Performance of Double Acid-Etched Surface External Hex Titanium Implants in Relation to One- and Two-Stage Surgical Procedures

Evaluation of the Cortical Deformation Induced by Distal Cantilevers Supported by Extra-Short Implants: A Finite Elements Analysis Study

Background: The aim of the study was to analyze the distribution of stresses caused by an axial force in a three-dimensional model with the finite element method in the implant-supported fixed partial denture with distal overhang (PPFIVD) on short dental implants in the posterior edentulous maxilla. Methods: geometrical models of the maxilla with a bone remnant of 9 and 5 mm were created. Straumann SP® (Base, Switzerland) implants were placed in the premolar area. Two groups with subgroups were designed. Group A (GA): PPFIVD on two implants (GA1: 4.1 × 8 mm and GA2: 4.1 × 4 mm); Group B (GB): PPFIVD on the single implant (GB1: 4.1 × 8 mm and GB2: 4.1 × 4 mm). It was applied to a static force of 100 N to 30°. Results: PPFIVD on two implants reached the maximum tension in GA2 with respect to GA1; the difference was not significant in implants. In the maxilla GA2 was lower in relation to GA1; the difference was not significant. In PPFIVD over an implant, the stress was greater in GB2 with respect to GB1; the difference was significant in maxilla and implants. Peri-implant bone micro deformations and prosthesis-implant displacements were observed. Conclusions: PPFIVD over short splinted implants could be viable in the maxilla with reduced bone height, being an option when lifting the floor of the maxillary sinus. The rehabilitation with unitary implant (4 mm) did not provide adequate results. The dominant tensions evidenced bone micro-distortions with a displacement of the prosthesis-implant set. The real statement of this paper was to define that short splinted implants can be used in soft bone with high success rate in reducing bending forces.

Microscopic Study of Surface Microtopographic Characteristics of Dental Implants

OBJECTIVE

To determine and compare the micro topographic characteristics of dental implants submitted to different surface treatments, using scanning electron microscopy (SEM).

MATERIALS AND METHODS

Implants were divided into 7 groups of 3 specimens each, according to the surface treatment used: group 1: Osseotite, BIOMET 3i; group 2: SLA surface, Institut Straumann AG; group 3: Oxalife surface, Tree-Oss implant; group 4: B&W implant surface; group 5: Q-implant surface; group 6: ML implant surface; group 7: RBM surface, Rosterdent implant. The surfaces were examined under SEM (Carl Zeiss FE-SEM-SIGMA). Image Proplus software was used to determine the number and mean diameter of pores per area unit (mm). The data obtained were analyzed with the Mann-Whitney test. A confocal laser microscope (LEXT-OLS4100 Olympus) was used to conduct the comparative study of surface roughness (Ra). Data were analyzed using Tukey's HSD test.

RESULTS

The largest average pore diameter calculated in microns was found in group 5 (3.45 µm+/-1.91) while the smallest in group 7 (1.47µm+/-1.29). Significant differences were observed among each one of the groups studied (p<0.05). The largest number of pores/mm(2) was found in group 2 (229343) and the smallest number in group 4 (10937). Group 2 showed significant differences regarding the other groups (p<0.05). The greatest roughness (Ra) was observed in group 2 (0.975µm+/-0.115) and the smallest in group 4 (0.304µm+/-0.063). Group 2 was significantly different from the other groups (p<0.05).

CONCLUSION

The micro topography observed in the different groups presented dissimilar and specific features, depending on the chemical treatment used for the surfaces..

A wide-body implant as an alternative for sinus lift or bone grafting

PURPOSE

The aim was to evaluate the outcome of a short wide-body implant in the atrophic posterior jaw without a grafting procedure.

MATERIALS AND METHODS

Patients treated with a tapered wide-body implant measuring 8 to 9 mm in width and 7 to 9 mm in length (Max implant; Southern Implants, Irene, South Africa) were recalled to scrutinize implant survival. Preoperative cone beam computed tomography images were analyzed to measure bone height in reference to the mandibular canal and sinus floor.

RESULTS

There were 57 implants inserted in 18 men and 24 women after a 2-stage procedure and delayed loading. The mean follow-up was 15 months (SD, 10; range, 1-32 months), with 63.2% of the implants having at least 1 year of follow-up and 26.3% having at least 2 years' follow-up. Forty-six implants were inserted in the posterior maxilla and eleven in the mandible. Fifteen were placed in an extraction socket and forty-two in healed bone. Thirteen implants were supporting a single crown. Two implants failed, resulting in a survival rate of 96.5%, with rates of 90.9% and 97.8% for mandible and maxilla, respectively. This was not affected by gender, jaw, immediate or delayed placement, implant diameter and length, or the use of a bone substitute. The mean preoperative bone height was 7.21 mm in maxilla and 8.76 mm in mandible. In 41 cases implant length surpassed available bone height.

CONCLUSIONS

Despite the compromised bone condition and height, the survival rate of 96.5% is comparable to normal implants and, therefore, placing a wide-body implant may be an alternative to avoid grafting procedures. This is probably related to the enlarged implant surface area and the good primary stability.

Assessing double Acid-etched implants submitted to orthodontic forces and used as prosthetic anchorages in partially edentulous patients

Abstract:

The use of implants as anchorage for orthodontic forces seems to be a good alternative in partially edentulous patients needing orthodontic treatment.

This study is aimed at assessing the performance and behavior of microtextured surface endosseous implants obtained by means of a double acid etching against orthodontic forces, as well as their adequacy to be used first as anchorage and later as fixtures for the definitive prosthesis.

Materials and Methods:

A total of 93 double acid-etched surface parallel wall implants (Osseotite® Implants, Implant Innovations Inc., Palm Beach, Florida, USA) were inserted in 38 partially edentulous patients prior to orthodontic treatment This was carried out by following two-stage surgery protocols in the maxilla as well as in the mandible.

After a healing period of six months for the maxilla and four months for the mandible, the implants were used as anchorage for sliding, compression and traction orthodontic forces between 100 to 200 g by means of Ni-TI springs.

Bone level and Resonance Frequency Analysis (RFA) were measured before and after the introduction of the orthodontics forces.

Results:

After removal of the orthodontics appliances, all the implants remained stabile and served as support for prosthetic replacement of missing teeth. The bone level showed no variationeven when a positive difference 0.02 ± 0.38mm was noticed. The RFA scored a significant difference (p≤ 0.03) between the initial Implant Stability Quotient (ISQ) values (66) and the final ones (68).

Conclusions:

These findings showed that Osseotite implants were able to support the orthodontic forces applied during this investigation, maintaining osseointegration without significant variation in bone level. Therefore, they can be used to support dental prosthesis once they have been used as orthodontic anchorage under the cited conditions.

The challenge of implant therapy in the posterior maxilla: providing a rationale for the use of short implants

Rehabilitating patients with a resorbed maxilla presents several challenges when the desired treatment plan involves the placement of endosseous implants. Correct diagnosis requires knowledge on jaw healing patterns, systemic effects, and the impact of bone quality changes on implant success rates. Appropriate treatment planning requires an in-depth understanding of the materials and methods available to the contemporary implant surgeon. The clinician must be able to persist on evidence-based techniques and adhere to those proven methods. Successful surgical placement requires correct use of the available armamentarium and acceptance of the limitations that implant dentistry still presents. Especially challenging is the implant treatment of maxillary molars due to the plethora of complicating factors such as limited bone availability, interarch space challenges, sinus problems, etc. These are just a few of the factors that may lead us to placement of short implants in these sites. An extensive review of the literature that is available for short implants (implants < 10 mm in length) indicates that although they are commonly used in areas of the mouth under increased stress (posterior region), their success rates mimic those of longer implants when careful case selection criteria have been used. The available studies and case-series offer a valid rationale for placement of short implants so long as one understands the limitations, indications, risk factors, and limited studies that actually follow-up success rates of short implants for over 5 years. This review of the literature will provide the reader an in-depth view of the evidence in using short implants as an alternative treatment modality for the maxillary molar region.

Survival of Immediately Provisionalized Dental Implants Placed Immediately Into Fresh Extraction Sockets

BACKGROUND

The aim of this study was to evaluate the survival rate of immediately provisionalized dental implants immediately placed into fresh extraction sockets.

METHODS

The study consisted of 87 consecutive patients, ranging in age from 21 to 76 years (average: 53.30 +/- 13.34 years), who received 210 immediately provisionalized, immediately placed dental implants between the years 2000 and 2005. Data were recorded regarding the survival rate of these implants and the incidence of complications.

RESULTS

Follow-up ranged from 6 to 52 months (mean: 15.60 +/- 12.60 months). Smoking, past and present, was reported by 28.7% and 20.7% of patients, respectively. The maxillary incisors were replaced most frequently, followed by the mandibular lateral incisors. Most of the implants were >13 mm in length and > or = 3.75 mm in diameter. There were 47 (22.4%) single restored implants and 163 (77.6%) splinted implants. Overall, the implant survival rate was 97.6% (five implants failed). Complications, such as swelling, inflammation, and pain, were observed in 24 (11.4%) of the implants. No relation was found between complications and failure. The present study failed to reveal a relationship between implant survival rate and smoking, implant dimensions, and area of implantation.

CONCLUSION

Immediately provisionalized immediate implants can serve as a predictable procedure with high survival rates.

Consensus Conference on Immediate Loading: The Single Tooth and Partial Edentulous Areas

PURPOSE

A consensus conference was held to determine what the parameters should be for the immediate functional loading of the single-tooth implant restoration and short-span fixed implant-supported bridgework.

MATERIALS

Forty-one clinicians and researchers presented cases and situations relating to the topic. A panel then distilled questions that were presented to the audience (430) at large. Answers were gleaned to formulate a consensus.

RESULTS

Ten distinct answers evolved that constituted the essence of guidelines for clinicians to be aware of when undertaking immediate loading. These guidelines are contained within the body of the text.

CONCLUSIONS

Extreme caution and adherence to a universal generic protocol are suggested for clinicians who are involved with single-tooth and short-span multiple-teeth implant replacements as related to immediate loading as defined within this text.

Immediate Occlusal Loading of Double Acid-Etched Surface Titanium Implants in 41 Consecutive Full-Arch Cases in the Mandible and Maxilla: 6- to 74-Month Results

BACKGROUND

The high success rate of dental implants has changed the quality of life for many patients. Immediate loading finds its application in some clinical cases and certainly adds another modality of treatment for the implant patient. Starting with a few implants immediately loaded with a bar overdenture in the mandible, the concept of immediate loading evolved to loading multiple implants in both the maxilla and mandible.

METHODS

In this investigation, 41 consecutive patients who needed full-arch restorations were treated with 343 double acid-etched surface implants between May 1998 and March 2004. The sample included smokers and bruxers. Twenty-three mandibular and 26 maxillary cases were treated, loading the implants within 48 hours, by using resin provisional prostheses, metal-reinforced provisional prostheses, or definitive prostheses (metal-acrylic or metal-ceramic). All implants were followed for 12 to 74 months. Follow-up consisted of clinical as well as radiographic examination. Furthermore, resonance frequency analysis was done in most of the implants during the last 2 years.

RESULTS

The success rate obtained was 99.42% (only two mandibular implants that are still surviving were considered failures). The bone level was measured every year. The average radiographic bone level change was 0.56 mm at 12, 0.76 mm at 24, 0.84 mm at 36, 0.82 mm at 48, 0.83 mm at 60, and 0.94 mm at 72 months.

CONCLUSION

A high success rate can be achieved when double acid-etched surface implants are immediately loaded with fixed full-arch restorations in the maxilla and mandible.