Minimal Marginal Bone Loss Research Articles

The Long-Term Esthetic and Radiographic Outcome of Implants Placed in the Anterior Maxilla after Ridge Preservation, Combining Bovine Xenograft with Collagen Matrix.

The objective of the study was to evaluate the long-term esthetic and radiographic results of implants placed in the anterior maxilla after ridge preservation, combining bovine xenograft with collagen matrix. Fifteen patients who required a single tooth extraction because of fracture, root resorption, or extended caries were included in the study. After extraction, all sites were grafted using Deproteinized Bovine Bone Mineral (DBBM) with collagen and covered by a resorbable collagen matrix (CM). Five months after socket grafting, implants were successfully installed. The implant diameter range was between 3.8 and 4.2 mm. All patients were monitored for over 7 years, both clinically and radiographically. Three independent observers evaluated the long-term esthetic outcome, employing the Pink Esthetic Score (PES) technique. Over a period exceeding seven years, a 100% survival rate was observed for all 15 implants, with minimal marginal bone loss. The mean PES was 11.40 (±1.44) at the first assessment and 11.38 (±1.63) at the second assessment. The difference was not statistically significant (p = 0.978), and the scores of PES measurements indicated excellent esthetic results even after seven years. Based on these preliminary results, it seems that placing collagen bovine bone in a fresh extraction socket, covered with a collagen matrix, can preserve the alveolar ridge and provide long-term stable esthetic results.

Clinical and Radiographic Outcomes of a New Fully Tapered Implant with the One-Abutment One-Time Approach: In-Line Clinical Case Series with a 1-Year Follow-up.

To evaluate the bone level changes in a new implant design (fully tapered with platform switching) with the one-abutment one-time protocol after 1 year of loading. Thirty patients received 1 or 2 implants (6-, 8-, or 10-mm length and 3.5-, 3.75-, or 4.5-mm diameter, bone-level design) to replace one or multiple edentulous sites. Only the mesial implant was assessed. Radiographic, clinical, and esthetic results and the survival and success rates were evaluated 1 year after final loading. At 1 year, no peri-implant bone loss was seen in any of the cases. Mean marginal crestal bone loss between surgery and crown placement was 0.19 ± 0.17 mm (P < .0001). Between surgery and the 1-year follow-up, the mean marginal crestal bone loss was 0.25 ± 0.24 mm (P < .0001). The difference in the modified Plaque Index between 1 year of follow-up and crown placement was significant for in the mesial (0.33 ± 0.54 mm; P = .003) and distal surfaces (0.5 ± 0.73 mm; P = .001). The probing pocket depth was statistically significantly deeper at 1 year than at crown placement at the mesial and distal aspects (average depth = 0.75 mm; P < .0005). No statistically significant differences were found for any other clinical or esthetic parameters. The overall survival and success rates after 1 year were 100%. The fully tapered, deep-thread, platform-switched implant design placed with the one-abutment one-time protocol demonstrated minimal marginal crestal bone loss and crestal bone stability at 1 year of follow-up.

Hybrid Prosthesis versus Overdenture: Effect of BioHPP Prosthetic Design Rehabilitating Edentulous Mandible.

To compare the BioHPP (biocompatible high-performance polymer) as a substructure for the hybrid prosthesis versus the BioHPP bar supporting and retaining implant overdenture by radiographic evaluation to identify bone height alteration around the implants and to evaluate satisfaction based on visual analoge scale questionnaire. Ill-fitting mandibular dentures were chosen for 14 fully edentulous male patients with adequate dental hygiene, enough interarch space, and free of systemic diseases and parafunctional habits. Patients who received new dentures (CDs) were randomly allocated into each group using computer software, and four interforaminal implants were inserted in parallel using a surgical guide. Three months after osseointegration, the patients received either CAD-CAM BioHPP framework hybrid prosthesis (Group I) or BioHPP bar supported and retained overdenture (Group II). Using digital preapical radiography, the bone loss is evaluated 6, 12, and 18 months after insertion. The subjective patient evaluation was done using a questionnaire based on the VAS includes five points for chewing, comfort, esthetics, speech, oral hygiene, and general satisfaction. The overall marginal bone loss (MBL) revealed that Group I (hybrid prosthesis) was more than Group II (bar overdenture) at all intervals in the anterior and posterior implants' mesial and distal surfaces. The patient satisfaction survey results showed that, after 18 months, the difference was statistically not significant between them all (P > 0.05) except for the comfort (for the overdenture group, 4.43 ± 0.53 while the fixed hybrid was 5.00 ± 0.00). BioHPP framework material is an alternative material for implant rehabilitation of edentulous mandible with minimal MBL in BioHPP bar overdenture compared to BioHPP hybrid prosthesis.

Efficacy of simultaneous placement of dental implants in osteotome-mediated sinus floor elevation with and without bone augmentation: A systematic review and meta-analysis.

The aim of the present systematic review was to assess the effectiveness of simultaneous placement of implant in osteotome-mediated sinus floor elevation (OMSFE) procedure with and without bone augmentation. An exploration of randomized clinical trials (RCTs) was systematically done in three databases comprising PubMed, Cochrane, and Google Scholar complemented by a thorough manual search of periodontology/implantology-related journals. A final inclusion of 6 RCTs (2010-2020) was done to investigate the efficiency of simultaneous implant placement with OMSFE in conjunction with bone augmentation. A meta-analysis was further conducted with comparable studies which assisted in attaining a final conclusion regarding the survival rate, endosinus bone gain (ESBG), and marginal bone loss (MBL). Data synthesis was performed on the basis of 6 trials and further meta-analysis was performed to statistically validate the clinical and radiographic outcomes. Meta-analysis on the parameters indicated greater ESBG (mean difference [MD]: 0.82; [95% confidence interval [CI]: 0.72-0.91, P ≤ 0.0001]), which was also associated with minimal MBL (MD: -1.11; [95% CI: -1.53-0.68, P ≤ 0.0001)] in the bone augmentation group. However, the parameter of implant survival rate (risk ratio: 1.04; [95% CI: 0.83-1.31, P = 0.6849)] failed to reveal significant difference between the two groups. In the restoration of masticatory apparatus, simultaneous placement of implant in OMSFE with bone augmentation can be considered as successful and predictable treatment approach in deficient posterior maxillary ridges. It contributes toward bone neoformation resulting in greater ESBG as well as a substantial decrease in MBL.

Dental implant failure in immunosuppressed renal transplant patient: A case report

Background: In the literature, the dental implant survival rate has been reported one hundred percent in immunosuppressed patients after a solid organ transplant (SOT). There is no previously published dental implant failure that has been reported on immunosuppressed renal transplant, which is the most common SOT therapy. Case Report: The case presented is that of a 66-years old male edentulous patient suffering from lack of functional prosthesis and who received a renal transplant two years ago. No complications such as infection, radiolucency, or pus were detected after two dental implants were placed in the mandible and after three months recovery period. The right mandibular dental implant failure occurred due to compression of the dental implant and healing head during the delivery of the patient’s removable prosthesis. Following implant socket healing after two months, the 4.8 mm diameter implant was placed immediately after. Osseointegration was completed uneventfully, and the patient was successfully rehabilitated with a two implant-retained mandibular overdenture prosthesis. The implant restoration was performing well with stable Peri-implant bone levels have shown minimal marginal bone loss at a 2-year follow-up. Conclusion: Treatment of combined immunosuppressive medication used in renal transplant patients after dental implant rehabilitation, as well as accompanying chronic diseases, should be performed considering the possibility of failure in dental implant applications. In this case report, the causes of implant failure were reported patients who received dental implant treatment after renal transplantation from a cadaver. How to cite this article: Güler B, Özaltun B, Çukurluöz Bayındır B, Dal G. Dental implant failure in immunosuppressed renal transplant patient: A case report. Int Dent Res 2022;12(3):171-5. https://doi.org/10.5577/intdentres.2022.vol12.no3.10 Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

Clinical Outcomes of Dental Implants with Two Different Internal Connection Configurations—A RCT

Background: The aim of the present study was to highlight clinical and radiographical differences among implants sharing the same macro-geometry but with two different prosthodontic connections. Methods: Patients requiring at least 2 implants in the posterior area of the jaw were randomly divided into two groups (Conical (CS) and Internal Hexagonal (IH) connection). At implant surgery (T0), insertion torque, implant stability quotient (ISQ values recorded by resonance frequency analysis, RFA), and soft tissue thickness (STH) were assessed. A 1-abutment/1-time protocol was applied, and the prosthesis was realized following a fully digital workflow. At the 36-month follow-up periapical x-rays were taken. In order to statistically analyse differences among the two groups and the different variables, paired T-test was used. Linear regression analysis was conducted to analyze how marginal bone loss (MBL) was affected by other independent variables. A neural network created to predict the success (good or not good) of the implant itself was implemented. Results: 30 out of 33 patients (14 males, 16 females, mean age: 68.94 ± 13.01 years) (32 CS and 32 IH) were analyzed. No implants failed. Marginal bone loss at the 3-year time-point was 0.33 ± 0.34 mm and 0.43 ± 0.37 mm respectively for CS and IH with a significant difference between the two groups (p = 0.004). The presence of keratinized gingiva (p = 0.034) significantly influenced MBL. Conclusions: Both the implant connections investigated presented optimal clinical outcomes with minimal marginal bone loss; however, CS implants and implants with the presence of a greater width of keratinized tissue presented significantly lower MBL.

Evaluation of Immediately Loaded Parallel Conical Connection Implants with Platform Switch in the Maxillary Esthetic Zone: A Prospective Clinical Study

To assess immediately loaded parallel conical connection (Nobel Biocare) implants with platform switch design in the maxillary esthetic zone for soft and hard tissue changes. A total of 20 patients (n = 20) underwent prosthetic replacement of the missing maxillary anterior tooth, with an immediately loaded parallel conical connection implant (Noble Biocare, Sweden) having a platform switch design. The size of the implant was 3.75 mm in width and 13 mm in length for all patients and placement followed a standardized surgical protocol. Postoperatively, acrylic provisionalization was done within 48 hours followed by a definitive zirconia prosthesis in the 3rd month. Clinically and radiographically, the implants were evaluated for hard tissue (bone density, implant stability, crestal bone loss) and soft tissue changes (mucosal thickness-MT, sulcus probing depth-PD, bleeding on probing-BOP, width of keratinized gingiva-KG) at baseline till 36 months with follow-up intervals after loading. All patients showed uneventful healing. The difference in implant stability and density scores was significant (p <0.05*) from baseline to 36 months indicating bone formation and osseointegration of the implant. Bleeding on probing was not observed, and probing depth remained within the acceptable range (≤5 mm) at all time intervals after loading. The marginal bone loss was minimal (≤0.2 mm annually) with the absence of implant mobility and without any peri-implant radiolucency. The thickness of the gingiva (3.47 ± 0.34 mm) and width of keratinized gingiva (2.46 ± 0.39 mm) remained within reasonable limits at the 36th month with acceptable esthetic appearance. In the present study, immediate loading of Nobel parallel conical connection implant in the maxillary anterior region provided adequate primary stability, minimal marginal bone loss, and increased bone density indicating earlier osseointegration. Decreased probing depth, absence of bleeding on probing, and adequate tissue collar at the neck showed better soft tissue emergence in the esthetic zone. The platform switch design demonstrated promising results and therefore can be used as an alternative to the conventional method. The present study results suggest that parallel conical connection implants (Nobel Biocare) with TiUnite surface, built-in platform switch combined with conical connection interface, parallel walled body, tapered apex, and double threads from tip to platform are all designed to provide high primary stability and support immediate function protocol, hence can be used flexibly in different bone densities.

Socket shield technique and delayed implant placement in maxilla: a series of five case reports

BackgroundTooth extraction is often followed by remodeling of hard and soft tissues, while socket shield technique has been proposed to prevent or minimize this remodeling. Socket shield accompanied with delayed implant placement is a novel technique that could be used when delayed implantation is selected; however, more scientific based evidence is required to recommend this technique as everyday clinical practice. Thus, the aim of this case series was to assess the clinical, radiographic, and esthetic outcomes of the delayed placed implants associated with previously prepared socket shield at 3–15 months follow-up after loading. The stability of the shield and the depth of soft tissue penetration palatal to the shield at reentry of 3–6 months were also assessed.Cases presentationFive case reports of socket shield with delayed implant placement were described in the study. The facial shields were prepared and simultaneously the sockets were grafted with mineralized allograft particles, then the implants were placed 3–6 months later. Periodontal probe was used to measure the depth of soft tissue penetration palatal to the shield at reentry. Clinical indices of bleeding index, plaque index, and probing depths were recorded. Radiographic evaluation to record the amount of marginal bone loss post-loading, esthetic assessment using modified pink esthetic score, and patient assessed outcomes were also evaluated at 3–15 months follow-up after loading. At 3–6 months reentry, all shields were stable with maintenance of the facial bone and with extreme hard tissue formation in the sockets. All five implants were successful and functional without any pain or inflammation, with optimal soft tissue health and esthetics, and with minimal radiographic marginal bone loss at the last follow-up visit (3–15 months after loading).ConclusionsWithin the limits of this study, socket shield technique with delayed implant placement could be a predictable minimally invasive option for cases requiring delayed implant placement; however, a long-term well-designed clinical proof is warranted.

Comparative Efficacy of Osteotome vs CAS Kit Assisted Indirect Maxillary Sinus Lift and Immediate Implant Placement in Posterior Atrophic Maxilla – A Study Protocol

Background: In today’s era implants are mostly used for replacing missing teeth. The greatest challenge for placing an implant is posterior maxillary teeth where the problems arise due to presence of maxillary sinus due which increases the risk of perforating the sinus membrane while implanting. In literature there are many techniques to overcome these problems and place the implant without perforating the sinus membrane. The current study is conducted to check either the traditional technique osteotome or modern technique CAS-Kit is better for placing an implant in posterior maxillary region.&#x0D; Objectives: The aim of these study is to compare and evaluate clinical and radiological outcomes of conventional osteotome technique and CAS kit use for indirect sinus lifting in atrophic posterior maxilla.&#x0D; Methodology: Two groups (study &amp; control) with 20 individuals requiring implant prosthesis in atrophic posterior maxillary region with RBH &lt; 3mm and minimum crestal width of 6mm are considered for the study model. After completion of osteotome and sinus lift procedure, integrity of sinus membrane will be checked by Valsalva manoeuvre. At three months after implant placement a second step surgery will be performed, stability of each implant will be checked. Marginal bone loss and amount of bone generation will be checked on Cone-beam computed tomography systems (CBCT) at 3, 6 &amp; 9 month interval.&#x0D; Expected Results: CAS kit is relatively newer and advanced equipment which is safer in placing implant in posterior atrophic maxilla without perforating sinus membrane with good amount of bone generation and stability of implant. with minimal marginal bone loss.&#x0D; Conclusion: Placement of an implant with CAS-Kit is better option than performing osteotome procedure which is time consumable with high chance of membrane perforation and large amount of marginal bone loss.

Efficacy of ankaferd blood stopper on healing after osseous grafting in the treatment of periodontal intrabony defects.

Abstract Objective: Periodontal diseases are multifactorial infections lead to destruction of the periodontal. The present study was designed to verify effect of ABS in conjunction with β-TCP on healing in the treatment of periodontal intrabony defects. Subjects and Methods: A total of 20 intrabony periodontal defects were treated in ten patients with Periodontal pocket depth ≥ 6 mm and radiographic osseous defect depth ≥ 4 mm, Interventional split mouth; 1st group (control group) Ten defects were treated by β-TCP and 2nd group (Test group) Ten defects were treated by (mixing 0.5 ml of ABS with β-TCP ). Phase I therapy was performed for all chosen patients to provide an oral environmental more favorable to wound healing. The following clinical indices measurements Plaque index, Gingival index, Periodontal pocket depth and Clinical attachment level. All indices were recorded at baseline, 6 and 12 months after surgery. The following Radiographic measurements bone density, M-D width of the defect and depth of the defect were recorded at baseline, 6 and 12 months after surgery under constant conditions. Results: β-TCP/ABS group showed a less mean plaque index, gingival index, clinical attachment loss, M-D width of the defect and depth of the defect and a high mean bone density than β-TCP group. Conclusion: Both treatment modalities demonstrated good standards of oral hygiene, with minimal inflammatory signs around teeth‏ and minimal marginal ‎bone loss. ABS combined with a synthetic bone graft may enhance the healing and regenerative processes and lead to more bone fill.

Factors influencing marginal bone loss at a hydrophilic implant design placed with or without GBR procedures: A 5‐year retrospective study

Background Preserving the peri-implant bone level is key for the longevity of an implant-supported prosthesis. In cases with non-optimal bone conditions, guided bone regeneration (GBR) procedures may be applied which might challenge the long-term peri-implant bone preservation. Aim/Hypothesis The aim of the present study was to retrospectively evaluate the survival rate and factors affecting marginal bone levels around implants with a hydrophilic surface after 5 years in function when placed with or without GBR procedures. Material and Methods The study group consisted of 51 consecutive patients previously treated with 159 hydrophilic implants (Neoss ProActive Straight implants) scheduled for annual check-ups with clinical and radiographic examinations during 5 years. Additional subgroup analysis was performed for patients receiving implants with or without GBR procedures, 91 and 68 implants respectively. The study group had a range of different length implant-supported prostheses, allowing both 1- and 2-stage surgical procedures with either delayed or immediate loading. Marginal bone levels were measured from peri-apical radiographs taken at placement and annual check-ups. Patient-, procedure-, and implant related factors was statistically analysed to evaluate their effect on marginal bone remodeling. Results Two implant failures, one from each sub-group, occurred during the first year in function resulting in an overall cumulative survival rate (CSR) of 98.7% following 5 years of loading. Thus, CSR for implants treated with or without GBR procedures were 98.9% and 98.5% respectively. The total marginal bone loss measured 0.7 ± 0.7 mm from insertion to 1-year and 0.8 ± 0.6 mm from insertion to 5 years. Between 1 year and 5 years no (0.0 ± 0.5 mm) marginal bone loss was recorded. No implants showed more than 3 mm bone loss after 5 years. Age, gender, implant position, biotype, implant diameter, implant length, indication, surgical loading protocol, and ISQ at prosthesis delivery were found to affect bone remodeling. No significant differences or correlations were seen for GBR, smoking, jaw, bone quantity, bone quality, sinus lift, and ISQ at implant placement. Conclusion and Clinical Implications The present implant design performed well with only few implant failures and minimal marginal bone loss after 5 years of loading, irrespective of placement with or without GBR. Marginal bone remodeling around implants is a complex phenomenon, which is affected by many patient-, procedure- and implant-related factors which needs to be further investigated.

Factors influencing marginal bone loss at a hydrophilic implant design placed with or without GBR procedures: A 5-year retrospective study.

Ongoing marginal bone loss is a threat to the longevity of implant-supported prostheses. The aim of the present study was to retrospectively evaluate the survival rate and factors affecting marginal bone levels at a hydrophilic implant design after 5 years in function. The study group consisted of 51 consecutive patients previously treated with 159 hydrophilic implants (Neoss Straight Proactive implants) and scheduled for annual check-ups with clinical and radiographic examinations during 5 years. Data were compiled for the entire study population as well as for two subgroups: one where guided bone regeneration (GBR) was performed (91 implants) and the other where no GBR procedures (68 implants) were performed. Marginal bone levels were measured from peri-apical radiographs taken at placement and annual follow-ups. Statistical analyses were applied to evaluate the effect of different factors on marginal bone remodeling. Two implant failures, one from each subgroup, occurred during the first year of function resulting in an overall cumulative survival rate (CSR) of 98.7% after 5 years of loading. The mean marginal bone loss amounted to 0.7 ± 0.7 mm after 1 year and 0.8 ± 0.6 mm after 5 years. No implants showed more than 3 mm bone loss after 5 years. Age, gender, implant position, biotype, implant diameter, implant length, indication, surgical/loading protocol, and ISQ at prosthesis delivery were found to affect bone remodeling. No significant differences or correlations were seen for smoking, jaw, bone quantity, bone quality, GBR, sinus lift, and ISQ at implant placement. The present implant design performed well with few failures and minimal marginal bone loss after 5 years of loading. Marginal bone remodeling at implants is a complex phenomenon, which is affected by many patient-, procedure-, and implant-related factors that need to be further investigated.

Immediate nonfunctional loading of implants placed simultaneously using computer-guided flapless maxillary crestal sinus augmentation with bone morphogenetic protein-2/collagen matrix.

Immediate loading has shown positive results for total, partial, or single edentulism. The effects of BMP-2 addition to graft materials on bone formation and implant stability in the early stages of healing have rarely been studied, especially in patients with severely atrophic maxillae. To evaluate the effects of simultaneously placed immediate non-functional loaded implants and bone morphogenetic protein-2 (BMP-2)-loaded Bio-Oss collagen, on bone formation and implant stability during the early healing stages of patients with a severely atrophic posterior maxilla using crestal approach. Thirty-three cases presenting posterior maxillary residual alveolar bone height of 1-3 mm were evaluated. Flapless crestal sinus augmentation surgery was performed using BMP-2-loaded Bio-Oss collagen, with non-functional implants immediately loaded after surgery. The bone height was assessed using preoperative and postoperative cone beam computed tomography (CBCT). Bone density of the sinus graft sites and implant stability (after 3 months) were evaluated using postoperative CBCT scans and Periotest, respectively. The periodontal parameters and marginal bone loss around the implant were checked after 37.3 months of final prosthesis. The survival rate of the implants was 100% and the gingiva around the implants remained healthy. All implants remained integrated, and all sinus grafts showed radiographic bone formation. The results indicated high level of bone density and good implant stability, showing minimal marginal bone loss after 37.3 months. This technique could be used in the posterior maxillary region exhibiting poor bone quantity.

Fixed and Removable Full-Arch Restorations Supported by Short (≤ 8-mm) Dental Implants In the Mandible: A Systematic Review and Meta-Analysis.

To evaluate, through a systematic review of the literature, the published data regarding marginal bone loss, implant failure proportion, biologic and prosthetic complications, and risk factors associated with short (≤ 8-mm) implants supporting fixed or removable full-arch restorations in the edentulous mandible. Two reviewers performed a search of five databases, with handsearching through the reference lists and grey literature. Controlled clinical trials and prospective cohort studies were selected in a two-phase process. The data were independently gathered for the same two reviewers. Quality assessment of the studies was done using the Cochrane Handbook for Systematic Reviews of Interventions for Randomized Clinical Trials and the Newcastle-Ottawa Scale for Prospective Cohort Studies. Marginal bone loss and Implant failure proportion were meta-analyzed using random (R-Em) and fixed-effects models (FEm), respectively, with a 95% confidence interval. A descriptive analysis was performed of the prevalence of biologic and prosthetic complications. Meta-regression analysis was run as fixed-effect models for risk factors. Six studies met the eligibility criteria and had data extracted. A total of 291 short implants (lengths 5 to 8 mm) were placed in 122 patients (82 females; mean age, 64.7 ± 10.8) supporting 23 fixed and 99 removable full-arch restorations. The pooled marginal bone loss overall was 0.12 mm (0.07 to 0.17 mm). Marginal bone loss for fixed full-arch restorations was 0.11 mm (0.01 to 0.21 mm) and for removable full-arch restorations was 0.14 mm (0.07 to 0.21 mm). The pooled implant failure proportion was 2.0% (1.0% to 5.0%) for the overall studies. Implant failure proportion for fixed and removable restorations was 2.0% with a confidence interval of (0.0% to 9%) and (0.0% to 6%), respectively. The prevalence of prosthetic complications was 34.5% for fixed restorations and 2.6% for removable restorations. No biologic complications were found for fixed restorations, while 13.1% of removable restorations did have biologic complications. Risk factors did not demonstrate statistical differences regarding Implant failure proportion and marginal bone loss. All included studies demonstrated a high methodological quality. Findings from this systematic review and meta-analysis suggest that full-arch restorations supported by short implants in atrophic edentulous mandibles might be a viable treatment option, presenting minimal marginal bone loss and implant failure in the short-term. However, further well-performed prospective clinical trials with long-term observation are needed.

Study The Effect of Diffrent Two Materials Used to Secur Locator Attachments on Marginal Bone Loss of Implant Retained Mandibular Overdenture

This study was to evaluate the effect of two different types of housing securing materials on bone hight changes using Radiographic evaluation by using cone beam CT. of Locator retained mandibular overdenture. All patient received Locator attachments. The patients were divided into two groups according to resilient or hard the securing material.Radiographic evaluation by using cone beam CT was done for all patients after 12 months. After radiographic evaluation the securing materials were change for each group (The first group was used self-cure acrylic resin for securing the housing of locator. While, the second group used soft liner). The results of the study showed minimal marginal bone loss in soft liner group, at the end of 12 months follow-up period indicating a significant difference between the two groups.

Comparative evaluation of the effectiveness of the implantation in the lateral part of the mandible between short tissue level (TE) and bone level (BL) implant systems

Short dental implants can be an alternative method of treatment to a vertical bone augmentation procedure at sites of reduced alveolar height. However, for successful treatment, an implant system that causes a minimal marginal bone loss (MBL) should be taken into consideration.The aim of the study has been to evaluate implantation effectiveness for bone level and tissue level short implants provided in lateral aspects of partially edentulous mandible and limited alveolar ridge height. The MBL and primary as well as secondary implant stability were determined in the study.Patients were randomly divided into two groups according to the method of treatment provided. Sixteen short Bone Level Implants (OsseoSpeed TX, Astra tech) and 16 short Tissue Level Implants (RN SLActive®, Straumann) were successfully placed in the edentulous part of the mandible. The determination of the marginal bone level was based on radiographic evaluation after 12 and 36 weeks. Implant stability was measured immediately after insertion and after 12 weeks.The marginal bone level of Bone Level Implants was significantly lower compared to Tissue Level Implants. Furthermore, the Bone Level Implants had greater primary and secondary stability in comparison with Tissue Level Implants (Primary: 77.8 ISQ versus 66.5 ISQ; Secondary: 78.9 ISQ versus 73.9 ISQ, respectively).Since short Bone Level Implants showed a significantly decreased MBL 12 and 36 weeks after implantation as well as better results for the primary stability compared to Tissue Level Implants, they should preferentially be used for this mentioned indication.

Immediate Versus Delayed Loading of Implant for Replacement of Missing Mandibular First Molar: A Randomized Prospective Six Years Clinical Study.

Emergence of dental implants made the replacement of missing tooth easy. During the early days of introduction, implants were loaded three to six months after implant insertion, but understanding of healing cascade and improved production technology has changed the phase of restoration from delayed to immediate loading. To evaluate and compare the clinical outcome of immediate and delayed loaded implant supported prosthesis for missing mandibular first molar. The objectives were bleeding on probing, probing depth, implant mobility, marginal bone level and peri-implant radiolucency were evaluated during follow up period. Twenty patients were included in this study who were in the need of fixed implant supported prosthesis for missing mandibular first molar. Single tooth implant with immediate loading done within two days of implant insertion in one group and another group were loaded after three months of implant insertion. These groups were evaluated clinically and radiographically over a period of 72 months after loading using Wilcoxon matched pairs test and Mann-Whitney U test. The study consists of 14 male and six female patients with the age range of 19 to 31 years. There was no bleeding on probing and probing depth remained well within the normal range even after 72 months of loading among both the groups. Minimal marginal bone loss observed with no mobility and peri-implant radiolucency. Implant supported prosthesis for missing mandibular first molar with immediate loading can be used as a successful treatment modality. It reduces treatment time, provides early function and prevents undue migration of adjacent tooth. Immediate loading showed similar clinical and radiographic results as that of delayed loading, indicating it as an equally efficient technique for implant supported prosthesis.

A One-year Follow-up Study of a Tapered Hydrophilic Implant Design Using Various Placement Protocols in the Maxilla.

Purpose:To study the clinical/radiographic outcomes and stability of a tapered implant design with a hydrophilic surface when placed in the maxilla using various protocols and followed for one year.Methods:Ninety-seven consecutive patients treated as part of daily routine in two clinics with 163 tapered implants in healed sites, in extraction sockets and together with bone augmentation procedures in the maxilla were evaluated after one year in function. Individual healing periods varying from 0 to 6 months had been used. Insertion torque (IT) and resonance frequency analysis (RFA) measurements were made at baseline. Follow-up RFA registrations were made after 6 and 12 months of loading. The marginal bone levels were measured in intraoral radiographs from baseline and after 12 months. A reference group consisting of 163 consecutive straight maxillary implants was used for the comparison of baseline IT and RFA measurements.Results:Five implants failed before loading, giving an implant survival rate of 96.9% and a prosthesis survival rate of 99.4% after one year. The mean marginal bone loss after one year was 0.5 mm (SD 0.4). The mean IT was statistically significantly higher for tapered than for straight reference implants (41.3 ± 12.0 Ncm vs 33.6 ± 12.5 Ncm, p < 0.001). The tapered implants showed a statistically insignificantly higher mean ISQ value than the straight references implants (73.7 ± 6.4 ISQ vs 72.2 ± 8.0 ISQ, p=0.119). There was no correlation between IT and marginal bone loss. There was a correlation between IT and RFA measurements (p < 0.001).Conclusion:The tapered implant showed a high survival rate and minimal marginal bone loss after one year in function when using various protocols for placement. The tapered implant showed significantly higher insertion torque values than straight reference implants.

CLINICAL AND RADIOGRAPHIC EVALUATION OF SOFT-LINER ATTACHMENT FOR BAR/IMPLANT RETAINED MAXILLARY OVERDENTURES. A ONE YEAR PROSPECTIVE STUDY

Aim of the study: This study aimed to evaluate clinical and radiographic outcome of soft-liner attachment for bar/implant retained maxillary overdentures after one year. Materials and methods: Six completely edentulous patients (3 males and 3 females) complained from lack of stability and insufficient retention of their maxillary dentures received 4 implants in the anterior part of the maxilla (2 at canine areas and 2 at 2nd premolar areas) using the standardized two-stage submerged surgical protocol. Six months after surgery, implants were connected with a resilient bar with 2 short distal cantilevers of 7mm length. The fitting surfaces of maxillary dentures were lined with auto polymerized addition silicone resilient liner which is used as a female housing over the bar using closed mouth technique. Plaque Index (PI), Bleeding Index (BI), and Gingival Index (GI), Probing depth (PD), Implant stability (ISQ) and Marginal bone loss (MBL) were evaluated at time of overdenture insertion T0, 6 months after overdenture insertion (T6) and 12 months after overdenture insertion (T12). Results: None of the implants failed after one year follow-up resulted in 100% survival rate. There was no significant difference in PI, GI, BI between observation times. Both PD and MBL increased significantly with time. ISQ decreased significantly at T6 and increased again at T12. There was a significant positive correlation between MBL and PD only. Conclusion: Soft liner attachments for cantilevered bar-implant retained maxillary overdentures are associated with good peri-implant soft tissue health, good implant stability and minimal marginal bone loss after one year.

Evaluation of Hi-Tec Implant Restoration in Mandibular First Molar Region- A Prospective Clinical Study.

Missing teeth lead to loss of structural balance, inefficient function, poor aesthetics and psychological effects on human beings, which needs restoration for normal contour, function and aesthetics. Several natural or synthetic substitutes are being used for replacement of missing tooth since centuries. Implants are the latest modality of replacement. So, the study was aimed to assess clinical success rate of Hi-Tec implant; which is economical and new in market. Results of the study will help clinician for appropriate implant selection. The study included 10 patients from 19 to 31 years and needed restoration of missing mandibular first molar. Restoration had done using Hi Tec Single-tooth implants with metal-ceramic single crown prosthesis after three months of osseointegration. The implants were evaluated clinically (bleeding on probing, probing depth, implant mobility- periotest) and radiographically (marginal bone loss and peri-implant radiolucency) for six years. The observers were blinded for the duration of the study to prevent bias. All the patients had uneventful post-surgical healing. No bleeding on probing, Implant mobility, peri-implant radiolucency with minimal marginal bone loss and constant probing depths were observed well within the normal range during follow-up periods. Two stage single-tooth Hi Tec implant restoration can be used as a successful treatment modality for replacing mandibular first molar in an economic way. However, these results were obtained after 6 years of follow up with a smaller sample size, so long term multi center studies with a larger sample size is recommended for the predictability of success rate conclusively.