gupta
- Department of Oral and Maxillofacial Surgery, Saraswati Medical College, Hapur, Uttar Pradesh, India
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De Marco G, Di Francesco F, Lanza A. Analysis and management of implant-prosthetic complications: Description of a diagnostic and therapeutic algorithm with a clinical case. J Prosthodont Res 2017; 62:386-390. [PMID: 28844413 DOI: 10.1016/j.jpor.2017.08.001] [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] [Received: 02/15/2017] [Revised: 07/03/2017] [Accepted: 08/01/2017] [Indexed: 10/28/2022]
Abstract
PATIENT A 65-year-old non-smoker man with stabilized chronic periodontitis and in good general health conditions presented to our observation. The patient reported crown mobility, gingival inflammation and localized pain, corresponding to the mandibular right first molar rehabilitated with a cement-retained implant crown. This clinical situation suspected a fracture of an implant-prosthetic component. Through the described diagnostic algorithm, an abutment hexagon fracture was revealed. Thus, a minimally invasive treatment was carried out in order to use the residual implant-prosthetic components for a new implant-prosthetic rehabilitation. DISCUSSION Fractures of implant-prosthetic components are clinical occurrences that may result in irreversible failures. The main causes of a possible fracture are dependent on biomechanical considerations and production processes of implant-prosthetic components. The respect of the rigorous planning and the employment of the implant-prosthetic devices of the same manufacturer are recommended. CONCLUSIONS Specific employments and protocols have to be offered in order to manage the fractures of implant-prosthetic components. This work showed that through the described diagnostic and therapeutic algorithm, the clinician can be guided towards a proper diagnosis and a correct management of the cases where a fracture of implant-prosthetic components may occur.
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Affiliation(s)
- Gennaro De Marco
- Prosthodontics Division, Multidisciplinary Department of Medical, Surgical and Dental Sciences, Campania University Luigi Vanvitelli, Naples, Italy
| | - Fabrizio Di Francesco
- Prosthodontics Division, Multidisciplinary Department of Medical, Surgical and Dental Sciences, Campania University Luigi Vanvitelli, Naples, Italy
| | - Alessandro Lanza
- Prosthodontics Division, Multidisciplinary Department of Medical, Surgical and Dental Sciences, Campania University Luigi Vanvitelli, Naples, Italy.
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Giannakopoulos NN, Ariaans K, Eberhard L, Klotz AL, Oh K, Kappel S. Immediate and delayed loading of two-piece reduced-diameter implants with locator-analog attachments in edentulous mandibles: One-year results from a randomized clinical trial examining clinical outcome and patient expectation. Clin Implant Dent Relat Res 2017; 19:643-653. [PMID: 28440024 DOI: 10.1111/cid.12489] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 02/28/2017] [Accepted: 04/01/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND Prosthetic management of thin alveolar ridges in the edentulous mandibles of elderly patients, especially the time of loading, the number of implants needed, and patient expectations and perception, is a challenge in implant dentistry. PURPOSE Survival of conventionally and immediately loaded 2-piece reduced-diameter implants in the interforaminal region of the edentulous mandible supporting locator-analog attachments was evaluated. Prosthetic complications and peri-implant hygiene were also studied, and patient expectation and subjective evaluation of the treatment were documented. MATERIAL AND METHODS Twenty-five patients with adapted complete dentures received 4 reduced-diameter implants. All anterior implants were immediately loaded. Three months later, patients were allocated by randomization to 1 of 2 treatment groups: 2 locator-analog attachments on the anterior implants (Group A); or 4 locator-analog attachments (Group B). After another 3 months patient allocation was changed (crossover design) for the next 3 months. Questionnaires with Likert scales and numeric rating scales were used to assess patients' expectations and subjective overdenture-related variables, respectively. RESULTS One implant was lost in the immediate-loading group. Survival was 98% and 100% for immediate and delayed loading, respectively. During 12-month observation, 8 complications required aftercare. At the beginning of treatment, patients' expectations were highly positive. Subjective assessment of overdenture-related variables 3 months after immediate loading of 2 implants revealed a statistically significant improvement for most of the variables studied; this was maintained 1 year later. In the subjective assessments, there were no statistically significant differences between Groups A and B. CONCLUSION Immediate loading of reduced-diameter implants supporting locator-analog attachments resulted in high implant survival, few prosthetic complications, good oral hygiene, and improvement of subjective denture perception in the short-term. It might be a promising treatment option, especially for elderly patients with a narrow mandibular ridge.
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Affiliation(s)
| | - Kirsten Ariaans
- Department of Prosthodontics, University of Heidelberg, INF 400, Heidelberg, 69120, Germany
| | - Lydia Eberhard
- Department of Prosthodontics, University of Heidelberg, INF 400, Heidelberg, 69120, Germany
| | - Anna-Luisa Klotz
- Department of Prosthodontics, University of Heidelberg, INF 400, Heidelberg, 69120, Germany
| | - Keunyoung Oh
- Department of Prosthodontics, University of Heidelberg, INF 400, Heidelberg, 69120, Germany
| | - Stefanie Kappel
- Department of Prosthodontics, University of Heidelberg, INF 400, Heidelberg, 69120, Germany
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Abstract
The orthopedic field has accumulated ample evidence that bone formation is related to functional loading and in general to physical activity. However, despite evidence that immediately loaded implants can be predictably successful, many clinicians still use the classical (delayed loading) treatment protocol. This paper examines the effects of loading on dental implants and discusses the advantages of immediate loading. The role of loading on augmented alveolar ridges is also addressed and provides evidence that early bone resorption may be controlled when bone is functionally loaded. Similar data are emerging for advanced augmentation techniques in order to control crestal bone loss.
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Muelas-Jiménez MI, Olmedo-Gaya MV, Manzano-Moreno FJ, Reyes-Botella C, Vallecillo-Capilla M. Long-Term Survival of Dental Implants with Different Prosthetic Loading Times in Healthy Patients: A 5-Year Retrospective Clinical Study. J Prosthodont 2015; 26:99-106. [DOI: 10.1111/jopr.12371] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2015] [Indexed: 11/27/2022] Open
Affiliation(s)
| | | | | | - Candela Reyes-Botella
- Department of Stomatology, School of Dentistry; University of Granada; Granada Spain
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Abstract
OBJECTIVE To investigate the clinical immediate load at an angle after immediate placement of the implant. METHODS Select 4 adult dogs; through establishing the angle loading animal experiment model, perform lateral loading on 32 implants respectively at vertical and 0°, 10°, and 20°, with which as a basis for grouping, determine the osseointegration index and new bone growth rate; and observe the peri-implant bone remodeling conditions. RESULTS The 20° group is found with the most obvious bone absorption, and compared with other groups, its osseointegration index and new bone growth rate are statistically significant (P < 0.01); bone remodeling under 0° load stress is the best, with the formation of new bone and the highest bone contact ratio, which is the most reasonable under this the stress distribution compared with other angles. CONCLUSIONS The implant stress distribution at 0° against the occlusal force direction is closer to physiologic optimum stress on the implant bone interface, and it is permitted for the long axis of the immediately implanted and immediately loaded implant to be tilted within about 10° against the load angle.
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Cavalcanti AGDA, Fonseca FTA, Zago CDR, Brito Junior RB, França FMG. Efficacy of Gutta-Percha and Polytetrafluoroethylene Tape to Microbiologically Seal the Screw Access Channel of Different Prosthetic Implant Abutments. Clin Implant Dent Relat Res 2015; 18:778-87. [PMID: 25873366 DOI: 10.1111/cid.12344] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
PURPOSE To evaluate in vitro, the efficacy of gutta-percha (GP) and polytetrafluoroethylene (PTFE) tape to act as a seal against the penetration of Escherichia coli through prosthetic implant abutments (PIA) with external hexagon (EH) and morse taper (MT) connections. MATERIALS AND METHODS 120 sets of implant analogs with their respective PIA were used. 60 sets from each system were divided into four groups (n = 15): I - GP sealing; II - PTFE tape sealing; III - no sealing (NS) and IV - negative control. Microbiological challenge was performed by placing bacterial colonies inside the titanium PIA before screwing them into their respective analogs. Each set was immersed in 5 mL of BHI and incubated for 14 days with daily checks for contamination, according to the nutrient medium turbidity. RESULTS The type of seal used influenced microbial penetration at all evaluation times (p < 0.05). Compared to GP, PTFE led to an increase in turbidity and its effectiveness against microbial penetration was equivalent to group NS. When the sealing efficacy of each group was compared in terms of time, Cochran's Q test revealed that in the two groups sealed with PTFE, there was a progressive increase in the number of turbid nutrient media (p < 0.0001), while in the group sealed with GP, this was only observed in the MT system (p = 0.0310). CONCLUSIONS Sealing the PIA channel with GP was a significantly superior approach to sealing it with PTFE tape. PTFE tape or NS led to a progressive increase in microbiological leakage over time in PIA channels, however, this only occurred with GP in the MT system.
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Göthberg C, André U, Gröndahl K, Thomsen P, Slotte C. Bone Response and Soft Tissue Changes Around Implants With/Without Abutments Supporting Fixed Partial Dentures: Results From a 3-Year, Prospective, Randomized, Controlled Study. Clin Implant Dent Relat Res 2015; 18:309-22. [PMID: 25801339 DOI: 10.1111/cid.12315] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Diverging opinions exist regarding rough surface abutment usage, and abutment exclusion effects are unstudied. PURPOSE The study aims to: (1) assess tissue response to oxidized or machined abutments or no abutment; and (2) evaluate immediate implant-loading effects. MATERIALS AND METHODS In a 2005-2008 parallel-group randomized, clinical trial, 50 partially edentulous subjects received three Brånemark TiUnite™ (Nobel Biocare®, Gothenburg, Sweden) implants. Superstructures were attached via abutments (one with a TiUnite surface - AOX, and one with a machine-milled surface - AM) or directly at implant level (IL). Implants were immediately loaded (test) or unloaded for 3 months (control). Postoperative examinations were done up to 3 years. RESULTS Forty-seven subjects were reexamined after 3 years. Four and two implants were lost in test and control groups, respectively, during the first year. Thereafter, no implant loss occurred (95.7% survival). After 1 year, mean (SEM) peri-implant marginal bone loss (MBL) was 1.33 (0.08) mm (test) and 1.25 (0.08) mm (control). Between 1 and 3 years, a nonsignificant MBL occurred: 0.36 (0.08) mm (test) and 0.33 (0.06) mm (control). Similar MBL was found at IL (1.81 [0.93] mm) and AOX (1.77 [0.14] mm) after 3 years and was significantly lower at AM (1.42 [0.17] mm) than at IL (groups merged); 42% of the implants displayed mucosal bleeding at 3 years and probing pocket depths varied between 2.13 (0.12) mm and 3.62 (0.15) mm, significantly lower buccally. Bleeding on probing (BoP) in minute amounts was found in 30-45% of the sites and abundant BoP at about 20% of the sites. Soft tissue retracted mostly during year 1 and was more pronounced buccally. Regression analyses revealed significant effects from smoking, periodontal disease, abundant BoP, and a low initial implant stability quotient on MBL. CONCLUSIONS No further significant MBL was found between 1 and 3 years, irrespective of loading protocol. Use of machined abutments may benefit marginal bone stability over time.
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Affiliation(s)
- Catharina Göthberg
- Department of Prosthetic Dentistry, The Institute for Postgraduate Dental Education, Jönköping, Sweden.,Department of Biomaterials, VINN Excellence Center of Biomaterials and Cell Therapy, Institute for Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - Ulrika André
- Department of Prosthetic Dentistry, The Institute for Postgraduate Dental Education, Jönköping, Sweden
| | - Kerstin Gröndahl
- Department of Oral and Maxillofacial Radiology, The Institute for Postgraduate Dental Education, Jönköping, Sweden
| | - Peter Thomsen
- Department of Biomaterials, VINN Excellence Center of Biomaterials and Cell Therapy, Institute for Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - Christer Slotte
- Department of Biomaterials, VINN Excellence Center of Biomaterials and Cell Therapy, Institute for Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden.,Department of Periodontology, The Institute for Postgraduate Dental Education, Jönköping, Sweden
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Wentaschek S, Scheller H, Schmidtmann I, Hartmann S, Weyhrauch M, Weibrich G, Lehmann KM. Sensitivity and Specificity of Stability Criteria for Immediately Loaded Splinted Maxillary Implants. Clin Implant Dent Relat Res 2014; 17 Suppl 2:e542-9. [PMID: 25536516 DOI: 10.1111/cid.12283] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND To assess the suitability of dental implants for immediate loading, primary stability is usually evaluated intraoperatively. PURPOSE This retrospective study aimed to assess the suitability of three stability parameters - namely, insertion torque (IT), implant stability quotient (ISQ; measured by resonance frequency analysis), and Periotest (PT) values - as potential predictors for the risk of nonosseointegration of immediately loaded splinted implants. The stability parameters were routinely collected under immediate loading. MATERIALS AND METHODS Nineteen patients with 11 edentulous and 8 partially edentulous maxillae were treated with 105 dental implants, which were immediately loaded using temporary fixed dentures. The IT results, PT values, and ISQ results were recorded. Receiver operating characteristic analysis was performed to assess the quality of each parameter as a diagnostic test. RESULTS After a 3-month observation period, 11 implants in four patients were not osseointegrated. The IT and ISQ (IT 25.0 ± 12.5 Ncm and 8.4 ± 2.3 Ncm; PT -1.5 ± 3.0 and +2.7 ± 3.0; and ISQ 62.6 ± 6.7 and 54.7 ± 6.2) differed significantly between the osseointegrated and failed implants (p < .005). The IT showed the greatest specificity at a sensitivity of 1 and the greatest area under the curve (AUC; 0.929), followed by the PT value (AUC = 0.836) and ISQ (AUC = 0.811). CONCLUSIONS Among the intraoperative parameters analyzed, IT showed the highest specificity at a high sensitivity of 1. Therefore, the IT can be considered the most valid prognostic factor for osseointegration of immediately loaded splinted dental implants.
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Affiliation(s)
- Stefan Wentaschek
- Department of Prosthetic Dentistry, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Herbert Scheller
- Department of Prosthetic Dentistry, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Irene Schmidtmann
- Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Sinsa Hartmann
- Department of Prosthetic Dentistry, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Michael Weyhrauch
- Department of Prosthetic Dentistry, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Gernot Weibrich
- Department of Prosthetic Dentistry, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Karl Martin Lehmann
- Department of Prosthetic Dentistry, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
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19
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Simamoto-Júnior PC, Fernandes-Neto AJ, Neves FD, Dantas TS, Naves LZ. Retrieval technique for full-arch implant-supported fixed prosthesis: a clinical report. J Prosthodont 2014; 24:168-71. [PMID: 24990286 DOI: 10.1111/jopr.12185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2014] [Indexed: 11/28/2022] Open
Abstract
In the event of the loss of an implant and to take advantage of the preexisting structures, a rescue procedure that allows continuous use of the original fixed restoration during the restoration of the tripod support at the implant level can be used. When nonphysiological occlusion forces are avoided, the success rate of this rescue procedure is very similar to any other rehabilitation made following a conventional protocol. Furthermore, the fact that the patient has already adapted to the prosthesis position and its vertical dimension results in easier functional adaptation in the postoperative period and, consequently, greater comfort.
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Affiliation(s)
- Paulo César Simamoto-Júnior
- Department of Occlusion, Fixed Prosthodontics and Dental Materials, Federal University of Uberlândia, Uberlândia, Brazil
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20
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Hultin M, Svensson KG, Trulsson M. Clinical advantages of computer-guided implant placement: a systematic review. Clin Oral Implants Res 2013; 23 Suppl 6:124-35. [PMID: 23062137 DOI: 10.1111/j.1600-0501.2012.02545.x] [Citation(s) in RCA: 126] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To systematically scrutinize the current scientific literature regarding the clinical advantages of computer guidance of implant placement. MATERIALS AND METHODS Four electronic databases were searched using specified indexing terms. The reference lists of publications were also searched manually. For inclusion, publications had to meet pre-established criteria. RESULTS The searches yielded 1028 titles and abstracts. After data extraction and interpretation, 28 publications and 2 systematic reviews remained for inclusion. Fifteen studies were prospective observational and four were retrospective observational. Nine studies included a control group (controlled clinical trials) of which seven were prospective and two retrospective. Only three of the prospective studies were randomized (RCT's). A total of 852 patients were treated with 4032 implants using computer-guided implant surgery. The number of patients included in each study ranged from 6 to 206. The age ranged from 16 to 92 years and the follow-up period varied between 1 and 49 months. CONCLUSIONS The limited scientific evidence available suggests that guided placement has at least as good implant survival as conventional protocols. However, several unexpected procedure-linked adverse events during guided implant placement indicate that the clinical demands on the surgeon were no less than those during conventional placement. A clinical advantage with flapless guided surgery is that the technique is likely to decrease pain and discomfort in the immediate postoperative period.
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Affiliation(s)
- Margareta Hultin
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, PO Box 4064, SE-141 04, Huddinge, Sweden.
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21
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Rea M, Botticelli D, Ricci S, Soldini C, González GG, Lang NP. Influence of immediate loading on healing of implants installed with different insertion torques - an experimental study in dogs. Clin Oral Implants Res 2013; 26:90-5. [DOI: 10.1111/clr.12305] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Massimiliano Rea
- Faculty of Dentistry; University of Medical Science; La Habana Cuba
| | - Daniele Botticelli
- Faculty of Dentistry; University of Medical Science; La Habana Cuba
- Faculdade de Odontologia de Araçatuba; Universidade Estadual Paulista (UNESP); Araçatuba Brasil
- ARDEC; Ariminum Odontologica; Rimini Italy
- Prince Philip Dental Hospital; The University of Hong Kong; Hong Kong China
| | | | | | | | - Niklaus P. Lang
- Prince Philip Dental Hospital; The University of Hong Kong; Hong Kong China
- University of Zurich; Zurich Switzerland
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22
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Calvo-Guirado JL, Aguilar-Salvatierra A, Delgado-Ruiz RA, Negri B, Fernández MPR, Maté Sánchez de Val JE, Gómez-Moreno G, Romanos GE. Histological and Histomorphometric Evaluation of Zirconia Dental Implants Modified by Femtosecond Laser versus Titanium Implants: An Experimental Study in Fox Hound Dogs. Clin Implant Dent Relat Res 2013; 17:525-32. [DOI: 10.1111/cid.12162] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
| | | | - Rafael Arcesio Delgado-Ruiz
- Department of Prosthodontics and Digital Technology; School of Dental Medicine; Stony Brook University; Stony Brook NY USA
| | - Bruno Negri
- Faculty of Medicine and Dentistry; University of Murcia; Murcia Spain
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23
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Stokholm R, Isidor F, Nyengaard JR. Histologic and histomorphometric evaluation of peri-implant bone of immediate or delayed occlusal-loaded non-splinted implants in the posterior mandible--an experimental study in monkeys. Clin Oral Implants Res 2013; 25:1311-1318. [PMID: 24118392 DOI: 10.1111/clr.12274] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The primary aim of this study was to compare the bone reaction around immediate-loaded non-splinted single implants vs. delayed loaded non-splinted single implants placed in healed ridges in the posterior mandible. MATERIALS AND METHODS Six adult Macaca Fascicularis monkeys were used in this study. The first and second premolars and the first molar were extracted in both sides of the mandible. After 3 months of healing, four implants (Replace Select Tapered; Nobel Biocare, Gothenburg, Sweden) with a moderately rough surface (TiUnite, Nobel Biocare) were placed in the edentulous areas of each monkey, two in each side. The implants had a length of 10 mm and a diameter of 3.5 mm. Four groups of varying time and occlusal loading aspects were created: (i) control group: implant placed non-loaded for 3 months; (ii) immediate loaded: implant placed and loaded immediately for 3 months; (iii) immediate loaded: implant placed and loaded immediately for 6 months; and (iv) delayed loaded: implant placed submerged for 3 months and then loaded for 3 months. At the loaded implants, after a second stage surgery, a composite crown was made directly on an abutment mounted on the implant reinsuring simultaneous occlusal contact on the implant crown and the neighboring teeth. After euthanization of the animals, histologic specimens were quantified in the light microscope. RESULTS All implants were clinically, radiographically, and histologically osseointegrated at the time of euthanization and with only mild signs of inflammation in the peri-implant mucosa. The histologic marginal bone level was located on average 1.14-1.74 mm apical to the margin of the implants in the various groups. The average bone-to-implant contact (BIC) varied between 55% and 65% and the average bone density (i.e., the proportion of mineralized bone tissue from the implant surface and to a distance of 1 mm lateral to the implant) varied between 30.6% and 34.2%. No statistical significant differences between groups were observed in the above-stated histomorphometric parameters. CONCLUSIONS Similar histologic and histomorphometric findings were observed in immediately and delayed loaded non-splinted implants placed in the posterior mandible of macaque monkeys.
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Affiliation(s)
- Rie Stokholm
- Section of Prosthetic Dentistry, Department of Dentistry, Aarhus University, Aarhus, Denmark
| | - Flemming Isidor
- Section of Prosthetic Dentistry, Department of Dentistry, Aarhus University, Aarhus, Denmark
| | - Jens R Nyengaard
- Stereology and Electron Microscopy Laboratory, Centre for Stochastic Geometry and Advanced Bioimaging, Aarhus University, Aarhus, Denmark
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24
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Wu AYJ, Huang HL, Hsu JT, Chee W. Biomechanical effects of the implant material and implant-abutment interface in immediately loaded small-diameter implants. Clin Oral Investig 2013; 18:1335-1341. [PMID: 23999686 DOI: 10.1007/s00784-013-1099-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2013] [Accepted: 08/21/2013] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Small-diameter implants have been available since the 1990s, but few studies have analyzed their mechanical properties. This study evaluated the effects of the implant material and the implant-abutment connection designs on the primary stability and the marginal bone strain of small-diameter implant subject to immediate loading. MATERIALS AND METHODS Insertion torque value (ITV), implant stability quotient (ISQ), and Periotest value (PTV) of three implant systems with four parameters (titanium, titanium alloy, internal and external hexagon connections) were measured after placing implants into artificial type 2 jaw-bone models. Specimens were tested under both vertical and oblique static loads at 190 N. Peak values of the principal bone strain were recorded and analyzed statistically by the Kruskal-Wallis test and multiple-comparisons Bonferroni test. RESULTS PTV and ISQ were higher for the NIOSM311 (internal-hex and Ti alloy) and FOSM311 (external-hex and pure Ti) implants, respectively, than for the NOSM311 (external-hex and Ti alloy) implant. Under vertical loading the peak value of peri-implant bone strains did not differ significantly among these three implant systems. However, the peak bone strains were at least 32 % lower for the NIOSM311 and FOSM311 implants than for the NOSM311 implant under lateral loading. CONCLUSIONS The implant material and the implant-abutment connection design significantly influence the peri-implant bone strain of immediately loaded small-diameter implants, but barely affect their primary stability. CLINICAL RELEVANCE A commercially pure titanium implant with an internal connection has the potential to reduce the risk of implant failure of small-diameter implant related to biomechanical complications.
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Affiliation(s)
- Aaron Yu-Jen Wu
- Department of Dentistry, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Heng-Li Huang
- School of Dentistry, China Medical University, Taichung, Taiwan
| | - Jui-Ting Hsu
- School of Dentistry, China Medical University, Taichung, Taiwan
| | - Winston Chee
- Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA. .,Center for Prosthetic Dentistry, Glendale, CA, USA.
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25
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Andersen OZ, Offermanns V, Sillassen M, Almtoft KP, Andersen IH, Sørensen S, Jeppesen CS, Kraft DC, Bøttiger J, Rasse M, Kloss F, Foss M. Accelerated bone ingrowth by local delivery of strontium from surface functionalized titanium implants. Biomaterials 2013; 34:5883-90. [DOI: 10.1016/j.biomaterials.2013.04.031] [Citation(s) in RCA: 132] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Accepted: 04/16/2013] [Indexed: 01/31/2023]
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26
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Yamamoto M, Ogawa T, Yokoyama M, Koyama S, Sasaki K. Influence of immediate and early loading on bone metabolic activity around dental implants in rat tibiae. Clin Oral Implants Res 2013; 25:1084-90. [PMID: 23802506 DOI: 10.1111/clr.12218] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2013] [Indexed: 01/28/2023]
Abstract
OBJECTIVES The aim of this study was to examine the influence of immediate and early loading on dynamic changes in bone metabolism around dental implants using bone scintigraphy. MATERIAL AND METHODS Two titanium implants were inserted in the right tibiae of 21 rats. Closed coil springs with 4.0-N loads were applied parallel to the upper portion of the implants for 35 days. According to the load application timing, rats were divided into three groups: immediate loading (IL) group, early loading 1 day after implant insertion (1-D early loading [EL]) group, and loading 3 days after implant insertion (3-D EL) group. Rats were intravenously injected with technetium-99 m-methylene diphosphonate (Tc99 m-MDP) (74 MBq/rat) and scanned by bone scintigraphy at 1, 4, 7, 11, 14, 21, 28, and 35 days after load application. The ratio of accumulation of Tc99 m-MDP around the implants to that of a reference site (uptake ratio) was calculated to evaluate bone metabolism. RESULTS In every group, the uptake ratio increased until 7 days after load application and then gradually decreased. It was significantly higher than baseline at 4, 7, 11, and 14 days (P < 0.001). The uptake ratio in the 1-D EL and 3-D EL groups were significantly higher than that in the control group and also that in the IL group (P < 0.001). CONCLUSIONS Bone metabolism initially increased and then gradually decreased to baseline despite differences in load timing. Increases in bone metabolic activity differed according to load application timing; the later the load application, the more enhanced the bone metabolism.
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Affiliation(s)
- Miou Yamamoto
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
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27
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Huang Y, Van Dessel J, Liang X, Depypere M, Zhong W, Ma G, Lambrichts I, Maes F, Jacobs R. Effects of immediate and delayed loading on peri-implant trabecular structures: a cone beam CT evaluation. Clin Implant Dent Relat Res 2013; 16:873-83. [PMID: 23551564 DOI: 10.1111/cid.12063] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE To develop a method for characterizing trabecular bone microarchitecture using cone beam computed tomography (CBCT) and to evaluate trabecular bone changes after rehabilitation using immediate versus delayed implant protocols. MATERIALS AND METHODS Six mongrel dogs randomly received 27 titanium implants in the maxillary incisor or mandibular premolar areas, following one of four protocols: (1) normal extraction socket healing; (2) immediate implant placement and immediate loading; (3) delayed implant placement and delayed loading; (4) delayed implant placement and immediate loading. The animals were euthanized at 8 weeks, and block biopsies were scanned using high resolution CBCT. Standard bone structural variables were assessed in coronal, middle, and apical levels. RESULTS Coronal and middle regions had more compact, more platelike, and thicker trabeculae. Protocols (2), (3), and (4) had significantly higher values (p < 0.001) than protocol (1) for bone surface density, bone surface volume ratio, and connectivity density, while significantly lower values (p < 0.001) were found for trabecular separation and fractal dimension. However, protocols (2), (3), and (4) did not show significantly different bone remodeling. CONCLUSIONS Compared with normal extraction healing, the implant protocols have an improved bone structural integration. Results do not suggest a different bone remodeling pattern when a delayed versus an immediate implant protocol is used.
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Affiliation(s)
- Yan Huang
- Oral Imaging Center, Department of Oral Health Science, KU Leuven, Leuven, Belgium; Oral Implant Center, West China College of Stomatology, Sichuan University, Chengdu, China
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28
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Calvo-Guirado JL, Aguilar-Salvatierra A, Gomez-Moreno G, Guardia J, Delgado-Ruiz RA, Mate-Sanchez de Val JE. Histological, radiological and histomorphometric evaluation of immediate vs. non-immediate loading of a zirconia implant with surface treatment in a dog model. Clin Oral Implants Res 2013; 25:826-30. [DOI: 10.1111/clr.12145] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2013] [Indexed: 11/27/2022]
Affiliation(s)
- Jose L. Calvo-Guirado
- Department of Implant Dentistry; Faculty of Medicine and Dentistry; University of Murcia; Murcia Spain
| | - Antonio Aguilar-Salvatierra
- Department of Pharmacological Research in Dentistry and Special Care; Faculty of Dentistry; University of Granada; Granada Spain
| | - Gerardo Gomez-Moreno
- Department of Pharmacological Research in Dentistry and Special Care; Faculty of Dentistry; University of Granada; Granada Spain
| | - Javier Guardia
- Department of Pharmacological Research in Dentistry and Special Care; Faculty of Dentistry; University of Granada; Granada Spain
| | - Rafael A. Delgado-Ruiz
- Department of Implant Dentistry; Faculty of Medicine and Dentistry; University of Murcia; Murcia Spain
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29
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Esposito M, Grusovin MG, Maghaireh H, Worthington HV. Interventions for replacing missing teeth: different times for loading dental implants. Cochrane Database Syst Rev 2013; 2013:CD003878. [PMID: 23543525 PMCID: PMC7156879 DOI: 10.1002/14651858.cd003878.pub5] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND To minimise the risk of implant failures after their placement, dental implants are kept load-free for 3 to 8 months to establish osseointegration (conventional loading). It would be beneficial if the healing period could be shortened without jeopardising implant success. Nowadays implants are loaded early and even immediately and it would be useful to know whether there is a difference in success rates between immediately and early loaded implants compared with conventionally loaded implants. OBJECTIVES To evaluate the effects of (1) immediate (within 1 week), early (between 1 week and 2 months), and conventional (after 2 months) loading of osseointegrated implants; (2) immediate occlusal versus non-occlusal loading and early occlusal versus non-occlusal loading; (3) direct loading versus progressive loading immediately, early and conventionally. SEARCH METHODS The following electronic databases were searched: the Cochrane Oral Health Group's Trials Register (to 8 June 2012), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, 2012, Issue 4), MEDLINE via OVID (1946 to 8 June 2012) and EMBASE via OVID (1980 to 8 June 2012). Authors of identified trials were contacted to find unpublished randomised controlled trials (RCTs). There were no restrictions regarding language or date of publication. SELECTION CRITERIA All RCTs of root-form osseointegrated dental implants, having a follow-up of 4 months to 1 year, comparing the same implant type immediately, early or conventionally loaded, occlusally or non-occlusally loaded, or progressively loaded or not. Outcome measures were: prosthesis and implant failures and radiographic marginal bone level changes. DATA COLLECTION AND ANALYSIS Data were independently extracted, in duplicate, by at least two review authors. Trial authors were contacted for missing information. Risk of bias was assessed for each trial by at least two review authors, and data were extracted independently, and in duplicate. Results were combined using fixed-effect models with mean differences (MD) for continuous outcomes and risk ratios (RR) for dichotomous outcomes with 95% confidence intervals (CI). A summary of findings table of the main findings was constructed. MAIN RESULTS Forty-five RCTs were identified and, from these, 26 trials including a total of 1217 participants and 2120 implants were included. Three trials were at low risk of bias, 12 were at high risk of bias and for the remaining 11 the risk of bias was unclear. In nine of the included studies there were no prosthetic failures within the first year, with no implant failures in 7 studies and the mean rate of implant failure in all 26 trials was a low 2.5%. From 15 RCTs comparing immediate with convential loading there was no evidence of a difference in either prosthesis failure (RR 1.87; 95% CI 0.70 to 5.01; 8 trials) or implant failure (RR 1.65; 95% CI 0.68 to 3.98; 10 trials) in the first year, but there is some evidence of a small reduction in bone loss favouring immediate loading (MD -0.10 mm; 95% CI -0.20 to -0.01; P = 0.03; 9 trials), with some heterogeneity (Tau² = 0.01; Chi² = 14.37, df = 8 (P = 0.07); I² = 44%). However, this very small difference may not be clinically important. From three RCTs which compared early loading with conventional loading, there is insufficient evidence to determine whether or not there is a clinically important difference in prosthesis failure, implant failure or bone loss. Six RCTs compared immediate and early loading and found insufficient evidence to determine whether or not there is a clinically important difference in prosthesis failure, implant failure or bone loss. From the two trials which compared occlusal loading with non-occlusal loading there is insufficient evidence to determine whether there is a clinically important difference in the outcomes of prosthesis failure, implant failure or bone loss. We did not identify any trials which evaluated progressive loading of implants. AUTHORS' CONCLUSIONS Overall there was no convincing evidence of a clinically important difference in prosthesis failure, implant failure, or bone loss associated with different loading times of implants. More well-designed RCTs are needed and should be reported according to the CONSORT guidelines (www.consort-statement.org/).
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Affiliation(s)
- Marco Esposito
- Cochrane Oral Health Group, School of Dentistry, The University of Manchester, Manchester, UK.
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30
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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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31
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Göthberg C, André U, Gröndahl K, Ljungquist B, Thomsen P, Slotte C. Immediately Loaded Implants with or without Abutments Supporting Fixed Partial Dentures: 1-Year Results from a Prospective, Randomized, Clinical Trial. Clin Implant Dent Relat Res 2013; 16:487-500. [DOI: 10.1111/cid.12025] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Catharina Göthberg
- Department of Prosthetic Dentistry; The Institute for Postgraduate Dental Education; Jönköping Sweden
- Department of Biomaterials; VINN Excellence Center of Biomaterials and Cell Therapy; Institute for Clinical Sciences; Sahlgrenska Academy; University of Gothenburg; Göteborg Sweden
| | - Ulrika André
- Department of Prosthetic Dentistry; The Institute for Postgraduate Dental Education; Jönköping Sweden
| | - Kerstin Gröndahl
- Department of Oral & Maxillofacial Radiology; The Institute for Postgraduate Dental Education; Jönköping Sweden
| | | | - Peter Thomsen
- Department of Biomaterials; VINN Excellence Center of Biomaterials and Cell Therapy; Institute for Clinical Sciences; Sahlgrenska Academy; University of Gothenburg; Göteborg Sweden
| | - Christer Slotte
- Department of Periodontology; The Institute for Postgraduate Dental Education; Jönköping Sweden
- Department of Biomaterials; VINN Excellence Center of Biomaterials and Cell Therapy; Institute for Clinical Sciences; Sahlgrenska Academy; University of Gothenburg; Göteborg Sweden
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Bone Morphometric Evaluation around Immediately Placed Implants Covered with Porcine-Derived Pericardium Membrane: An Experimental Study in Dogs. Int J Biomater 2012; 2012:279167. [PMID: 23227052 PMCID: PMC3512292 DOI: 10.1155/2012/279167] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2012] [Accepted: 10/24/2012] [Indexed: 11/24/2022] Open
Abstract
Objective. To investigate whether porcine-derived bioresorbable pericardium membrane coverage enhances the osseointegration around implants placed in fresh extraction sockets. Study Design. Twenty-four commercially available endosseous implants were placed in the fresh extraction sockets of the mandibular first molar of mature beagles (n = 6). On one side, implants and osteotomy sites were covered with porcine-derived bioresorbable pericardium membranes, whereas on the other side, no membranes were used. After 6 weeks, samples were retrieved and were histologically processed for histomorphometric analysis. Results. The histological observation showed that bone loss and soft tissue migration in the coronal region of the implant were evident for the control group, whereas bone fill was evident up to the neck of the implant for the membrane-covered group. Bone-to-implant contact was significantly higher for the membrane-covered group compared to the control group, 75% and 45% (P < 0.02), respectively. Conclusion. The experimental membranes proved to regenerate bone around implants placed in fresh extraction sockets without soft tissue intrusion.
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Yoon JH, Park YB, Cho Y, Kim CS, Choi SH, Moon HS, Lee KW, Shim JS. Development of implant loading device for animal study about various loading protocol: a pilot study. J Adv Prosthodont 2012; 4:227-34. [PMID: 23236575 PMCID: PMC3517961 DOI: 10.4047/jap.2012.4.4.227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2012] [Revised: 11/06/2012] [Accepted: 11/12/2012] [Indexed: 11/21/2022] Open
Abstract
PURPOSE The aims of this pilot study were to introduce implant loading devices designed for animal study and to evaluate the validity of the load transmission ability of the loading devices. MATERIALS AND METHODS Implant loading devices were specially designed and fabricated with two implant abutments and cast metal bars, and orthodontic expansion screw. In six Beagles, all premolars were extracted and two implants were placed in each side of the mandibles. The loading device was inserted two weeks after the implant placement. According to the loading protocol, the load was applied to the implants with different time and method,simulating early, progressive, and delayed loading. The implants were clinically evaluated and the loading devices were removed and replaced to the master cast, followed by stress-strain analysis. Descriptive statistics of remained strain (µε) was evaluated after repeating three cycles of the loading device activation. Statistic analysis was performed using nonparametric, independent t-test with 5% significance level and Friedman's test was also used for verification. RESULTS The loading devices were in good action. However, four implants in three Beagles showed loss of osseointegration. In stress-strain analysis, loading devices showed similar amount of increase in the remained strain after applying 1-unit load for three times. CONCLUSION Specialized design of the implant loading device was introduced. The loading device applied similar amount of loads near the implant after each 1-unit loading. However, the direction of the loads was not parallel to the long axis of the implants as predicted before the study.
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Affiliation(s)
- Joon-Ho Yoon
- Department of Prosthodontics, Yonsei University College of Dentistry, Seoul, Korea
| | - Young-Bum Park
- Department of Prosthodontics, Yonsei University College of Dentistry, Seoul, Korea
| | - Yuna Cho
- Department of Prosthodontics, Yonsei University College of Dentistry, Seoul, Korea
| | - Chang-Sung Kim
- Department of Periodontology, Yonsei University College of Dentistry, Seoul, Korea
| | - Seong-Ho Choi
- Department of Periodontology, Yonsei University College of Dentistry, Seoul, Korea
| | - Hong-Seok Moon
- Department of Prosthodontics, Yonsei University College of Dentistry, Seoul, Korea
| | - Keun-Woo Lee
- Department of Prosthodontics, Yonsei University College of Dentistry, Seoul, Korea
| | - June-Sung Shim
- Department of Prosthodontics, Yonsei University College of Dentistry, Seoul, Korea
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Thoma DS, Martin IS, Mühlemann S, Jung RE. Systematic review of pre-clinical models assessing implant integration in locally compromised sites and/or systemically compromised animals. J Clin Periodontol 2012; 39 Suppl 12:37-62. [PMID: 22533946 DOI: 10.1111/j.1600-051x.2011.01833.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The aim was to systematically search the dental literature for pre-clinical models assessing implant integration in locally compromised sites (part 1) and systemically compromised animals (part 2), and to evaluate the quality of reporting of included publications. METHODS A Medline search (1966-2011) was performed, complimented by additional hand searching. The quality of reporting of the included publications was evaluated using the 20 items of the ARRIVE (Animals in Research In Vivo Experiments) guidelines. RESULTS One-hundred and seventy-six (part 1; mean ARRIVE score = 15.6 ± 2.4) and 104 (part 2; 16.2 ± 1.9) studies met the inclusion criteria. The overall mean score for all included studies amounted to 15.8 ± 2.2. Housing (38.3%), allocation of animals (37.9%), numbers analysed (50%) and adverse events (51.4%) of the ARRIVE guidelines were the least reported. Statistically significant differences in mean ARRIVE scores were found depending on the publication date (p < 0.05), with the highest score of 16.7 ± 1.6 for studies published within the last 2 years. CONCLUSIONS A large number of studies met the inclusion criteria. The ARRIVE scores revealed heterogeneity and missing information for selected items in more than 50% of the publications. The quality of reporting shifted towards better-reported pre-clinical trials within recent years.
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Affiliation(s)
- Daniel S Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland.
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Romanos GE, May S, May D. Implant-supporting telescopic maxillary prostheses and immediate loading. Clin Implant Dent Relat Res 2012; 16:412-8. [PMID: 22998571 DOI: 10.1111/cid.12003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
UNLABELLED Immediate loading (IL) in the maxilla is a successful concept when implants are splinted together using a fixed restoration. This concept is associated with high number of implants or difficulties in the plaque control underneath the restoration, which may reduce the patient comfort and satisfaction and compromise the implant prognosis. OBJECTIVE The aim of this study was to evaluate the long-term clinical outcome of implants placed in the maxilla using telescopic-retained removable prostheses under immediate functional loading protocol. MATERIAL AND METHODS The present retrospective study included 117 implants with a progressive thread design placed in 26 patients (age 57.04 ± 8.87 years old) with clinical and radiographic evaluation for a period of at least 2 years. A total of 29 implants (24.79%) were placed in fresh extraction sockets. All implants were placed 1-3 mm subcrestally from the mid-facial crest of bone level. The implants were connected immediately after placement with conical prefabricated abutments (4- to 6-degree angle) using a final torque of 15 Ncm immediately after surgery. Secondary prefabricated copings with precise fit for the abutments were placed and the partial dentures were relined chair-side. The restorations were palate-free and were to remain in place without removal for 10 days to splint the implants together. RESULTS After a loading period of 54.42 ± 15.68 months (min. 26 months/max. 87 months), the study showed 7 failures (5.98% failure rate), and 10 implants presented a crestal bone loss of more than 2 mm (8.55%). This represented a cumulative survival rate of 94.02% and a success rate for the evaluated implants of 85.47%. All patients were satisfied with the stability of their prostheses and no complications were reported. CONCLUSIONS Telescopic implant-supported maxillary prostheses in conjunction with IL present an alternative prosthetic solution for the edentulous maxilla, providing long-term predictability and improving the patient comfort and clinical outcome.
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Affiliation(s)
- Georgios E Romanos
- Department of Oral Surgery and Implant Dentistry, University of Frankfurt, Frankfurt, Germany; School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA
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Del Corso M, Mazor Z, Rutkowski JL, Dohan Ehrenfest DM. The use of leukocyte- and platelet-rich fibrin during immediate postextractive implantation and loading for the esthetic replacement of a fractured maxillary central incisor. J ORAL IMPLANTOL 2012; 38:181-7. [PMID: 22568469 DOI: 10.1563/aaid-joi-d-12-cl.3802] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Veyrune JL, Opé S, Nicolas E, Woda A, Hennequin M. Changes in mastication after an immediate loading implantation with complete fixed rehabilitation. Clin Oral Investig 2012; 17:1127-34. [PMID: 22814760 DOI: 10.1007/s00784-012-0787-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2012] [Accepted: 07/02/2012] [Indexed: 10/28/2022]
Abstract
OBJECTIVE This study aimed to measure modifications of mastication after immediate loading full-arch prosthesis (ILFAP) rehabilitation. MATERIALS AND METHOD Fourteen patients were observed before and 6 months after ILFAP rehabilitation when masticating two natural, standardized foods (peanut and carrot) and three model foods with increasing hardness. The granulometry of the expectorated boluses from carrot and peanuts was characterized by median particle size (D50), determined at the natural point of swallowing. Chewing time (CT), number of chewing cycles (CC), and chewing frequency (CF) were video recorded. A self-assessment questionnaire for oral health-related quality of life [Geriatric Oral Health Assessment Index (GOHAI)] was also used. RESULTS After ILFAP rehabilitation, the mean D50 values for carrot and peanuts were smaller [Repeated Model Procedures (RMP), F = 41, p < 0.001]. Mean CT and CC values recorded with the three model foods decreased, while CF increased regardless of the model food hardness (RMP, F = 14, F = 10, and F = 11, respectively, p < 0.001). The GOHAI score increased from 43 ± 9 to 56 ± 3 (t test, p < 0.001). CONCLUSION ILFAP rehabilitation improves the ability to reduce the bolus particle size and the ability to discriminate between different food hardnesses in the 6 months post-surgery period. CLINICAL RELEVANCE This study encourages the clinical development of immediate loading implantation with a fixed full-arch prosthesis protocol.
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Affiliation(s)
- J L Veyrune
- Clermont University, University of Auvergne, CROC-EA 4847, Clermont-Ferrand, France
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Donati M, Botticelli D, La Scala V, Tomasi C, Berglundh T. Effect of immediate functional loading on osseointegration of implants used for single tooth replacement. A human histological study. Clin Oral Implants Res 2012; 24:738-45. [DOI: 10.1111/j.1600-0501.2012.02479.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2012] [Indexed: 11/29/2022]
Affiliation(s)
- Mauro Donati
- Department of Periodontology; The Sahlgrenska Academy at University of Gothenburg, Private practice; Perugia; Italy
| | | | | | - Cristiano Tomasi
- Department of Periodontology; The Sahlgrenska Academy at University of Gothenburg, Private practice; Trento; Italy
| | - Tord Berglundh
- Department of Periodontology; The Sahlgrenska Academy at University of Gothenburg
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Paniz G, Chierico A, Tomasi P, Cuel S. A technique for immediate occlusal implant loading of a completely edentulous mandible: A clinical report. J Prosthet Dent 2012; 107:221-6. [DOI: 10.1016/s0022-3913(12)60064-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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40
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Xiao JR, Li YQ, Guan SM, Kong L, Liu B, Li D. Effects of lateral cortical anchorage on the primary stability of implants subjected to controlled loads: an in vitro study. Br J Oral Maxillofac Surg 2012; 50:161-5. [DOI: 10.1016/j.bjoms.2011.01.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2010] [Accepted: 01/17/2011] [Indexed: 10/18/2022]
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Browaeys H, Defrancq J, Dierens MCA, Miremadi R, Vandeweghe S, Van de Velde T, De Bruyn H. A Retrospective Analysis of Early and Immediately Loaded Osseotite Implants in Cross-Arch Rehabilitations in Edentulous Maxillas and Mandibles Up to 7 Years. Clin Implant Dent Relat Res 2011; 15:380-9. [PMID: 21745328 DOI: 10.1111/j.1708-8208.2011.00367.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Hilde Browaeys
- Department of Oral and Maxillofacial Surgery, Dental School, Faculty of Medicine and Health Sciences, University of Ghent, University Hospital Ghent, Ghent, Belgium
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Dohan Ehrenfest DM, Vazquez L, Park YJ, Sammartino G, Bernard JP. Identification card and codification of the chemical and morphological characteristics of 14 dental implant surfaces. J ORAL IMPLANTOL 2011; 37:525-42. [PMID: 21728785 DOI: 10.1563/aaid-joi-d-11-00080] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Dental implants are commonly used in daily practice; however, most surgeons do not really know the characteristics of these biomedical devices they are placing in their patients. The objective of this work is to describe the chemical and morphological characteristics of 14 implant surfaces available on the market and to establish a simple and clear identification (ID) card for all of them, following the classification procedure developed in the Dohan Ehrenfest et al (2010) Codification (DEC) system. Fourteen implant surfaces were characterized: TiUnite (Nobel Biocare), Ospol (Ospol), Kohno HRPS (Sweden & Martina), Osseospeed (AstraTech), Ankylos (Dentsply Friadent), MTX (Zimmer), Promote (Camlog), BTI Interna (Biotechnology Institute), EVL Plus (SERF), Twinkon Ref (Tekka), Ossean (Intra-Lock), NanoTite (Biomet 3I), SLActive (ITI Straumann), Integra-CP/NanoTite (Bicon). Three samples of each implant were analyzed. Superficial chemical composition was analyzed using X-ray photoelectron spectroscopy/electron spectroscopy for chemical analysis, and the 100 nm in-depth profile was established using Auger electron spectroscopy. The microtopography was quantified using light interferometry. The general morphology and nanotopography were evaluated using a field emission-scanning electron microscope. Finally, the characterization code of each surface was established using the DEC system, and the main characteristics of each surface were summarized in a reader-friendly ID card. From a chemical standpoint, of the 14 different surfaces, 10 were based on a commercially pure titanium (grade 2 or 4), 3 on a titanium-aluminum alloy (grade 5 titanium), and one on a calcium phosphate core. Nine surfaces presented different forms of chemical impregnation or discontinuous coating of the titanium core, and 3 surfaces were covered with residual aluminablasting particles. Twelve surfaces presented different degrees of inorganic pollutions, and 2 presented a severe organic pollution overcoat. Only 2 surfaces presented no pollution (Osseospeed and Ossean). From a morphological standpoint, 2 surfaces were microporous (anodization) and 12 were microrough, with different microtopographical aspects and values. Ten surfaces were smooth on the nanoscale, and therefore presented no significant and repetitive nanostructures. Four implants were nanomodified: 2 implants were nanorough (Osseospeed and Ossean), and 2 were covered with nanoparticles (NanoTite and SLActive). TiUnite and Kohno HRPS were covered with extended cracks all over the surface. Only 8 surfaces could be considered homogeneous. This systematic approach allowed the main characteristics of these commercially available products to be gathered in a single ID card. It can be used as an experimental tool or a method for controlling industrial implant productions. The DEC system could be an interesting basis for the development of a clear and simple ISO standard for dental implant surfaces and other implantable devices.
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