Types Of Dental Implants Research Articles

Short-term clinical success of root-form titanium implant systems

Original review Esposito M, Coulthard P, Worthington HV, Jokstad A, Wennerberg A. Interventions for replacing missing teeth: Different types of dental implants (Cochrane Review). In: The Cochrane Library, Issue 1, 2003. Oxford: Update Software. Date of most recent amendment: 9 July 2002. Level of evidence 1a Purpose To test the null hypothesis that there was no difference in clinical performance between various root-formed osseointegrated implant types Source of funding Industry support for most included studies Type of study/design Systematic review

Interventions for replacing missing teeth: different types of dental implants.

Dental implants are available in different materials, shapes and with different surface characteristics. In particular, numerous implant surface modifications have been developed for enhancing clinical performances. To test the null hypothesis of no difference in clinical performance between various root-formed osseointegrated dental implant types. We searched the Cochrane Oral Health Group's Trials Register, The Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE. Handsearching included several dental journals. We checked the bibliographies of relevant clinical trials and review articles for studies outside the handsearched journals. Two extensive personal libraries were consulted. We wrote to authors of the identified randomised controlled trials (RCTs), to more than 55 oral implant manufacturers; we used personal contacts and we asked on an internet discussion group in an attempt to identify unpublished or ongoing RCTs. No language restriction was applied. The last electronic search was conducted 21st March 2003. All RCTs of oral implants comparing osseintegrated implants with different materials, shapes and surface properties having a follow up of at least 1 year. We carried out a quality assessment of the included RCTs and contacted the authors for missing information. We independently extracted the data in duplicate. We followed the Cochrane Oral Health Group's statistical guidelines. Twenty-five different RCTs were identified. Ten of these RCTs, reporting results from a total of 428 patients, were suitable for inclusion in the review. Nine different implant types were compared with a follow up ranging from 1 to 3 years. All implants were made in commercially pure titanium and had different shapes and surface preparations. On a patient rather than per implant basis there were no statistically significant differences for failures, marginal bone level changes on intraoral radiographs and peri-implantitis between various implant systems. There was no evidence that any of the implant systems evaluated was superior to the other. However, these findings are based on a few RCTs all having short follow-up periods and few participants. More RCTs should be conducted, with follow up of at least 5 years and including a sufficient number of patients to detect a true difference if any exists. Such trials should be reported according to the CONSORT guidelines (http://www.consort-statement.org/).

Histomorphometric comparison of implant anchorage for two types of dental implants after 3 and 6 months' healing in baboon jaws

Statement of Problem. A complete understanding of dental implant prognosis requires better knowledge of the bone anatomy after implant healing. Such baseline data are necessary to compare against load-induced changes in anatomy. Purpose. The purpose of this article is to describe and compare measures of implant support (percentage [%] integration and percentage [%] bone area) for various implants in baboon jaws after healing times of 3 and 6 months. Material and Methods. Commercially pure titanium (cpTi) and titanium alloy (Ti-alloy) screw-shaped implants were placed in the posterior jaws of 9 female baboons after 2 months of postextraction healing. Specimens were harvested after 3 months (5 baboons: 8 cpTi, 7 Ti-alloy) and after 6 months (4 baboons: 8 cpTi, 8 Ti-alloy). Each implant provided 6 polished horizontal sections for data collection, which was accomplished from digitized images with the IMAGE analysis system (reliability at 1.6%). Three- and six-month data for each parameter were compared with the use of ANOVA (P<.01). Results. The results revealed a significant increase in the % integration (cpTi 39.1 to 56.2; Ti-alloy 40.0 to 55.2) and the % bone area (cpTi 38.8 to 47.9; Ti-alloy 38.9 to 49.2) from 3 to 6 months for both implants. This significant increase was also true for comparisons by jaw for each implant material (P<.01 for overall and by jaw comparisons). Conclusion. A time-dependent increase in jawbone anchorage was measured in this nonhuman primate population, and it was shown that the 6-month maxillary data were comparable to the 3-month mandibular data. These results lend support to the clinical strategy of waiting longer to load implants in the maxilla. (J Prosthet Dent 2001;85:276-80.)

Use of alendronate in peri-implant defect regeneration.

Previous studies have demonstrated an increase in bone mass and density with use of systemic alendronate sodium. This agent acts as an inhibitor of osteoclast activity, and is thought to result in more net osteoblastic activity. The objective of this study was to determine the effects of locally applied alendronate sodium on guided bone regeneration around dental implants. Six adult mongrel dogs were divided into 2 groups: one group received alendronate-coated dental implants, and the other group served as control. Two types of dental implants were used in each dog: hydroxyapatite (HA)-coated and titanium machine-polished (TMP), for a total of 4 groups. Dental implants were placed immediately after extraction of the right and left second, third, and fourth mandibular premolars; a resorbable collagen membrane was secured over the implants and defects; and the flaps were closed primarily. Fluorescent labels were administered intravenously on days 0, 6, 12, and 22 to measure bone formation rate. Dogs were sacrificed on day 28. The specimens were sectioned and mounted, and bone formation rate was recorded with a computerized microscopic digitizer. Specimens were stained with Stevenel's blue and van Gieson's picric fuchsin. Bone-to-implant contact was recorded with a computerized microscopic digitizer. The results indicated a significant effect of locally applied alendronate (P < 0.0001) with both types of implants (HA and TMP), as well as the HA coating (P< 0.02) on increased bone formation rate. Additionally, alendronate had a significant effect on bone-to-implant contact, with an increase in the TMP model (P < 0.0001) and a decrease in the HA model (P < 0.0001 ). HA coating also had a significant effect on increasing bone-to-implant contact (P < 0.04). The results indicate that alendronate increases early bone formation rate around dental implants. Additionally, the local application as described resulted in greater bone-to-implant contact with TMP implants.

TREATMENT PLANNING OF THE ELDERLY IMPLANT PATIENT

The prevalence of partial and complete edentulism in the older adult patient and the predictability of specific types of dental implants obligates the dental health professional to consider the fabrication of implant-related prostheses as an alternative treatment option. Special emphasis is placed in this article on the provision of clip-bat overdentures in the treatment of the fully edentulous patient and their relative advantages compared to a fixed-hybrid prosthesis.

Predoctoral implant dentistry programs in US dental schools.

Surveys of US dental schools over the last 20 years have reported a continual increase in the number and types of predoctoral and postdoctoral implant dentistry programs being taught. The purpose of the following article is to report on the results of a survey intended to update the status of predoctorl programs with respect to their curricular placement, departmental jurisdictions, and course contents. In June 1993, 54 US dental schools received the implant dentistry curriculum survey, and 50 of the schools (93%) returned responses. Results indicate that the trend toward implementation of more predoctoral implant dentistry programs has been sustained, with 86% of schools reporting the existence of implant curricula. This compares with 33% and 73% of US schools having such programs in 1974 and 1989, respectively. The major reasons that schools gave for not having implant dentistry courses for predoctoral students are a lack of curriculum time and scarce financial resources. The dental disciplines most frequently guiding such programs are oral surgery and periodontics. Schools offer varying degrees of lectures, laboratories, and clinical experiences in predoctoral implant dentistry, with the number of curriculum hours peaking in years three and four. General curricular topics most commonly include a historical overview of implant dentistry, diagnosis and treatment planning, classifications and types of dental implants, and surgical and prosthodontic procedures. Seventeen percent of schools require some form of undergraduate clinical implant dentistry exposure for all of their students.

Primary Placement of Osseointegrated Implants in Microvascular Mandibular Reconstruction

The goal of mandibular reconstruction is to rehabilitate the patient by restoring occlusal relationships, lower facial contour, oral continence, and a denture-bearing surface. One of the major advantages of the use of vascularized bone over all other methods of mandibular reconstruction is its ability to achieve dental rehabilitation rapidly. The use of osseointegrated dental implants is a valuable adjunct in oral rehabilitation. It provides the most rigid form of stabilization to withstand the forces of mastication. In situations in which soft tissue reconstruction or the height of the alveolar ridge is not sufficient for a tissue-borne denture, implants offer the most suitable alternative. Mandibular reconstruction with free tissue transfer techniques is ideally suited for the placement of implants. These can be inserted at the time of mandibular reconstruction. Four months after surgery, when the integration process has occurred, the implants are unroofed, loaded, and ready for prosthetic placement. We will present several representative patients who underwent mandibular reconstruction with microvascular free bone transfer who have been successfully rehabilitated by osseointegrated implants. The process of osseointegration, different types of dental implants, and issues regarding radiation and implants are discussed. This is the first report of dental rehabilitation by primary placement of dental implants in patients undergoing microvascular mandibular reconstruction.

Current implant usage

The types of dental implants in current use are described with comments on the various designs, the materials of which the implants are made, the patient situations for which they are used, and the age range of patients treated. The training background of the various clinicians involved is mentioned and comparisons are made between the United States, Japan and Central Europe. Predictions for the future use of implants are made and areas for future research are indicated, based upon deficiencies in our present knowledge.

Soft tissue response to endosseous titanium oral implants

T he use of titanium for oral implants is rapidly gaining acceptance by the dental comniunity. The clinical success of titanium implants over long periods of time has been reported.‘, 2 Although there is impressive evidence in favor of titanium as the material of choice for certain types of dental implants, continued research is necessary to scientifically support the clinical results. This article reviews the nature of the soft tissue response to titanium implants.

An analysis of stresses in a dental implant system

Successful replacement for missing teeth is one of the most complex problems facing the dental profession. Although many different types of dental implants are now available, their performance in restoring masticatory function is still limited and the subject of much controversy. Finite element stress analysis (FESA) has been used in the evaluation of existing dental implant design and offers the potential of evaluating and improving implant design without the risk and expense of implantation. A two-dimensional FESA was performed to study the effects that methods for trabecular bone representation and surgical positioning of the implant have on stresses around LTI carbon and aluminum oxide (Al 2O 3) dental implants. The results of this study have shown that modeling of individual cancellous bone trabeculae and modeling cancellous bone as a homogeneous material resulted in similar stress distributions; however, significant differences in stress magnitudes were observed. It was also observed that placement of the implant strongly influenced the state of stress in tissues surrounding it.