Osseointegration of SLActive implants in diabetic pigs.
ABSTRACT OBJECTIVES: Diabetes mellitus is currently classified as a relative contraindication for implant treatment because of microangiopathies with the consequence of impaired bone regeneration and higher rates of implant failure. The study aim was to investigate peri-implant bone formation in a diabetic animal model in comparison to healthy animals and to evaluate the differences between conventional (SLA(®) ) and modified (SLActive(®) ) titanium implant surfaces on osseointegration. MATERIAL AND METHODS: Each six implants were placed in the calvaria of 11 diabetic and 4 healthy domestic pigs. At 30 and 90 days after implant placement, the bone-to-implant contact (BIC) and bone density (BD) were appraised. Additionally, the expression of the bone-matrix proteins collagen type I and osteocalcin was evaluated at both points in time by using immunohistochemical staining methods. RESULTS: Overall, BIC was reduced in the diabetic group at 30 and 90 days. After 90 days, the SLActive(®) implants showed significantly higher BICs compared with the SLA(®) implants in diabetic animals. Peri-implant BD was higher in the SLActive(®) group at 30 and 90 days in healthy and diabetic animals. Collagen type I protein expression was higher using SLA(®) implants in diabetic pigs at 30 days. Values for osteocalcin expression were not consistent. CONCLUSIONS: The results indicate the negative effect of untreated diabetes mellitus on early osseointegration of dental implants. The modified SLA(®) surface (SLActive(®) ) elicited an accelerated osseointegration of dental implants, suggesting that a better prognosis for implant treatment of diabetic patients is possible.
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ABSTRACT: We speculated that the long-term survival of narrow or conventional diameter (< 5mm) implants is higher than that of wide-diameter implants (≥ 5mm) when placed in posterior atrophic maxillae. The aim of this paper was to systematically review indexed literature regarding the influence of implant diameter on long-term survival of dental implants placed in posterior maxilla. The addressed focused question was “Does implant diameter influence long-term survival of dental implants placed in posterior maxilla?” Databases were searched from 1986 up to and including June 2014 using the following MeSH terms: “dental implants”, “dental implant-abutment design”, “maxilla” and “survival”. Review articles, case-reports, letters to the editor, unpublished data and studies published in languages other than English were excluded. The initial search yielded 51 studies. Scrutiny of the titles and abstracts reduced the number of clinical studies included in the present review to 19. In all studies, implants were placed in posterior atrophic maxilla of patients with age ranging between 37-60 years. Cylindrical and tapered implants were used in 12 and 3 studies, respectively. In all studies, threaded, rough-surfaced dental implants with diameters ranging between 3.0mm-5.5mm were used. In all studies, follow-up periods and cumulative survival rates ranged between 5-15 years and 80.5-100%, respectively. A well-designed surgical protocol, achievement of sufficient primary stability at the time of implant placement and pre- and postsurgical oral hygiene maintenance visits are critical factors that influence the long-term survival of dental implants placed in posterior atrophic maxilla. However, contribution of implant diameter in this regard seems secondary.Clinical Oral Investigations 10/2014; · 2.29 Impact Factor
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ABSTRACT: The authors conducted a prospective cohort study to determine whether poor glycemic control is a contraindication to implant therapy in patients with type 2 diabetes. The study sample consisted of 117 edentulous patients, each of whom received two mandibular implants, for a total of 234 implants. Implant-retained mandibular overdentures were loaded after a four-month healing period and followed up for an additional one year. The authors assessed implant survival and stability (by means of resonance frequency analysis) relative to glycated hemoglobin A1c (HbA1c) levels, with baseline levels up to 11.1 percent and levels as high as 13.3 percent over one year. Implant survival rates for 110 of 117 patients who were followed up for one year after loading were 99.0 percent, 98.9 percent and 100 percent, respectively, for patients who did not have diabetes (n = 47), those with well-controlled diabetes (n = 44) and those with poorly controlled diabetes (n = 19). The authors considered the seven patients lost to follow-up as having had failed implants; consequently, their conservative estimates of survival rates in the three groups were 93.0 percent, 92.6 percent and 95.0 percent (P = .6510). Two implants failed at four weeks, one in the nondiabetes group and the other in the well-controlled diabetes group. Delays in implant stabilization were related directly to poor glycemic control. The results of this study indicate that elevated HbA1c levels in patients with type 2 diabetes were not associated with altered implant survival one year after loading. However, alterations in early bone healing and implant stability were associated with hyperglycemia. Within the clinical parameters of this study, the findings indicate likely implant success among patients with type 2 diabetes who lacked good glycemic control. Further investigation, including longer-term evaluation, is needed.Journal of the American Dental Association (1939) 12/2014; 145(12):1218-26. · 1.82 Impact Factor
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ABSTRACT: Background Cell interactions, adherence, and osseointegration at the bone-implant interface can be directly influenced by the surface properties of the titanium implant. PurposeTo characterize osseointegration of Neoss® implants with conventional (control group) and hydrophilic (test group) surface treatments. Materials and Methods Six Labrador dogs received Neoss implants with conventional and hydrophilic surfaces. The bone-implant interfaces were evaluated 1 and 4 weeks after implantation, and osseointegration was evaluated using histological, histomorphometric, fluorescence, and resonance frequency analyses. The surfaces were also subjected to topographic and hydrophilicity analyses. ResultsThe topographic analyses revealed increased surface roughness in the test group compared with the control group (surface area roughness 0.42 and 0.78 μm, respectively, for control and test group surfaces; p ≤ .05). The wettability values were higher in the test group (contact angles 67.2° and 27.2° for the control and test group surfaces, respectively; p ≤ .05). Implants in the test group also exhibited better stability, more bone-implant contact, and increased bone area compared with implants in the control group. Conclusion Neoss implants in the test group improved bone formation in the early stages of osseointegration compared with implants in the control group.Clinical Implant Dentistry and Related Research 03/2014; · 3.82 Impact Factor