Abstract
Porous tantalum trabecular metal biomaterial has a similar structure to trabecular bone, and was recently added to titanium dental implants as a surface enhancement. The purpose of this prospective pilot study was to describe 5-year survival results and crestal bone level changes around immediately-provisionalized Trabecular Metal Dental Implants. Eligible patients were adults in need of ≥1 implants in the posterior jaw. A non-occluding single acrylic provisional crown was in place for up to 14 days before final restoration. Clinical evaluations with radiographs were conducted at each follow-up visit (1 month, 3 months, 6 months, and 1 to 5 years). The primary endpoint was implant survival, characterized using the Kaplan-Meier method. The secondary endpoint was changes in crestal bone level, evaluated using a paired t-test to compare mean crestal bone levels between the baseline, 6-month, and annual follow-up values. In total, 30 patients (37 implants) were treated. Mean patient age was 45.5 years, and 63% were female. There was one implant failure; cumulative survival at 5 years was 97.2%. After the initial bone loss of 0.40 mm in the first 6 months, there were no statistically significant changes in crestal bone level over time up to 5 years of follow-up.
Highlights
Porous tantalum has been used in the orthopedic industry since the 1980s for joint arthroplasty, bone augmentation, and as an integral part of orthopedic implants to facilitate bone ingrowth [1]
Nonclinical research showed that the multi-dimensional enhancement of implant surfaces with porous tantalum trabecular metal (PTTM) allowed for excellent bone ingrowth within porous tantalum structures [1,3,5,6] and that the material was chemically stable and biocompatible [7,8]
All 25 implants that completed 5-years of follow-up were surviving and clinically stable, with no indicators of pain, mobility, radiolucency, or clinically meaningful crestal bone loss. The results from this descriptive pilot study of 37 implants showed that immediate provisional restoration of titanium dental implants with surfaces enhanced with PTTM were clinically effective, with a 5-year survival rate of 97.2%
Summary
Porous tantalum has been used in the orthopedic industry since the 1980s for joint arthroplasty, bone augmentation, and as an integral part of orthopedic implants to facilitate bone ingrowth [1]. In the early 1990s porous tantalum trabecular metal (PTTM) was introduced [2]. Known commercially as Trabecular Metal (TM) Material (Zimmer Trabecular Metal Technology, Inc., Parsippany, NJ, USA) is a highly porous biomaterial made from elemental tantalum, with a similar structure to trabecular bone by having a repeating pattern of regular, interconnecting pores, which provide a high volume (70% to 80%) of porosity [1,2,3]. Nonclinical (canine and bovine) research showed that the multi-dimensional enhancement of implant surfaces with PTTM allowed for excellent bone ingrowth within porous tantalum structures [1,3,5,6] and that the material was chemically stable and biocompatible [7,8]. Porous tantalum trabecular metal has excellent biocompatibility and high frictional characteristics, which make it conducive to biologic fixation [1,2], and it has been
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