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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1600-0501
OCLC
46677841
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Blackwell Publishing
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Publications in this journal
Authors: Christoph Arnhart, Gabriella Dvorak, Caroline Trefil, Christian Huber, Georg Watzek, Werner Zechner
Clinical oral implants research.
OBJECTIVE: Moderately rough, surfaced implants are widely used. Nevertheless data on long-term soft and hard tissue parameters are still conflicting. The purpose of this study was to evaluateOBJECTIVE: Moderately rough, surfaced implants are widely used. Nevertheless data on long-term soft and hard tissue parameters are still conflicting. The purpose of this study was to evaluate peri-implant bone level and soft tissue integration of anodized vs. turned surfaced implants in the anterior mandible after a mean functional loading time of 85 months. METHODS: Of 114 edentulous patients invited for follow-up, 41,2% were available for recall. Forty-seven patients with a mean age of 71 ± 9 years (14 men and 33 women) received 188 dental implants; All patients were edentulous and prosthetic rehabilitation was carried out by a bar-retained overdenture. Radiographic peri-implant bone level was assessed twice at baseline and recall. Clinical examination contained peri-implant sounding (PPD, BoP) and indexing oral hygiene (mPI). RESULTS: From baseline up to 85 months two patients experienced implant loss (four implants), which corresponds to an overall-survival rate of 97.9%. No significant differences were found between implant surfaces concerning the clinical parameters, such as plaque, calculus, bleeding on probing and pocket probing depth. The moderately rough surfaced implants showed significantly less decrease in peri-implant bone level (1.53 ± 0.25 mm) than turned surfaced implants (2.42 ± 0.34 mm) (P = 0.036). The interaction between the position of the implant and surface topography (P = 0.037) as well as the site at the implant (P = 0.004) had a significant influence on bone level changes. CONCLUSION: Both surface topographies with bar-supported overdentures have excellent long-term clinical outcomes. Moreover, a moderately roughened, anodized surface has beneficial effects in the anterior lower jaw.
Authors: Jung-Yoo Choi, Ui-Won Jung, Chang-Sung Kim, Sung-Min Jung, In-Seop Lee, Seong-Ho Choi
Clinical oral implants research.
OBJECTIVE: The purpose of this study was to evaluate the osseointegration of two different types of surfaces, smooth and roughened surface implants nanocoated with calcium phosphate (CAP) aroundOBJECTIVE: The purpose of this study was to evaluate the osseointegration of two different types of surfaces, smooth and roughened surface implants nanocoated with calcium phosphate (CAP) around different bone environment. MATERIALS AND METHODS: Five male mongrel dogs were used in this study. The premolars and molars were extracted on both sides of the mandible. Eight weeks after extraction, implants were submerged on both sides of the mandible. On the left, CAP nanocoated roughened surface (RCAP) implants were installed whereas, the CAP nanocoated smooth surface (SCAP) implants were installed on the right side. The control group had no defect, on the other hand, three-wall intrabony defects were surgically created adjacent to the implant in the experimental group. The dogs were sacrificed after 12 weeks. RESULTS: Histological and histomorphometrical analysis were performed with the specimen. The SCAP and RCAP implants showed good osseointegration with no statistical significance in the control group. Histologically, the SCAP group showed little resolution of the defect compared with the RCAP group. In the experimental groups, there was a significant difference in defect fill between SCAP and RCAP. CONCLUSION: Within the limits of our study, it can be concluded that SCAP and RCAP implants show no difference in sufficient bone area whereas, CAP nanocoating on roughened implant surface may enhance osseointegration in deficient bone environment.
Authors: Marta Monjo, Joana M Ramis, Hans J Rønold, Sébastien F Taxt-Lamolle, Jan E Ellingsen, Staale P Lyngstadaas
Clinical oral implants research.
OBJECTIVES: A better understanding of the biological processes controlling osseointegration at the bone-to-implant interface is needed. The aim of this study was to examine which are the molecularOBJECTIVES: A better understanding of the biological processes controlling osseointegration at the bone-to-implant interface is needed. The aim of this study was to examine which are the molecular and biochemical variables that are significantly related to osseointegration, using multiple regression analysis. MATERIALS AND METHODS: Titanium coins were placed into the tibial cortical bone of New Zealand White rabbits and evaluated using pull-out test after 4 and 8 weeks of healing. Correlations between pull-out and several markers from tissue fluid (Lactate dehydrogenase [LDH] and Alkaline phosphatase [ALP] activities and total protein content) and peri-implant bone tissue (total protein, RNA and DNA content, implant area covered with bone and gene expression of osteoblast, osteoclast and inflammation markers) were used to assess the importance of these parameters in bone healing and in relation to implant performance. RESULTS: Our results showed a negative correlation between the content of DNA, RNA and total protein at the peri-implant bone tissue and the pull-out force, indicating that as bone matures and implant becomes more osseointegrated, the organic content of bone decreases. The negative correlation found between pull-out force and ALP activity pointed to a delayed healing in implants with lower pull-out values and primary mineralization still ongoing. LDH activity and total protein content in the tissue fluid were as well negatively correlated with the pull-out force. Finally, a positive correlation was observed between the pull-out force and the expression of the osteoblast and the bone resorption markers, being osteocalcin and collagen-I the best predictive markers for osseointegration after 4 and 8 weeks of healing respectively. CONCLUSIONS: These results suggest that the evaluation of these markers could be relevant for the assessment of new implant surfaces for rapid bone healing and improved implant performance.
Authors: Güliz N Güncü, Yağmur D Yıldırım, Hasan Güney Yılmaz, Pablo Galindo-Moreno, Miguel Velasco-Torres, Khalid Al-Hezaimi, Reema Al-Shawaf, Erdem Karabulut, Hom-Lay Wang, Tolga F Tözüm
Clinical oral implants research.
OBJECTIVES: The effect of gender on anatomic structures and various body systems were illustrated in the literature. The purpose of this study was to identify the influence of gender and tooth lossOBJECTIVES: The effect of gender on anatomic structures and various body systems were illustrated in the literature. The purpose of this study was to identify the influence of gender and tooth loss on incisive canal characteristics and buccal bone dimensions in the anterior maxilla. MATERIALS AND METHODS: Computed tomographies (CTs) of 417 male and 516 female patients in four dental clinics were included in this study. The diameter and the length of the incisive canal; width and the length of the bone anterior to the canal; palatal bone length, root length, and root width of the central incisor teeth were measured and recorded from CT sections. RESULTS: Mean incisive canal length was 11.96 ± 2.73 mm and 10.39 ± 2.47 mm in men and women, respectively, (P < 0.05). In men, mean canal diameter was 2.79 ± 0.94 mm whereas in women it was 2.43 ± 0.85 mm and this difference was statistically significant (P < 0.05). Men had significant higher buccal bone dimensions (length and width of the bone anterior to the canal) than women. Absence of teeth in the anterior maxilla decreased incisive canal length and buccal bone dimensions; however, canal diameter remain unchanged. CONCLUSIONS: Present results suggested a gender related differences in anatomic features of incisive canal and surrounding buccal bone. In addition, crestal canal diameter, buccal bone length, and thickness parameters might be different in distinct countries.
Authors: Christiano de Oliveira-Santos, Izabel R F Rubira-Bullen, Solange A C Monteiro, Jorge E León, Reinhilde Jacobs
Clinical oral implants research.
OBJECTIVE: This study aimed to assess the presence of additional foramina and canals in the anterior palate region, through cone beam computed tomography (CBCT) images, describing their location,OBJECTIVE: This study aimed to assess the presence of additional foramina and canals in the anterior palate region, through cone beam computed tomography (CBCT) images, describing their location, direction, and diameter. MATERIALS & METHODS: CBCT exams of 178 subjects displaying the anterior maxilla were included and the following parameters were registered: gender; age group; presence of additional foramina in the anterior palate (AFP) with at least 1 mm in diameter; location and diameter of AFP; and direction of bony canals associated with AFP. RESULTS: Twenty-eight patients (15.7%) presented AFP and in total 34 additional foramina were registered. No statistical differences between patients with or without AFP were found for gender or age. The average diameter of AFP was 1.4 mm (range from 1 to 1.9 mm). Their location was variable, with most of the cases occurring in the alveolar process near the incisors or canines (n = 27). In 18 cases, AFP was associated with bony canals with upward or oblique direction toward the anterior nasal cavity floor. In 14 cases, the canal presented as a direct extension of the canalis sinuosus, in an upward direction laterally to the nasal cavity aperture. In two cases, the canal was observed adjacent to the incisive and joined the nasopalatine canal superiorly. DISCUSSION: CBCT images have a crucial role in the recognition of anatomical variations by allowing detailed tridimensional evaluations. Additional foramina and canals in the anterior region of the upper jaw are relatively frequent. Practitioners should be aware and trained to identify these variations. CONCLUSIONS: Over 15% of the population studied had additional foramina in the anterior palate, between 1 mm and 1.9 mm wide, with variable locations. In most cases the canals associated with these foramina either presented as a direct extension of the canalis sinuosus, or coursed towards the nasal cavity floor.
Authors: Luigi Canullo, Costanza Micarelli, Giuliano Iannello
Clinical oral implants research.
AIM: This study was aimed to assess contaminants on the abutment surface close to the implant-abutment interface and the connection, after common technical protocols. MATERIALS AND METHODS: A totalAIM: This study was aimed to assess contaminants on the abutment surface close to the implant-abutment interface and the connection, after common technical protocols. MATERIALS AND METHODS: A total of 40 abutments were divided into four groups: control group (abutment removed from the plastic envelop), test group(1) (milled), test group(2) (milled and polished), test group(3) (milled, polished and steamed). Groups were subjected to scanning electron microscope (SEM) analysis. Pollution particles were counted and measured. Mean values and standard deviation (SD) were calculated. To evaluate any difference between groups Wilcoxon Signed Rank Test was conducted. In addition, contaminant chemical characterization was investigated by Energy-dispersive X-ray spectroscopy (EDX). RESULTS: Control group presented minimal amount of pollution (mean value of 2.1 spots [SD: 1.66] covering 0.004% of the surface). On the other hand, SEM analysis revealed on the abutment surface a mean value of 115.9 (SD: 32.27), 162 (SD: 21.17), and 32.5 (SD: 9.73) spots, respectively, in Test group 1, 2, and 3. Micro-particles covered the 0.025%, 0.057%, 0.0404% of the surface, respectively, in Test group 1, 2, and 3. On the connection, SEM analysis revealed a mean value of 61.9 (SD: 9.07), 39 (SD: 12.35), 42.1 (SD: 8.59) spots, respectively, in Test group 1, 2, and 3. Micro-particles covered the 0.0774%, 0.0869%, and 0.0392% of the surface, respectively, in Test group 1, 2, and 3. Spots were identified by EDX as micro-particles of lubricant and titanium smear layer. All differences were statistically significant. CONCLUSIONS: After technical procedures, presence of contaminants on the abutment surface in contact with the peri-implant tissues was confirmed. To prevent that such debris could interfere with biological stability of peri-implant tissues and, thus, enhance the implant-prosthesis integration, different cleaning protocols should be evaluated.
Authors: Dorothee Schär, Christoph A Ramseier, Sigrun Eick, Nicole B Arweiler, Anton Sculean, Giovanni E Salvi
Clinical oral implants research.
OBJECTIVE: To compare the adjunctive clinical effects in the non-surgical treatment of peri-implantitis with either local drug delivery (LDD) or photodynamic therapy (PDT). MATERIAL AND METHODS:OBJECTIVE: To compare the adjunctive clinical effects in the non-surgical treatment of peri-implantitis with either local drug delivery (LDD) or photodynamic therapy (PDT). MATERIAL AND METHODS: Forty subjects with initial peri-implantitis, i.e. pocket probing depths (PPD) 4-6 mm with concomitant bleeding on probing (BoP) and marginal bone loss ranging from 0.5 to 2 mm between delivery of the reconstruction and pre-screening appointment were randomly assigned to two treatment groups. All implants underwent mechanical debridement with titanium curettes, followed by a glycine-based powder airpolishing. Implants in the test group (n = 20) received adjunctive PDT, whereas minocycline microspheres were locally delivered into the peri-implant pockets of control implants (n = 20). At sites with residual BoP, treatment was repeated after 3 and 6 months. The primary outcome variable was the change in the number of sites with BoP. Secondary outcome variables were changes in PPD, in clinical attachment level (CAL), and in mucosal recession (REC). RESULTS: After 3 months, implants of both groups yielded a statistically significant reduction (P < 0.0001) in the number of BoP-positive sites compared with baseline (LDD: from 4.41 ± 1.47 to 2.20 ± 1.28, PDT: from 4.03 ± 1.66 to 2.26 ± 1.28). After 6 months, complete resolution of mucosal inflammation was obtained in 15% of the implants in the control group and in 30% of the implants in the test group (P = 0.16). After 3 months, changes in PPD, REC, and modified Plaque Index (mPlI) were statistically significantly different from baseline (P < 0.05). No statistically significant changes (P > 0.05) occurred between 3 and 6 months. CAL measurements did not yield statistically significant changes (P > 0.05) in both groups during the 6-month observation time. Between-group comparisons revealed no statistically significant differences (P > 0.05) at baseline, 3 and 6 months with the exception of the mPlI after 6 months. CONCLUSIONS: In cases of initial peri-implantitis, non-surgical mechanical debridement with adjunctive use of PDT is equally effective in the reduction of mucosal inflammation as with the adjunctive use of minocycline microspheres up to 6 months. Adjunctive PDT may represent an alternative treatment modality in the non-surgical management of initial peri-implantitis. Complete resolution of inflammation, however, was not routinely achieved with either of the adjunctive therapies.
Authors: Peter Rammelsberg, Stefanie Schwarz, Christin Schroeder, Justo L Bermejo, Olaf Gabbert
Clinical oral implants research.
OBJECTIVE: The objective of this clinical study was to evaluate survival and incidence of complications for metal-ceramic and all-ceramic implant-supported fixed dental prostheses (FDPs) andOBJECTIVE: The objective of this clinical study was to evaluate survival and incidence of complications for metal-ceramic and all-ceramic implant-supported fixed dental prostheses (FDPs) and tooth-implant-supported FDPs. MATERIAL AND METHODS: One-hundred and sixty-six FDPs placed in 132 patients from a prospective study were selected for this retrospective analysis. Included were 91 conventional implant-supported FDPs with implant support on both extremities, 27 implant-supported cantilever FDPs, and 48 tooth-implant-supported FDPs. All restorations were veneered with ceramic. Twenty-six FDPs had a zirconia framework and 140 had a metal framework. Kaplan-Meier analysis was performed to estimate FDP success defined as complication-free survival and the Cox regression model was used to isolate risk factors for the most frequent complications. RESULTS: Within a median follow-up of 1 year and 2 months, three failures were caused by a failed implant (n = 2) and by extended chipping of the veneer (n = 1). In contrast with this low incidence of failure was a high incidence of complications including chipping (n = 29), loss of retention (n = 35), and abutment fractures (n = 2). Multivariate survival analysis revealed a significantly greater incidence of chipping for males and a tendency to increased incidence of chipping for zirconia-based FDPs. The incidence of loss of retention tended to be less for tooth-implant-supported FDPs, for which semi-permanent cement was the only significant risk factor, with a hazard ratio of almost 5. CONCLUSIONS: As chipping of the ceramic veneer was the most frequent complication leading to substantial aftercare, improvements of ceramic veneers are desirable for zirconia-based and metal-based FDPs.
Authors: S Kühl, S Zürcher, T Mahid, M Müller-Gerbl, A Filippi, P Cattin
Clinical oral implants research.
OBJECTIVES: The benefit in terms of higher accuracy for full guided implant surgery (template based guided cavity preparation and guided implant insertion) compared with half-guided surgery (templateOBJECTIVES: The benefit in terms of higher accuracy for full guided implant surgery (template based guided cavity preparation and guided implant insertion) compared with half-guided surgery (template based guided cavity preparation and free-handed, manual implant insertion) has not been proved till now. MATERIAL AND METHODS: A total of 38 identical implants were inserted into five human cadaver jaws, after virtual implant planning with the coDiagnostiX(™) device. All cavities were drilled using templates equipped with tubes for guidance. At random, 19 implants were inserted in a free handed way (half-guided), whereas 19 implants were inserted in a guided way through the templates tubes (full guided). Postoperative cone beam computer tomographies (CBCT) were performed, and based on image fusion the total deviations between the virtual implant positions at the implants base and tip were determined and compared between both implantation modi. RESULTS: The mean difference in accuracy between both implantation modalities at the implants bases was 0.72 mm (range: 0.16-1.17 mm, SD: 0.45). The mean difference in accuracy between both modalities at the implants tips was 0.46 mm (range: 0.16-1.23 mm. SD: 0.49). Although full guided implantation showed a generally higher accuracy (mean tip: 1.54 mm, range: 0.33-3.64 mm; mean base: 1.52 mm, range: 0.4-3.54 mm) than half-guided implantation (mean tip: 1.84 mm, range: 0.84-3.22 mm; mean base: 1.56 mm, range: 0.49-3.43 mm), the differences were not statistically significant. CONCLUSIONS: The accuracy of half-guided implant surgery is comparable with full guided implant surgery.
Authors: Alexandra Marrone, Jérôme Lasserre, Pierre Bercy, Michel C Brecx
Clinical oral implants research.
OBJECTIVES: This study aimed to evaluate in a Belgian population the frequence of mucositis and peri-implantitis in patients with implants of at least 5 years of function. Another outcome was toOBJECTIVES: This study aimed to evaluate in a Belgian population the frequence of mucositis and peri-implantitis in patients with implants of at least 5 years of function. Another outcome was to access implants/patients characteristics as possible risk indicators for peri-implantitis. MATERIAL AND METHODS: One hundred and three patients (38 males/65 females) with a total of 266 implants were examined. Implants had been inserted in university hospitals as well as in private clinics and the mean time of implants in function was 8.5 years (±3.2). The average patients' age within the population was 62 years (±13.4). General health informations were recorded as well as habits regarding smoking, maintenance visits and oral hygiene. Full mouth clinical parameters (PlI, BoP, PPD) were assessed and radiographs taken to determine the periodontal status and implants diagnosis. RESULTS: Prevalences of mucositis and peri-implantitis at the patient's level were respectively 31% and 37%. They were 38% and 23% at the implant's level. Subjects older than 65 years (OR = 1.39) and those with active periodontitis (OR = 1.98) were prone to peri-implantitis. The association was stronger for hepatitis (OR = 2.92) and totally edentulous patients (OR = 5.56). Finally, at the implant's level, a significant correlation was found in the multi-level analyses between rough surfaces, overdentures and peri-implantitis. CONCLUSION: After 8.5 years an important proportion (±60%) of implants presented biological complications. Furthermore, a positive correlation was showed between age, periodontitis, absence of teeth, rough surfaces and peri-implantitis. Consequently, patients with such characteristics should be informed before implant placement and frequently re-called after for maintenance visits.
Authors: Matteo Chiapasco, Luca Autelitano, Dimitri Rabbiosi, Marco Zaniboni
Clinical oral implants research.
PURPOSE: To compare: (i) the incidence of soft tissue dehiscences; (ii) bone resorption before and after implant placement; and (iii) the survival and success rates of implants placed in two groupsPURPOSE: To compare: (i) the incidence of soft tissue dehiscences; (ii) bone resorption before and after implant placement; and (iii) the survival and success rates of implants placed in two groups of patients with severe bone defects of the jaws reconstructed with autogenous onlay bone grafts alone (control group) or in association with autogenous pericranium coverage (study group). MATERIAL AND METHODS: Forty-four patients affected by severe atrophy of the alveolar ridges underwent bone reconstruction with vertical/tridimensional autogenous onlay grafts harvested from the calvarium or the mandibular ramus. In 23 patients (study group), grafts were covered with autogenous pericranium before suturing, while in 21 patients (control group) no coverage of the grafts before suturing was performed. After a 4-7 month waiting period, 199 implants were placed (105 in the study group, 94 in the control group) and 3-4 months afterward prosthetic rehabilitation was carried out. The mean follow-up after the start of prosthetic loading was 23.9 months (range: 12-48 months). RESULTS: The incidence of soft tissue dehiscences was 5,7% in the study group and 16% in the control group. The mean graft resorption before implant placement was 0.12 mm (SD ± 0.32) in the study group and 0.98 mm (SD ± 2.79) in the control group. The mean peri-implant bone resorption at the end of the follow-up period was 0.21 mm (SD ± 0.48) in the study group and 0.43 mm (SD ± 0.83) in the control group. The survival rate of implants was 99.1% in the study group and 100% in the control group, while success rate was 96.2% in the study group and 93.6% in the control group. CONCLUSIONS: The use of pericranium as an autogenous membrane for the coverage of onlay bone grafts seems to reduce the risk of soft tissue dehiscences after the reconstruction of atrophic edentulous ridges to reduce peri-implant bone resorption over time, while it seems to have no significant effect in reducing bone resorption in the reconstructed areas before implant placement.
Authors: Thallita P Queiroz, Francisley Á Souza, Antônio C Guastaldi, Rogério Margonar, Idelmo R Garcia-Júnior, Eduardo Hochuli-Vieira
Clinical oral implants research.
OBJECTIVES: The purpose of this study was to evaluate the surfaces of commercially pure titanium (cp Ti) implants modified by laser beam (LS), without and with hydroxyapatite deposition by theOBJECTIVES: The purpose of this study was to evaluate the surfaces of commercially pure titanium (cp Ti) implants modified by laser beam (LS), without and with hydroxyapatite deposition by the biomimetic method (HAB), without (HAB) and with thermal treatment (HABT), and compare them with implants with surfaces modified by acid treatment (AS) and with machined surfaces (MS), employing topographical and biomechanics analysis. METHODS: Forty-five rabbits received 75 implants. After 30, 60, and 90 days, the implants were removed by reverse torque and the surfaces were topographically analyzed. RESULTS: At 30 days, statistically significant difference (P < 0.05) was observed among all the surfaces and the MS, between HAB/HABT and AS and between HAB and LS. At 60 days, the reverse torque of LS, HAB, HABT, and AS differed significantly from MS. At 90 days, difference was observed between HAB and MS. The microtopographic analysis revealed statistical difference between the roughness of LS, HAB, and HABT when compared with AS and MS. CONCLUSIONS: It was concluded that the implants LS, HAB, and HABT presented physicochemical and topographical properties superior to those of AS and MS and favored the osseointegration process in the shorter periods. In addition, HAB showed the best results when compared with other surfaces.
Authors: Duygu Boynueğri, Seçil K Nemli, Yeliz A Kasko
Clinical oral implants research.
OBJECTIVE: The aim of this investigation was to evaluate the significance of keratinized mucosa (KM) around dental implants both clinically and biochemically for 12 months. MATERIAL AND METHODS:OBJECTIVE: The aim of this investigation was to evaluate the significance of keratinized mucosa (KM) around dental implants both clinically and biochemically for 12 months. MATERIAL AND METHODS: Fifteen edentulous patients treated with implant-retained overdentures in edentulous mandible (four implants per patient). Based on the presence of keratinized mucosa on the buccal surfaces, implants were divided into two groups: Implants having minimal 2 mm of KM on their buccal surfaces and implants having no KM on their buccal surfaces. Thirty-six implants were included in the evaluations; 19 implants in 15 patients had minimal 2 mm of KM on their buccal surfaces and 17 implants in 15 patients had no KM on their buccal surfaces. Clinical measurements of Plaque Index, Gingival Index, probing depths, and Bleeding on Probing were performed and peri-implant crevicular fluid (PICF) were collected immediately before loading (baseline) and at 6th, 12th months after loading. Interleukin-1 beta (IL-1 β) and tumor necrosis factor-alpha (TNF-α) have been assessed in the crevicular fluid. Results were analyzed by repeated-measures of variance (ANOVA) and Wilcoxon signed rank tests. RESULTS: After 12 months of evaluation the results of ANOVA showed that implants with KM had lower levels of TNF-α total amounts than implants without KM (P < 0.05). Additionally, TNF-α total amounts were significantly higher at 12(th) month compared to baseline for implants without KM (P < 0.05). Plaque index and Gingival index values were also found significantly higher for implants without KM (P < 0.05). For IL-1 β and PICF volume levels the differences between the implant groups were non significant, whereas the differences between the periods were significant. (P < 0.05) Additionally, both of the groups had higher levels of PII and BoP scores when compared to baseline (P < 0.05). CONCLUSIONS: The results of this study showed that an adequate band of keratinized mucosa was related with less plaque accumulation and mucosal inflammation as well as pro-inflammatuar mediators, suggesting that it may be critical especially for plaque control and plaque associated mucosal lesions around dental implants.
Authors: Philippe Hujoel, William Becker, Burton Becker
Clinical oral implants research.
OBJECTIVE: The aim of this study was to report on the failure rates of two distinct dental implant systems in a clinical practice setting. MATERIALS AND METHODS: Date of implant placement and lossOBJECTIVE: The aim of this study was to report on the failure rates of two distinct dental implant systems in a clinical practice setting. MATERIALS AND METHODS: Date of implant placement and loss were entered prospectively in a data registry system. Failure rates of two commercially pure titanium implants, one with a porous oxydized surface (POS) and the other with a chemically altered surface (CAS), were assessed using a quality control chart and survival analyses. RESULTS: A total of 860 POS and 759 CAS implants were placed. A warning of an increased failure rate of the CAS implant was identified by means of the quality control chart. Survival analyses indicated that the CAS implant failure rate was twice that of the POS implant (Hazard Ratio: 2.08; 95% CI: 1.33-3.28, P-value < 0.0012). After adjusting for alternative explanations, the CAS implant remained associated with a 95% increased failure rate (95% CI: 1.14-3.35; P-value = 0.0146). Abandoning the CAS implant and returning to a POS implant was associated with a non-significant 64% drop in the implant failure rate within less than a year (HR: 0.36; 95% CI: 0.12-1.14; P-value < 0.0826). CONCLUSION: The difference between a 4% failure rate with the POS implant and an 8% failure with the CAS implant appears inconsistent with the assumption of substantial equivalence.
Authors: Raúl González-García, Florencio Monje
Clinical oral implants research.
OBJECTIVES: To analyze the reliability of micro-computed tomography (micro-CT) to assess bone density and the microstructure of the maxillary bones at the alveolar process in human clinics by directOBJECTIVES: To analyze the reliability of micro-computed tomography (micro-CT) to assess bone density and the microstructure of the maxillary bones at the alveolar process in human clinics by direct comparison with conventional stereologic-based histomorphometry. MATERIALS AND METHODS: Analysis of osseous microstructural variables including bone volumetric density (BV/TV) of 39 biopsies from the maxillary alveolar bone was performed by micro-CT. Conventional stereologic-based histomorphometry of 10 bone biopsies was performed by optic microscopy (OM) and low-vacuum surface electronic microscopy (SEM). Percentages of bone between micro-CT and conventional stereologic-based histomorphometry were compared. RESULTS: Significant positive correlations were observed between BV/TV and the percentage of bone (%Bone) analyzed by SEM (r = 0.933, P < 0.001), by toluidine blue staining OM (r = 0.950, P < 0.001) and by dark field OM (r = 0.667, P = 0.05). The high positive correlation coefficient between BV/TV and trabecular thickness illustrates that a value of BV/TV upper than 50% squares with a bone presenting most of their trabecules thicker than 0.2 mm. The high negative correlation between BV/TV and trabecular separation shows that values of BV/TV upper than 50% squares with a bone presenting most of their trabecules separated less than 0.3 mm each other. CONCLUSION: BV/TV assessed by micro-CT correlates with the percentage of bone assessed by conventional stereologic-based histomorphometry. Micro-CT is a reliable technique to determine the bone density and the microstructure of the maxillary alveolar bone at the site of dental implant insertion.
Authors: Mauro Donati, Daniele Botticelli, Vincenzo La Scala, Cristiano Tomasi, Tord Berglundh
Clinical oral implants research.
OBJECTIVE: To analyze hard tissue reactions to immediate functionally loaded single implants that were installed either with a conventional drill preparation procedure or with an osteotomeOBJECTIVE: To analyze hard tissue reactions to immediate functionally loaded single implants that were installed either with a conventional drill preparation procedure or with an osteotome preparation technique. MATERIALS AND METHODS: Thirteen subjects with two sites requiring single tooth rehabilitation by means of implants volunteered for the study. Each subject received one test (immediate functionally loaded) and one control (non-loaded) implant. In six subjects (group 1) the implants were placed using a conventional drilling procedure, whereas in the remaining seven subjects (group 2) an osteotome preparation procedure was performed. Block biopsies containing test and control implants and peri-implant bone tissues were collected at 1 month in four of the subjects in group 1 and in five subjects of group 2. The remaining implant sites were sampled at 3 months after implant placement. The biopsies were prepared for histological examination. RESULTS: Two implants of the test-2 group (osteotome preparation) representing 1 month of healing and another test-2 implant representing 3 months of healing failed to integrate. A multilevel multivariate statistical analysis demonstrated that no differences in bone-to-implant contact (BIC)% were found in between test and control implants, the density of newly formed peri-implant bone was significantly higher around test than control implants at 1 and 3 months of healing. Sections representing osteotome technique sites showed fractured trabeculae and large amounts of bone particles. CONCLUSIONS: It is suggested that immediate loading of implants does not influence the osseointegration process, whereas the density of newly formed peri-implant bone at such sites appears to be increased in relation to unloaded control implants. The use of an osteotome preparation technique during installation results in damage of peri-implant bone and enhances the risk for failure in osseointegration.
Authors: Hendrik J Santing, Gerry M Raghoebar, Arjan Vissink, Laurens den Hartog, Henny J A Meijer
Clinical oral implants research.
AIM: The purpose of this prospective study was to evaluate radiographic, clinical and aesthetic outcomes and patient satisfaction of cases treated with platform-switched single implant restorationsAIM: The purpose of this prospective study was to evaluate radiographic, clinical and aesthetic outcomes and patient satisfaction of cases treated with platform-switched single implant restorations in the aesthetic region of the maxilla. Furthermore, the influence of an augmentation procedure 3 months before implant placement and the type of restoration (screw-retained vs. cement-retained) was evaluated. MATERIAL AND METHODS: Sixty patients with a missing anterior tooth in the maxilla were treated with a Straumann Bone Level Implant. Bone augmentation was performed in 29 patients at 3 months before implant placement. Implants were loaded after 3 months of submerged healing. Follow-up was conducted at 7 and 18 months after implant placement. Peri-implant mucosa and implant crown aesthetic outcomes were determined using the Implant Crown Aesthetic Index (ICAI) and the Pink Esthetic Score-White Esthetic Score (PES-WES). RESULTS: No implants were lost. At 18 months after implant placement, mean bone level change was -0.10 ± 0.27 mm and mean probing pocket depth was 2.57 mm. No differences were found between augmented and nonaugmented sites (P = 0.28). The ICAI indicated satisfactory mucosa and crown aesthetics in 67% and 75% of the cases, respectively, while the PES score was 14.4. ICAI mucosa (P = 0.004) and PES (P = 0.02) scores were significantly less favourable for augmented sites compared with nonaugmented sites. Patient satisfaction was high (8.9 ± 1.1 on VAS-score). CONCLUSIONS: From the present prospective, clinical study, it can be concluded that the Straumann Bone Level Implant shows an excellent survival rate, marginal bone stability and good clinical and aesthetic results. Bone augmentation before implant placement does not lead to more marginal bone loss. However, less favourable pink aesthetic outcomes were found in augmented sites compared with nonaugmented sites, while no differences were found between cement-retained and screw-retained restorations.
Authors: Thomas Jensen, Søren Schou, Hans Jørgen G Gundersen, Julie Lyng Forman, Hendrik Terheyden, Palle Holmstrup
Clinical oral implants research.
OBJECTIVES: The objective was to test the hypotheses: (i) no differences in bone-to-implant contact formation, and (ii) no differences between the use of autogenous mandibular or iliac bone grafts,OBJECTIVES: The objective was to test the hypotheses: (i) no differences in bone-to-implant contact formation, and (ii) no differences between the use of autogenous mandibular or iliac bone grafts, when autogenous bone, Bio-Oss mixed with autogenous bone, or Bio-Oss is used as graft for the maxillary sinus floor augmentation. MATERIAL AND METHODS: Bilateral sinus floor augmentation was performed in 40 mini pigs with: (A) 100% autogenous bone, (B) 75% autogenous bone and 25% Bio-Oss, (C) 50% autogenous bone and 50% Bio-Oss, (D) 25% autogenous bone and 75% Bio-Oss, or (E) 100% Bio-Oss. Autogenous bone was harvested from the iliac crest or the mandible and the graft composition was selected at random and placed concomitant with the implant placement. The animals were euthanized 12 weeks after surgery. Bone-to-implant contact was estimated by stereological methods and summarized as median percentage with 95% confidence interval (CI). Bone-to-implant contact formation was evaluated by fluorochrome labelling and assessed by median odds ratios (OR) with 95% (CI). RESULTS: Median bone-to-implant contact was: (A) 42.9% (95% CI: 32.1-54.5%), (B) 37.8% (95% CI: 27.1-49.9%), (C) 43.9% (95% CI: 32.6-55.9%), (D) 30.2% (95% CI: 21.6-40.3%), and (E) 13.9% (95% CI: 11.4-16.9%). Bone-to-implant contact was significantly higher for A, B, C, D as compared to E (P < 0.0001). Bone-to-implant contact was not significantly influenced by the ratio of Bio-Oss and autogenous bone (P = 0.19) or the origin of the autogenous bone (P = 0.72). Fluorochrome labelling revealed extensive variation in bone-to-implant contact formation over time. The labelling at weeks 2-3 was significantly increased with A compared to E (OR = 8.1 CI: 5.0-13.1, P < 0.0001), whereas E showed a significantly increased labelling at weeks 8-9 compared to A (OR = 0.5 CI: 0.3-0.7, P = 0.0028). CONCLUSIONS: The hypothesis of no differences in bone-to-implant contact between the various treatment modalities was rejected since the bone-to-implant contact was significantly increased with autogenous bone or Bio-Oss mixed with autogenous bone as compared to Bio-Oss. Early bone-to-implant contact formation was more advanced with autogenous bone. No differences between the use of mandibular or iliac bone grafts were observed since the bone-to-implant contact was not significantly influenced by the origin of the bone graft.
Authors: Bernd Lethaus, Lucas Poort, Kensuke Yamauchi, Anita Kloss-Brandstätter, Roland Boeckmann, Peter Kessler
Clinical oral implants research.
OBJECTIVE: The purpose of this paper was to find a correlation between laser doppler flowmetry (LDF) and the bone mineral density quotient (BMDQ) to evaluate irradiated bone quality preoperatively.OBJECTIVE: The purpose of this paper was to find a correlation between laser doppler flowmetry (LDF) and the bone mineral density quotient (BMDQ) to evaluate irradiated bone quality preoperatively. MATERIALS AND METHODS: Premolars and molars were extracted from six minipigs. After a three-month healing period, three animals received irradiation at a total dose of 24 Gy. Three months after irradiation, quantitative computed tomography was performed using a calibration bone phantom to determine the 120-position BMDQ in the alveolar bone. A drill template was created to define the exact location for measurement. LDF was then recorded after osteotomy of the residual alveolar ridge. The correlation between the BMDQ and LDF was investigated. RESULTS: There was a linear negative correlation between LDF and BMDQ in non-irradiated bone (r = -0.435, P = 0.001) and less pronounced also in irradiated bone (r = -0.309, P = 0.017). In both non-irradiated and irradiated bone, we found distinct differences between the maxilla and mandible with respect to BMDQ. However, a clear difference in mandibular and maxillary vascularity was only seen in non-irradiated bone. CONCLUSION: In non-irradiated bone, LDF and BMDQ were inversely correlated. In irradiated bone, the BMDQ alone is not an adequate preoperative tool for evaluating bone quality because it was not correlated with bone perfusion.
Authors: Florian G Draenert, Anna-Lena Nonnenmacher, Peer W Kämmerer, Jutta Goldschmitt, Wilfried Wagner
Clinical oral implants research.
OBJECTIVES: Combination of scaffolds and growth factors is a promising option for several clinical problems in bone biomaterials. Simplified growth factor loading by adsorption from aqueous solutionOBJECTIVES: Combination of scaffolds and growth factors is a promising option for several clinical problems in bone biomaterials. Simplified growth factor loading by adsorption from aqueous solution is one important option for this technology. We evaluated the adsorption followed by PBS rinsing, release and biological effect of transient loading with basic fibroblast growth factor (bFGF) and bone morphogenic protein 2 (BMP-2) on fresh frozen bone, processed bone matrix, collagen, and a ceramic material with immunofluorescence, enzyme-linked immunosorbent assay (ELISA), and qRT-PCR. MATERIALS AND METHODS: The study consisted of three in vitro experiments (immunofluorescence, ELISA, and qRT-PCR) in human osteoblasts (HOB). The first evaluated the adsorption of the growth factors bFGF and BMP-2 to the biomaterials, analyzed by immunofluorescence assays. The second experiment used ELISA to analyze the release of the growth factors from the matrix. The biological effect of the growth factors on HOB was then studied with qRT-PCR experiments as the third step. RESULTS: Strongest sustained release peaks in ELISA were observed in bFGF loading on processed bone matrix (steam-resistant mineralized bone matrix, SMBM) with up to 553 pg/ml medium. BMP-2 loading was less effective in ELISA peak release experiments with up to 257 pg/ml medium in processed bone matrix (SMBM). bFGF showed also higher release peaks in collagen material (192 pg/ml) compared with BMP-2 (101 pg/ml). Cumulative release values 0-72 h were estimated. The expression of runX2, osteocalcin, and alkaline phosphatase as markers for osteoblast activity was correlating. CONCLUSION: The results showed sustained release of BMP-2 and bFGF after transient loading on bone biomaterials with a stronger effect in biological scaffolds. This is interesting for therapeutic growth factor loading as well as insights in natural growth factor matrix deposition during bone healing.
Authors: Christian Mehl, Stephan T Becker, Yahya Acil, Sönke Harder, Jörg Wiltfang, Arthur A Dabbagh-Afrouz, Wiebke de Buhr, Matthias Kern
Clinical oral implants research.
OBJECTIVES: The main aim of this study was to evaluate the impact of vertical loading occurring during removal of cemented restorations on the implant-bone interface. METHODS: Thirty-six titaniumOBJECTIVES: The main aim of this study was to evaluate the impact of vertical loading occurring during removal of cemented restorations on the implant-bone interface. METHODS: Thirty-six titanium implants (Camlog 4.3 × 9 mm) were placed 1 mm supraosseous in the frontal skull of four minipigs. After a 13 week healing period the implants were exposed and the implant stability was measured. Three implants per minipig were vertically loaded using 20 or 100 impulses, respectively with an 18 Ns impulse imitating a crown removal. Three implants were left unloaded as control. The animals were sacrificed after 13 or 18 weeks. The harvested specimens were analyzed using scanning electron microscopy (SEM), light and fluorescence microscopy. RESULTS: No post operative complications or deaths of the minipigs occurred. All implants osseointegrated. The average bone-implant contact area (BIC) was 78 ± 5.1%. No statistically significant difference could be found when comparing the BIC areas of the control and the experimental groups between the sacrificed animals at 13 weeks and 18 weeks (P > 0.05). Therefore, the results of each subgroup were pooled. No significant differences regarding the BIC area could be detected between the control and the experimental groups (P > 0.05). Except one failing implant no cracks due to vertical loading could be evaluated in the SEM. Fluorescence microscopy revealed a significantly higher bone remodeling activity in the vertically loaded groups. CONCLUSIONS: Removal of cemented implant restorations seems not to have an impact on the mechanical implant stability, but seems to increase bone remodeling activity.
Authors: Bjarni E Pjetursson, Christoph Helbling, Hans-Peter Weber, Giedre Matuliene, Giovanni E Salvi, Urs Brägger, Kurt Schmidlin, Marcel Zwahlen, Niklaus P Lang
Clinical oral implants research.
OBJECTIVE: To assess the long-term survival of implants inserted in periodontally susceptible patients and to investigate the influence of residual pockets on the incidence of peri-implantitis andOBJECTIVE: To assess the long-term survival of implants inserted in periodontally susceptible patients and to investigate the influence of residual pockets on the incidence of peri-implantitis and implant loss. MATERIALS AND METHODS: For 70 patients, comprehensive periodontal treatment was followed by installation of 165 Straumann(®) Dental implants. Subsequently, 58 patients entered a University supportive periodontal therapy (SPT) program and 12 had SPT in a private practice. The follow-up time ranged from 3 to 23 years (mean 7.9 years). Bleeding on probing (BOP), clinical attachment level (CAL), and peri-implant probing depths (PPD) were evaluated at baseline (T0), completion of active treatment (T1), and at follow-up (T2). Peri-implant bone levels were assessed on radiographs at T2. Patients were categorized as having implants not affected by peri-implantitis (non-PIP), or affected by peri-implantitis (PIP). RESULTS: From 165 implants inserted, six implants were lost, translating into a cumulative survival rate of 95.8%. Solid screw implants yielded significantly higher survival rates than the hollow cylinder and hollow screw implants (99.1% vs. 89.7%). Implants lost due to peri-implant infection were included in the PIP groups. When peri-implantitis (PPD≥ 5 mm, BOP+) was analyzed, 22.2% of the implants and 38.6% of patients had one or more implants affected by peri-implantitis. Using the peri-implantitis definition (PPD≥6 mm, BOP+), the prevalence was reduced to 8.8% and 17.1%, respectively. Moreover, all these implants demonstrated significant (≥2 mm) bone loss at T2. At T1, the non-PIP group had significantly (P = 0.011) fewer residual pockets (≥5 mm) per patient than the PIP group (1.9 vs. 4.1). At T2, the PIP group displayed an increased number of residual pockets compared to T1, whereas in the non-PIP group, the number remained similar to T1. At T2, mean PPD, mean CAL and BOP were significantly higher in the PIP group compared with the non-PIP group. The prevalence of peri-implantitis was lower in the group that was in a well organized SPT at the University. CONCLUSIONS: In periodontitis susceptible patients, residual pockets (PPD ≥5 mm) at the end of active periodontal therapy represent a significant risk for the development of peri-implantitis and implant loss. Moreover, patients in SPT developing re-infections are at greater risk for peri-implantitis and implant loss than periodontally stable patients.
Authors: Rafael Scaf de Molon, Juliana Aparecida Najarro Dearo Morais-Camilo, Mario Henrique Arruda Verzola, Rafael Silveira Faeda, Maria Teresa Pepato, Elcio Marcantonio
Clinical oral implants research.
OBJECTIVES: To evaluate bone healing around dental implants with established osseointegration in experimental diabetes mellitus (DM) and insulin therapy by histomorphometric and removal torqueOBJECTIVES: To evaluate bone healing around dental implants with established osseointegration in experimental diabetes mellitus (DM) and insulin therapy by histomorphometric and removal torque analysis in a rat model. MATERIALS AND METHODS: A total of 80 male Wistar rats received a titanium implant in the tibiae proximal methaphysis. After a healing period of 60 days, the rats were divided into four groups of 20 animals each: a 2-month control group, sacrificed at time (group A), a diabetic group (group D), an insulin group (group I), and a 4-month control group (group C), subdivided half for removal torque and half for histomorphometric analysis. In the D and I groups the DM was induced by a single injection of 40 mg/kg body weight streptozotocin (STZ). Two days after DM induction, group I received subcutaneous doses of insulin twice a day, during 2 months. Groups C and D received only saline. Two months after induction of DM, the animals of groups D, C and I were sacrificed. The plasmatic levels of glucose (GPL) were monitored throughout the experiment. Evaluation of the percentages of bone-to-implant contact and bone area within the limits of the implant threads was done by histomorphometric and mechanical torque analysis. Data were analyzed by anova at significant level of 5%. RESULTS: The GPL were within normal range for groups A, C and I and higher for group D. The means and standard deviations (SD) for histomorphometric bone area showed significant difference between group D (69.34 ± 5.00%) and groups C (78.20 ± 4.88%) and I (79.63 ± 4.97%). Related to bone-to-implant contact there were no significant difference between the groups D (60.81 + 6.83%), C (63.37 + 5.88%) and I (66.97 + 4.13%). The means and SD for removal torque showed that group D (12.91 ± 2.51 Ncm) was statistically lower than group I (17.10 ± 3.06 Ncm) and C (16.95 ± 5.39 Ncm). CONCLUSIONS: Diabetes mellitus impaired the bone healing around dental implants with established osseointegration because the results presented a lower percentage of bone area in group D in relation to groups C and I resulting in a lowest torque values for implant removal. Moreover, insulin therapy prevents the occurrence of bone abnormalities found in diabetic animals and osseointegration was not compromised.
Authors: Ulrike Kuchler, Eloa R Luvizuto, Fernando Muñoz, Julia Hofbauer, Georg Watzek, Reinhard Gruber
Clinical oral implants research.
OBJECTIVE: Crohn's disease is a chronic inflammatory process that has recently been associated with a higher risk of early implant failure. Herein we provide information on the impact of colitis onOBJECTIVE: Crohn's disease is a chronic inflammatory process that has recently been associated with a higher risk of early implant failure. Herein we provide information on the impact of colitis on peri-implant bone formation using preclinical models of chemically induced colitis. METHODS: Colitis was induced by intrarectal instillation of 2,4,6-trinitro-benzene-sulfonic-acid (TNBS). Colitis was also induced by feeding rats dextran-sodium-sulfate (DSS) in drinking water. One week after disease induction, titanium miniscrews were inserted into the tibia. Four weeks after implantation, peri-implant bone volume per tissue volume (BV/TV) and bone-to-implant contacts (BIC) were determined by histomorphometric analysis. RESULTS: Cortical histomorphometric parameters were similar in the control (n = 10), DSS (n = 10) and TNBS (n = 8) groups. Cortical BV/TV was 92.2 ± 3.7%, 92.0 ± 3.0% and 92.6 ± 2.7%. Cortical BIC was 81.3 ± 8.8%, 83.2 ± 8.4% and 84.0 ± 7.0%, respectively. No significant differences were observed when comparing the medullary BV/TV and BIC (19.5 ± 6.4%, 16.2 ± 5.6% and 15.4 ± 9.0%) and (48.8 ± 12.9%, 49.2 ± 6.2 and 41.9 ± 11.7%), respectively. Successful induction of colitis was confirmed by loss of body weight and colon morphology. CONCLUSIONS: The results suggest bone regeneration around implants is not impaired in chemically induced colitis models. Considering that Crohn's disease can affect any part of the gastrointestinal tract including the mouth, our model only partially reflects the clinical situation.
Authors: Daniel R Reissmann, Björn Dietze, Michael Vogeler, Rainer Schmelzeisen, Guido Heydecke
Clinical oral implants research.
OBJECTIVES: To assess and compare changes in health-related quality of life (HRQoL) and oral health-related quality of life (OHRQoL) after bone graft harvesting for dental implants with respect toOBJECTIVES: To assess and compare changes in health-related quality of life (HRQoL) and oral health-related quality of life (OHRQoL) after bone graft harvesting for dental implants with respect to the donor site. MATERIAL AND METHODS: Autologous bone grafts were harvested in a consecutive sample of 23 patients (mean age: 46.1 years; 52% female) either from an intra-oral (IO; N = 8; chin, ascending ramus, buttress region) or an extra-oral (EO; N = 15; anterior iliac crest) donor site, followed by implant placements. HRQoL was self-administered by the patients using the Short-Form 36 (SF-36) and OHRQoL was assessed using the Oral Health Impact Profile (OHIP-49) preoperatively, 3 days and 4 weeks after surgery. Impact of donor site on changes in both concepts of QoL was determined in multiple linear regression analyses. RESULTS: Patients with extra-oral donor sites reported a substantial deterioration in the physical component (PC) of HRQoL indicated by an increase in the PC score of the SF-36 (P < 0.001), whereas this score did not significantly change in patients with intra-oral donor sites. The mental health component (MC) of HRQoL (MC score of the SF-36) remained virtually identical in both groups. OHRQoL deteriorated from baseline (67.7 OHIP points) to first follow-up (76.6 OHIP points) in both groups, however, changes were not statistically significant. CONCLUSION: In clinical decision-making regarding donor site for bone graft harvesting, patients and clinicians should be aware of the expected decrease in HRQoL if deciding to use extra-oral donor sites. Whenever possible, intra-oral donor sites should be preferred.
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