Years Of Prosthetic Loading Research Articles

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.

Immediate Occlusal Loading of Brånemark System® TiUnite™ Implants Placed Predominantly in Soft Bone: 4‐Year Results of a Prospective Clinical Study

Immediate occlusal implant loading has been documented as a viable treatment option for various indications. However, most of the available studies reported on the short-term outcome of this treatment modality. The purpose of this prospective clinical study was to document, on a long-term basis, the outcome of immediate occlusally loaded Brånemark System Mk IV TiUnite (Nobel Biocare AB, Göteborg, Sweden) implants placed to support fixed reconstructions in various regions of the jaws. Thirty-eight patients received a total of 51 fixed prosthetic reconstructions, all of which were connected on the day of implant insertion. Twenty restorations replaced single teeth, 30 were fixed partial dentures, and 1 was a full-arch fixed lower restoration. These prostheses were supported by 102 Brånemark System Mk IV TiUnite implants (38 maxillary and 64 mandibular), the majority of which were placed in posterior regions (88%) and mainly in soft bone (76%). Resonance frequency measurements and marginal periimplant soft tissue evaluations were conducted during the course of the study. Furthermore, radiographic examinations were performed at the time of prosthesis delivery and at the 1- and 6-month and 1-, 2-, 3-, and 4-year follow-up visits. This report summarizes the results after 4 years of loading. Three maxillary implants were removed, although stable, in one patient at the 8-week follow-up owing to postoperative infection in the adjacent guided bone regeneration area. No implants were lost further on. This resulted in a cumulative implant success rate of 97.1% after 4 years of prosthetic loading. The mean marginal bone remodeling after 4 years of function was 1.3 +/- SD 0.9 mm. At 4 years, absence of marginal plaque and bleeding on probing was reported for 87% and 69% of the sites, respectively, thereby remaining unchanged since the 1-year follow-up. On average, the interproximal soft tissue fill increased for both mesial and distal papillae from scores of 1.4 +/- 1.1 and 1.0 +/- 1.1, respectively, at the preoperative assessment to 2.0 +/- 0.8 and 1.7 +/- 0.8, respectively, at the 4-year assessment. The applied immediate loading protocol, in combination with a slightly tapered implant design and a modified implant surface texture, was shown to be a successful treatment alternative in regions exhibiting soft bone.

Maxillary sinus reconstruction with calvarium bone grafts and endosseous implants

Purpose The objectives of this study were 1) to evaluate the survival rate for implants placed in maxillary sinuses augmented with autogenous calvarium bone graft and 2) to evaluate the feasibility, complications, and morbidity of this technique as well as patient satisfaction. Patients and methods Seventy-nine maxillary sinuses in 58 patients were reconstructed with calvarium grafts between 1992 and 2002 with more than 1 year of prosthetic loading. Two hundred twenty-three implants were placed 3 to 11 months after grafting. Bone levels were measured preoperatively after grafting and 1 year after prosthetic loading. Results Successful healing was observed in 77 sinuses (97.4%), and 2 patients (2.6%) showed dehiscence and graft loss. All implants integrated; 211 (94.6%) were used for fixed restorations and 12 implants (5.4%) were used in 2 patients for overdentures (6 implants each). The fixed prosthesis survival rate was 100% after 1 year of loading and remained successful in all cases during the follow-up. At the second stage of surgery, crestal bone loss was measured with a caliper. No crestal bone loss was observed in 210 implants (94%). However, in 13 implants (6%), a crestal bone loss between 1.5 and 2.5 mm was observed, but no further bone loss occurred during the follow-up, as shown on panoramic radiography. Panoramic radiograph measurements showed a total bone height (alveolar bone plus grafted bone) of more than 15 mm in all sinuses and of more than 20 mm in 25 sinuses (32.4%) with a mean of 18 mm. Bone levels were maintained during the follow-up. Conclusions 1) Calvarium provides graft material of excellent quality and quantity. 2) Satisfactory results can be obtained with implants placed after sinus augmentation with calvarium bone graft as shown in this study with no implant failure. Bone levels, implants, and bridge survival were maintained during the follow-up.

Long‐term evaluation of osseointegrated implants inserted at the time or after vertical ridge augmentation

The purpose of the present study was to evaluate retrospectively, after 1 to 5 years of prosthetic loading, 123 implants consecutively inserted at the time of vertical ridge augmentation in 4 clinics. At the time of the implant surgery, 3 different techniques were used: the implants were allowed to protrude 2 to 7 mm from the bone level and a titanium reinforced expanded-polytetrafluoroethylene (e-PTFE) membrane was positioned to protect either the blood clot (Group A, 6 patients), or an allograft (Group B, 11 patients), or an autograft (Group C, 32 patients). The annual implant evaluation was carried out according to a standard protocol utilized for long term studies with endosseous implants inserted in non-regenerated bone. Only 1 implant failed immediately after the second stage surgery and after 1 month it was substituted with a new implant. All the remaining implants appeared clinically stable, no signs of radiolucency were present at the bone-implant interface, therefore, they could be defined successfully osseointegrated. The radiographic analysis showed stable bone crest levels with a mean bone loss of 1.35 mm for the Group A, of 1.87 mm for the Group B and of 1.71 for the Group C during the period of observation. Only 2 implants demonstrated an increased crestal bone loss of 3.5 mm and 4 mm respectively at the first year examination. On the base of these results, we can confirm previous long term studies on regenerated bone and we can conclude that vertically augmented bone with GBR techniques responds to implant placement like native, non-regenerated bone.

A bone quality-based implant system: first year of prosthetic loading.

This interim report presents the data from a prospective study of BioHorizons, a bone quality-based implant system, with four implant designs. The surgical survival of 975 implants was 99.4%, with the survival 100% for D4 bone. Three critical phases of crestal bone loss have been identified: bone remodeling from stage I to stage II surgery; stage II uncovery to prosthesis delivery (transition period); and prosthesis delivery up to the first year of loading (early loading bone loss). The stage I to stage II uncovery crestal bone remodeling resulted in a mean vertical bone loss of 0.21 mm to 0.36 mm (SD = 0.90 mm), dependent on whether the implant became exposed in the oral cavity during osseous healing. No statistically significant difference was found among the four implant designs, diameter, bone density, or location. The stage II to prosthesis delivery mean vertical bone loss ranged from 0.12 mm to 0.20 mm. One hundred three consecutive patients (partially and totally edentulous) were restored, with 360 implants and 105 prostheses in function for a period of 12 to 26 months. No early loading implant failure occurred, and all patients with implants are in satisfactory to optimum health according to the Misch Implant Quality Scale. The mean early loading bone loss was 0.29 mm (SD = 0.99 mm). Past clinical reports in the literature indicate most failures or crestal bone loss occur by the first year of loading. This study suggests the bone quality based dental implant design minimizes overall implant failure and crestal bone loss, regardless of bone density.

GBR with an e-PTFE membrane associated with DFDBA

As a result of a fracture to the cemented post and core, a pure titanium implant was extracted from a 54-year-old patient after 4 years of clinical loading. At implantation, the implant was positioned into an extraction socket and the defect was treated with an e-PTFE membrane associated with a DFDBA graft. At retrieval the implant underwent histologic and histochemical examination to assess the characteristics of the regenerated bone after 4 years of prosthetic loading. The implant showed an angular bony defect at the smooth collar, but the bone-implant direct contact rate seemed to be elevated in the remaining implant surface. Normal transmitted and polarized light examinations demonstrated that most of the DFDBA particles were resorbed and substituted by vital newly formed bone. The regenerated bone appeared compact with secondary osteons and large haversian canals; however, some partially mineralized remnants residuated in the spaces, between the osteons. Within the limits of this study, the authors concluded that DFDBA can be substituted by the host bone, but the rate of substitution is very slow and not complete after 4 years. From a clinical point of view, however, the load-bearing capacity of the bone regenerated with the membrane technique associated with DFDBA appeared to be similar to that of normal bone.