Description
This journal conveys scientific progress in the field of implant dentistry and its related areas to clinicians teachers and researchers concerned with the application of this information for the benefit of patients in need of oral implants. The journal addresses itself to clinicians general practitioners periodontists oral and maxillofacial surgeons and prosthodontists as well as to teachers academicians and scholars involved in the education of professionals and in the scientific promotion of the field of implant dentistry.
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Clinical oral implants research (Online)
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0905-7161
OCLC
46677841
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Document, Periodical, Internet resource
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Blackwell Publishing
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Publications in this journal
Authors: Atieh MA, Alsabeeha NH, Duncan WJ, de Silva RK, Cullinan MP, Schwass D, Payne AG
Clinical Oral Implants Research.
BACKGROUND:
In the replacement of missing teeth, a paradigm shift is currently observed with immediate implant placement and/or restoration, particularly in the aesthetic zone. In molar sites,BACKGROUND:
In the replacement of missing teeth, a paradigm shift is currently observed with immediate implant placement and/or restoration, particularly in the aesthetic zone. In molar sites, however, anatomical, occlusal and biomechanical considerations remain deterrent factors influencing the outcome of this treatment paradigm. The aim of this report was to evaluate immediate placement and immediate restoration of strongly tapered wide-diameter implant in fresh mandibular molar extraction sockets.
METHODS:
Twenty-four 8- or 9-mm diameter implants were placed in either a fresh molar extraction socket or a healed site. All the implants received provisional crowns within 48 h. The provisional crowns were replaced with full ceramic crowns after 8 weeks of implant placement.
RESULTS:
The overall implant success rate after 1 year of service for the 24 implants in two treatment groups was 75%. Success rates were 83.3% and 66.7% for the delayed and immediate placement groups respectively, with no significant difference observed between the two groups (P = 0.35). Implant stability measurements identified the immediately placed implants to be more stable immediately after surgery than delayed placed implants. In contrast, the delayed placed implants were more stable after 8 week healing time.
CONCLUSIONS:
The rehabilitation of single missing mandibular molars by immediately placed and restored wide-diameter implants was associated with a relatively high failure rate.
Authors: Marco Degidi, Giovanna Iezzi, Antonio Scarano, Adriano Piattelli
Clinical oral implants research. 19(3):276-82.
BACKGROUND: After implant insertion and loading, crestal bone usually undergoes remodeling and resorption. If the horizontal relationship between the outer edge of the implant and a smaller-diameterBACKGROUND: After implant insertion and loading, crestal bone usually undergoes remodeling and resorption. If the horizontal relationship between the outer edge of the implant and a smaller-diameter component ('platform switching') is altered, there seems to be reduced crestal bone loss. Immediate loading allows immediate restoration of esthetics and function, reduces morbidity, and facilitates functional rehabilitation. MATERIALS AND METHODS: Three Morse cone connection implants were inserted in the right posterior mandible in a 29-year-old partially edentulous patient. The platform of the implant was inserted 2 mm below the level of the alveolar crest. After a 1-month loading period, the most distal mandibular implant was retrieved with a trephine bur for psychological reasons. RESULTS: At low-power magnification, it was possible to see that bone was present 2 mm above the level of the implant shoulder. No resorption of the coronal bone was present. No infrabony pockets were present. At the level of the shoulder of the implant, it was possible to observe the presence of dense connective tissue with only a few scattered inflammatory cells. Newly formed bone was found in direct contact with the implant surface. The bone-implant contact percentage was 65.3+/-4.8%. CONCLUSIONS: Abutments smaller than the diameter of the implant body (platform switching) in combination with an absence of micromovement and microgap may protect the peri-implant soft and mineralized tissues, explaining the observed absence of bone resorption. Immediate loading did not interfere with bone formation and did not have adverse effects on osseointegration.
Authors: Ana Flávia N Diniz, Elismauro F Mendonça, Claudio R Leles, Adérico S Guilherme, Marcelo P Cavalcante, Maria Alves G S Silva
Clinical oral implants research. 19(3):249-53.
OBJECTIVE: To investigate variation in the pre-surgical treatment planning after using conventional spiral tomography in addition to conventional radiographic exams. MATERIAL AND METHODS: Twenty-nineOBJECTIVE: To investigate variation in the pre-surgical treatment planning after using conventional spiral tomography in addition to conventional radiographic exams. MATERIAL AND METHODS: Twenty-nine partial or fully edentulous patients referred to implant therapy were selected and submitted to periapical, panoramic and conventional cross-sectional tomography exams. Pre-surgical treatment planning of 120 potential implant sites in 69 edentulous areas was performed by two independent experienced dental implant surgeons. After clinical examination, pre-surgical planning was made using only periapical and panoramic exams. Examiners were requested to reformulated initial planning after assessing tomographic images. Four treatment parameters were evaluated: length and width of implants, need of bone grafting and need of other surgical procedures. RESULTS: Implant length and width remained unchanged in 60.2% and 87.2% of cases, respectively. No difference in length (P=0.576) and width (P=1) scores was observed in treatment planning with and without tomography. Variation in implant dimension was not affected by location of edentulous areas. Bone grafting and other surgical procedures significantly changed after tomograms (P<0.001), independent of the location of edentulous areas. In 15.8% and 5.3% of cases bone grafting and other procedures were planned only after tomograms, respectively. Significant differences were observed in all maxillary and mandibular regions. CONCLUSION: Conventional spiral tomography plays an important role in pre-surgical treatment planning, increasing clinician's certainty of the need of additional surgical procedures (bone grafting, sinus lifting, and others) in pre-surgical treatment stage.
Authors: Tiziano Testori, Massimo Del Fabbro, Matteo Capelli, Francesco Zuffetti, Luca Francetti, Roberto L Weinstein
Clinical oral implants research. 19(3):227-32.
OBJECTIVES: The aims of this prospective study were to assess the treatment outcome of immediately loaded full-arch fixed bridges anchored to both tilted and axially placed implants for theOBJECTIVES: The aims of this prospective study were to assess the treatment outcome of immediately loaded full-arch fixed bridges anchored to both tilted and axially placed implants for the rehabilitation of fully edentulous maxillae and to compare the outcome of axial vs. tilted implants. MATERIAL AND METHODS: Forty-one patients with edentulous maxillae were included in the study. Each patient received a full-arch fixed bridge supported by four axial implants and two distal tilted implants. Loading was applied within 48 h from surgery. Patients were scheduled for follow-up at 6 months, 1 year and annually up to 5 years. Radiographic evaluation of marginal bone-level change was performed at 1 year. RESULTS: One patient died 4 months after surgery. Thirty patients were followed for a minimum of 1 year (range 3-42 months, mean 22.1 months). Three failures were recorded at 1-year follow-up (two axial implants and one tilted). Two more implants (one tilted and one axially placed) were lost within 18 months of loading. The 1-year implant survival rate was 98.8% for both axial and tilted implants. Prosthesis success rate was 100% at 1 year. Marginal bone loss around axial and tilted implants at 12-month evaluation was similar, being, respectively, 0.9+/-0.4 (standard deviation) mm and 0.8+/-0.5 mm. CONCLUSIONS: The present preliminary data suggest that immediate loading associated with tilted implants could be considered to be a viable treatment modality for the atrophic maxilla and that there does not seem to be a different clinical outcome between tilted and axial implants.
Authors: Eli E Machtei, Dan Mahler, Orit Oettinger-Barak, Otman Zuabi, Jacob Horwitz
Clinical oral implants research. 19(3):259-64.
OBJECTIVES: The purpose of the present study was to evaluate the survival rate of dental implants in previously failed implant sites. In addition, factors that might affect the outcome of these redoOBJECTIVES: The purpose of the present study was to evaluate the survival rate of dental implants in previously failed implant sites. In addition, factors that might affect the outcome of these redo procedures were also explored. MATERIAL AND METHODS: Patients that had failed dental implants, which were replaced with the same implant type at the same site, were included. Data on the failed implants were collected. The same parameters, along with the interval between retrieval and re-implantation, were collected for the second set of implants. Descriptive statistics were used to describe the patients and implants. Life table analysis of these implants was tabulated for both implant sets. The effect of systemic, environmental and local factors on the survival of the redo dental implants was evaluated. RESULTS: Fifty-six patients with a total of 79 redo implants were included in this study. Implants were followed for 7-78 months (mean 29.9+/-2). Thirteen implants failed that resulted in an overall survival rate of 83.5%. Successful implants had greater diameter (4.05+/-0.52 mm) than failed implants (3.72+/-0.56 mm); however, these differences were only marginal (P=0.06). Conversely, smoking habits, implants length and location, mode of placement and spontaneous exposure did not have a significant effect on the outcome of this procedure. CONCLUSION: Redo of dental implants has a lesser survival rate compared with previous reports for implants in pristine sites. These results were not associated with most implant- and/or patient-related factors. Thus, a possible negative effect that is associated with the specific implant's site might account for this phenomenon.
Authors: Rino Burkhardt, Axel Preiss, Andreas Joss, Niklaus P Lang
Clinical oral implants research. 19(3):314-9.
OBJECTIVES: To evaluate the influence of flap tension on the tearing characteristics of mucosal tissue samples in relation to various suture and needle characteristics. MATERIAL AND METHODS: LiningOBJECTIVES: To evaluate the influence of flap tension on the tearing characteristics of mucosal tissue samples in relation to various suture and needle characteristics. MATERIAL AND METHODS: Lining and masticatory mucosal tissue samples obtained from pig jaws were prepared for in vitro testing. Tension tearing diagrams of 60 experiments were traced for 3-0, 5-0 and 7-0 sutures with applied forces up to 20 N. In the second part, the same experiments were repeated with 100 diagrams to test the influence of needle characteristics with 5-0 and 6-0 sutures using only gingival tissue samples. RESULTS: 3-0 sutures mainly lead to tissue breakage at an average of 13.4 N. In contrast, 7-0 sutures only resulted in breakage of the thread at a mean applied force of 3.7 N. With 5-0 sutures, both events occurred at random at a mean force of 14.6 N. Irrespective of the needle characteristics, the mean breaking force for gingival samples with 5-0 and 6-0 sutures was approximately 10 N. CONCLUSIONS: Tissue trauma may be reduced by choosing finer suture diameters, because thinner (6-0, 7-0) sutures lead to thread breakage rather than tissue breakage.
Authors: David M Kim, Rachel L Badovinac, Rachel L Lorenz, Joseph P Fiorellini, Hans P Weber
Clinical oral implants research. 19(3):254-8.
OBJECTIVE: The purpose of this prospective study was to evaluate one-stage dental implants clinically and radiographically after 10 years in function. MATERIAL AND METHODS: Twenty-five patients withOBJECTIVE: The purpose of this prospective study was to evaluate one-stage dental implants clinically and radiographically after 10 years in function. MATERIAL AND METHODS: Twenty-five patients with a total of 68 implants [46 hollow screws (HS) and 22 hollow cylinders (HC)] who previously participated in 5-year prospective clinical study returned for a 10-year follow-up. For each patient, informed consent was obtained, medical and dental history was reviewed and soft and hard tissue conditions were evaluated using the modified plaque index, modified sulcus bleeding index, probing depth, suppuration, attachment level, distance from the implant crown margin to the coronal border of the peri-implant mucosa keratinized mucosa and periapical radiographs to calculate crestal bone-level changes. RESULTS: As expected, the mean crestal bone-level changes were the greatest in the first year following restoration placement, while only minimal changes were noticed in the subsequent years. HC implants showed a statistically significant higher mean crestal bone loss when compared with HS implants at year 10. Gender was also statistically significantly related to the mean crestal bone loss at years 1, 3, 5 and 10, with male subjects exhibiting more bone loss than female subjects. However, age and peri-implant soft tissue parameters showed low levels of correlation with the mean crestal bone-level changes, and proved to be weak predictors for the mean crestal bone loss at years 5 and 10. CONCLUSIONS: This study confirms that the mean crestal bone loss rates of the HS and HC implants are well within the clinically acceptable parameters. In addition, some of the clinical parameters could be used to assess and predict future crestal bone loss.
Authors: Rudi C van Staden, Hong Guan, Newell W Johnson, Yew-Chaye Loo, Neil Meredith
Clinical oral implants research. 19(3):303-13.
OBJECTIVES: Using the finite element method (FEM), the insertion process of a dental implant into a section of the human mandible is analysed. The ultimate aim of this article is to advance the useOBJECTIVES: Using the finite element method (FEM), the insertion process of a dental implant into a section of the human mandible is analysed. The ultimate aim of this article is to advance the use of an innovative engineering approach in dental practices, especially in the process of dental implantation. MATERIAL AND METHODS: The FEM and analysis techniques are used to replicate and evaluate the stress profile created within the mandible during the implantation process. RESULTS: The von Mises stress profiles in both cancellous and cortical bone are examined during implant insertion. The applied torque and the insertion stage are found to strongly influence the resulting stress profile within the surrounding jawbone. CONCLUSIONS: Through the combination of both dental and engineering expertise, a simplified and efficient modelling technique is developed. This improves the understanding of the biomechanical reaction that the jawbone exhibits due to the insertion of implant. The current research is a pilot study using the FEM to model and simulate the dental implantation process. The assumptions made in the modelling and simulation process are: (1) the implantation process is simulated as a step-wise process instead of a continuous process; (2) the implant is parallel threaded and the implant does not rotate during insertion into the jawbone. Although the modelling and simulation techniques had to be simplified, a significant amount of information is gained that helps lay a good foundation for future research. Recommendations for future studies include the variation of the torque applied during the implantation process and upgrading the software capabilities to simulate the full dynamical process of implantation.
Authors: Lars Sennerby, Antonio Rocci, William Becker, Lars Jonsson, Lars-Ake Johansson, Tomas Albrektsson
Clinical oral implants research. 19(3):219-26.
PURPOSE: The present retrospective clinical study was undertaken to evaluate the survival rate and marginal bone conditions around Nobel Direct one-piece implants. The purpose was also to compare thePURPOSE: The present retrospective clinical study was undertaken to evaluate the survival rate and marginal bone conditions around Nobel Direct one-piece implants. The purpose was also to compare the results with when these implants are used for immediate/early loading with implants allowed to heal before loading. MATERIAL AND METHODS: Forty-three consecutive patients previously treated with 117 Nobel Direct implants at four different centres were evaluated. The implants had been used in both jaws for treatment after loss of single and multiple teeth. Immediate/early loading (within 2 weeks) with a provisional crown/bridge was applied to 95 implants, while 22 implants healed unloaded for 6 weeks to 6 months before loading. Calculations of marginal bone loss were performed in radiographs taken at placement and after an average of 10.2 months (range 1-18 months) of loading. RESULTS: Six (5.1%) of the 117 implants were removed during the follow up. All failed implants belonged to the immediate/early loading group giving a failure rate of 6.3% for this group and 0% for two-stage implants. The failure rate was higher for flapless (7.9%) than for flap surgery (0%). The marginal bone loss was -2.4 mm (SD 1.5) for all implants, while 37.6% showed more than 3 mm of loss during the follow up. Bone loss increased with time of follow up. Implants subjected to immediate/early loading showed more bone loss than two-stage implants: -2.6 mm (SD 1.5) vs. -1.6 mm (SD 1.1). Moreover, 41.3% of immediately loaded and 22.7% of two-stage implants presented with more than 3 mm of bone loss. CONCLUSIONS: This short-term retrospective analysis showed a poor clinical outcome of Nobel Direct implants. Extensive marginal bone loss (>3 mm) was found around more than 1/3 of the implants evaluated. Less resorption and no failures were experienced when implants were allowed to heal from 6 weeks to 6 months before occlusal loading. Within the limitations of the present study design, data indicate that immediate loading, the use of this implant for multi-unit constructions and flapless surgery are risk factors for failure of Nobel Direct implants.
Authors: Fatih Arikan, Nurcan Buduneli, Necil Kütükçüler
Clinical oral implants research. 19(3):283-8.
AIMS: To evaluate the levels of soluble receptor activator of nuclear factor-kappaB ligand (sRANKL) and osteoprotegerin (OPG) in crevicular fluid of endosseous dental implants. METHODS: Eighty-sixAIMS: To evaluate the levels of soluble receptor activator of nuclear factor-kappaB ligand (sRANKL) and osteoprotegerin (OPG) in crevicular fluid of endosseous dental implants. METHODS: Eighty-six implants in 39 patients were evaluated. All patients were treated with root-type implants placed at least 16 months and loaded at least 12 months before the examination. Peri-implant crevicular fluid (PICF) samples were obtained from buccal and lingual aspects of implants. Modified plaque index, probing depth, gingival index, and bleeding on probing (BOP) were recorded at four sites per implant. PICF levels of sRANKL and OPG were analysed by ELISA. Spearman's correlations were utilised to relate biochemical data and clinical parameters. RESULTS: The PICF level of sRANKL did not show significant correlation with the clinical parameters or the OPG level. The total amount of OPG was positively correlated with PICF volume, gingival index, and BOP (P<0.05) and negatively correlated with pack years (P<0.05). CONCLUSION: The findings of this preliminary study suggest that the crevicular fluid level of OPG deserves further investigation as a possible marker to evaluate the health status of surrounding tissues of dental implants, as this was not the case for the sRANKL level. Larger scale studies, particularly in peri-implantitis cases, may shed more light on this subject.
Authors: Yoshinobu Maeda, Mitsuhiro Horisaka, Kaztomo Yagi
Clinical oral implants research. 19(3):271-5.
OBJECTIVES: This study aimed to examine the biomechanical rationale of a single implant-retained overdenture (SIO) system using an in vitro model. MATERIAL AND METHODS: Laboratory implant analogsOBJECTIVES: This study aimed to examine the biomechanical rationale of a single implant-retained overdenture (SIO) system using an in vitro model. MATERIAL AND METHODS: Laboratory implant analogs (3.75 x 13 mm) were embedded into the midline and canine regions on both sides of the mandibular phantom model with artificial mucosa. Magnetic attachments (flat, FM; dome, DM) and a ball attachment (Ball) were mounted to the abutment where lateral forces were measured with four miniature strain gauges attached to the surface. A 50 N static load was applied at five different sites of the occlusal surface of the simulated denture base using each counterpart of the attachments. Strain data were compared between SIO and two implant-retained configurations (TIO) with three attachments. Three-dimensional (3D) denture base displacements were also measured. Statistical analysis was performed by multiple comparisons using a post hoc test (P<0.05). RESULTS: Statistically significantly smaller lateral forces to abutments were obtained in SIO than in TIO with the Ball with the molar load, while there were no statistical differences between SIO and TIO with FM. There were no statistical differences in 3D denture base movements between SIO and TIO in the midline and molar regions, while there were larger movements in SIO than in TIO with FM. CONCLUSION: Within the limitations of our in vitro study, we suggested that single-implant overdentures with dome-type magnet or ball attachments had biomechanical effects similar to two-implant overdentures in terms of lateral forces to the abutment and denture base movements under molar functional loads.
Authors: Ronald E Jung, Bjarni E Pjetursson, Roland Glauser, Anja Zembic, Marcel Zwahlen, Niklaus P Lang
Clinical oral implants research. 19(2):119-30.
OBJECTIVES: The objective of this systematic review was to assess the 5-year survival of implant-supported single crowns (SCs) and to describe the incidence of biological and technical complications.OBJECTIVES: The objective of this systematic review was to assess the 5-year survival of implant-supported single crowns (SCs) and to describe the incidence of biological and technical complications. METHODS: An electronic MEDLINE search complemented by manual searching was conducted to identify prospective and retrospective cohort studies on SCs with a mean follow-up time of at least 5 years. Failure and complication rates were analyzed using random-effects Poisson's regression models to obtain summary estimates of 5-year proportions. RESULTS: Twenty-six studies from an initial yield of 3601 titles were finally selected and data were extracted. In a meta-analysis of these studies, survival of implants supporting SCs was 96.8% [95% confidence interval (CI): 95.9-97.6%] after 5 years. The survival rate of SCs supported by implants was 94.5% (95% CI: 92.5-95.9%) after 5 years of function. The survival rate of metal-ceramic crowns, 95.4% (95% CI: 93.6-96.7%), was significantly (P=0.005) higher than the survival rate, 91.2% (95% CI: 86.8-94.2%), of all-ceramic crowns. Peri-implantitis and soft tissue complications occurred adjacent to 9.7% of the SCs and 6.3% of the implants had bone loss exceeding 2 mm over the 5-year observation period. The cumulative incidence of implant fractures after 5 years was 0.14%. After 5 years, the cumulative incidence of screw or abutment loosening was 12.7% and 0.35% for screw or abutment fracture. For supra-structure-related complications, the cumulative incidence of ceramic or veneer fractures was 4.5%. CONCLUSION: It can be concluded that after an observation period of 5 years, high survival rates for implants and implant-supported SCs can be expected. However, biological and particularly technical complications are frequent.
Authors: Matthias Karl, Friedrich Graef, Siegfried Heckmann, Tim Krafft
Clinical oral implants research. 19(2):214-8.
OBJECTIVES: There is no proven clinical tool to evaluate the amount of osseointegration and stability around dental implants. Therefore, the aim of this retrospective clinical study was to evaluateOBJECTIVES: There is no proven clinical tool to evaluate the amount of osseointegration and stability around dental implants. Therefore, the aim of this retrospective clinical study was to evaluate resonance frequency analysis values of 385 ITI solid screw implants. MATERIAL AND METHODS: Both at implant placement and after healing, implant stability quotients (ISQs) were determined. For statistical analysis, Pearson's correlation coefficients, Welch's two-sample t-tests and paired samples t-tests were computed at a level of significance of alpha=0.05. RESULTS: ISQ values ranged from 39 to 86 at implant placement and from 35 to 89 after healing, showing a significant increase. The highest ISQ values at both stages were obtained in the posterior mandible (P < or = 0.002). After healing, ISQ values in the anterior mandible were significantly higher than in the anterior maxilla (P=0.005). Implant length had a significant influence on ISQ in the anterior mandible (P=0) at insertion and in the anterior (P=0.005) and posterior mandible (P=0.036) after healing. Implant diameter and ISQ at insertion correlated in the anterior mandible (P=0.037). After healing, a significant influence was found for all regions, except the posterior maxilla (P=0.795). With the exception of the anterior maxilla (P=0.542), ISQ at placement had a significant influence on ISQ after healing. In the anterior maxilla (P=0.002) and in the posterior mandible (P=0.007), healing time significantly influenced ISQ after healing. CONCLUSIONS: It appears that only repeated ISQ measurements of a specific implant have some diagnostic benefit, although the parameters influencing the absolute values still remain unclear.
Authors: Dimitris Nikolidakis, Juliette van den Dolder, Joop G C Wolke, John A Jansen
Clinical oral implants research. 19(2):207-13.
OBJECTIVES: The purpose of the present study was to investigate the effect of local application of platelet-rich plasma (PRP) on the early healing of cortical bone around Ti implants with twoOBJECTIVES: The purpose of the present study was to investigate the effect of local application of platelet-rich plasma (PRP) on the early healing of cortical bone around Ti implants with two different surface configurations. MATERIAL AND METHODS: Six goats were used in this study. PRP fractions were obtained from a venous blood sample of the goats and administered immediately before implant insertion. PRP was applied via gel preparation and installation of the gel into the implant site, or via dipping of the implants in PRP fraction before insertion. A total of 36 implants (18 non-coated and 18 Ca-P-coated) were placed into the tibial cortical bone. The animals were sacrificed at 6 weeks after implantation and implants with surrounding tissue were prepared for histological examination. Histomorphometrical variables like the percentage of implant surface with direct bone-implant contact and the percentage of new and old bone adjacent to the implant were evaluated. RESULTS: More interfacial bone-to-implant contact was observed for all the three groups of Ca-P-coated implants and the Ti/PRP liquid group. All groups revealed similar percentages of old and new bone adjacent to the implant. CONCLUSIONS: It was concluded that the additional use of PRP did not have any effect on the early cortical bone response to the Ca-P-coated implants, while PRP in a liquid form showed a tendency to increase bone apposition to roughened titanium implants.
Authors: Kenji Maekawa, Yasuhiro Yoshida, Atsushi Mine, Bart Van Meerbeek, Kazuomi Suzuki, Takuo Kuboki
Clinical oral implants research. 19(3):320-5.
PURPOSE: To evaluate the effect of polyphosphoric acid (PPA) pre-treatment of titanium (Ti) on the initial attachment, proliferation, and differentiation of mouse osteoblast-like cells (MC3T3-E1).PURPOSE: To evaluate the effect of polyphosphoric acid (PPA) pre-treatment of titanium (Ti) on the initial attachment, proliferation, and differentiation of mouse osteoblast-like cells (MC3T3-E1). MATERIALS AND METHODS: Adsorption of PPA to Ti was achieved by immersing Ti disks (15 mm in diameter) into 0, 1, and 10 wt% PPA and 10 wt% orthophosphoric acid (OPA) for 24 h. On each pre-treated Ti disk, 5.0 x 10(4) MC3T3-E1 cells were seeded, and 1, 3, and 5 h later cell attachment was evaluated. Cell proliferation was also determined 1, 3, and 5 days after cell seed. Cell differentiation was evaluated 5, 10, and 15 days after cell seed using osteoblast marker gene expression. Total RNA was purified from each culture and Type-I collagen, alkaline phosphatase, and osteocalcin mRNA expression levels were measured by real-time reverse transcription polymerase chain reaction. RESULTS: Adsorption of PPA or OPA to Ti significantly accelerated initial cell attachment at every time point (P<0.0001). As with cell attachment, cell proliferation was also accelerated on the PPA-treated Ti disks in a dose-dependent manner at every time point (P<0.0001). However, OPA-treated Ti disks did not enhance the cell proliferation. Regarding osteoblastic differentiation, PPA-treated Ti significantly accelerated the Type-I collagen gene expression at 5 and 10 days after cell seed. Regarding alkaline phosphatase and osteocalcin gene expression, no significant difference was found among the different Ti surface conditions. CONCLUSION: The accelerated cell behavior following Ti pre-treatment with PPA is a promising new strategy to fabricate bioactive Ti implants.
Authors: Ingemar Abrahamsson, Jean-Pierre Albouy, Tord Berglundh
Clinical oral implants research. 19(2):153-9.
OBJECTIVE: To study the healing at fluoride-modified implants placed in wide circumferential defects. MATERIAL AND METHODS: Six mongrel dogs were used. The mandibular premolars and first molars wereOBJECTIVE: To study the healing at fluoride-modified implants placed in wide circumferential defects. MATERIAL AND METHODS: Six mongrel dogs were used. The mandibular premolars and first molars were extracted. Three months later four implants were placed in one side of the mandible of each dog. The control implants (MicroThread) had a TiOblast surface, while the test implants (OsseoSpeed) had a fluoride-modified surface. Two implants of each type were placed. The marginal 50% of the prepared canal was widened using step drills. Following installation a 1 mm wide gap occurred between the implant surface and the bone wall in the defect. All implants were submerged. The installation procedure was repeated in the opposite side of the mandible 4 weeks after the first implant surgery. Two weeks later the animals were euthanized and block biopsies containing the implant and surrounding tissues were prepared for histological analysis. RESULTS: The histological analysis revealed that a significantly larger area of osseointegration was established within the defect at fluoride-modified implants than at implants with a TiOblast surface after 6 weeks of healing. Further, the degree of bone-to-implant contact within the defect area was larger at fluoride-modified implants than at the TiOblast implants. CONCLUSION: It is suggested that the fluoride-modified implant surface promotes bone formation and osseointegration.
Authors: Mohamed Alhag, Stefan Renvert, Ioannis Polyzois, Noel Claffey
Clinical oral implants research. 19(2):182-7.
OBJECTIVE: The purpose of the study was to investigate whether osseointegration can occur on rough implant surfaces that previously had been coated with bacterial biofilm. MATERIALS AND METHODS: TheOBJECTIVE: The purpose of the study was to investigate whether osseointegration can occur on rough implant surfaces that previously had been coated with bacterial biofilm. MATERIALS AND METHODS: The premolars on both sides of the mandible in four beagle dogs were extracted. Following 3 months healing, three titanium implants Ti-Unite, Nobel Biocare were partially inserted in the left side of each mandible. Some threads protruded from the tissues into the oral cavity. Plaque accumulated on the exposed part of the implant. Following a 5-week healing period, the contaminated parts of each implant were treated using three different techniques: (1) swabbing with citric acid for 30 s followed by rinsing with physiological saline, (2) cleansing with a toothbrush and physiological saline for 1 min, and (3) swabbing with 10% hydrogen peroxide for 1 min followed by rinsing with physiological saline. The treated implants and one pristine implant (control) were installed to the full implant length on the contralateral sides of the mandibles. Following 11 weeks of healing, the dogs were sacrificed and biopsies were obtained. Ground sections were prepared for histomorphometric analysis. RESULTS: All treatment modalities were associated with direct bone-to-implant contact on the portion of implant surface previously exposed to the oral environment. CONCLUSIONS: The results demonstrate that rough surfaces, which were plaque contaminated and cleaned by different methods, can re-osseointegrate.
Authors: Michael M Bornstein, Pilar Valderrama, Archie A Jones, Thomas G Wilson, Reinhart Seibl, David L Cochran
Clinical oral implants research. 19(3):233-41.
PURPOSE: The aim of this study was to evaluate bone apposition to a modified sandblasted and acid-etched (SLA) implant surface (modSLA) in the canine mandible as compared with the standard SLAPURPOSE: The aim of this study was to evaluate bone apposition to a modified sandblasted and acid-etched (SLA) implant surface (modSLA) in the canine mandible as compared with the standard SLA surface. MATERIAL AND METHODS: In this experimental study, all mandibular premolars and first molars were extracted bilaterally in five foxhounds. After a healing period of 6 months, each side of the mandible received six randomly assigned dental implants alternating between the standard SLA and modSLA surface. The dogs were sacrificed at 2 weeks (n=2) or 4 weeks (n=3) after implant placement. Histologic and histomorphometric analyses were then performed for each implant. RESULTS: The microscopic healing patterns at weeks 2 and 4 for the two implant types with the standard SLA and modSLA surfaces showed similar qualitative findings. New bone tissue had already established direct contact with implant surfaces after 2 weeks of healing. The mean percentage of newly formed bone in contact with the implant (BIC) was significantly greater for modSLA (28.2+/-7.9%) than for SLA (22.2+/-7.3%) (P<0.05). This difference was no longer evident after 4 weeks. An increase in BIC for both implant surface types occurred from weeks 2 to 4. This increase was statistically significant when compared with SLA at 2 weeks (P<0.05), but not when compared with modSLA at 2 weeks. CONCLUSION: The data from the present study demonstrate significantly more bone apposition for the modSLA surface than the standard SLA surface after 2 weeks of healing. This increased bone apposition may allow a further reduction of the healing period following implant placement for patients undergoing early loading procedures.
Authors: Giovanni E Salvi, Mirjam M Fürst, Niklaus P Lang, G Rutger Persson
Clinical oral implants research. 19(3):242-8.
AIMS: (i) To assess the pattern of early bacterial colonization on titanium oral implants after installation, at 12 weeks and at 12 months, (ii) to compare the microbiota at submucosal implant sitesAIMS: (i) To assess the pattern of early bacterial colonization on titanium oral implants after installation, at 12 weeks and at 12 months, (ii) to compare the microbiota at submucosal implant sites and adjacent subgingival tooth sites and (iii) to assess whether or not early colonization was predictive of 12-month colonization patterns. MATERIAL AND METHODS: Submucosal/subgingival plaque samples from 17 titanium oral implants and adjacent teeth were analyzed by checkerboard DNA-DNA hybridization 30 min, 12 weeks and 12 months after implant installation. RESULTS: At 12 months, none of the inserted implants had been lost or presented with signs of peri-implantitis. The distribution of sites at implants and teeth with bleeding on probing varied between 2% and 11%. Probing pocket depths < or =3 mm were found at 75% of implant sites. At 12 months, the sum of the bacterial counts of 40 species was statistically significantly higher at tooth compared with implant sites (mean difference: 34.4 x 10(5), 95% confidence interval -0.4 to 69.4, P<0.05). At 12 months, higher individual bacterial counts at tooth sites were found for 7/40 species compared with implant sites. Detection or lack of detection of Staphylococcus aureus at implant sites at 12 weeks resulted in the highest positive (e.g. 80%) and negative (e.g. 90%) predictive values, respectively. Between 12 weeks and 12 months, the prevalence of Tannerella forsythia increased statistically significantly at implant sites (P<0.05). Lack of detection of Porphyromonas gingivalis at 12 weeks yielded a negative predictive value of 93.1% of this microorganism being undetectable at implant sites at 12 months. CONCLUSIONS: Within the limits of this study, the findings showed (i) a few differences in the prevalence of bacterial species between implant and adjacent tooth sites at 12 months and (ii) high positive and negative predictive values for selected bacterial species.
Authors: Haim Tal, Avital Kozlovsky, Zvi Artzi, Carlos E Nemcovsky, Ofer Moses
Clinical oral implants research. 19(3):295-302.
OBJECTIVE: This double-blind study clinically and histologically evaluated long-term barrier bio-durability of cross-linked and non-cross-linked collagen membranes (CLM and NCLM) in sites treated byOBJECTIVE: This double-blind study clinically and histologically evaluated long-term barrier bio-durability of cross-linked and non-cross-linked collagen membranes (CLM and NCLM) in sites treated by guided bone regeneration procedures. MATERIALS AND METHODS: In 52 patients, 52 bony defects were randomly assigned to treatment with either a CLM or a NCLM. Post-surgical spontaneous membrane exposures were recorded. Before implant placement, full-thickness standard soft tissue discs were retrieved wherever suitable for histologic examination. RESULTS: Spontaneous membrane exposure was observed in 13 (50%) CLM sites and in six (23.1%) NCLM sites (P<0.05). Clinical healing at exposed sites lasted 2-4 weeks. CLM were histologically intact in all non-perforated sites, were interrupted in five perforated sites, and undetected in four. NCLMs were undetected in all 18 specimens examined. In three non-perforated CLM sites, bone apposition and ossification at or within the membrane was observed. CONCLUSIONS: CLMs were more resistant to tissue degradation than NCLMs, and maintained integrity during the study. Neither membrane was resistant to degradation when exposed to the oral environment. CLMs were associated with a higher incidence of tissue perforations. In non-perforated sites, CLM ossification at or within the membrane was occasionally observed.
Authors: Michael Payer, Robert Kirmeier, Norbert Jakse, Christof Pertl, Walther Wegscheider, Martin Lorenzoni
Clinical oral implants research. 19(3):265-70.
OBJECTIVES: The aim of this experimental study was to identify relevant surgical parameters influencing the mesiodistal angular deviation of dental implants. MATERIAL AND METHODS: Pilot drillings ofOBJECTIVES: The aim of this experimental study was to identify relevant surgical parameters influencing the mesiodistal angular deviation of dental implants. MATERIAL AND METHODS: Pilot drillings of 2 mm diameter were performed in bovine ribs with a parallelometer. The subsequent preparation of the implant socket was performed freehand. Utilizing six different implant systems, at least 80 drillings per system of different diameters were performed. The pilot drillings were marked with 2 mm steel pins and cephalometric radiographs were taken. The mesiodistal angle between the longitudinal implant axis and the marked pilot drillings was measured and evaluated by a blinded investigator. To evaluate the influence of the surgeons' experience, their drillings were compared with those of a group of unexperienced surgeons. Additionally, the influence of drilling speed and size of bur steps on drilling accuracy were evaluated. RESULTS: The difference between the lowest value of 0.91 degrees of mesiodistal angular deviation found for 3i implants and the highest of 1.36 degrees for Ankylos implants was of low statistical significance (P=0.065). Drillings of experienced surgeons showed less deviation compared with those of a beginners group (P<0.0001). Higher deviations were measured when a bur size was skipped. Drillings performed at high speed showed significantly higher deviations than those with fewer rewinds per minute. CONCLUSION: In order to achieve precise implant angulation, all bur diameters available should be used. Utilizing low drilling speeds results in less mesiodistal deviation. The surgeon's experience seems to be the most relevant factor in precise implant placement.
Authors: Daiki Mizuno, Hideaki Kagami, Hirokazu Mizuno, Junji Mase, Kazutada Usami, Minoru Ueda
Clinical oral implants research. 19(3):289-94.
OBJECTIVES: This study aimed to demonstrate the feasibility of a cultured periosteum (CP) membrane for use in guided bone regeneration at sites of implant dehiscence. MATERIAL AND METHODS: FourOBJECTIVES: This study aimed to demonstrate the feasibility of a cultured periosteum (CP) membrane for use in guided bone regeneration at sites of implant dehiscence. MATERIAL AND METHODS: Four healthy beagle dogs were used in this study. Implant dehiscence defects (4 x 4 x 3 mm) were surgically created at mandibular premolar sites where premolars had been extracted 3 months back. Dental implants (3.75 mm in diameter and 7 mm in length) with machined surfaces were placed into the defect sites (14 implants in total). Each dehiscence defective implant was randomly assigned to one of the following two groups: (1) PRP gel without cells (control) or (2) a periosteum membrane cultured on PRP gel (experimental). Dogs were killed 12 weeks after operation and nondecalcified histological sections were made for histomorphometric analyses including percent linear bone fill (LF) and bone-to-implant contact (BIC). RESULTS: Bone regeneration in the treatment group with a CP membrane was significantly greater than that in the control group and was confirmed by LF analysis. LF values in the experimental and the control groups were 72.36+/-3.14% and 37.03+/-4.63%, respectively (P<0.05). The BIC values in both groups were not significantly different from each other. The BIC values in the experimental and the control groups were 40.76+/-10.30% and 30.58+/-9.69%, respectively (P=0.25) and were similar to native bone. CONCLUSION: This study demonstrated the feasibility of a CP membrane to regenerate bone at implant dehiscence defect.
Authors: Bjarni E Pjetursson, Wah Ching Tan, Ken Tan, Urs Brägger, Marcel Zwahlen, Niklaus P Lang
Clinical oral implants research. 19(2):131-41.
OBJECTIVES: The objectives of this systematic review were to assess the 5-year survival of resin-bonded bridges (RBBs) and to describe the incidence of technical and biological complications.OBJECTIVES: The objectives of this systematic review were to assess the 5-year survival of resin-bonded bridges (RBBs) and to describe the incidence of technical and biological complications. METHODS: An electronic Medline search complemented by manual searching was conducted to identify prospective and retrospective cohort studies on RBBs with a mean follow-up time of at least 5 years. Patients had to have been examined clinically at the follow-up visit. Assessment of the identified studies and data extraction were performed independently by two reviewers. Failure and complication rates were analyzed using random-effects Poissons regression models to obtain summary estimates of 5-year proportions. RESULTS: The search provided 6110 titles and 214 abstracts. Full-text analysis was performed for 93 articles, resulting in 17 studies that met the inclusion criteria. Meta-analysis of these studies indicated an estimated survival of RBBs of 87.7% (95% confidence interval (CI): 81.6-91.9%) after 5 years. The most frequent complication was debonding (loss of retention), which occurred in 19.2% (95% CI: 13.8-26.3%) of RBBs over an observation period of 5 years. The annual debonding rate for RBBs placed on posterior teeth (5.03%) tended to be higher than that for anterior-placed RBBs (3.05%). This difference, however, did not reach statistical significance (P=0.157). Biological complications, like caries on abutments and RBBs lost due to periodontitis, occurred in 1.5% of abutments and 2.1% of RBBs, respectively. CONCLUSION: Despite the high survival rate of RBBs, technical complications like debonding are frequent. This in turn means that a substantial amount of extra chair time may be needed following the incorporation of RBBs. There is thus an urgent need for studies with a follow-up time of 10 years or more, to evaluate the long-term outcomes.
Authors: Mario Roccuzzo, Marco Aglietta, Marco Bunino, Luca Bonino
Clinical oral implants research. 19(2):148-52.
OBJECTIVES: The aim of the present split-mouth study is to assess the peri-implant conditions around early-loaded sandblasted and acid-etched (SLA) implants, 5 years after abutment connection and toOBJECTIVES: The aim of the present split-mouth study is to assess the peri-implant conditions around early-loaded sandblasted and acid-etched (SLA) implants, 5 years after abutment connection and to compare, in the same patients, the results obtained with a standard protocol using identical implants with a TPS surface. MATERIAL AND METHODS: Surgical procedure was performed by the same operator and was identical at test (SLA) and control (TPS) sites, in 32 healthy patients. Abutment connection was carried out at 35 N cm 6 weeks postsurgery for test sites and 12 weeks for the controls. Patients were seen regularly, for control and professional cleaning. At 60 months, clinical measures and radiographic bone changes were recorded by the same operator, blind to the type of surface of the implant, on 27 patients, as five patients were lost to follow-up. RESULTS: A total number of 106 implants were examined. No implant was lost. No significant differences were found with respect to the presence of plaque [modified plaque index (mPI) 0.27+/-0.56 vs. 0.32+/-0.54], bleeding on probing (29% vs. 32%), mean pocket depth (3.2+/-1 vs. 3.2+/-1 mm) or mean marginal bone loss (0.32+/-1.04 vs. 0.44+/-1.12 mm) between test and control. Four implants that presented 'spinning' at the time of abutment connection presented no significant differences from the rest of the test sites. CONCLUSION: The results of this prospective study confirm that SLA implants, under defined conditions, are suitable for early loading at 6 weeks in both the mandible and the maxilla. Limited implant spinning, occasionally found at abutment connection, produces no detrimental effect on the clinical outcome when properly handled.
Authors: Henk W D Verdonck, Gert J Meijer, Thorsten Laurin, Fred H Nieman, Christian Stoll, Dieter Riediger, Paul J W Stoelinga, Cees de Baat
Clinical oral implants research. 19(2):201-6.
OBJECTIVES: Primary implant stability is related to local bone density. After insertion of an implant, implant stability is subject to changes due to bone remodeling. In patients who have undergoneOBJECTIVES: Primary implant stability is related to local bone density. After insertion of an implant, implant stability is subject to changes due to bone remodeling. In patients who have undergone radiotherapy in the head and neck region, implant stability is impaired because irradiation reduces bone vitality. The current study was designed to monitor and test implant stability immediately after implant placement and during osseointegration in irradiated and non-irradiated minipig alveolar bone. MATERIALS AND METHODS: All maxillary and mandibular premolars and molars of six adult Göttingen minipigs were extracted. The maxilla and mandible of three minipigs received three irradiation exposures at a total dose of 24 Gy. After irradiation, five initial implant holes were drilled in the residual alveolar ridge of each edentulous site. In order to assess bone vascularity, laser Doppler flowmetry recordings were carried out in the initial holes. A total of 120 implants were placed in the six minipigs. Subsequently, and at 8, 16, and 24 weeks after implant placement, implant stability was recorded by resonance frequency analysis (RFA). RFA values were expressed as an implant stability quotient (ISQ). RESULTS: ISQ values recorded immediately after implant placement showed no differences between irradiated and non-irradiated minipigs. Repeated measurements at the four recording moments showed a decrease of ISQ values in all minipigs, being more pronounced in irradiated bone, when compared with non-irradiated bone. The results at the third and fourth recording moments showed a stabilization or even a slight increase of ISQ values. CONCLUSIONS: The results document the negative effect of irradiation on bone vascularity and hence on implant stability.
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