Researchs in Dental Implantology Research Papers (original) (raw)

BACKGROUND: Some studies indicated that implant failures are commonly concentrated in few patients. PURPOSE: To identify and analyze cluster behavior of dental implant failures among subjects of a retrospective study. MATERIALS AND METHODS: This retrospective study included patients receiving at least three implants only. Patients presenting at least three implant failures were classified as presenting a cluster behavior. Univariate and multivariate logistic regression models and generalized estimating equations analysis evaluated the effect of explanatory variables on the cluster behavior. RESULTS: There were 1406 patients with three or more implants (8337 implants, 592 failures). Sixty-seven (4.77%) patients presented cluster behavior, with 56.8% of all implant failures. The intake of antidepressants and bruxism were identified as potential negative factors exerting a statistically significant influence on a cluster behavior at the patient-level. The negative factors at the implant-level were turned implants, short implants, poor bone quality, age of the patient, the intake of medicaments to reduce the acid gastric production, smoking, and bruxism. CONCLUSIONS: A cluster pattern among patients with implant failure is highly probable. Factors of interest as predictors for implant failures could be a number of systemic and local factors, although a direct causal relationship cannot be ascertained.

ABSTRACT : Aim : To cover root surface with periosteum pedicle graft. Methods : A patient with miller class I recession i.r.t 31, 32 and 33, with probing depth of 2.5mm and clinical attachment loss of 4mm i.r.t 31, 32 and 33 and class III gingival recession i.r.t 41 and 43 was treated using periosteum pedicle graft. 42 was missing. Periosteum was dissected and increased in length coronaly to cover the root surface. After stabilizing the periosteal graft with sutures, the epithelium was positioned over it and sutured. Result : Uneventful healing of the operated site was observed after 1 month. There was full coverage of the gingival recession with satisfactory results. There was an increase in morphologic and chromatic resemblance with the adjacent area. Conclusion : Periosteum can be successfully used for the treatment of multiple gingival recession defects. Key words : gingival recession, osteogenic properties, periosteum.
Dr VINEET VINAYAK | Dr VINEET VINAYAK|

Background: The goal of this article to is present and evaluate the clinical effectiveness of a new surgical approach using a coronally advanced flap performed during second stage implant surgery for the reconstruction of peri implant... more

- by Britto Falcon
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- Periodontics, Implantology, Surgery, Plastic Surgery

RESUMEN Los tratamientos de implantes dentales se han convertido en un tratamiento cotidiano dentro de la práctica diaria, por lo que la presencia de defectos del reborde alveolar que se da por la reabsorción ósea ha conllevado al desarrollo de muchos procedimientos de aumento óseo con la intención de mejorar la cantidad y calidad del hueso, para así lograr un tratamiento de implantes dentales predecible. El objetivo de esta revisión de la literatura es la de presentar los principales procedimientos referidos al manejo de los defectos horizontales del reborde alveolar, que siempre representan un desafío para los clínicos. ABSTRACT Dental implant treatments have become a daily treatment within daily practice, so that the presence of defects of the alveolar ridge that results from bone resorption has led to the development of many bone augmentation procedures with the intention of improving the quantity and quality of the bone to achieve a predictable dental implant treatment. The objective of this review of the literature is to present the main procedures related to the management of horizontal defects of the alveolar ridge, which are always a challenge for clinicians.

- by Britto Falcon
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- Periodontics, Implantology, Dental Research, Regeneration

ABSTRACT
Background: Mandibular implant-retained overdentures solve complete denture wearer
problems who complain from poor retention and stability. Immediate loading can have several
advantages, as it allows the patient to resume normal masticatory function as quickly as possible
after surgery. In addition, splinting of implants with two posterior bilateral bars provide more
retention and stability. Recently, the use of pre-fabricated bars reduces time and costs for the
dentist, dental technician and the patient. Purpose This study aimed to evaluate peri-Implant
tissue health evaluation of immediately loaded implants supporting mandibular overdenture
retained by bilateral prefabricated bar. Materials and Methods Six completely edentulous males
were selected for this study. For each patient, two standardized size; of 13 mm length and 3.6
mm width; screw type implants were surgically inserted in the canine areas and two standardized
size of 10 mm length and 3.6 width were inserted in the first molar areas and splinted with two
bilateral posterior pre-fabricated bars to retain immediately loaded mandibular overdenture. The
tissue health was investigated in the aspects of per-implant probing depth, peri-implant bleeding
index, peri-implant plaque index and implant mobility. Results: In all periods of the present
study, the probing depth was found to be less than 3 mm, the plaque accumulation increased
significantly at the end of the first three months of the present study then decreased during
the second three months, the bleeding on probing showed a slight increase at the end of first
three months of study then decreased during the second three months of study and all implants
exhibited no mobility three months after insertion, but after six months 41.6% of posterior
implants exhibited mobility. Conclusion: Within limitations of this study, it can be concluded
that: (1) Splinting of immediately loaded implants with bilateral prefabricated posterior bar for
retaining mandibular overdenture cannot be considered as a successful prosthetic approach for
completely edentulous patient. (2) The implants in the posterior region of the mandible cannot
be proposed as a promising abutment for supporting mandibular overdenture retained with
bilateral prefabricated bar.

- by Nesreen El Mekawy
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- Researchs in Dental Implantology

This is the first comprehensive review of the classification, preventative measures, diagnosis, treatment methods, and determination of success criteria of buccal bone plate fenestrations (BPFs) secondary to posterior implant surgeries. The purpose of this review is to present and discuss the current literature from peer-reviewed journals, recent studies, and international implantology guidelines and to provide practitioners with guiding points to identify and understand whether BPFs are complications or accidents of implant surgeries. In addition, this review sets forth a detailed set of criteria for the evaluation and diagnosis of BPFs and for the subsequent classification of BPFs as either complications or accidents of posterior implant surgeries. From the literature analyzed, it is clear that BPFs are disqualified from the class of implant treatment failures because BPFs neither impair nor significantly delay treatment. A comprehensive outline of preventative measures and surgery aids to avoid fenestrating the buccal bone plate during implant placement, and a variety of repair methods are included in this review. Considerations of treatment outcomes and patient sensitivities are also included in this comprehensive review.

- by Liviu Steier
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- Implantology, Dental Research, Dental Implants, Dental Education

Existe una demanda cada vez mayor y una necesidad creciente para colocar implantes dentales, pero el tratamiento con implantes sólo está alcanzando a una limitada parte de la población. No hay indicios para suponer que la profesión odontológica no sea capaz de satisfacer las necesidades actuales, pero el odontólogo tiene que hacer un profundo análisis ético para que la atención a sus pacientes sea ofrecida de la mejor manera posible.

- by AGUSTIN ZERON
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- Dentistry, Dental Materials, Dental Implants, Researchs in Dental Implantology

Purpose. Nowadays, the advancements in direct metal laser sintering (DMLS) technology allow the fabrication of titanium dental implants. The aim of this study was to evaluate implant survival, complications, and peri-implant marginal bone loss of DMLS implants used to support bar-retained maxillary overdentures. Materials and Methods. Over a 2-year period, 120 implants were placed in the maxilla of 30 patients (18 males, 12 females) to support bar-retained maxillary overdentures (ODs). Each OD was supported by 4 implants splinted by a rigid cobalt-chrome bar. At each annual follow-up session, clinical and radiographic parameters were assessed. The outcome measures were implant failure, biological and prosthetic complications, and peri-implant marginal bone loss (distance between the implant shoulder and the first visible bone-to-implant contact, DIB). Results. The 3-year implant survival rate was 97.4% (implant-based) and 92.9% (patient-based). Three implants failed. The incidence of biological complication was 3.5% (implant-based) and 7.1% (patient-based). The incidence of prosthetic complication was 17.8% (patient-based). No detrimental effects on marginal bone level were evidenced. Conclusions. The use of 4 DMLS titanium implants to support bar-retained maxillary ODs seems to represent a safe and successful procedure. Long-term clinical studies on a larger sample of patients are needed to confirm these results.

- by Anil Sukumaran and +1
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- Dental Research, Dental Materials, Researchs in Dental Implantology, Osseointegrated Implants

Dental transposition is a form of ectopic eruption with change in position of normal adjacent teeth. Its prevalence is very low in general population and could be frequently missed on oral examination. We present a rare case of dental... more

Recent studies have suggested that the insertion of dental implants in patients being diagnosed with bruxism negatively affected the implant failure rates. The aim of the present study was to investigate the association between the bruxism and the risk of dental implant failure. This retrospective study is based on 2670 patients who received 10096 implants at one specialist clinic. Implant- and patient-related data were collected. Descriptive statistics were used to describe the patients and implants. Multilevel mixed effects parametric survival analysis was used to test the association between bruxism and risk of implant failure adjusting for several potential confounders. Criteria from a recent international consensus (Lobbezoo et al., J Oral Rehabil, 40, 2013, 2) and from the International Classification of Sleep Disorders (International classification of sleep disorders, revised: diagnostic and coding manual, American Academy of Sleep Medicine, Chicago, 2014) were used to define and diagnose the condition. The number of implants with information available for all variables totalled 3549, placed in 994 patients, with 179 implants reported as failures. The implant failure rates were 13.0% (24/185) for bruxers and 4.6% (155/3364) for non-bruxers (P < 0.001). The statistical model showed that bruxism was a statistically significantly risk factor to implant failure (HR 3.396; 95% CI 1.314, 8.777; P = 0.012), as well as implant length, implant diameter, implant surface, bone quantity D in relation to quantity A, bone quality 4 in relation to quality 1 (Lekholm and Zarb classification), smoking and the intake of proton pump inhibitors. It is suggested that the bruxism may be associated with an increased risk of dental implant failure.

Purpose: To investigate the association between the intake of proton pump inhibitors (PPIs) and the risk of dental implant failure. Materials and Methods: The present retrospective cohort study is based on patients consecutively treated between 1980 and 2014 with implant-supported/retained prostheses at one specialist clinic. Modern endosseous dental implants with cylindrical or conical design were included, and only complete cases were considered; ie, only those implants with information available for all variables measured were included in the regression model analysis. Zygomatic implants and implants detected in radiographies but without basic information about them in the patients' files were excluded from the study. Implant-and patient-related data were collected. Multilevel mixed-effects parametric survival analysis was used to test the association between PPI exposure (predictor variable) and risk of implant failure (outcome variable), adjusting for several potential confounders. Results: A total of 3,559 implants were placed in 999 patients, with 178 implants reported as failures. The implant failure rates were 12.0% (30/250) for PPI users and 4.5% (148/3,309) for nonusers. A total of 45 out of 178 (25.3%) failed implants were lost up to abutment connection (6 in PPI users, 39 in nonusers), with an early-to-late failure ratio of 0.34:1. The intake of PPIs was shown to have a statistically significant negative effect for implant survival rate (HR 2.811; 95% CI: 1.139 to 6.937; P = .025). Bruxism, smoking, implant length, prophylactic antibiotic regimen, and implant location were also identified as factors with a statistically significant effect on the implant survival rate. Conclusion: This study suggests that the intake of PPIs may be associated with an increased risk of dental implant failure. Int J Oral MaxIllOfac IMplants 2017 (6 pages). doi: 10.11607/jomi.5662 Keywords: dental implant, failure, multilevel mixed effects parametric survival analysis, multivariate analysis, proton pump inhibitors, risk factors

A descoberta dos bisfosfonatos (BFs) como fármacos relacionados à inibição da reabsorção óssea os consagrou para o tratamento de pacientes porta- dores de osteoporose e de neoplasias com metástases ósseas, o que culminou com o seu uso ampliado. O presente trabalho tem por objetivo expor a importância da identicação dos pacientes que fazem uso dos BFs contribuindo assim para o adequado conhecimento sobre os riscos de complicações que acometem esses pacientes. O trabalho enfoca o emprego clínico dos BFs, os riscos que representam para os ossos da face, consideradas as suas características, bem como a importância de diagnosticar pacientes que fazem uso desses fármacos, a m de orientá-los sobre o adequado tratamento odontológico a ser realizado, e desta forma contribuir para a redução da complicação que tem evolução imprevisível e consequências devastadoras para os pacientes.

BACKGROUND: Implant fractures are rare but offer a challenging clinical situation. PURPOSE: To determine the prevalence of implant fracture and the possible risk factors predisposing an implant to a higher fracture risk. MATERIALS AND METHODS: This retrospective study is based on 2670 patients consecutively treated with implant-supported prostheses. Anatomical-, patient-, and implant-related factors were collected. Descriptive statistics and survival analyses were performed. Generalized estimating equations (GEE) evaluated the effect of explanatory variables on implant fracture. RESULTS: Forty-four implants (out of 10 099; 0.44%) fractured. The mean ± standard deviation time for fracture to occur was 95.1 ± 58.5 months (min-max, 3.8-294.7). Half of the occurrences of fracture happened between 2 and 8 years after implantation. Five factors had a statistically significant influence on the fracture of implants (increase/decrease in fracture probability): use of higher grades of titanium (decrease 72.9%), bruxism (increase 1819.5%), direct adjacency to cantilever (increase 247.6%), every 1 mm increase in implant length (increase 22.3%), every 1 mm increase in implant diameter (decrease 96.9%). CONCLUSIONS: It is suggested that 5 factors could influence the incidence of implant fractures: grade of titanium, implant diameter and length, cantilever, bruxism.

Methods: Zirconia rods were immersed in 1.23% and 0.123% APF solutions and maintained at 37°C for determined periods of time. Surfaces of all specimens were imaged using digital microscopy and scanning electron microscopy (SEM). Sample mass and dimensions were measured for mass loss determination. Samples were characterized by powder X-ray diffraction (XRD) to detect changes in crystallinity. A biosensor based on electrochemical impedance spectroscopy (EIS) was used to detect ion dissolution of material into the immersion media. Results: Digital microscopy revealed diminishing luster of the materials Although no structural change was found, the absorption of salts (sodium phosphate) greater change of impedance for the immersion solutions with increasing bathing time. Conclusion: Immersion of zirconia in APF solutions showed deterioration limited to the surface, not extending to the bulk of the material. Inferences on zirconia performance in acidic oral environment can be elucidated from the study.

Background and objective: Primary implant stability is considered necessary for
achieving and maintaining osseointegration. This experimental study aimed to evaluate the
outcome of implants without primary stability, clinically and radiographically.
Methods: Two adult sheep (3-4 years of age), 70 kg in weight, were included in the study.
After sedation and local anesthesia, the lateral side of the basal bone of mandible is
exposed by a single long incision. The implant bed performed in the inferior border of the
basal bone of mandible drilling to 5 mm in diameter and 10 mm in length. Five implants
were inserted into the basal bone of mandible for each side (right and left), but the sizes of
inserted implant was 3.8 mm in diameter and 10 mm in length, after 4 months the 2 sheep
were sacrificed and the universal torque ratchet was used to measure the stability of the
implant by a counter torque 30 N/cm test. Cone Beam Tomography (CBCT) was used to
evaluate the implants radiographically.
Results: Nineteen (from 20) implants successfully tolerated a 30 N/cm countertorque test
comprising (95%). Only one implant failed to osseointegrate (5%). During the healing
period, no any adverse clinical signs reported.
Conclusion: Dental implants may have a chance to osseointegrate even in the lack of
primary stability.
Keywords: Dental implant, Osseointegration, Primary stability.

- by Abduljaleel Samad
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- Researchs in Dental Implantology

Aims and Objective: Chemically modified and sandblasted acid‑etched (SAE) mechanism leads to wettability of surfaces of dental implants which helps in osseointegration. The present study was conducted to determine the implant stability quotient (ISQ) of SAE and SAE chemically modified dental implants.
Materials and Methods: The present study was conducted on 210 patients with 120 males and 90 females. Dental implants (Adin) with SAE (Group A) and SAE chemically modified (Group B) were inserted in patients. RFA was done immediately after implant insertion and after 1 week, 2 weeks, 6 weeks, 10 weeks, and 14 weeks. Results were statistically evaluated using SPSS Statistics for Windows, Version 21.0, IBM Corp., Armonk, NY, USA.
Results: Maximum patients were in the age group of 25–35 years
(males – 65, females – 48), followed by 35–45 years (males – 40, females – 32) and 45–55 years (males – 15, females – 10). Maximum dental implants were given in the right side (88) in males than females (56). On the left side, maximum implants were given in females (62) than males (56). Maximum RFA value of 86.2 and minimum value of 44.6 were observed in SAE dental implants (A). The maximum mean RFA
value in chemically modified implants SAE (B) was 89.4 and minimum was 32.5.
Conclusion: It was observed that surface treatment of dental implants shows higher implant–bone osseointegration. There is fastest osseointegration in implants with hydrophilic surfaces than those with SAE surfaces. ISQ was higher than 75 in both groups, which indicate higher implant stability.

Purpose: To assess the influence of several factors on the prevalence of dental implant failure, with special consideration of the placement of implants by different dental surgeons. Materials and Methods: This retrospective study is based on 2,670 patients who received 10,096 implants at one specialist clinic. Only the data of patients and implants treated by surgeons who had inserted a minimum of 200 implants at the clinic were included. Kaplan-Meier curves were stratified with respect to the individual surgeon. A generalized estimating equation (GEE) method was used to account for the fact that repeated observations (several implants) were placed in a single patient. The factors bone quantity, bone quality, implant location, implant surface, and implant system were analyzed with descriptive statistics separately for each individual surgeon. Results: A total of 10 surgeons were eligible. The differences between the survival curves of each individual were statistically significant. The multivariate GEE model showed the following variables to be statistically significant: surgeon, bruxism, intake of antidepressants, location, implant length, and implant system. The surgeon with the highest absolute number of failures was also the one who inserted the most implants in sites of poor bone and used turned implants in most cases, whereas the surgeon with the lowest absolute number of failures used mainly modern implants. Separate survival analyses of turned and modern implants stratified for the individual surgeon showed statistically significant differences in cumulative survival. Conclusion: Different levels of failure incidence could be observed between the surgeons, occasionally reaching significant levels. Although a direct causal relationship could not be ascertained, the results of the present study suggest that the surgeons' technique, skills, and/or judgment may negatively influence implant survival rates. Int J Prosthodont 2017 (10 pages). doi: 10.11607/ijp.5151

Pulsed laser deposition was used to deposit bioactive triphasic glass-ceramic composition (HASi) over titanium substrate using dense HASi target. Bioactive glass compositions are considered the most useful synthetic materials for immediate bone attachment because of its bioresorption, osteoconduction and osteointegration characteristics under in vivo conditions. The disadvantage of its brittleness associated with bioactive glass-ceramics has prompted its coating over metallic implants for the combination of duo mechanical and bioactive properties. The hard HASi target was able to undergo laser ablation under ambient gas pressure without bulk erosion of the target. Laser deposition was found to be efficient in depositing triphasic composition for immediate bone integration. The target and deposits were analyzed for the phase, composition and microstructural characteristics by means of X-ray diffraction, Fourier transform infrared spectroscopy, energy-dispersive X-ray analysis and scanning electron microscopy. Simultaneously, the adherent nature and mechanical behaviour of deposits were confirmed by scratch test and micro-indentation methods. Further, the in vitro dissolution and bioactivity were assessed by soaking in simulated body fluid followed by elemental analysis using inductively coupled plasma spectroscopy. The deposits were found to be cell-friendly, which was indicated by the phenomenology of stem cells under in vitro conditions.

Objectives: The aims of this study were (i) to determine the spatial resolution and sensitivity of micro-versus nano-computed tomography (CT) techniques and (ii) to validate micro-versus nano-CT in a dog dental implant model, comparative to histological analysis. Material and methods: To determine spatial resolution and sensitivity, standardized reference samples containing standardized nano-and microspheres were prepared in polymer and ceramic matrices. Thereafter, 10 titanium-coated polymer dental implants (3.2 mm in Ø by 4 mm in length) were placed in the mandible of Beagle dogs. Both micro-and nano-CT, as well as histological analyses, were performed. Results: The reference samples confirmed the high resolution of the nano-CT system, which was capable of revealing sub-micron structures embedded in radiodense matrices. The dog implantation study and subsequent statistical analysis showed equal values for bone area and bone–implant contact measurements between micro-CT and histology. However, because of the limited sample size and field of view, nano-CT was not rendering reliable data representative of the entire bone–implant specimen. Conclusions: Micro-CT analysis is an efficient tool to quantitate bone healing parameters at the bone–implant interface, especially when using titanium-coated PMMA implants. Nano-CT is not suitable for such quantification, but reveals complementary morphological information rivaling histology, yet with the advantage of a 3D visualization.

- by Anil Sukumaran and +2
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- Dental Implants, Researchs in Dental Implantology, Micro Computed Tomography, Bone Contacts

- by Gabriela Steier
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- Dentistry, Implantology, Dental Research, Treatment Outcome

This study compared the surface topography, hydrophilicity, and bioactivity of titanium implants after 3 different surface treatments (sandblasting and acid etching, modified sandblasting and acid etching, and thermal oxidation) with those of machined implants. One hundred indigenously manufactured threaded titanium implants were subjected to 3 methods of surface treatment. The surface roughness of the nontreated (Group A) and treated samples (Groups B through D) was evaluated with a scanning electron microscope (SEM) and profilometer. The wettability was visually examined using a colored dye solution. The calcium ions attached to the implant surface after immersing in simulated body fluid (SBF) were assessed on days 1, 2, and 7 with an atomic electron spectroscope. The data were analyzed statistically. The SBF test allowed the precipitation of a calcium phosphate layer on all surface-treated samples, as evidenced in the SEM analysis. A significantly higher amount of calcium ions and increased wettability were achieved in the thermally oxidized samples. The mean roughness was significantly lower in Group A (0.85 6 0.07) compared to Group B (1.35 6 0.17), Group C (1.40 6 0.14), and Group D (1.36 6 0.18). The observations from this in vitro study indicated that surface treatment of titanium improved the bioactivity. Moreover, results identified the implants that were sandblasted, acid etched, and then oxidized attracted more calcium ions.

- by Anil Sukumaran and +2
- •
- Osseointegration, Dental Implants, Oral health, aestetics and oral implants, Researchs in Dental Implantology
- by Jiten Master
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- Researchs in Dental Implantology

Objective: The functional, esthetic, and psychological problems of 3–6 months of edentulousness and also discomfort of two-stage surgery might cause many patients to avoid implant-supported restorations. Therefore, the immediate non-functional loading protocol might be of value.Methods: Twenty Astra Tech implants, 11–13 mm in length and 3.5–4 mm in diameter, were placed in maxillary and mandibular posterior sites of 10 healthy patients (two for each) with adequate alveolar bone. Temporary prostheses were relieved of all centric and eccentric contacts. Functional permanent prostheses were fabricated 13 weeks postoperatively. Clinical and radiographic examinations (including the implant stability quotient [ISQ]) were carried out immediately after implantation and 3, 6, and 12 months postoperatively.Results: A 100% success rate was observed within 1 year. The plaque and bleeding indices, and pocket-probing depths did not show a significant change throughout the study. The ISQ values after implant insertion, and 3, 6, and 12 months later were respectively 76.6 ± 6.57, 77.6 ± 10.54, 81.8 ± 6.8, and 82.43 ± 3.7. The increase was statistically significant (P=0.004) according to the Freidman test. The ISQ values measured after the implant insertion were significantly different from those measured in the sixth and 12th postoperative months (P<0.008) according to the Wilcoxon signed-ranks test. The mean crestal alveolar bone resorption values in the third, sixth, and 12th postoperative months were 0.4 ± 0.55, 0.48 ± 0.37, and 0.48 ± 0.21 mm, respectively; and the change in marginal alveolar bone loss was not significant according to the Freidman test.Conclusion: Within the limitations of this pilot study, non-functional immediate loading might meet the expectations of both the patients and clinicians.To cite this article: Rismanchian M, Fazel A, Rakhshan V, Eblaghian G. One-year clinical and radiographic assessment of fluoride-enhanced implants on immediate non-functional loading in posterior maxilla and mandible: a pilot prospective clinical series study. Clin. Oral Impl. Res. xx, 2011; 000–000. doi: 10.1111/j.1600-0501.2010.02134.x