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Kadkhodazadeh M, Amid R, Moscowchi A, Lakmazaheri E. Short-term and long-term success and survival rates of implants supporting single-unit and multiunit fixed prostheses: A systematic review and meta-analysis. J Prosthet Dent 2023:S0022-3913(23)00008-2. [PMID: 36781339 DOI: 10.1016/j.prosdent.2022.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 12/29/2022] [Accepted: 12/29/2022] [Indexed: 02/13/2023]
Abstract
STATEMENT OF PROBLEM Whether placing implants to replace each missing tooth or using implant-supported fixed partial dentures provides better outcomes is unclear. PURPOSE The purpose of this systematic review and meta-analysis was to assess the success and survival rates of implants supporting single-unit and multiunit fixed prostheses by using conventional protocols for placement and loading in short- and long-term follow-ups. MATERIAL AND METHODS An electronic search was conducted in PubMed, Scopus, and Web of Science for studies published up to March 17, 2022. Comparative studies that reported the success or survival rates of both single-unit and splinted multiunit prostheses were considered for qualitative and quantitative analyses. RESULTS A total of 68 publications comprising 11 271 implants were included. Compared with the single prostheses, the splinted multiunit group showed no significant differences in implant success rates in the short-term (risk difference=-0.004; 95% confidence interval (CI)=-0.033 to 0.025; P=.780) and long-term (risk difference=0.003; 95% confidence interval (CI)=-0.029 to 0.034; P=.874) follow-ups. Significant statistical differences were also not found in terms of the survival rates of the 2 groups (short-term risk difference=-0.004; 95% CI=-0.031 to 0.023; P=.779, long-term risk difference=-0.002; 95% CI=-0.029 to 0.025; P=.887). CONCLUSIONS Implants supporting single-unit or splinted multiunit prostheses seem to be a predictable treatment in terms of survival and success over short and long periods. Nonetheless, it seems that cantilever and nonsplinted multiunit prostheses should be used with more caution.
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Affiliation(s)
- Mahdi Kadkhodazadeh
- Professor, Research Institute for Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Professor, Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Amid
- Associate Professor, Research Institute for Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Associate Professor, Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Anahita Moscowchi
- Assistant Professor, Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ehsan Lakmazaheri
- Undergraduate student, Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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2
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Coli P, Jemt T. On marginal bone level changes around dental implants. Clin Implant Dent Relat Res 2021; 23:159-169. [PMID: 33463007 DOI: 10.1111/cid.12970] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 12/03/2020] [Accepted: 12/17/2020] [Indexed: 01/25/2023]
Abstract
BACKGROUND Peri-implant bone level values have been used as the clinical standard of reference to describe the status of a dental implant, despite the fact that their significance for the long-term survival of the implant has never been properly assessed. PURPOSE To challenge the assumption that the natural course of peri-implant bone loss is the loss of the implant. MATERIALS AND METHODS This article is a narrative review on reasons and interpretations of marginal bone level changes around dental implants. RESULTS AND CONCLUSIONS Different views regarding the pattern and progression of marginal bone loss depending on dental specialties have been identified. However, the present finding of a negative correlation between an increasing cumulative marginal bone loss and a decreasing risk of implant failures over time indicates that peri-implant marginal bone loss does not necessarily represent a condition of disease. Reduction of marginal bone levels may be observed in a majority of patients during follow-up time, with only a minority of those patients losing implants and implant-supported prostheses in the long term. Bone level changes seem often to occur as a consequence of physiological processes and/or as an adaptation to altered external as well as host response factors. Periodical radiological assessments of implant-restorations remain a valid diagnostic tool for the detection of potential implant fractures, loss of osseointegration, screws working loose and for the detection of the few cases with advanced, continuously progressing marginal bone loss during time. The detection of peri-implant marginal bone loss at one time point should not be immediately considered as a sign of ongoing pathology and of an increased risk of future loss of the implant in question.
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Affiliation(s)
- Pierluigi Coli
- Edinburgh Dental Specialists, Edinburgh, UK.,Department of Prosthetic Dentistry/Dental Material Science, The Sahlgrenska Academy at Göteborg University, Gothenburg, Sweden
| | - Torsten Jemt
- Department of Prosthetic Dentistry/Dental Material Science, The Sahlgrenska Academy at Göteborg University, Gothenburg, Sweden.,Brånemark Clinic, Public Dental Health Care Service, Gothenburg, Västra Götaland, Sweden
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3
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Shiel AI, Ayre WN, Blom AW, Hallam KR, Heard PJ, Payton O, Picco L, Mansell JP. Development of a facile fluorophosphonate-functionalised titanium surface for potential orthopaedic applications. J Orthop Translat 2020; 23:140-151. [PMID: 32818135 PMCID: PMC7427324 DOI: 10.1016/j.jot.2020.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/29/2022] Open
Abstract
Background Aseptic loosening of total joint replacements (TJRs) continues to be the main cause of implant failures. The socioeconomic impact of surgical revisions is hugely significant; in the United Kingdom alone, it is estimated that £137 m is spent annually on revision arthroplasties. Enhancing the longevity of titanium implants will help reduce the incidence and overall cost of failed devices. Methods In realising the development of a superior titanium technology, we exploited the natural affinity of titanium for phosphonic acids and developed a facile means of coating the metal with (3S)1-fluoro-3-hydroxy-4-(oleoyloxy)butyl-1-phosphonate (FHBP), a phosphatase-resistant analogue of lysophosphatidic acid (LPA). Importantly LPA and selected LPA analogues like FHBP synergistically cooperate with calcitriol to promote human osteoblast formation and maturation. Results Herein, we provide evidence that simply immersing titanium in aqueous solutions of FHBP afforded a surface that was superior to unmodified metal at enhancing osteoblast maturation. Importantly, FHBP-functionalised titanium remained stable to 2 years of ambient storage, resisted ∼35 kGy of gamma irradiation and survived implantation into a bone substitute (Sawbone™) and irrigation. Conclusion The facile step we have taken to modify titanium and the robustness of the final surface finish are appealing properties that are likely to attract the attention of implant manufacturers in the future. The translational potential of this article We have generated a functionalised titanium (Ti) surface by simply immersing Ti in aqueous solutions of a bioactive lipid. As a facile procedure it will have greater appeal to implant manufacturers compared to onerous and costly developmental processes.
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Affiliation(s)
- Anna I Shiel
- Department of Applied Sciences, University of the West of England, Coldharbour Lane, Bristol, BS16 1QY, UK
| | - Wayne N Ayre
- School of Dentistry, Cardiff University, Cardiff, CF14 4XY, UK
| | - Ashley W Blom
- Musculoskeletal Research Unit, University of Bristol, Southmead, Bristol, BS10 5NB, UK
| | - Keith R Hallam
- University of Bristol, Interface Analysis Centre, HH Wills Physics Laboratory, Tyndall Avenue, Bristol, BS8 1TL, UK
| | - Peter J Heard
- University of Bristol, Interface Analysis Centre, HH Wills Physics Laboratory, Tyndall Avenue, Bristol, BS8 1TL, UK
| | - Oliver Payton
- University of Bristol, Interface Analysis Centre, HH Wills Physics Laboratory, Tyndall Avenue, Bristol, BS8 1TL, UK
| | - Loren Picco
- University of Bristol, Interface Analysis Centre, HH Wills Physics Laboratory, Tyndall Avenue, Bristol, BS8 1TL, UK.,Department of Physics, Virginia Commonwealth University, Richmond, 23284, VA, USA
| | - Jason P Mansell
- Department of Applied Sciences, University of the West of England, Coldharbour Lane, Bristol, BS16 1QY, UK
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4
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Abstract
There are few absolute contraindications to dental implant placement. Relative contraindications include cognitive decline, American Society of Anesthesiology patient status IV or higher categories, or medical conditions that may jeopardize the life or lifespan of the patient. Precautions for placing dental implants should be viewed with respect to the evidence-based exposures that can contribute to risk of failure, including but not limited to local, behavioral, and medical factors. Risk for dental implant failure increases in association with (1) past history of periodontal disease, (2) bruxism, (3) smoking, and (4) radiation therapy.
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Affiliation(s)
- Amritpal S Kullar
- Division of Oral Diagnosis, Oral Medicine, Oral Radiology, MN324 College of Dentistry, University of Kentucky, 800 Rose Street, Lexington, KY 40356-0297, USA
| | - Craig S Miller
- Division of Oral Diagnosis, Oral Medicine, Oral Radiology, MN324 College of Dentistry, University of Kentucky, 800 Rose Street, Lexington, KY 40356-0297, USA.
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5
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Kattimani VS, Kondaka S, Lingamaneni KP. Hydroxyapatite–-Past, Present, and Future in Bone Regeneration. ACTA ACUST UNITED AC 2016. [DOI: 10.4137/btri.s36138] [Citation(s) in RCA: 122] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Hydroxyapatite (HA) is an essential element required for bone regeneration. Different forms of HA have been used for a long time. The essence of bone regeneration always revolves around the healthy underlying bone or it may be the surroundings that give enough strength. HA is well known for bone regeneration through conduction or by acting as a scaffold for filling of defects from ancient times, but emerging trends of osteoinductive property of HA are much promising for new bone regeneration. Emerging technology has made the dreams of clinicians to realize the use of HA in different forms for various regenerative purposes both in vivo and in vitro. The nanostructured calcium apatite plays an important role in the construction of calcified tissues. The nanostructured material has the ability to attach biological molecules such as proteins, which can be used as functional materials in many aspects, and the capability of synthesizing controlled structures of apatite to simulate the basic structure of bone and other calcified tissues. The process of regeneration requires a biomimetic and biocompatible nanostructured novel material. The nanostructured bioceramic particles are of interest in synthetic bone grafts and bone cements both injectable and controlled setting, so that such composites will reinforce the strength of bioceramics. Extensive research is being carried out for bone regeneration using nanotechnology. Artificial bone formation is not far from now. Nanotechnology has made many dreams come true. This paper gives comprehensive insights into the history and evolution with changing trends in the use of HA for various regenerative purposes.
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Affiliation(s)
| | - Sudheer Kondaka
- Department of Prosthodontics, Lenora Institute of Dental Sciences, Rajahmundry, Andhra Pradesh, India
| | - Krishna Prasad Lingamaneni
- Department of Oral and Maxillofacial Surgery, SIBAR Institute of Dental Sciences, Guntur, Andhra Pradesh, India
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6
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van Oirschot BAJA, Bronkhorst EM, van den Beucken JJJP, Meijer GJ, Jansen JA, Junker R. A systematic review on the long-term success of calcium phosphate plasma-spray-coated dental implants. Odontology 2016; 104:347-56. [PMID: 26886570 DOI: 10.1007/s10266-015-0230-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2015] [Accepted: 11/01/2015] [Indexed: 01/29/2023]
Abstract
The objectives of the current review were (1) to systematically appraise, and (2) to evaluate long-term success data of calcium phosphate (CaP) plasma-spray-coated dental implants in clinical trials with at least 5 years of follow-up. To describe the long-term efficacy of functional implants, the outcome variables were (a) percentage annual complication rate (ACR) and (b) cumulative success rate (CSR), as presented in the selected articles. The electronic search yielded 645 titles. On the basis of the inclusion criteria, 8 studies were finally included. The percentage of implants in function after the first year was estimated to be 98.4 % in the maxilla and 99.2 % in the mandible. The estimates of the weighted mean ACR-percentage increased over the years up to 2.6 (SE 0.7) during the fifth year of function for the maxilla and to 9.4 (SE 8.4) for the mandible in the tenth year of function. After 10 years, the mean percentage of successful implants was estimated to be 71.1 % in the maxilla and 72.2 % in the mandible. The estimates seem to confirm the proposed, long-term progressive bone loss pattern of CaP-ceramic-coated dental implants. Within the limits of this meta-analytic approach to the literature, we conclude that: (1) published long-term success data for calcium phosphate plasma-spray-coated dental implants are limited, (2) comparison of the data is difficult due to differences in success criteria among the studies, and (3) long-term CSRs demonstrate very weak evidence for progressive complications around calcium phosphate plasma-spray-coated dental implants.
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Affiliation(s)
- B A J A van Oirschot
- Department of Biomaterials, College of Dental Sciences, Radboudumc, PO Box 9101, 6500 HB, Nijmegen, The Netherlands.
| | - E M Bronkhorst
- Department of Preventive and Curative Dentistry, Radboudumc, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - J J J P van den Beucken
- Department of Biomaterials, College of Dental Sciences, Radboudumc, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - G J Meijer
- Department of Implantology and Periodontology, Radboudumc, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - J A Jansen
- Department of Biomaterials, College of Dental Sciences, Radboudumc, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - R Junker
- Department of Prosthodontics and Biomaterials, Danube Private University, Krems a.d. Donau, Austria
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7
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Sousa V, Mardas N, Farias B, Petrie A, Needleman I, Spratt D, Donos N. A systematic review of implant outcomes in treated periodontitis patients. Clin Oral Implants Res 2015; 27:787-844. [DOI: 10.1111/clr.12684] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2015] [Indexed: 11/26/2022]
Affiliation(s)
- Vanessa Sousa
- Department of Clinical Research; Periodontology Unit; UCL Eastman Dental Institute; London UK
| | - Nikos Mardas
- Centre for Adult Oral Health, Periodontology Unit; QMUL Bart's and The London School of Dentistry and Hospital; London UK
| | - Bruna Farias
- Federal University of Pernambuco; Recife-Pernambuco Brazil
| | - Aviva Petrie
- Biostatistics Unit; UCL Eastman Dental Institute; London UK
| | - Ian Needleman
- Department of Clinical Research; Periodontology Unit; UCL Eastman Dental Institute; London UK
- International Centre for Evidence-Based Oral Health; UCL Eastman Dental Institute; London UK
| | - David Spratt
- Department of Microbial Diseases; UCL Eastman Dental Institute; London UK
| | - Nikolaos Donos
- Department of Clinical Research; Periodontology Unit; UCL Eastman Dental Institute; London UK
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8
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Renvert S, Quirynen M. Risk indicators for peri-implantitis. A narrative review. Clin Oral Implants Res 2015; 26 Suppl 11:15-44. [DOI: 10.1111/clr.12636] [Citation(s) in RCA: 143] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2015] [Indexed: 12/24/2022]
Affiliation(s)
- Stefan Renvert
- Department of Oral Health Sciences; Kristianstad University; Kristianstad Sweden
- School of Dental Sciences; Trinity College; Dublin Ireland
- Blekinge Institute of Technology; Karlskrona Sweden
| | - Marc Quirynen
- Department of Oral Health Sciences; Katholieke Universiteit Leuven; University Hospitals Leuven; Leuven Belgium
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9
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Abstract
Dental professionals are often faced with challenges when formulating a treatment plan for patients presenting with a compromised tooth. A common dilemma involves the decision between tooth retention using endodontic treatment with crown restoration, and extraction and an implant-borne restoration. In this article the authors evaluate the 2 treatment modes, and observe that because outcomes are similar with both treatments, decisions should be based on the patient's informed decision concerning restorability, costs associated with the procedures, esthetics, potential adverse outcomes, and ethical factors.
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Affiliation(s)
- W R Bowles
- Department of Restorative Sciences, University of Minnesota School of Dentistry, 515 Delaware Street SE, Minneapolis, MN 55455, USA.
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10
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Sailer I, Philipp A, Zembic A, Pjetursson BE, Hämmerle CHF, Zwahlen M. A systematic review of the performance of ceramic and metal implant abutments supporting fixed implant reconstructions. Clin Oral Implants Res 2009; 20 Suppl 4:4-31. [DOI: 10.1111/j.1600-0501.2009.01787.x] [Citation(s) in RCA: 216] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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11
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Noda I, Miyaji F, Ando Y, Miyamoto H, Shimazaki T, Yonekura Y, Miyazaki M, Mawatari M, Hotokebuchi T. Development of novel thermal sprayed antibacterial coating and evaluation of release properties of silver ions. J Biomed Mater Res B Appl Biomater 2009; 89:456-465. [PMID: 18937261 DOI: 10.1002/jbm.b.31235] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Several studies have addressed the use of antibacterial coating to reduce implant-associated infections. In this study, novel silver (Ag)-containing calcium-phosphate (CP) coating technology based on the thermal spraying method was developed. The coating's physical and chemical properties, in vitro antibacterial activity, hydroxyapatite (HA)-forming ability, and release of Ag ions were evaluated. An amorphous structure of the coating was confirmed by X-ray diffraction, and Ag residue in the coating was determined by elementary analysis. The coating showed strong antibacterial activity to methicillin-resistant Staphylococcus aureus in fetal bovine serum (FBS) along with HA-forming ability in simulated body fluid. Therefore, it is expected that the coating would confer antibacterial and bone bonding abilities to the implant surface. Time course release testing of Ag ions from the coating on immersion in FBS showed pronounced Ag release for up to 24 h after immersion, with consistent strong antibacterial activity at the early postoperative stage. In repeated testing, the amount of released Ag ions was about 6500 parts per billion (ppb, microg/L) for the first release test, after which it gradually decreased. However, retention of significant release of Ag ions after a sixth repeat implies that Ag release from the coating is slow in FBS.
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Affiliation(s)
- Iwao Noda
- Research Department, Japan Medical Materials Corporation, Osaka 532-0003, Japan
| | - Fumiaki Miyaji
- Research Department, Japan Medical Materials Corporation, Osaka 532-0003, Japan
| | - Yoshiki Ando
- Research Department, Japan Medical Materials Corporation, Osaka 532-0003, Japan.,Department of Pathology and Microbiology, Faculty of Medicine, Saga University, Saga 849-8501, Japan
| | - Hiroshi Miyamoto
- Department of Pathology and Microbiology, Faculty of Medicine, Saga University, Saga 849-8501, Japan
| | - Takafumi Shimazaki
- Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, Saga 849-8501, Japan
| | - Yutaka Yonekura
- Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, Saga 849-8501, Japan
| | - Masaki Miyazaki
- Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, Saga 849-8501, Japan
| | - Masaaki Mawatari
- Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, Saga 849-8501, Japan
| | - Takao Hotokebuchi
- Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, Saga 849-8501, Japan
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12
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Renvert S, Persson GR. Periodontitis as a potential risk factor for peri-implantitis. J Clin Periodontol 2009; 36 Suppl 10:9-14. [DOI: 10.1111/j.1600-051x.2009.01416.x] [Citation(s) in RCA: 183] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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13
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Alexander F, Christian U, Stefan T, Christoph V, Reinhard G, Georg W. Long-term effects of magnetron-sputtered calcium phosphate coating on osseointegration of dental implants in non-human primates. Clin Oral Implants Res 2009; 20:183-8. [DOI: 10.1111/j.1600-0501.2008.01635.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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14
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15
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Iqbal MK, Kim S. A Review of Factors Influencing Treatment Planning Decisions of Single-tooth Implants versus Preserving Natural Teeth with Nonsurgical Endodontic Therapy. J Endod 2008; 34:519-29. [PMID: 18436028 DOI: 10.1016/j.joen.2008.01.002] [Citation(s) in RCA: 100] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2007] [Revised: 01/05/2008] [Accepted: 01/05/2008] [Indexed: 11/26/2022]
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16
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Schliephake H, Scharnweber D. Chemical and biological functionalization of titanium for dental implants. ACTA ACUST UNITED AC 2008. [DOI: 10.1039/b715355b] [Citation(s) in RCA: 100] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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17
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Simon RL. Single implant-supported molar and premolar crowns: a ten-year retrospective clinical report. J Prosthet Dent 2003; 90:517-21. [PMID: 14668750 DOI: 10.1016/j.prosdent.2003.08.025] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Evidence of the successful use of osseointegrated dental implants for the restoration of individual teeth has been reported for anterior teeth more frequently than for posterior teeth. Contiguous implants placed in posterior quadrants are often splinted without clear rationale. This clinical report describes the data collected from the charts of patients provided with implant-supported single crowns in posterior quadrants in a prosthodontic practice in southern California. Forty-nine patients with 126 implants restored with molar or premolar crowns were recalled for examination after periods ranging from 6 months to 10 years. The implant failure rate was 4.6%, with complications of abutment screw loosening (7%) and loss of cement bond (22%). Osseointegrated implants in molar and premolar positions may be restored as single crowns.
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18
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Goodacre CJ, Bernal G, Rungcharassaeng K, Kan JYK. Clinical complications with implants and implant prostheses. J Prosthet Dent 2003; 90:121-32. [PMID: 12886205 DOI: 10.1016/s0022-3913(03)00212-9] [Citation(s) in RCA: 517] [Impact Index Per Article: 24.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The purpose of this article is to identify the types of complications that have been reported in conjunction with endosseous root form implants and associated implant prostheses. A Medline and an extensive hand search were performed on English-language publications beginning in 1981. The searches focused on publications that contained clinical data regarding success/failure/complications. The complications were divided into the following 6 categories: surgical, implant loss, bone loss, peri-implant soft tissue, mechanical, and esthetic/phonetic. The raw data were combined from multiple studies and means calculated to identify trends noted in the incidences of complications. The most common implant complications (those with a greater than a 15% incidence) were loosening of the overdenture retentive mechanism (33%), implant loss in irradiated maxillae (25%), hemorrhage-related complications (24%), resin veneer fracture with fixed partial dentures (22%), implant loss with maxillary overdentures (21%), overdentures needing to be relined (19%), implant loss in type IV bone (16%), and overdenture clip/attachment fracture (16%). It was not possible to calculate an overall complications incidence for implant prostheses because there were not multiple clinical studies that simultaneously evaluated all or most of the categories of complications. Although the implant data had to be obtained from different studies, they do indicate a trend toward a greater incidence of complications with implant prostheses than single crowns, fixed partial dentures, all-ceramic crowns, resin-bonded prostheses, and posts and cores.
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19
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Schliephake H, Scharnweber D, Dard M, Röbetaler S, Sewing A, Hüttmann C. Biological performance of biomimetic calcium phosphate coating of titanium implants in the dog mandible. J Biomed Mater Res A 2003; 64:225-34. [PMID: 12522808 DOI: 10.1002/jbm.a.10363] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The aim of the present study was to analyze the in vivo effect of biomimetic calcium phosphate coating of titanium implants on periimplant bone formation and bone-/implant contact. Five types of implants were used: 1) Ti6Al4V implants with a polished surface; 2) Ti6Al4V implants with collagen coating; 3) Ti6Al4V implants with a mineralized collagen layer; 4) Ti6Al4V implants with sequential coating of hydroxyapatite (HA) and collagen; and 5) Ti6Al4V implants with HA coating only. All implants had square cross sections with an oblique diameter of 4.6 mm and were inserted press fit into trephine burr holes of 4.6 mm in the mandibles of ten beagle dogs. The implants of five animals each were evaluated after a healing period of 1 month and 3 months, respectively, during which time sequential fluorochrome labeling of bone formation had been performed. Bone formation was evaluated by morphometric measurement of the newly formed bone around the implants and the percentage of implant bone contact. After 1 month, there was a significantly higher percentage of mean bone/implant contact in the HA-coated implants compared to those with polished surface and those with the collagen-coated surface. After 3 months, these differences were not present anymore. Bone apposition was significantly higher next to implants with sequential HA/collagen coating compared to polished surfaces and mineralized collagen layer. It is concluded that biomimetic coating of titanium implants with HA has shown the clearest trend to increase bone-implant contact in the early ingrowth period. The addition of collagen to an HA coating layer may hold some promise when used as sequential HA/collagen coating with mineralized collagen as the surface layer.
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Affiliation(s)
- H Schliephake
- Department of Oral and Maxillofacial Surgery, George-Augusta-University, Robert Koch Str. 40 37075, Göttingen, Germany.
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20
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Itoh D, Yoneda S, Kuroda S, Kondo H, Umezawa A, Ohya K, Ohyama T, Kasugai S. Enhancement of osteogenesis on hydroxyapatite surface coated with synthetic peptide (EEEEEEEPRGDT) in vitro. JOURNAL OF BIOMEDICAL MATERIALS RESEARCH 2002; 62:292-8. [PMID: 12209950 DOI: 10.1002/jbm.10338] [Citation(s) in RCA: 96] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Some dental implants are coated with hydroxyapatite (HA), which preferentially binds to bone. Several matrix proteins have an arginine-glycine-aspartic acid (RGD) sequence where cells attach via an integrin receptor. We hypothesized that coating an HA surface with an RGD-containing peptide might enhance the attachment and differentiation of osteoblasts. The HA disks (diameter 34 mm, thickness 1 mm) were treated with a solution (50 mM Tris/HCl and 150 mM NaCl, pH 7.4) containing the peptide EEEEEEEPRGDT, in which the E repetition exerts a high affinity to HA. After washing with phosphate-buffered saline, KUSA/A1 mouse osteoblastic cells were inoculated onto the HA surface and cultured. After 30 min, the number of cells attached to the surface was counted. The DNA content and alkaline phosphatase (ALP) activity were measured after 10 days in culture. Expression of bone matrix proteins was also examined by means of reverse transcriptase-polymerase chain reaction at 7 days; the mineralized area of the culture was also evaluated by staining with Alizarin Red S after 10 days. Treatment with the peptide stimulated cell attachment and increased DNA content and ALP activity. Furthermore, matrix protein expression and mineralized nodule formation were enhanced to a greater extent on the peptide-treated surface than on the nontreated surface. Our results indicate that coating an HA surface with RGD-containing peptide enhances osteoblast attachment and differentiation. This peptide treatment of HA-coated implants may stimulate the osseointegration of the implants.
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Affiliation(s)
- D Itoh
- Removable Prosthodontics, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan.
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21
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Davies SJ, Gray RJM, Young MPJ. Good occlusal practice in the provision of implant borne prostheses. Br Dent J 2002; 192:79-88. [PMID: 11841055 DOI: 10.1038/sj.bdj.4801298] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The increased use of endosseous dental implants means that many dentists will encounter patients with dental implants in their everyday practice. Dental practitioners might be actively involved in the provision of implant borne prostheses at both the surgical and restorative phases, or only at the restorative stage. This section is written for all dentists and aims to examine the subject of occlusion within implantology. It aims to provide guidelines of good occlusal practice to be used in the design of the prosthesis that is supported or retained by one or more implants. As implantology is a 'new' discipline of dentistry, there are fewer standard texts and this section, therefore, is much more extensively referenced than the subjects that have been considered to date.
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Affiliation(s)
- S J Davies
- University Dental Hospital of Manchester.
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22
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Young MP, Carter DH, Sloan P, Quayle AA. Survey of clinical members of the association of dental implantology in the United Kingdom: Part I. Levels of activity and experience in oral implantology. IMPLANT DENT 2001; 10:68-74. [PMID: 11307651 DOI: 10.1097/00008505-200101000-00019] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The aims of this survey were to 1) determine recruitment rates of active oral implantologists, 2) establish the proportion of participants who carry out the surgical aspects of implantology, 3) quantify levels of surgical activity, 4) determine the type of qualifications held by this sample, and 5) identify the location of implant activity of clinical members of the Association of Dental Implantology (UK). Questionnaires were mailed to the 408 members of the ADI registered as clinical members of the ADI; data were collected between July 1998 and May 1999. A response rate of 66.9% was achieved. Active members increased markedly from 1985 to 1995. Surgical activity and clinical experience varied widely: 32.9% had placed 100 to 499 implants, 29.8% had inserted 1 to 49 implants, and 4.3% had inserted > or = 2,000 implants. The total number of implants inserted by this sample could only be estimated (between 51,000 and 90,000). The majority of this sample possessed postgraduate qualifications, although only 2.6% possessed a degree in oral implantology. The data from this sample indicated that the recruitment rate to the ADI (UK) increased markedly between 1985 to 1995, after which it seems to have slowed down. Most of the respondents were involved in the surgical aspects of implantology, although the level of surgical involvement varied widely. The low incidence of postgraduate degrees in implantology might reflect the relatively limited opportunities currently available for such training in the UK.
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Affiliation(s)
- M P Young
- Units of Oral Surgery and Oral Pathology, Turner Dental School and Hospital, University of Manchester, United Kingdom
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23
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Tinsley D, Watson CJ, Russell JL. A comparison of hydroxylapatite coated implant retained fixed and removable mandibular prostheses over 4 to 6 years. Clin Oral Implants Res 2001; 12:159-66. [PMID: 11251666 DOI: 10.1034/j.1600-0501.2001.012002159.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
In a 6-year prospective clinical study, 181 hydroxylapatite coated endosseous dental implants were placed into the anterior mandible of 48 patients. Twenty-one patients were treated with fixed prostheses and 27 patients with an overdenture. When the implants were exposed all 181 had integrated. To date, there is 100% survival of all implants and they all retain a functioning prostheses. The initial results were very promising, in both groups the interval success was over 95% in the first 4 years of the study. However, by year 6, the interval success rates had fallen to 83% for both the fixed and removable groups. This study also compares the construction and maintenance complications for the two types of restorations. The clinical time taken, after implant exposure, to construct the prostheses was similar whether the fixed (mean of 8 visits) or removable option (mean of 7 visits) was chosen. However, the removable restoration cost less than half the price of the fixed when both technical time and implant component costs were evaluated. Maintenance for both groups was higher than expected, but patients required more appointments in the removable group both in the first year and beyond. Regarding the prostheses itself, the incidence of remakes, relines and general adjustments was higher in the removable group. This study has shown that the overdenture offers an effective and initially a more economical alternative to the fixed prostheses, in the treatment of the edentulous mandible. However, long-term maintenance of such a prosthesis can be significant.
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Affiliation(s)
- D Tinsley
- Division of Restorative Dentistry, Leeds Dental Institute, Leeds, UK.
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Hydroxylapatite coated dental implants. Br Dent J 1999. [DOI: 10.1038/sj.bdj.4800210a1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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