The effects of laser microtexturing of the dental implant collar on crestal bone levels and peri-implant health
Polished and machined collars have been advocated for dental implants to reduce plaque accumulation and crestal bone loss. More recent research has suggested that a roughened titanium surface promotes osseointegration and connective tissue attachment. The purpose of this research was to compare crestal bone height adjacent to implants with laser-microtextured and machined collars from two different implant systems.
Four implants, two with laser-microtextured collars and two with machined collars, were placed in the anterior mandible to serve as overdenture abutments. They were placed in alternating order, and the distal microtextured- and machined-collar implants were loaded with ball abutments. The mesial implants were left unloaded. The distal implants were immediately loaded with prefabricated dentures. Plaque Index, Bleeding Index, and probing depths (PDs) were measured after 6 and 12 months for the loaded implants. Bone loss for both groups (loaded and unloaded) was evaluated via standardized radiographs.
Plaque and bleeding values were similar for both implant types. The microtextured-collar implants showed shallower PDs (0.36 ± 0.5 mm and 0.43 ± 0.51 mm) than those with machined collars (1.14 ± 0.77 mm and 1.64 ± 0.93 mm; < .05 for 6 and 12 months, respectively). At 6 and 12 months, respectively, the microtextured implants showed less crestal bone loss for both loaded (0.19 ± 0.15 mm and 0.42 ± 0.34 mm) and unloaded groups (0.15 ± 0.15 mm and 0.29 ± 0.20 mm) than the machined implants for both the loaded (0.72 ± 0.5 mm and 1.13 ± 0.61 mm) and unloaded groups (0.29 ± 0.28 mm and 0.55 ± 0.32 mm).
Application of laser-microtextured grooves to the implant collar resulted in shallower PDs and less peri-implant crestal bone loss than that seen around implants with machined collars.
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- "There might be several reasons for this disparity. Botos et al. (2011) study had only 15 patients and that may not be sufficient to reflect general population . In addition, initial gingival tissue thickness was not measured in these studies; therefore, final conclusions might be limited. "
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To compare how laser-microtextured implants and implants with platform switching maintain crestal bone stability in thin peri-implant tissues.Material and methodsThirty laser-microtextured implants of 4.6 mm diameter (Tapered Internal Laser-Lok, BioHorizons, Birmingham, AL, USA; Group 1) and 30 implants with platform switching of 5/4 mm diameter (Certain Prevail; Biomet/3i, Palm Beach Gardens, FL, USA; Group 2) were placed in 30 patients (12 males and 18 females, mean age 42.3 ± 2.4) with thin mucosal tissues (≤2 mm). Implants were placed in posterior mandible in one-stage approach and after integration were restored with screw-retained metal-ceramic restorations. Radiographic examination was performed after implant placement, 2 months after healing, at prosthetic restoration delivery and after 1-year follow-up. Mean crestal bone loss was calculated, Mann–Whitney U-test was applied, and significance was set to 0.05.ResultsAfter 2 months of healing, the crestal bone loss was 0.71 ± 0.25 mm SD (range, 0.25–1.6 mm) and 1.02 ± 0.25 mm SD (range, 0.6–1.55 mm) in groups 1 and 2, respectively (P = 0.001). At restorations' delivery, the crestal bone loss was 1.10 ± 0.30 mm SD (range, 0.65–1.85 mm) and 1.37 ± 0.27 mm SD (range, 0.90–1.80 mm) in groups 1 and 2, respectively (P = 0.001). After 1-year follow-up, the crestal bone loss was 1.41 ± 0.42 mm SD (range, +0.1–2.30 mm) and 1.43 ± 0.23 mm SD (range, 1–1.80 mm) in groups 1 and 2, respectively (P = 0.976).Conclusions
Laser-microtexturing of implant collar or platform-switched implant/abutment connection did not eliminate crestal bone loss, if at the time of implant placement vertical soft tissue thickness was ≤2 mm. However, laser-microtextured implants may present less proximal bone loss than platform-switching implants in the period before implant loading.
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ABSTRACT: The aims of this study were to evaluate the effects of Er:YAG laser on surface morphology of dental restorative materials namely glass ionomer cement, composite resin, polyacid-modified composite resin, resin-modified glass ionomer cement and unfilled resin, and to ascertain the ablation threshold of these materials. Crater diameters, crater depths and crater volumes of the ablated sites were measured to assess the ablation characteristics of different restorative materials. The surface morphology changes varied from nil effect, to ablation, fusion, combustion, and various combinations of these. The ablation threshold of all materials was 40 mJ except Delton (60 mJ).
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