Screw-type Implants Research Articles

Immediate Occlusal versus Non‐Occlusal Loading of Implants: A Randomized Clinical Pilot Study

Immediate occlusal and non-occlusal loading protocols have been discussed and, despite varying success rates, are considered viable in selected cases. Preoperative implant planning and intraoperative transfer are essential to the success of implant-supported reconstructions in partially or completely edentulous jaws. This study was performed to compare clinical outcomes of immediate occlusal versus non-occlusal loading of posterior implants. Of 19 patients with 52 screw-type implants replacing mandibular molars or premolars, nine patients with 21 implants were randomized to a study group that received immediate restorations with occlusal loading, whereas 10 patients with 31 implants were randomized to a control group that received provisional restorations without occlusal loading. Occlusal loading was defined as full loading in maximum intercuspidation. Single-tooth or splinted multiunit restorations were incorporated by screw retention or cementation. Marginal bone defects (MBD), implant survival, and implant success were evaluated 12 months after insertion. Both groups revealed similar MBD levels consistent with previous reports. No implants were lost (overall survival: 100%) or found to fail (overall success: 100%). No significant intergroup differences were noted for any of the evaluated parameters. Immediate restorations in partially edentulous mandibles demonstrated successful clinical and radiographic 12-month results. Larger long-term prospective studies are needed to confirm the final evidence and predictability of immediate functional loading as a standard treatment concept for partially edentulous jaws.

The Influence of implant geometry and surface composition on bone response

The implant design and surface modification are independent conditions that can alter the implant bone response. The objective of this study is to compare the bone response to roughened tapered and cylindrical screw-type implants with and without hydroxyapatite (HA) surface coating in the femoral trabecular bone of rabbits. Thirty-two implants (8×3.5mm) consisting of four different types (eight implants in each group), that is, tapered implants, cylindrical implants, HA-coated tapered implants, and HA-coated cylindrical implants were installed in the femoral condyle of 16 rabbits. After 8weeks of healing, the femoral condyles were retrieved and studied histologically. The bone-to-implant contact percentage was assessed and analyzed statistically. The histomorphometric analysis revealed that the bone-to-implant contact (BIC) values seemed to be higher for HA-coated tapered implants (65.62±13.02) followed by cylindrical non-coated implants. All four types of implants showed wide distribution of BIC with no statistical significance between different types of implants. It can be concluded that under the current experimental conditions, implant design and surface composition had little effect on the bone-to-implant interface.

The Effect of Ultraviolet-C Irradiation Via a Bactericidal Ultraviolet Sterilizer on an Anodized Titanium Implant: A Study in Rabbits

After placement, titanium dental implants are conditioned by blood and tissue fluid. These initial processes are affected by the hydrophilicity of the implant. The hydrophilicity of titanium dioxide (TiO2) can be increased by ultraviolet (UV)-C irradiation. Anodic oxidation is an electrochemical treatment used to form TiO2 layers that are characterized by their thickness, roughness, and porosity on the surface of titanium implants. These oxide layers increase implant durability and performance. Therefore, the aim of this study was to investigate the effect of UV-C irradiation on the anodized titanium surface and the resultant tissue response. Twenty-five titanium disks and 56 screw-type implants were fabricated of commercially pure titanium and anodized. The samples were divided into a control group (anodized) and a test group (anodized and UV-C irradiated with a bactericidal UV sterilizer for 24 hours just prior to experimentation). The surface characteristics of the disks, including roughness, crystal phase of the oxide layer, chemical composition, and water contact angle, were then evaluated. Implants were placed into rabbit tibiae, and histomorphometric analysis was performed after healing periods of 4 and 12 weeks. The results were compared between groups. The surface topography and phase of the oxide layer were not significantly different between test and control groups. Carbon surface impurities were noticeably decreased after UV-C irradiation, and water contact angle measurements were significantly lower (P < .001). After a healing period of 4 weeks, test implants showed higher values for both bone-to-implant contact and the amount of bone in the thread area of the implant (P < .01). No significant differences between groups were found for either histomorphometric measurement after 12 weeks. UV-C irradiation of an anodized titanium implant, accomplished via a bactericidal UV sterilizer, promoted an early bone response in rabbit tibiae.

Effect of Static Magnetic Fields on the Osseointegration of Immediately Placed Implants

The aim of this study was to evaluate the effects of static magnetic fields (SMFs) on the implants immediately placed in fresh extraction sockets. Twenty patients who were in need of 20 fixed implant-supported single crowns in the anterior maxilla were included. After tooth extraction, screw-type implants were placed immediately into fresh extraction sockets and were randomly covered with either magnetic abutment (test group) or conventional healing abutment (control group). Radio frequency analysis (RFA) was conducted at implant placement and after 1, 2, and 3 months. Marginal bone level changes were recorded 1, 2, and 3 months postoperatively. The RFA measurements showed a significant higher stability for implants in test group than that of control group after 1 month (P = 0.04). At month 2, less crestal bone loss was found in the test group (P = 0.03). However, at month 3, there was no significant difference between the groups for both parameters (P > 0.05). SMFs caused more noticeable increase in implant stability and less bone loss during the initial weeks of healing.

Evaluation of the RB–RB/LB–LB mnemonic rule for recording optimally projected intraoral images of dental implants: anin vitrostudy

The aim of this study was to evaluate a simple mnemonic rule (the RB-RB/LB-LB rule) for recording intra-oral radiographs with optimal projection for the control of dental implants. 30 third-year dental students received a short lesson in the RB-RB/LB-LB mnemonic rule. The rule is as follows: if right blur then raise beam (RB-RB), i.e. if implant threads are blurred at the right side of the implant, the X-ray beam direction must be raised towards the ceiling to obtain sharp threads on both implant sides; if left blur then lower beam (LB-LB), i.e. if implant threads are blurred at the left side of the implant, the X-ray beam direction must be lowered towards the floor to obtain sharp threads on both implant sides. Intra-oral radiographs of four screw-type implants placed with different inclination in a Frasaco upper or lower jaw dental model (Frasaco GmbH, Tettnang, Germany) were recorded. The students were unaware of the inclination of the implants and were instructed to re-expose each implant, implementing the mnemonic rule, until an image of the implant with acceptable quality (subjectively judged by the instructor) was obtained. Subsequently, each radiograph was blindly assessed with respect to sharpness of the implant threads and assigned to one of four quality categories: (1) perfect, (2) not perfect, but clinically acceptable, (3) not acceptable and (4) hopeless. For all implants, from one non-perfect exposure to the following, a higher score was obtained in 64% of the cases, 28% received the same score and 8% obtained a lower score. Only a small variation was observed among exposures of implants with different inclination. On average, two exposures per implant (range: one to eight exposures) were needed to obtain a clinically acceptable image. The RB-RB/LB-LB mnemonic rule for recording intra-oral radiographs of dental implants with a correct projection was easy to implement by inexperienced examiners.

Biomechanical evaluation of macro and micro designed screw‐type implants: an insertion torque and removal torque study in rabbits

To investigate the combined effect of macro and pitch shortened threads on primary and secondary stability during healing, but before dynamic loading. Two sets of turned implants with different macro geometry were prepared. The test group possessed pitch shortened threads in between the large threads and the control group did not have thread alterations. The two implant groups were placed in both femur and tibiae of 10 lop-eared rabbits, and at the time of implant insertion, insertion torques were recorded. After 4weeks, all implants were subjected to removal torque tests. The insertion torque values for the control and test groups for the tibia were 15.7 and 20.6Ncm, respectively, and for the femur, 11.8, and 12.8Ncm respectively. The removal torque values for the control and test groups in the tibia were 7.9 and 9.1Ncm, respectively, and for the femur, 7.9 and 7.7Ncm respectively. There was no statistically significant difference between the control and test groups. Under limited dynamic load, the addition of pitch shortened threads did not significantly improve either the primary or the secondary stability of the implants in bone.

Evaluation of Stress Patterns Produced by Implant-Retained Overdentures and Implant-Retained Fixed Partial Denture

The purposes of this study were to photoelastically measure the biomechanical behavior of 4 implants retaining different cantilevered bar mandibular overdenture designs and to compare a fixed partial denture (FPD). A photoelastic model of a human edentulous mandible was fabricated, which contained 4 screw-type implants (3.75 × 10 mm) embedded in the parasymphyseal area. An FPD and 3 overdenture designs with the following attachments were evaluated: 3 plastic Hader clips, 1 Hader clip with 2 posterior resilient cap attachments, and 3 ball/O-ring attachments. Vertical occlusal forces of 100 N were applied between the central incisor and unilaterally to the right and left second premolars and second molars. Stresses that developed in the supporting structure were monitored photoelastically and recorded photographically. The results showed that the anterior loading, the overdenture with 3 plastic Hader clips, displayed the largest stress concentration at the medium implant. With premolar loading, the FPD and overdenture with 3 plastic Hader clips displayed the highest stresses to the ipsilateral terminal implant. With molar loading, the overdenture with 3 ball/O-ring attachments displayed the most uniform stress distribution in the posterior edentulous ridge, with less overloading in the terminal implant. It was concluded that vertical forces applied to the bar-clip overdenture and FPD created immediate stress patterns of greater magnitude and concentration on the ipsilateral implants, whereas the ball/O-ring attachments transferred minimal stress to the implants. The increased cantilever in the FPD caused the highest stresses to the terminal implant.

Immediate rehabilitation of the edentulous mandible with screw type implants: results after up to 10 years of clinical function

The aim of this prospective case series was to evaluate the results of an immediate loading concept using four Xi VE S plus implants in the edentulous mandible, after a period of up to 10years of clinical function. Thirty patients were treated with four implants each placed interforaminally and provisionally restored within 1week. Radiographic bone levels, condition of the peri-implant mucosa, implant survival and success were recorded annually from implant insertion (baseline) up to 10years after final restoration. A total of 120 Xi VE S plus implants were placed in the interforaminal region. A significant coronal bone loss of 1.80mm (SD±0.65) was recorded within the first 8years of function (P<0.001). Within the next years no further significant increase of bone resorption was observed. The mean values of the plaque, calculus, bleeding and mucosal indices and probing depth remained low throughout this period. All implants were inserted with an insertion torque of more than 32N cm. Two losses (1.7%) occurred prior to permanent restoration (1 and 3months post-insertion), resulting in a survival rate of 98.3% over the entire observation period. Four implants were recorded as failures due to excessive bone resorption, resulting in an overall success rate of 95%. The results of this study indicate that in selected patients immediate restoration of dental implants in the edentulous mandible will achieve a clinically predictable outcome.

Translocation of autogenous bone particles to improve peri-implant osteogenesis

During the placement of titanium implants into bone, particles are loosened and translocated as a result of the inherent roughness of the surface. Such bone particles have been shown to play a significant role in new bone formation. Therefore, the aim of the present study was to establish a new regenerative procedure, which can be implemented immediately during surgery, to provide implants with additional autogenous bone particles. Thereafter, we investigated the effect of such 'bone-coated' implants on the healing response. In our model, dental screw-type implants were placed in the iliac crests of goats, following three approaches: (a) implants were placed, then removed while retaining bone debris on the surface, and subsequently placed into freshly prepared holes; (b) new implants were installed in the donor sites from group 1; and (c) control implants were inserted according to the standard protocol. After 3 weeks, microcomputed tomography and histomorphometerical analyses on bone-implant contact (BIC) and bone area (BA) were performed. The results showed that the retained bone debris in group 1 was viable bone-like tissue when cultured in vitro. In vivo histological results showed a significantly higher BIC for the 'bone-coated' (43.42 ± 11.29%) compared to the control (28.15 ± 11.86%) implants. Also, adjacent to the implants a significantly higher BA was found for 'bone-coated' implants (39.51 ± 11.17%) compared to the controls (31.92 ± 10.25%). Notably, no detrimental effects were noticed for the 'donor-site' positions. In conclusion, the transported autogenous bone particles accelerated peri-implant osteogenesis. Clinical studies are needed to evaluate the potential of this procedure in clinical practice.

Implant image quality in dental radiographs recorded using a customized imaging guide or a standard film holder

To compare a customized imaging guide and a standard film holder for obtaining optimally projected intraoral radiographs of dental implants. Intraoral radiographs of four screw-type implants with different inclination placed in an upper or lower dental phantom model were recorded by 32 groups of examiners after a short instruction in the use of the RB-RB/LB-LB mnemonic rule. Half of the examiners recorded the images using a standard film holder and the other half used a customized imaging guide. Each radiograph was assessed under blinded conditions with regard to rendering of the implant threads and was assigned to one of four quality categories: (1) perfect, (2) not perfect, but clinically acceptable, (3) not acceptable, and (4) hopeless. For the upper jaw, the same number of exposures per implant were made to achieve an acceptable image (P=0.86) by the standard film holder method (median=2) and the imaging guide method (median=2). For the lower jaw, medians for the imaging guide method and the film holder method were 1 and 2, respectively (P=0.004). For the imaging guide method, the first exposure was rated as perfect/acceptable in 62% of the cases and for the film holder method in 41% of the cases (P=0.013). After ≤ 2 exposures, 78% (imaging guide method) and 69% (film holder method) of the implant images were perfect/acceptable (P=0.23). The implant inclination did not have a major influence on the outcomes. Perfect or acceptable images were achieved after two exposures with the same frequency either using a customized imaging guide method or a standard film holder method. However, the use of a customized imaging guide method was overall significantly superior to a standard film holder method in terms of obtaining perfect or acceptable images with only one exposure.

Osteotome-Mediated Sinus Floor Elevation Using Only Platelet-Rich Fibrin: An Early Report on 110 Patients

This article describes a technique and reports on the early healing for localized sinus augmentation using a crestal approach in combination with an autologous leukocyte- and platelet-rich fibrin (PRF) concentrate. From November 2008 to January 2010, 138 implants were placed in 110 patients using osteotome-mediated sinus floor elevation (OMSFE) with PRF. The mean residual subantral bone height of the alveolar ridge was 6.6 mm (range, 4-8 mm). The mean increase in the height of implant sites by OMSFE/PRF was 3.4 mm (range, 2.5-5 mm). A variety of 8- to 11.5-mm long (mean length, 10.1 mm) and 3.5- to 6-mm wide (mean width, 4.4 mm) screw-type implants were used. Of the 138 implants that had been placed, 97 have been restored and in function for an average loading time of 5.2 months (range, 1-11 months). The mean healing time for the loaded implants was 4 months until abutment insertion (range, 3-5 months). Three implants failed before loading for an early survival rate of both loaded and unloaded implants of 97.8%. Early review of the OMSFE/PRF technique presented for localized sinus floor elevation and implant placement demonstrates a high degree of safety and success at sites with 5- to 8-mm residual subantral bone height.

Immediate provisional restoration of screw‐type implants in the posterior mandible: results after 5 years of clinical function

The aim of this prospective study was to evaluate the outcome of immediately provisionally restored implants in the posterior mandible after a minimum of 60 months in function. Twenty-four patients were treated with 40 screw-type implants replacing mandibular molars and premolars. Implants were provisionalized immediately after placement. Radiographic coronal bone levels, implant survival and success were evaluated 12, 24, 36, 48 and 60 months after the final restoration. Measurements of the mean marginal bone levels around immediately loaded implants after 12 months showed a significant bone loss (P<0.001) within the first year after the final restoration. Measurements of coronal bone levels after 24, 36, 48 and 60 months, respectively, showed no further significant increase of bone resorption. Two implants were lost within the first year after the final restoration, resulting in an overall survival rate of 95%; a total of three implants were recorded as failures (two implant losses and one excessive bone resorption above 50%), resulting in an overall success rate of 92.5 after an implant observation period of up to 8 years. The present data revealed results comparable to conventionally loaded implants. Careful patient selection in combination with high primary stability seem to be key factors for immediately loaded implants. Larger long-term randomized clinical trials are needed to confirm the final evidence of this protocol as the standard treatment concept for the partially edentulous mandible.

Prefabricated zirconium dioxide implant abutments for single‐tooth replacement in the posterior region: evaluation of peri‐implant tissues and superstructures after 12 months of function

In the present study, prefabricated abutments made of zirconium dioxide Y-TZP (tetragonal zirconia polycrystals) were inserted into the posterior region under controlled clinical conditions. The aim was to test whether abutments made of zirconium dioxide are suitable for this indication. Investigation parameters included reactions of peri-implant tissue and the structural integrity of the all-ceramic superstructures on the implants. Results after 12 months in function are reported in this article. Forty implants of the XiVE S plus screw-type implants (DENTSPLY Friadent) were inserted into the posterior region of 24 patients. After the healing period, the implants were provided with all-ceramic abutments made of zirconium dioxide Y-TZP (FRIADENT CERCON Abutment; DENTSPLY Friadent). All-ceramic crowns (CERCON smart ceramics; DENTSPLY DeguDent) were used as superstructures and cemented using the conventional method. The following parameters were used to document the state of soft tissue: modified plaque index (mPI), sulcus fluid flow rate (SFFR, Periotron; Oraflow Inc), modified sulcus bleeding index (mSBI) and pocket depth (ST). Mesial and distal bone levels were determined on radiographs during the prosthetic treatment and at the 12-month recall. The Periotest (Medizintechnik Gulden) was used to determine implant stability. All implants could be followed up after 12 months in function. In the presence of good oral hygiene (mPI: 0.5), the parameters SFFR (18) and mSBI (0.5) were indicative of stable and healthy soft tissue. ST was highest at the distal points of measurement (2.3 mm) and was generally at a low level. Compared with the baseline situation, proximal bone defects were reduced from -1.1 to -1 mm during the 12-month period of functioning. The mean Periost values at the 12-month recall were -1.9 in the maxilla and -3.8 in the mandible. Neither implant loss nor crown fractures occurred. Chipping of parts of the veneering ceramic was registered in four cases (10%). After 12 months of wear, no mechanical failure was registered in any of the all-ceramic abutments. On clinical investigation, the peri-implant hard and soft tissues were largely healthy and devoid of inflammation.

Early Loading at 21 Days of Non‐Submerged Titanium Implants With a Chemically Modified Sandblasted and Acid‐Etched Surface: 3‐Year Results of a Prospective Study in the Posterior Mandible

This study evaluates 3-year success rates of titanium screw-type implants with a chemically modified sandblasted and acid-etched surface (mod SLA), which were functionally loaded after 3 weeks of healing. A total of 56 implants, inserted in the posterior mandibles of 39 partially edentulous patients, underwent undisturbed healing for 3 weeks. At day 21, the implants were fully loaded with provisional crowns. Definitive metal ceramic restorations were fabricated after 6 months of healing. Clinical measurements regarding soft tissue parameters and radiographs were obtained at different time points up to 36 months after implant placement. The soft tissue and radiographic parameters for the mod SLA implants after 3 years in function were compared to a historic control group of implants with an SLA surface using an early loading protocol after 6 weeks. None of the implants failed to integrate. However, two implants were considered "spinners" at day 21 and were left unloaded for an extended period. Therefore, 96.4% of the inserted implants were loaded according to the protocol tested. All 56 implants, including the "spinners," showed favorable clinical and radiographic findings at the 3-year follow-up examination. All 56 implants were considered successfully integrated, resulting in a 3-year survival and success rate of 100%. Dental implants with a mod SLA surface demonstrated statistically significant differences for probing depths and clinical attachment level values compared to the historic control group, with the mod SLA surface implants having overall lower probing depths and clinical attachment level scores. This prospective study using an early loading protocol demonstrates that titanium implants with the mod SLA surface can achieve and maintain successful tissue integration over a period of 3 years.

Single‐Tooth Implant Placement and Loading in Fresh and Regenerated Extraction Sockets. Five‐Year Results: A Case Series Using Two Different Implant Designs

Implant-supported restorations are a commonly used treatment modality. However, insufficient data are available that compare treatment outcomes of implant restorations using different protocols. Similarly, data comparing the treatment outcomes of different implant designs are limited. This retrospective, non-randomized study evaluates 241 single implants in 241 patients (127 males and 114 females; mean age: 49.3 years; range: 45 to 75 years). Tapered-type (TAP; n = 118) and cylindric screw-type (CYL; n = 123) implants were used. Implants were grouped into the treatment categories of immediate placement, delayed placement, immediate non-occlusal loading, and delayed loading. Clinical parameters, including clinical attachment level (CAL), plaque index (PI), and bleeding on probing (BOP), were recorded at examinations at baseline (BSL) and 1 (E1), 3 (E3), and 5 years (E5) after loading with the final restoration. Eleven implants were lost (five CYL and six TAP). CAL and PI outcomes were similar for both implant types. No significant influence of implant position was found. A CAL loss of 1.5 mm was observed during the first 3 years. The type of implant and timing of placement showed no significant influence on the survival rate, whereas the failure rate was lower for immediate non-occlusal loaded implants. The type of implant, position, and timing of placement and loading did not influence the survival rate of this treatment method.

Influence of maxillary cortical bone thickness, implant design and implant diameter on stress around implants: A three-dimensional finite element analysis

There is no clear evidence of the factors that could improve implant biomechanics in the posterior maxilla. Thus, a finite element analysis was performed to investigate the effect of maxillary cortical bone thickness, implant design and diameter on stress around implants. A total of 12 models of the posterior maxilla with implant were computer-simulated by varying the thickness of the alveolar cortical bone (1.5, 1.0, 0.5 or 0 mm) and implant characteristics (cylindrical implant of 4.1-mm diameter, screw-type implants of 4.1-mm or 4.8-mm outer diameters). On top of each implant, forces were separately applied axially (100 N) and buccolingually (50 N), and the von Mises stresses were calculated. Regardless of load direction, implant design and diameter, cortical and cancellous bone stresses increased with the decrease of crestal cortical bone thickness. In the absence of crestal cortical bone, cancellous bone stresses were highest and, under axial load, were transferred to the sinus floor. Implant design and diameter influenced stress to a less extent, especially under buccolingual load and in the presence of crestal cortical bone. From a biomechanical viewpoint, to improve implant success odds in the posterior maxilla, rather than implant selection, careful preoperative evaluation of the cortical bone at the planned implant site is recommended. If this cortical bone is very thin or even lacking, implant treatment should be carried on with caution by progressive loading in the range of functional loads.

Early loading of implants with fixed dental prostheses in edentulous mandibles: 4.5‐year clinical results from a prospective study

The purpose of this study was to evaluate the survival and success of early-loaded implants placed in the intraforaminal area of the edentulous mandible, and the survival of the implant-supported fixed dental prostheses (FDP). Thirty-seven patients (18.9% male, mean age 64.5 years) with edentulous lower jaws were treated with implant-supported FDPs in the mandible. One hundred and eighty-five screw-type implants were placed in the intraforaminal area of the symphysis (five implants per patient). Immediately after implant placement, a framework was fabricated and the FDP was manufactured on the framework. Within 2 weeks, the implants were rigidly connected and loaded with the implant-retained FDP. During the 1-8-year observation period (mean 4.5 years), a total of 32 implant-retained complications occurred. Nineteen implants were lost in 10 patients, resulting in a cumulative survival of 89.7%. Nine implants in five patients did not osseointegrate. Although these implants were not removed, because stability within the connective tissue was acceptable and inflammation was absent, they were recorded as unsuccessful. Consequently, the cumulative success declined to 84.9%. Four implants in three patients had clinical signs of periimplantitis (2.2% of all implants). Denture-related complications included one complete failure, when one FDP had to be removed after the last of five implants had been replaced. Furthermore, 10 fractures of the framework occurred in six patients, three FDPs had to be adapted or modified, and the facing of the FDP had to be repaired 16 times in 11 patients. Although one-stage early-loaded implants functioned well for most patients with edentulous mandibles, immediate loading is associated with a larger number of implant-related complications than in other studies investigating delayed loading. Because of the substantial prosthetic complications and aftercare, this procedure cannot be generally recommended.

Which device is more accurate to determine the stability/mobility of dental implants? A human cadaver study

Non-invasive devices including resonance frequency (RF) analysis and mobility measuring (MM) damping capacity assessment are used to measure implant stability/mobility. The aims of the study were to compare the primary stability of implant inserted into extraction sockets by using RF with cable, RF wireless and new wireless MM device, to clarify the relation between these devices and to understand the correlations between peri-implant bone levels and implant stability. A total of 30 screw-type implants (3.75 x 11 and 4.2 x 11 mm) were inserted into extraction sockets of eight mandibular pre-molar regions of human cadavers. The primary stability of implants was measured by three devices after insertion. Peri-implant vertical defects were created in millimetre increments ranging between 0 and 5 mm, and stability/mobility of implants were analysed. At placement, the mean implant stability quotient of RF with cable, RF wireless and MM device values was 46 +/- 1, 57.8 +/- 9 and -5.4 +/- 1, respectively. Statistical correlations were demonstrated between these devices (P = 0.001). Statistically significant differences were presented for all peri-implant detects ranging between 0 and 5 mm for RF with cable and RF wireless at all increments. However, only a significant decrease was found between 0 and 1 mm defects, and 4 and 5 mm defects in MM device. Although RF with cable and RF wireless seem to be suitable to detect peri-implant bone loss around implants in 1 mm increments, the new MM device may not be suitable to detect the 1 mm peri-implant bone changes in human dried cadaver mandibles.

In vivo bone response and mechanical evaluation of electrosprayed CaP nanoparticle coatings using the iliac crest of goats as an implantation model

Recent trends in clinical implantology include the use of endosseous dental implant surfaces embellished with nano-sized modifications. The current study was initiated to evaluate the mechanical properties, as well as the potential beneficial effects, of electrosprayed CaP nanoparticle-coated (nano-CaP) implants on the in vivo osteogenic response, compared with grit-blasted, acid-etched (GAE) implant surfaces as controls. For this purpose nano-CaP coatings were deposited on cylindrical screw-type (St) implants and implanted bilaterally into the iliac crest of goats for 6 weeks. In addition to histological and histomorphometrical analyses, insertion torque and removal torque values were measured on implant placement and retrieval, respectively. The present study showed similar insertion and removal torque values for nano-CaP-coated and GAE control implants, with no statistically significant increase in torque value during the implant period for either group. With regard to bone–implant contact and peri-implant bone volume, no significant differences were found between nano-CaP-coated and GAE implants after 6 weeks implantation. In conclusion, this study has demonstrated that in situations in which implants are placed in a non-compromised situation using a standard press fit implantation strategy the performance of electrosprayed nano-CaP coatings is comparable with GAE implants, both with respect to implant fixation and bone healing response.

Early Loading of Nonsubmerged Titanium Implants with a Chemically Modified Sand‐Blasted and Acid‐Etched Surface: 6‐Month Results of a Prospective Case Series Study in the Posterior Mandible Focusing on Peri‐Implant Crestal Bone Changes and Implant Stability Quotient (ISQ) Values

The aim of this prospective case series study was to evaluate the short-term success rates of titanium screw-type implants with a chemically modified sand-blasted and acid-etched (mod SLA) surface after 3 weeks of healing. A total of 56 implants were inserted in the posterior mandible of 40 partially edentulous patients exhibiting bone densities of class I to III. After a healing period of 3 weeks, all implants were functionally loaded with a screw-retained crown or fixed dental prosthesis. The patients were recalled at weeks 4, 7, 12, and 26 for monitoring and assessment of clinical and radiological parameters, including implant stability quotient (ISQ) measurements. None of the implants failed to integrate. However, two implants were considered "spinners" at day 21 and left unloaded for an extended period. Therefore, 96.4% of the inserted implants were loaded according to the protocol tested. All 56 implants including the "spinners" showed favorable clinical and radiographic findings at the 6-month follow-up examination. The ISQ values increased steadily throughout the follow-up period. At the time of implant placement, the range of ISQ values exhibited a mean of 74.33, and by week 26, a mean value of 83.82 was recorded. Based on strict criteria, all 56 implants were considered successfully integrated, resulting in a 6-month survival and success rate of 100.0%. This prospective study using an early-loading protocol after 3 weeks of healing demonstrated that titanium implants with the modified SLA surface can achieve and maintain successful tissue integration over a period of at least 6 months. The ISQ method seems feasible to monitor implant stability during the initial wound-healing period.