A novel closed-loop electromechanical stimulator to enhance osseointegration with immediate loading of dental implant restorations

Immediate loading for implant restoration compared with early or conventional loading: A meta-analysis

PURPOSE

This meta-analysis was to further confirm the no inferiority of immediate loading in clinical and radiographic outcomes compared with non-immediate loadings (early or conventional loading).

MATERIALS AND METHODS

Literature search on Pubmed and Embase was performed up to August 2015. The overall risk radios (RRs) and standard mean differences (SMDs) as well as their 95% confidence intervals (CI) were calculated for comparison.

RESULTS

Total 29 RCT with 1342 implants receiving immediate loading and 1279 implants receiving non-immediate loadings were included in this meta-analysis. Results indicated that there was no significant difference between immediate and non-immediate loadings in implant failure rate based on patients (RR = 1.45, 95% CI: 0.79 to 2.68) and implants (RR = 1.38, 95% CI: 0.86 to 2.21), MBL (SMD = -0.11, 95% CI: -0.39 to 0.17), and ISQ (SMD = -0.26, 95% CI: -0.53 to 0.01). Meanwhile, immediate loading showed significantly less MBL change than non-immediate loading. In addition, subgroup analyses showed that the immediate loading indicated slightly higher implant failure rate and lower ISQ than conventional loading.

CONCLUSIONS

Although overall analysis confirmed no inferiority of immediate loading compared with non-immediate loadings, the technique still need to be explored for improving implant success and stability during immediate loading based on the results in subgroup analyses.

The effects of tooth extraction on alveolar bone biomechanics in the miniature pig, Sus scrofa

OBJECTIVE

This study investigated the role of occlusion in the development of biomechanical properties of alveolar bone in the miniature pig, Sus scrofa. The hypothesis tested was that the tissues supporting an occluding tooth would show greater stiffness and less strain than that of a non-occluding tooth.

DESIGN

Maxillary teeth opposing the erupting lower first molar (M(1)) were extracted on one side. Occlusion developed on the contralateral side. Serially administered fluorochrome labels tracked bone mineralisation apposition rate (MAR). A terminal experiment measured in vivo buccal alveolar bone strain on occluding and non-occluding sides during mastication. Ex vivo alveolar strains during occlusal loading were subsequently measured using a materials testing machine (MTS/Sintech). Whole specimen stiffness and principal strains were calculated.

RESULTS

MAR tended to be higher on the extraction side during occlusion. In vivo buccal shear strains were higher in the alveolar bone of the occluding side vs. the extraction side (mean of 471 microvarepsilon vs. 281 microvarepsilon, respectively; p=0.04); however, ex vivo shear strains showed no significant differences between sides. Stiffness differed between extraction and occlusion side specimens, significantly so in the low load range (344 vs. 668 MPa, respectively; p=0.04).

CONCLUSIONS

Greater in vivo shear strains may indicate more forceful chews on the occluding side, whereas the similarity in ex vivo bone strain magnitude suggests a similarity in alveolar bone structure and occlusal load transmission regardless of occlusal status. The big overall change in specimen stiffness that was observed was likely attributable to differences in the periodontal ligament rather than alveolar bone.