Soft Bone Quality Research Articles

Implants with an Oxidized Surface Placed Predominately in Soft Bone Quality and Subjected to Immediate Occlusal Loading: Results from an 11-Year Clinical Follow-Up.

The purpose of this clinical follow-up was to document the 11-year outcome of implants with a moderately rough oxidized surface subjected to immediate occlusal loading. Twenty-six of 38 patients enrolled in a 5-year prospective study were available for this follow-up analysis, with 33 restorations supported by 66 slightly tapered implants (Brånemark System MkIV, Nobel Biocare, Gothenburg, Sweden). The majority of implants were placed in posterior regions (88%) and into soft bone (76%). Parameters included cumulative survival rate (CSR), radiographic marginal bone level, bleeding on probing (BOP), intrasulcular counts of perio-pathogenic markers (DNA probes), and total bacterial load (TBL). The CSR was 97.1% at 11.2 years mean follow-up. Mean marginal bone remodeling was 0.47 mm (SD 1.09, n = 65) from 1 year postplacement to 11-year follow-up. BOP was absent at most sites (63.6%). No statistically significant differences in TBL or perio-pathogenic marker species were observed at implants and teeth. The results of the present follow-up show high long-term survival, stable marginal bone levels, and soft tissue outcomes of oxidized surface implants placed predominately in posterior regions and soft bone. The quantity and quality of intrasulcular microbiota were comparable at implants and teeth.

Implants with an Oxidized Surface Placed Predominately in Soft Bone Quality and Subjected to Immediate Occlusal Loading: Results from a 7‐Year Clinical Follow‐Up

The purpose of this clinical follow-up was to document the 7-year outcome of immediately loaded implants exhibiting an oxidized surface. Thirty-eight patients received a total of 51 implant-supported fixed prostheses. The restorations were supported by 102 implants, the majority of which were placed in posterior regions (88%) and primarily in soft bone quality (76%). Radiographic examinations were performed at prosthesis insertion, at 1- and 6-month follow-ups, and annually at the 1- through 5-year follow-up visits. Marginal peri-implant soft tissue evaluations were conducted at all these follow-ups. This report presents the results after at least 7 years of loading. After 7 years of prosthetic loading, the cumulative implant survival rate was 97.1% and the mean marginal bone remodeling was -1.51 mm (SD 1.00, n = 73) with significantly more initial remodeling at sites having received marginal guided bone regeneration procedures. A low rate of biological and technical complications was detected after 7 years of function. The quantification of intrasulcular plaque sampling showed no significant difference between teeth and implants. The 7-year follow-up data indicate that the introduced immediate loading protocol is a successful treatment alternative also including regions exhibiting soft bone conditions.

Five-year results of implants with an oxidized surface placed predominantly in soft quality bone and subjected to immediate occlusal loading

Numerous studies have demonstrated the feasibility and predictability of immediate implant loading or immediate implant restoration. However, most of these studies report primarily short-term outcomes. The purpose of this prospective clinical study was to document the 5-year outcome of immediate occlusally loaded implants with an oxidized, microtextured surface placed to support fixed prostheses in various regions of the jaws. Thirty-eight patients received a total of 51 implant-supported fixed prostheses, 29 mandibular and 22 maxillary, the day of implant insertion. Thirty were fixed partial dentures (FPDs), 20 replaced single teeth, and 1 was a fixed mandibular complete denture. The restorations were supported by 102 slightly tapered, screw-type implants, the majority of which were placed in posterior regions (88%) and primarily in soft bone quality (76%). Patients with ongoing signs of parafunctional habits were not included. All implants were placed using conventional flap procedures. Treatment with local regenerative procedures in connection with implant placement was accepted within the study design. Resonance frequency implant stability measurements and marginal periimplant soft tissue evaluations were conducted. Radiographic examinations were performed at the time of prosthesis insertion, at 1-and 6-month follow-ups, and annually at the 1- through 5-year follow-up visits. This report presents the results after 5 years of loading, summarized with descriptive statistics. Three maxillary implants were removed, although stable, in 1 patient at the 8-week follow-up due to postoperative infection in the adjacent guided bone regeneration (GBR) area. No additional implants were lost. This resulted in a cumulative implant success rate of 97.1% after 5 years of prosthetic loading. The mean marginal bone remodeling (SD) after 5 years of function was 1.54 (0.99) mm. At the 5-year examination, absence of marginal plaque and absence of bleeding on probing was reported for 75% and 74% of the sites, respectively, and remained generally unchanged from the 1-month follow-up. The 5-year follow-up data indicate that an immediate loading protocol using a slightly tapered implant design with an oxidized, microtextured surface is a successful treatment alternative in regions exhibiting soft bone quality.

The effect of posterior instrumentation following PLIF with BAK cages is most pronounced in weak bone.

The use of BAK-cages for lumbar fusion has become very popular but complications such as cage subsidence and settling occurred. To treat these complications posterior instrumentation was used to improve segmental stability. It is, however, poorly understood, why some patients require additional posterior instrumentation, whereas the majority do not. The objectives of the study presented were first to determine the influence of bone mineral density (BMD) to the initial compressive stiffness of a segment that underwent posterior lumbar interbody fusion (PLIF) with two BAK-cages. Second, to estimate the importance of additional posterior instrumentation for compressive stiffness with respect to bone mineral density. A validated finite element model (FEM) including posterior decompression and stabilisation by two BAK-cages (BAK_FEM) was used to predict the initial compression stiffness in axial loading of 600 N. This model was used to predict the influence of various grades of BMD on compression stiffness. A second FEM was generated in which additional posterior screw-rod instrumentation was simulated (BAK+PI_FEM) and this model used to predict the influence of BMD in axial loading. The responses of all FEM suggested that initial compressive stiffness will increase if there is an increase of BMD. The stiffness as predicted by BAK+PI_FEM was always superior to FEM_BAK. This difference was most pronounced for weak bone quality. Compression stiffness following PLIF with BAK-cages depends on BMD. Additional posterior instrumentation results in an additional increase of compression stiffness. This effect is most pronounced in simulated soft bone quality. These results may help to select patients for combined stabilisation.