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Gursoytrak B, Ataoglu H. Use of resonance frequency analysis to evaluate the effects of surface properties on the stability of different implants. Clin Oral Implants Res 2019; 31:239-245. [PMID: 31758589 DOI: 10.1111/clr.13560] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 10/31/2019] [Accepted: 11/11/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES We performed a randomized clinical study evaluating the stability of implants with different surfaces (alkali-modified or sandblasted) via resonance frequency analysis (RFA). MATERIALS AND METHODS Fourteen patients who were bilaterally edentulous in terms of their mandibular molars were enrolled. Implants with alkali-modified (bioactive) and sandblasted surfaces were randomly placed in either hemi-arch; the 50 implants used were identical in terms of diameter and length. RFA was used to measure the implant stability quotient (ISQ) immediately after placement (to assess primary stability) and 2, 6, and 12 weeks later. RESULTS The average RFA value for alkali-modified implants was significantly higher than that for sandblasted implants immediately after implantation, but the ISQs fell rapidly and were similar in the two groups at 2 and 6 weeks (p > .05); ISQ values were the same in the two groups at 3 months (p > .05). CONCLUSIONS Implants with alkali-modified surfaces were more stable than implants with sandblasted surfaces at all times after placement. The ISQs of bioactive implants exhibiting high-level primary stability fell to greater extents than did those of implants with sandblasted surfaces at 2 and 6 weeks postoperatively; both types of implant yielded similar clinical results at 12 weeks postoperatively.
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Affiliation(s)
- Burcu Gursoytrak
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Aydın Adnan Menderes University, Aydın, Turkey
| | - Hanife Ataoglu
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Medipol University, Istanbul, Turkey
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Influence of abutment height on peri-implant marginal bone loss: A systematic review and meta-analysis. J Prosthet Dent 2019; 122:14-21.e2. [DOI: 10.1016/j.prosdent.2018.10.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 10/10/2018] [Accepted: 10/10/2018] [Indexed: 01/11/2023]
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Yim HJ, Lim HC, Hong JY, Shin SI, Chung JH, Herr Y, Shin SY. Primary stability of implants with peri-implant bone defects of various widths: an in vitro investigation. J Periodontal Implant Sci 2019; 49:39-46. [PMID: 30847255 PMCID: PMC6399088 DOI: 10.5051/jpis.2019.49.1.39] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 02/18/2019] [Indexed: 11/18/2022] Open
Abstract
Purpose This study aimed to evaluate the effects of i) the extent of peri-implant bone defects and ii) the application of bone cement on implant stability with respect to the measurement direction. Methods In 10 bovine rib bones, 4 implant osteotomies with peri-implant bone defects of various widths were prepared: i) no defect (D0), ii) a 2-mm-wide defect (D2), iii) a 4-mm-wide defect (D4), and iv) a 8-mm-wide defect (D8). The height of all defects was 10 mm. Implant stability quotient (ISQ) values and Periotest values (PTVs) were measured after implant placement and bone cement application. Results With increasing defect width, decreased ISQs and increased PTVs were observed. Statistically significant differences were found between groups D0 and D8, D0 and D4, and D2 and D8. Prior to bone cement application, inconsistent PTVs were found in group D8 depending on the measurement direction. Bone cement increased the implant stability. Conclusion Peri-implant bone deficits measuring around 50% of the implant surface compromised implant stability. Clinically, PTVs should be cautiously interpreted in implants with large peri-implant defects due to inconsistent recordings with respect to the measurement direction.
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Affiliation(s)
- Hyun-Jin Yim
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, Kyung Hee University School of Dentistry, Seoul, Korea
| | - Hyun-Chang Lim
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, Kyung Hee University School of Dentistry, Seoul, Korea
| | - Ji-Youn Hong
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, Kyung Hee University School of Dentistry, Seoul, Korea
| | - Seung-Il Shin
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, Kyung Hee University School of Dentistry, Seoul, Korea
| | - Jong-Hyuk Chung
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, Kyung Hee University School of Dentistry, Seoul, Korea
| | - Yeek Herr
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, Kyung Hee University School of Dentistry, Seoul, Korea
| | - Seung-Yun Shin
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, Kyung Hee University School of Dentistry, Seoul, Korea
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Effect of Implant Thread Geometry on Secondary Stability, Bone Density, and Bone-to-Implant Contact: A Biomechanical and Histological Analysis. IMPLANT DENT 2017; 24:384-91. [PMID: 25939083 DOI: 10.1097/id.0000000000000269] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE This study evaluated the effect of 2 different thread designs on secondary stability (micromotion) and osseointegration rate in dense and cancellous bones. MATERIALS AND METHODS Forty large threaded and 40 small threaded implants (Cortex) were placed in low- (iliac crest) and high-density (mandible) bone of sheep. Two months later, micromobility tests and histological analysis were performed to measure secondary stability, osseointegration (bone-to-implant contact percentage [%BIC]), and bone density (bone volume percentage [%BV]). The value of actual micromotion of implant is introduced as a new parameter to evaluate secondary stability. RESULTS Large threaded implants showed significantly higher %BIC and %BV than small threaded implants in low-density bone and statistically higher secondary stability in cancellous and cortical bones. CONCLUSIONS Implants in dense bone reach higher secondary stability than those in cancellous bone, despite the lower %BIC. Implant geometry and bone density play a key role in secondary stability. Large thread design improves bone anchorage mechanically and histologically as compared with small threaded implants.
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Trisi P, Berardini M, Falco A, Podaliri Vulpiani M. Validation of value of actual micromotion as a direct measure of implant micromobility after healing (secondary implant stability). An in vivo
histologic and biomechanical study. Clin Oral Implants Res 2016; 27:1423-1430. [DOI: 10.1111/clr.12756] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Paolo Trisi
- Biomaterial Clinical Research Association; Pescara Italy
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Liao Z, Chen J, Zhang Z, Li W, Swain M, Li Q. Computational modeling of dynamic behaviors of human teeth. J Biomech 2015; 48:4214-20. [DOI: 10.1016/j.jbiomech.2015.10.019] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 10/09/2015] [Accepted: 10/18/2015] [Indexed: 11/17/2022]
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Dasmah A, Rasmusson C, Thor A, Rasmusson L. Simultaneous or Delayed Placement of Surface Modified and Fluoridated Dental Implants into Autogenous Block Bone Grafts: A Histologic and Biomechanical Study in the Rabbit. Clin Implant Dent Relat Res 2013; 17:395-401. [DOI: 10.1111/cid.12095] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Amir Dasmah
- Department of Oral & Maxillofacial Surgery; Institute of Odontology; The Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - Carl Rasmusson
- Department of Oral & Maxillofacial Surgery; Institute of Odontology; The Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - Andreas Thor
- Institute of Surgical Sciences; Department of Oral & Maxillofacial Surgery; Uppsala University; Uppsala Sweden
| | - Lars Rasmusson
- Department of Oral & Maxillofacial Surgery; Institute of Odontology; The Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
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Atieh MA, Alsabeeha NHM, Payne AGT, de Silva RK, Schwass DS, Duncan WJ. The prognostic accuracy of resonance frequency analysis in predicting failure risk of immediately restored implants. Clin Oral Implants Res 2012; 25:29-35. [DOI: 10.1111/clr.12057] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2012] [Indexed: 11/26/2022]
Affiliation(s)
- Momen A. Atieh
- Oral Implantology Research Group; Sir John Walsh Research Institute; School of Dentistry; University of Otago; 310 Great King Street Dunedin New Zealand
| | | | | | - Rohana K. de Silva
- Oral Implantology Research Group; Sir John Walsh Research Institute; School of Dentistry; University of Otago; 310 Great King Street Dunedin New Zealand
| | - Donald S. Schwass
- Oral Implantology Research Group; Sir John Walsh Research Institute; School of Dentistry; University of Otago; 310 Great King Street Dunedin New Zealand
| | - Warwick J. Duncan
- Oral Implantology Research Group; Sir John Walsh Research Institute; School of Dentistry; University of Otago; 310 Great King Street Dunedin New Zealand
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Fraguas E, Ribeiro M, Croci A, Santos L, Pallos D, Sendyk W. Stability of implants placed simultaneously or in a delayed manner on fresh frozen onlay allografts in rabbits. Clin Oral Implants Res 2012; 24:1295-9. [PMID: 22905701 DOI: 10.1111/j.1600-0501.2012.02572.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2012] [Indexed: 12/01/2022]
Affiliation(s)
| | - Marna Ribeiro
- Department of Peridontics and Implantology; UNISA; São Paulo Brazil
| | - Alberto Croci
- Hospital das Clínicas of the School of Medicine of the University of São Paulo; Tissue Bank Medical Director; São Paulo Brazil
| | - Luiz Santos
- Institute of Orthopedics and Traumatology; Hospital das Clínicas of the School of Medicine; University of São Paulo; São Paulo Brazil
| | - Débora Pallos
- Department of Peridontics and Implantology; UNISA; São Paulo Brazil
| | - Wilson Sendyk
- Department of Peridontics and Implantology; UNISA; São Paulo Brazil
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Becker W, Becker BE, Hujoel P, Abu Ras Z, Goldstein M, Smidt A. Prospective clinical trial evaluating a new implant system for implant survival, implant stability and radiographic bone changes. Clin Implant Dent Relat Res 2011; 15:15-21. [PMID: 21223489 DOI: 10.1111/j.1708-8208.2010.00333.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND There are a few prospective studies reporting on new implant systems. When a new implant is brought to market, prospective trials should be carried out to determine the predictability of that system. PURPOSE This prospective study evaluates implant survival, Resonance Frequency Analysis (RFA), and crestal bone level changes for a new implant system (Neoss System, Bimodal surface, Neoss Ltd, Harrogate, UK). MATERIALS AND METHODS Seventy-six patients, 38 females (age ranging from 23 to 57 years) and 38 males (ranging in age from 17 to 85 years) received 100 Neoss implants. Patients were consecutively enrolled in the study if they were missing one or more teeth in either arch, or a single tooth was scheduled for removal and immediate implant replacement. Evaluated implants were 4, 4.5, or 5 mm wide and were 7, 9, 11, 13, or 15 mm long. A one-stage approach was followed. At first stage and prior to healing abutment placement RFA measurements were taken. Measurements were retaken at second stage. Fifty-one implants were placed for restoration of single missing teeth and 49 were for short span implant bridges. RESULTS The cumulative survival rate at 1- to 2-year interval was 93%. Average initial RFA measurement for all implants was 72.06, while the average final score was 72.58. These changes were not statistically significant. Changes in RFA scores for maxillary implants were insignificant. Forty-two paired mandibular RFA measurements were evaluated. Initial and final mean mandibular RAF measurements were 73.65 (SD 9.203) and 77.186 (SD 6.177), respectively. These changes were statistically significant (p = .02). Sixty-four paired radiographs were available for evaluation. Between examinations, there was an average -0.6 mm of bone loss, which was statistically significant (p = .03). On average, 4.0-mm-wide implants lost 0.1 mm of bone when compared with 5-mm-wide implants. These differences were insignificant (p = .86). Bone loss was adjusted for implant length, and tooth position and there were small, but clinically insignificant changes. Five-millimeter-wide implants lose 0.2 mm more than 4.0-mm-wide implants (p = .7). Maxillary incisors lose the least amount of bone 0.152 (p = .33). CONCLUSIONS The implants tested in this study had initially high RAF readings, indicating good primary stability. RFA readings for implants placed in the mandible improved from baseline and the changes were statistically significant. Marginal bone levels revealed clinically insignificant bone loss from implant installation to second stage. Loss of seven implants with initially high RFA readings is surprising.
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Affiliation(s)
- William Becker
- School of Dentistry, Department of Graduate Periodontics, University of Southern California, 801 N Wilmot, Tucson, AZ 85711, USA.
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Rasmusson L, Thor A, Sennerby L. Stability Evaluation of Implants Integrated in Grafted and Nongrafted Maxillary Bone: A Clinical Study from Implant Placement to Abutment Connection. Clin Implant Dent Relat Res 2010; 14:61-6. [DOI: 10.1111/j.1708-8208.2010.00239.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Swider P, Guérin G, Baas J, Søballe K, Bechtold JE. Characterization of bone-implant fixation using modal analysis: application to a press-fit implant model. J Biomech 2009; 42:1643-9. [PMID: 19464687 DOI: 10.1016/j.jbiomech.2009.04.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2008] [Revised: 03/12/2009] [Accepted: 04/17/2009] [Indexed: 10/20/2022]
Abstract
Orthopaedic implant fixation is strongly dependant upon the effective mechanical properties of newly formed tissue. In this study, we evaluated the potential of modal analysis to derive viscoelastic properties of periprosthetic tissue. We hypothesized that Young's modulus and loss factor could be obtained by a combined theoretical, computational and experimental modal analysis approach. This procedure was applied to ex vivo specimens from a cylindrical experimental implant placed in cancellous bone in an unloaded press-fit configuration, obtained after a four week observation period. Four sections each from seven textured titanium implants were investigated. The first resonant frequency and loss factor were measured. Average experimentally determined loss factor was 2% (SD 0.4%) and average first resonant frequency was 2.1 KHz (SD: 50). A 2D axisymmetric finite element (FE) model identified effective Young's modulus of tissue using experimental resonant frequencies as input. Average value was 42 MPa (SD: 2.4) and no significant difference between specimens was observed. In this pilot study, the non-destructive method allowed accurate measure of dynamic loss factor and resonant frequency and derivation of effective Young's modulus. Prior to implementing this dynamic protocol for broader mechanical evaluation of experimental implant fixation, further work is needed to determine if this affects results from subsequent destructive shear push-out tests.
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Affiliation(s)
- P Swider
- Biomechanics Group, IMFT UMR CNRS 5502, University of Toulouse, France.
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BROUWERS JEIG, LOBBEZOO F, VISSCHER CM, WISMEIJER D, NAEIJE M. Reliability and validity of the instrumental assessment of implant stability in dry human mandibles. J Oral Rehabil 2009; 36:279-83. [DOI: 10.1111/j.1365-2842.2009.01944.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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WANG K, LI DH, GUO JF, LIU BL, SHI SQ. Effects of buccal bi-cortical anchorages on primary stability of dental implants: a numerical approach of natural frequency analysis. J Oral Rehabil 2009; 36:284-91. [DOI: 10.1111/j.1365-2842.2009.01936.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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GÜNCÜ GN, TÖZÜM TF, GÜNCÜ MB, YAMALIK N. Relationships between implant stability, image-based measures and nitric oxide levels. J Oral Rehabil 2008; 35:745-53. [DOI: 10.1111/j.1365-2842.2007.01844.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Friberg B. The posterior maxilla: clinical considerations and current concepts using Brånemark System implants. Periodontol 2000 2008; 47:67-78. [PMID: 18412574 DOI: 10.1111/j.1600-0757.2007.00238.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Barış Güncü M, Aslan Y, Tümer C, Güncü GN, Uysal S. In-patient comparison of immediate and conventional loaded implants in mandibular molar sites within 12 months. Clin Oral Implants Res 2008; 19:335-41. [DOI: 10.1111/j.1600-0501.2007.01471.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Veltri M, Balleri P, Ferrari M. Damping factor for monitoring the bone interface at dental implants. Clin Oral Implants Res 2007; 18:738-42. [PMID: 17888018 DOI: 10.1111/j.1600-0501.2007.01412.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The aim of this study is to investigate whether the damping of osseointegrated implants, as measured quantitatively with the Osstell equipment, is related to the fractal dimension of peri-implant bone. MATERIAL AND METHODS Fifty-five maxillary implants in function for 3 years before the present study were investigated. Two Osstell measurements were obtained for each implant with the transducer oriented first palatally and then distally. Using the half-power bandwidth method, the damping was calculated from the frequency/amplitude plot obtained from the Osstell. Damping data were then related to the fractal dimension of peri-implant bone. Fractal dimensions were calculated using a box-counting algorithm on digitally processed intra-oral radiographs of the implants. A Spearman's test was used to verify the correlation between damping and fractal dimension values. RESULTS All the implants were clinically stable and free from symptoms. The mean ISQ was 63 for the palatal orientation and 71 for the distal orientation. The mean fractal dimension was 1.47; the mean damping value for palatal orientation was 12.3%, while that for the distal orientation was 8.2%. No significant correlation was found. CONCLUSIONS Damping values, measured at peri-implant bone, were found not to be related to a radiographic parameter of trabecular bone pattern like the fractal dimension. The clinical implication would be that Osstell graphs displaying distinct or more rounded peaks might both indicate a stable implant as long as the associated implant stability quotients are in the range of satisfactory values proposed in the literature.
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Affiliation(s)
- Mario Veltri
- Department of Dental Materials, University of Siena, Siena, Italy.
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Glauser R, Zembic A, Ruhstaller P, Windisch S. Five-year results of implants with an oxidized surface placed predominantly in soft quality bone and subjected to immediate occlusal loading. J Prosthet Dent 2007; 97:S59-68. [PMID: 17618935 DOI: 10.1016/s0022-3913(07)60009-2] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
STATEMENT OF PROBLEM 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. PURPOSE 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. MATERIAL AND METHODS 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. RESULTS 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. CONCLUSIONS 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.
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Barone A, Rispoli L, Vozza I, Quaranta A, Covani U. Immediate Restoration of Single Implants Placed Immediately After Tooth Extraction. J Periodontol 2006; 77:1914-20. [PMID: 17076619 DOI: 10.1902/jop.2006.060072] [Citation(s) in RCA: 80] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Some of the original surgical protocols for implant surgery have been reassessed to satisfy the patient's continuously increasing expectation for shorter rehabilitation time, improved esthetics, and increased comfort. The aim of this study was to evaluate the 12-month clinical success of 18 single-tooth implants inserted immediately after tooth extraction and restored the same day with non-functional loading. METHODS A total of 18 patients (12 women and six men), 22 to 60 years old, were enrolled in this study. Eighteen single implants were inserted in fresh extraction sockets and immediately restored with temporary abutments and crowns. All experimental sites showed an absence of fenestrations or dehiscences of the bone walls and a residual gap between implant surfaces and surrounding bone walls < or =2 mm. All temporary prostheses were positioned the same day of surgery and were not in occlusal contact with opposing arches. The comparison between the baseline and 12-month visits was performed with the Student t test for paired data (statistically significant at a level of alpha = 0.05). RESULTS During the 12-month follow-up period, one fixture was removed 4 weeks after implant placement following an abscess. All remaining implants healed uneventfully with no complications and were assessed as stable and successful at the 12-month checkup. No technical complications such as screw loosening, resin fracture, or pain during chewing were registered during the 12-month period. CONCLUSIONS Within the limits of the data from this study, it can be suggested that immediate placement and restoration of a single implant can be a valid and successful option of treatment in the case of single compromised teeth. Moreover, this treatment protocol eliminates the need for removable provisional restoration and seems to maintain the preexisting architecture of soft and hard tissues in most cases. Nonetheless, further prospective and long-term studies are required to obtain a better insight into the limitations of this protocol.
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Affiliation(s)
- Antonio Barone
- School of Dental Medicine, University of Genova, Genova, Italy.
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Thor A, Wannfors K, Sennerby L, Rasmusson L. Reconstruction of the severely resorbed maxilla with autogenous bone, platelet-rich plasma, and implants: 1-year results of a controlled prospective 5-year study. Clin Implant Dent Relat Res 2006; 7:209-20. [PMID: 16336912 DOI: 10.1111/j.1708-8208.2005.tb00066.x] [Citation(s) in RCA: 94] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Prosthetic treatment of the edentulous maxilla may require bone augmentation to enable placement and integration of dental implants. This constitutes a complex healing situation, and resorption of the grafted bone and failure of the implants often occur. The application of autogenous platelet-rich plasma (PRP) has been suggested to improve incorporation and preservation of bone grafts. PURPOSE The aim of this controlled clinical study was to evaluate whether PRP in conjunction with grafting of particulated autogenous bone to the maxilla could improve the integration and clinical function of dental implants. An additional aim was to compare block bone grafts without PRP with PRP-treated particulated bone. MATERIAL AND METHODS Nineteen consecutive patients were included in the study and treated with iliac bone grafts and dental implants in the maxilla according to a split-mouth design. In the anterior maxilla, particulated bone mixed with PRP (test) was compared with onlay block grafts without additional PRP (control). In the posterior maxilla, particulated bone grafts with (test) or without (control) PRP were placed as sinus inlay grafts. After 6 months of healing, 152 implants (8 implants/patient) (TiOblast, Astra Tech AB, Mölndal, Sweden) were placed. Test (PRP; 76 implants) and non-PRP (76 implants) sides were evaluated and compared by implant survival rate, marginal bone level, and implant stability using resonance frequency analysis (RFA) during 1 year in function. RESULTS Two control implants in control sites in two patients were lost at abutment connection. After 1 year in function, no further implants were lost, giving an overall survival rate of 98.7%. The marginal bone level measurements showed no significant differences, although there was a tendency toward less resorption on PRP sides. RFA measurements showed statistically significantly higher implant stability quotient values for PRP sites at abutment connection in the anterior but not in the posterior regions. CONCLUSIONS The present clinical study showed that a high implant survival rate and stable marginal bone conditions can be achieved after 1 year of loading in the maxilla following autogenous bone grafting whether or not PRP is used. RFA measurements revealed differences at abutment connection, which could be explained by the type of graft rather than as an effect of PRP. Although no obvious positive effects of PRP on bone graft healing could be demonstrated, the handling of the particulated bone grafts was improved.
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Affiliation(s)
- Andreas Thor
- Department of Surgical Sciences, Oral and Maxillofacial Surgery, Uppsala University Hospital, Sweden.
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Sjöström M, Lundgren S, Nilson H, Sennerby L. Monitoring of implant stability in grafted bone using resonance frequency analysis. A clinical study from implant placement to 6 months of loading. Int J Oral Maxillofac Surg 2005; 34:45-51. [PMID: 15617966 DOI: 10.1016/j.ijom.2004.03.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2004] [Indexed: 11/19/2022]
Abstract
The aim of this prospective study was to compare implants placed in grafted and normal non-grafted maxilla by means of resonance frequency analysis (RFA), clinical stability and implant failure. Twenty-nine patients with severe atrophy of the edentulous maxilla were treated with autogenous bone grafts as onlay (24 patients) or as interpositional grafts in conjunction with a Le Fort I osteotomy (five patients) 6 months prior to placement of 222 implants. Ten non-grafted patients treated with 75 Brånemark implants in the edentulous maxillae served as a control group. RFA was performed at implant placement, abutment connection and after 6 months of bridge loading. Seventeen (8%) implants were lost in the grafted bone and one (1%) in normal bone. RFA revealed a similar pattern in both grafted and normal maxillae, i.e. increasing resonance frequency (RF) with time (Wilcoxon Signed Rank test for paired data). Twenty implants that were rotation mobile (low primary stability) at the time of insertion showed a significantly lower value at implant placement according to RFA (Mann-Whitney U-test, P = 0.020). The RF for the failed implants revealed a tendency towards lower values (Mann-Whitney U-test, P = 0.072), compared to the successful implants. It is concluded that implants placed in grafted bone when using a two-stage technique achieve a stability similar to that of implants placed in normal non-grafted bone.
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Affiliation(s)
- M Sjöström
- Department of Oral and Maxillofacial Surgery, Umeå University, SE 901 78 Umeå, Sweden.
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Becker W, Sennerby L, Bedrossian E, Becker BE, Lucchini JP. Implant Stability Measurements for Implants Placed at the Time of Extraction: A Cohort, Prospective Clinical Trial. J Periodontol 2005; 76:391-7. [PMID: 15857073 DOI: 10.1902/jop.2005.76.3.391] [Citation(s) in RCA: 82] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Studies indicate that implants placed at the time of extraction have high success rates. Implants must be stable at the time of insertion. Presently there are no data indicating the degree of implant stability when implants are placed at the time of extraction. This study evaluated changes in stability of implants from implant placement to abutment connection utilizing resonance frequency analysis (RFA). The unit of measurement was the international stability quotient (ISQ). METHODS Prior to treatment, patients were given medical history and dental evaluations. Periapical and panogram radiographs were taken. Fifty-two patients requiring extraction of one or two teeth and implant placement immediately after extraction were enrolled in this study. Under conscious sedation and local anesthesia or local anesthesia alone, teeth were atraumatically removed and the extraction sockets were debrided. A total of 73 dental implants (57 in the maxilla, 16 in the mandible) were placed. Using a one-stage approach, all implants were placed within the patient's alveolar envelope and were never placed directly into extraction sockets. All implants were placed into contained extraction sites. Bone augmentation procedures were not performed. After implant insertion, the RFA electronic transducer was attached to the head of the implant with the retaining screw. The device was attached to a computer designed to register RFA scores in ISQ units. RFA measurements were taken at implant placement and abutment connection. Bone qualities, quantity, implant length and width as well as site of placement were recorded. RESULTS The average interval between implant insertion and abutment connection was 5.6 months (SD 2.05). Two implants were lost between implant insertion and 1 year. At 2 to 3 years, the cumulative survival was 97.2%. Resonance frequency measurements at implant placement showed a mean primary stability of 62.0 (SE 1.1; range 43 to 83 ISQ) and a mean secondary stability after 1 year of 64.0 (SE 1.2; range 40 to 98 ISQ) for all implants. The increase was marginally significant (generalized estimating equation z-statistic = 1.79; P value = 0.07). CONCLUSIONS Implants placed at the time of extraction and inserted into native bone and not directly into extractions sockets have a high degree of initial stability as evidenced by RFA measurements. Implants with initial high ISQ levels revealed a slight drop in levels over time, while implants with levels lower than 60 had increases in levels between implant insertion and abutment connection. At 2 to 3 years the cumulative survival rate was 97.2%.
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Nedir R, Bischof M, Szmukler-Moncler S, Bernard JP, Samson J. Predicting osseointegration by means of implant primary stability. Clin Oral Implants Res 2004; 15:520-8. [PMID: 15355393 DOI: 10.1111/j.1600-0501.2004.01059.x] [Citation(s) in RCA: 223] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The purpose of the present clinical study was (1) to evaluate the Osstell as a diagnostic tool capable of differentiating between stable and mobile ITI implants, (2) to evaluate a cut-off threshold implant stability quotient (ISQ) value obtained at implant placement (ISQitv) that might be predictive of osseointegration, (3) to compare the predictive ISQitv of immediately loaded (IL) implants and implants loaded after 3 months (DL). Two patient groups were enrolled, 18 patients received 63 IL implants and 18 patients were treated with 43 DL implants. The ISQ was recorded at implant placement, after 1, 2, 4, 6, 8, 10 and 12 weeks. All implants passed the 1-year loading control. Two implants failed, one DL implant with ISQ at placement (ISQi) of 48 and one IL implant with ISQi of 53. The resonance-frequency analysis (RFA) method was not a reliable diagnostic tool to identify mobile implants. However, implant stability could be reliably determined for implants displaying an ISQ> or =47. After 1 year of loading, all DL implants with an ISQi> or =49 and all IL implants with an ISQi> or =54 achieved and maintained osseointegration. By the end of 3 months, implants with ISQi<60 had an increase of stability. Implants with ISQi 60-69 had their stability decrease during 8 weeks before returning to their initial values. Implants with ISQ>69 had their stability decrease during the first 4 weeks before remaining stable. Although preliminary, these data might orient the practitioner to choose among various loading protocols and to selectively monitor implants during the healing phase.
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Bischof M, Nedir R, Szmukler-Moncler S, Bernard JP, Samson J. Implant stability measurement of delayed and immediately loaded implants during healing.. A clinical resonance-frequency analysis study with sandblasted-and-etched ITI implants. Clin Oral Implants Res 2004; 15:529-39. [PMID: 15355394 DOI: 10.1111/j.1600-0501.2004.01042.x] [Citation(s) in RCA: 208] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The purpose of the present study was (1) to measure the primary stability of ITI implants placed in both jaws and determine the factors that affect the implant stability quotient (ISQ) determined by the resonance frequency method and (2) to monitor implant stability during the first 3 months of healing and evaluate any difference between immediately loaded (IL) implants and standard delayed loaded (DL) implants. The IL and DL groups consisted of 18 patients/63 implants and 18 patients/43 implants. IL implants were loaded after 2 days; DL implants were left to heal according to the one-stage procedure. The ISQ was recorded with an Osstell apparatus (Integration Diagnostics AB, Gothenburg, Sweden) at implant placement, after 1, 2, 4, 6, 8, 10 and 12 weeks. Primary stability was affected by the jaw and the bone type. The ISQ was higher in the mandible (59.8+/-6.7) than the maxilla (55.0+/-6.8). The ISQ was significantly higher in type I bone (62.8+/-7.2) than in type III bone (56.0+/-7.8). The implant position, implant length, implant diameter and implant deepening (esthetic plus implants) did not affect primary stability. After 3 months, the gain in stability was higher in the mandible than in the maxilla. The influence of bone type was leveled off and bone quality did not affect implant stability. The resonance-frequency analysis method did not reveal any difference in implant stability between the IL and DL implants over the healing period. Implant stability remained constant or increased slightly during the first 4-6 weeks and then increased more markedly. One DL and IL implant failed; both were 8 mm long placed in type III bone. At the 1-year control, the survival rate of the IL and the DL implants was 98.4% and 97.7%, respectively. This study showed no difference in implant stability between the IL and DL procedures over the first 3 months. IL short-span bridges placed in the posterior region and full arch rehabilitation of the maxilla with ITI sandblasted-and-etched implants were highly predictable.
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Affiliation(s)
- Mark Bischof
- CdC Clinique Dentaire de Chauderon, Lausanne, Switzerland.
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Johansson B, Bäck T, Hirsch JM. Cutting Torque Measurements in Conjunction with Implant Placement in Grafted and Nongrafted Maxillas as an Objective Evaluation of Bone Density: A Possible Method for Identifying Early Implant Failures? Clin Implant Dent Relat Res 2004; 6:9-15. [PMID: 15595704 DOI: 10.1111/j.1708-8208.2004.tb00022.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Bone grafts are frequently used to enable the placement of dental implants in atrophied jaws. The biomechanical properties of bone grafts used in one- or two-stage implant procedures (in comparison with the use of nongrafted bone) are not well known. PURPOSE The purpose of this study was (1) to measure cutting torques during the placement of self-tapping dental implants in nongrafted bone and in bone grafts, either as blocks or in a milled particulate form, in patients undergoing implant treatment in an edentulous maxilla and (2) to identify implants with reduced initial stability and to correlate these findings with a clinical classification of jawbone quality. MATERIALS AND METHODS The study included 40 consecutive patients with edentulous maxillas, 27 of whom were subjected to bone grafting prior to or in conjunction with implant placement (grafting group) and 13 of whom received implants without grafting (nongrafted group). Grafted bone from the iliac crest bone was used (1) as onlay blocks, (2) as maxillary sinus inlay blocks, or (3) in particulate form in the maxillary sinus. Implants were placed after 6 to 7 months of healing, except in the maxillary sinus inlay blocks, where implants were placed simultaneously. Cutting torque values were obtained from 113 grafted implant sites and from 109 nongrafted implant sites. RESULTS Significantly lower cutting torque values were assessed in grafted regions than in nongrafted regions, irrespective of grafting technique. Lower values were also seen for implants placed in block grafts after 6 months when compared to other grafting techniques used. The cutting torque values revealed an inverse linear relation to the Lekholm and Zarb bone quality index. CONCLUSION The cutting torque values correlated well with the Lekholm and Zarb index of bone quality. Significantly lower cutting torque values were seen in grafted bone than in nongrafted bone.
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Affiliation(s)
- Björn Johansson
- Department of Surgical Sciences, Oral and Maxillofacial Surgery, University Hospital of Uppsala, Uppsala, Sweden.
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Affiliation(s)
- Christoph H F Hämmerle
- Clinic for Fixed and Removable Prosthodontics, Center for Dental and Oral Medicine and Cranio-Maxillofacial Surgery, University of Zürich, Switzerland
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Nkenke E, Hahn M, Weinzierl K, Radespiel-Tröger M, Neukam FW, Engelke K. Implant stability and histomorphometry: a correlation study in human cadavers using stepped cylinder implants. Clin Oral Implants Res 2003; 14:601-9. [PMID: 12969364 DOI: 10.1034/j.1600-0501.2003.00937.x] [Citation(s) in RCA: 177] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The aim of the present study was to determine the correlation between the primary stability of dental implants placed in edentulous maxillae and mandibles, the bone mineral density and different histomorphometric parameters. After assessing the bone mineral density of the implant sites by computed tomography, 48 stepped cylinder screw implants were installed in four unfixed human maxillae and mandibles of recently deceased people who had bequeathed their bodies to the Anatomic Institute I of the University of Erlangen-Nuremberg for medical-scientific research. Peak insertion torque, Periotest values and resonance frequency analysis were assessed. Subsequently, histologic specimens were prepared, and bone-to-implant contact, the trabecular bone pattern factor (TBPf), the density of trabecular bone (BV/TV) and the height of the cortical passage of the implants were determined. The correlation between the different parameters was calculated statistically. The mean resonance frequency analysis values (maxilla 6130.4+/-363.2 Hz, mandible 6424.5+/-236.2 Hz) did not correlate with the Periotest measurements (maxilla 13.1+/-7.2, mandible -7.9+/-2.1) and peak insertion torque values (maxilla 23.8+/-2.2 N cm, mandible 45.0+/-7.9 N cm) (P=0.280 and 0.193, respectively). Again, no correlations could be found between the resonance frequency analysis, the bone mineral density (maxilla 259.2+/-124.8 mg/cm(3), mandible 349.8+/-113.3 mg/cm3), BV/TV (maxilla 19.7+/-8.8%, mandible 34.3+/-6.0%) and the TBPf (maxilla 2.39+/-1.46 mm-1, mandible -0.84+/-3.27 mm-1) (P=0.140 and 0.602, respectively). However, the resonance frequency analysis values did correlate with bone-to-implant contact of the oral aspect of the specimens (maxilla 12.6+/-6.0%, mandible 35.1+/-5.1%) and with the height of the crestal cortical bone penetrated by the implants in the oral aspect of the implant sites (maxilla 2.1+/-0.7 mm, mandible 5.1+/-3.7 mm) (P=0.024 and 0.002, respectively). The Periotest values showed a correlation with the height of the crestal cortical bone penetrated by the implants in the buccal aspect of the implant sites (maxilla 2.5+/-1.2 mm, mandible 5.4+/-1.2 mm) (P=0.015). The resonance frequency analysis revealed more correlations to the histomorphometric parameters than the Periotest measurements. However, it seems that the noninvasive determination of implant stability has to be improved in order to give a more comprehensive prediction of the bone characteristics of the implant site.
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Affiliation(s)
- Emeka Nkenke
- Department of Oral and Maxillofacial Surgery, University of Erlangen-Nuremberg, Germany.
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Sul YT, Johansson CB, Jeong Y, Wennerberg A, Albrektsson T. Resonance frequency and removal torque analysis of implants with turned and anodized surface oxides. Clin Oral Implants Res 2002; 13:252-9. [PMID: 12010155 DOI: 10.1034/j.1600-0501.2002.130304.x] [Citation(s) in RCA: 154] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The present experimental study was designed to address two issues. The first was to investigate whether oxide properties of titanium implants influenced bone tissue responses after an in vivo implantation time of six weeks. If such a result was found, the second aim was to investigate which oxide properties are involved in such bone tissue responses. Screw-shaped implants with a wide range of oxide properties were prepared by electrochemical oxidation methods, where the oxide thickness varied in the range of 200 nm to 1000 nm. The surface morphology was prepared in two substantially different ways, i.e. barrier and porous oxide film structures. The micropore structure revealed pore sizes of 8 microm in diameter, with a range in opening area from 1.27 microm 2 to 2.1 microm 2. Porosity ranged from 12.7% to 24.4%. The crystal structures of the titanium oxide were amorphous, anatase and a mixture of anatase and rutile type. The chemical compositions consisted mainly of TiO2. Surface roughness ranged from 0.96 microm to 1.03 microm (Sa). Each group of test samples showed its own, defined status with respect to these various parameters. The oxide properties of turned commercially pure titanium implants were used in the control group, which was characterized by an oxide thickness of 17.4 +/- 6.2 nm, amorphous type in crystallinity, TiO2 in chemical composition, and a surface roughness of 0.83 microm (Sa). Bone tissue responses were evaluated by resonance frequency measurements and removal torque tests that were undertaken six weeks after implant insertion in rabbit tibia. Implants that had an oxide thickness of approximately 600, 800 and 1000 nm demonstrated significantly stronger bone responses in the evaluation of removal torque values than did implants that had an oxide thickness of approximately 17 and 200 nm (P < 0.05). However, there were no difference between implants with oxide thicknesses of 17 and 200 nm (P = 0.99). It was concluded that oxide properties of titanium implants, which include oxide thickness, micropore configurations and crystal structures, greatly influence the bone tissue response in the evaluation of removal torque values. However, it is not fully understood whether these oxide properties influence the bone tissue response separately or synergistically.
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Affiliation(s)
- Young-Taeg Sul
- Department of Biomaterials/Handicap Research, Institute for Surgical Science, University of Göteborg, Sweden.
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Abstract
This review suggests some guidelines and protocols for treatment of the edentulous maxilla with osseointegrated implants. Evidence-based treatment options are discussed with reference to risk assessment. Developing technologies applicable to diagnosis, clinical procedures, and laboratory techniques are also discussed. Osseointegrated implants are increasingly advocated as a treatment option for maxillary edentulism and in many situations are the treatment of choice.
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